Veterinary Surgical

The course consists of 16 hours of frontal lessons and 16 hours of pratical rotation clinical course. The frontal lessons are structured as indicated in the list below, treating the most common soft tissue surgical diseases of dogs and cats. The main epidemiological data, the etiopathogenetic, the most frequent clinical presentation (signs and symptoms), the possible differential diagnoses, the diagnostic and laboratory examinations necessary for its classification, the possible therapeutic options and the prognosis will be repeated for each disease. In order to effectively interact with the lessons, the student needs to have acquired knowledge and skills from previous courses such as anatomy, topographic anatomy, pathology and clinical pathology, surgical and medical semeiotics, surgical pathology and medical pathology, diagnostic imaging , surgical techniques and veterinary anesthesiology The student learns how to approach the patient suffering from soft tissue surgical pathology and manage the possible differential diagnoses, the possible therapeutic choices, the possible short, medium and long term complications and the prognosis.
The student will have to demonstrate to own knowledge and concepts that lead him to a correct differential diagnosis in order to establish the correlations and the connections between the different topics covered.
The student must demonstrate the ability to critically analyze differential diagnoses.
Finally, the student will have to demonstrate the ability to communicate the skills acquired with appropriate terminology and to develop in an autonomous way the concepts and in-depth studies on dog and cat soft tissue surgery
FRONTAL LESSONS

Introduction Preoperative evaluation of the surgical patient 0.5h

Introduction to the course
Study material and its correct use
Introduction Clinical core practice in surgery
Problem-oriented medical history
Clinical examination and laboratory data
Diagnostic approach of surgical diseases and categorization of surgical prognosis
Communication with the owner

Introduction to oncologic surgery 1.5h

Definition of local, loco-regional, and distant disease
Examples of oncological staging in clinical practice
Classification of oncologic surgery techniques
Surgical biopsy for each anatomical site: techniques and equipment

Skin surgery 3h

Clinical management of skin wounds
Complications of healing of cutaneous wounds
Reconstruction of skin defects: stress release techniques; local flaps, myocutaneous axial flaps, free flaps.
Cutaneous oncological surgery: mast cell tumor and soft tissue sarcomas

Ear surgery 1h

Surgical therapy of external-medium and internal otitis
Surgical therapy of neoplasms of the external-internal ear
Surgical therapy of the pinna

Oral cavity and oropharynx surgery 1h

Congenital and acquired fistulas
Sialoceles
Oral and pharyngeal tumors





Esophagus surgery 0,5h

Cricopharyngeal Dyshagia
Vascular Ring Anomalies
Foreign bodies and laceration
Stricture diverticula, fistulae
Neoplasia

Gastric surgery 1h

Hiatal hernia
Gastroesophageal intussusception
Foreign bodies
Neoplasia
Gastric Ulceration and perforation
Gastric Dilatation and Volvulus

Small intestinal surgery 0,5h
Foreign bodies: linear and no linear
Intussusception and mesenteric volvulus
Neoplasia

Ciecum, Colon and rectum surgery 0,5 h
Surgical disease of ciecum
Megacolon
Neoplasia of the colon
Atresia ani
Rectal prolapse

Perineum surgery 1.5h

Perineal hernia
Perianal and perineal neoplasms
Perinal fistulas
Surgical diseases of the anal sacs

Upper respiratory tract surgery 1,5h

Brachycephalic dog syndrome
Laryngeal collapse
Laryngeal paralysis
Tracheal collapse
Nasal planum, nasal cavity and sinuses (tumors)
Rhinitis and nasal foreign body

Low respiratory tract surgery 1h

Lung
Chest wall
Thoracic cavity: pneumothorax, chylothorax , pyothorax tumor
Diaphragmatic hernia and Peritoneopericardial diaphragmatic hernia


Urinary and ureter bladder surgery 2 h

Ectopia ureters
Surgical management of bladder and urethral lithiasis
Urethral prolapse
Bladder rupture
Bladder and urethral neoplasms
Diseases of the cat's lower urinary tract


Abdominal surgery 1h

Ventral abdominal hernias
Inguinal, scrotal and femoral hernias
hemoperitoneum
peritonitis


Pratical rotation clinical course (16 h)

a) Consultation rooms ((under supervision of clinical/academic staff)
First opinion vs specialized consultation vs postoperative recheck

- Recording of the patient
- Clinical History collection ( discussion)
- Physical examination vs specialized examination ( discussion)
- Proposal of differential diagnosis ( discussion)
- Discussion with clinical staff on the decisional algorithm for diagnostic procedures
- Follow the patient in the diagnostic procedures( X-rays, ultrasonography endoscopy etc..)
- provide a diagnosis, adequate treatment and prognosis
- Write the clinical report and drug prescription ( if needed)
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b) Surgical theatre (under supervision of clinical/academic staff)

- Recording the patient
- Clinical History collection ( Discussion)
- Clinical examination for surgical treatment and anesthesiology protocol ( Discussion)
- Explanation of surgical treatment and anesthesiology protocol and possible complications ( Discussion)
- Cooperation in the owner consent taking for surgical treatment and anesthesiology protocol
- Discussion of the surgical treatment/technique, postoperative care and potential complications
- Discussion anesthesiologic and analgesic protocol based on surgical treatment plus postoperative analgesic protocol
- Preoperative- procedures for patient:
Preparation of the surgical site involves a series of steps such as clipping of hair, removal of dirt and oils, and removal of microbes.
Draping
- Preoperative procedures- surgical staff
Scrubs, scrubs hands and applications of specific surgical dress

- Preparation of the surgical site
- Assistant at surgical procedures/ performing some surgical procedures
- Planning postoperative care and communication with hospitalization service
- Follow/ recheck the patient in hospitalization service
- Write the surgical report
- Write the form for histopathologic exam ( surgical biopsy)
- Discussion with clinical staff of the surgical case/ cases.
- Write the clinical report and drug prescription ( if needed)

Students' reception: by appointment via e-mail

1. Orthopedics
a. Approach to an animal with orthopedic disease. Pain, lameness, gait disorders.
Examination, how to perform it, how to interpret it
b. Diagnostic tests in orthopedics. Blood tests, ultrasound, radiography, CT, MR,
c. Traumatic Orthopedic diseases
d. Non traumatic orthopedic diseases
2. Surgical Neurology
a. Clinical approach to the neurologic patient. Neurologic examination. Partient with
spinal pain, paresis /plegia in the limbs
b. Diagnostic procedures in Neurology. Blood tests, ultrasound, radiography, CT, MR
c. Surgical diseases of the brain and skull
d. Surgical diseases of the spine
3. Acutely traumatized patient, clinical procedures according to the ABC approach
a. A as Airways: respiratory emergencies
b. B as "bleeding", hemorrhage, shock
c. C as CNS traumatic pathology. Brain and spinal trauma
d. D as digestive, abdomen
e. E as secretory, abdomen
f. F as fractures, fractures and orthopedic traumatic conditions. See 1.c
g. In particular a more in deep study is requested for a.b.c. and f.
Class lectures:
- Neurology and Neurosurgery
- Function and anatomy in brief of the nervous system: motor system, sensory system,
ventricular system and CSF
- Diagnostic procedures and diagnosis of nervous system diseases
- Surgical Brain pathologies, list of diseases with associated clinical sigs
- Hydrocephalus
- COMS (Caudal Occipital Malformation Syndrome) / "Chiari like syndrome" - Syringomielia
- Arachnoid diverticula
- Traumatic Brain Injury (TBI)
- Brain Neoplasia
- Spinal Diseases, anatomy of the spine, clinical signs associated with spinal pathology
- C1C2 (atlanto-axial) instability / subluxation
- Acute Spinal Trauma
- Disc herniation
- Caudal Cervical Spondylomyelopathy ("wobbler syndrome")
- Degenerative lumbosacral disease
- Spondylosis, DISH, degenerative joint disease of spinal synovial joints
- Vascular pathologies. FCEM (fibrocartilagineous embolic myelopathy - spinal infarct)
- Spinal tumors
- Dyscospondylitis
- Orthopedics and traumatology of the skeleton and joints
- Joint pathologies, classification, generality
- Arthritis - polyarthritis
- Shoulder conditions: anatomy and joint physiology. Shoulder dysplasia, humeral head OCD, scapular and shoulder luxartions, shoulder instability, shoulder muscles pathology (infraspinatus, supraspinatus, brachial biceps), shoulder salvage procedures
- Elbow conditions: anatomy and joint physiology. Congenital Elbow luxation, elbow
dysplasia (UAP, FCP, OCD, humeral-radio-ulnar incongruence), degenerative joint disease, elbow salvage procedures
- Hip conditions: anatomy and joint physiology. Hip dysplasia, Legg Calvée Perthes disease, degenerative joint diseases, hip salvage procedures
- Stifle conditions: anatomy and joint physiology. Patellar luxation, OCD of the femur, cranial and caudal cruciate ligaments rupture, degenerative joint disease, stifle salvage procedures
- Hock conditions: anatomy and joint physiology. OCD of the talus. Hock salvage procedures
- Fractures and traumatic conditions of the forelimb: from scapula to hand
- Fractures and traumatic conditions of the hindlimb: from pelvis to foot
- General Traumatology
- Acutely traumatized patient, how to approach. ABC approach to trauma

A - LECTURES
The lectures are organized as indicated in the list below, dealing with the most common surgical diseases of large animals. Epidemiological data, etiopathogenesis, the most frequent clinical presentation (signs and symptoms), possible differential diagnoses, diagnostic and laboratory tests necessary for its classification, possible therapeutic options and prognosis will be reported for each disease. In order to interact effectively with the teacher, the student must have acquired the knowledge and skills of the previous courses (anatomy, topographical anatomy, pathological anatomy and clinical pathology, surgical and medical semeiotics, surgical and medical pathology radiology, operative medicine and anesthesiology).

Surgical treatment of the equine limb wounds in the equine (1 hour)
Equine Hoof surgical diseases (1 hour)
Surgical aproach to horse abdominal diseases (2 hours)
Surgical aproach for equine tendon pathologies (1 hour)
Surgical aproach to the diseases of the horse's upper respiratory tract (2 hours)
Surgical aproach to dental pathologies in the equine (2 hours)
Surgical aproach to equine joint diseases (1 hour)
Surgical aproach for cattle foot lesions (2 hours)
Surgical aproach to bovine abdominal diseases (2 hours)
Surgical aproach to umbilical diseases in calf (2 hours)
Surgical aproach to ocular pathologies in domestic animals (2 hours)

B - VET LABS (1CFU - 16 hours / student)

Vet labs takes place at the University Veterinary Teaching Hospital with specific reference to:

- Patient registration
- Collection of anamnesis (discussion)
- Basic clinical examination vs specialist examination (discussion)
- Proposal for differential diagnosis (discussion)
- Discussion with clinical staff on the decisional algorithm for diagnostic procedures
- Follow the patient in diagnostic procedures - Issuing a diagnosis, adequate treatment and prognosis
- Preparation of the clinical report and prescription of drug therapies (if necessary)
- Clinical examination for the surgical and anesthesiological protocol (Discussion)
- Explanation of the surgical and anesthesiological protocol and possible complications (Discussion)
- Participation in the illustration of the informed consent to surgical and anesthesiological procedures to the owner
- Discussion on surgical / technical treatment, postoperative care and potential short, medium and long term complications
- Discussion of anesthesiological and analgesic protocol based on surgical treatment plus discussion / choice of postoperative analgesic protocol

- Preoperative procedures for the patient:
- Patient preparation (trichotomy, cleaning and disinfection)
- Preoperative procedures - surgical staff (hand scrub and specific surgical clothing applications)
- Preparation of the surgical site
- Assistance to surgical procedures / execution of some surgical procedures
- Planning of postoperative assistance and communication with the hospitalization service
- Follow / recheck the patient in the ward
- Preparation of the surgical report
- Preparation of the form for the histopathological examination (surgical biopsy)
- Clinical discussion of the case / surgical cases.
- Preparation of the clinical report and prescription of drug therapies (if necessary)