The proximal paravertebral nerve block is commonly used to provide anaesthesia to the flank during standing surgical procedures in adult cattle. It has been reported that additional anaesthetic infiltration may be necessary to provide complete anaesthesia. In humans as well as animal species, another technique—the ultrasound (US)-guided erector spinae plane block (ESPB)—has been described. The goal of the present study was to develop and investigate an US-guided ESPB in comparison to a blind proximal paravertebral nerve block (PPNB) in cow cadavers. In 10 cadaver specimens, injections of methylene blue-lidocaine (1:1) were performed at the level of T13, L1 and L2 vertebras, on one side doing an ESPB block and, on the other side, a PPNB. Five cadavers were injected with high (40 mL per injection for PPNB and 20 mL for ESPB) and five with low (20 and 15 mL, respectively) volumes of injectate. For the ESPB, the ultrasound probe was oriented craniocaudally, and the ventral-cranial aspect of the articular processes (T13, L1 and L2) was targeted for injection. The dye spreading was evaluated by dissection. The landmarks for US-guided injection were easily visualized; however, injections were accidentally performed at T12, T13 and L1. Nevertheless, L2 was stained in 60% of ESPBs. Epidural spreading was observed with both techniques and all volumes. Viscera puncture was reported in two PPNBs. The ESPB resulted in similar nerve staining compared to the PPNB while using a lower volume of injectate. Even better staining is expected with a T13-L2 instead of a T12-L1 ESPB approach. Further studies are warranted to evaluate the clinical efficacy.
A 14‐year‐old alpaca and a 3‐year‐old llama presented independently with vague symptoms of abdominal discomfort. Bloodwork was unremarkable in the alpaca, but showed signs of sepsis in the llama, and abdominal ultrasonography was normal in both animals. Abdominal radiography revealed a metallic gastrointestinal foreign body in both cases. Ventral midline laparotomy was performed, and the foreign bodies were retrieved from the C3 compartment in the alpaca and from the proximal duodenum in the llama. Both camelids received broad‐spectrum antimicrobial drugs, non‐steroidal anti‐inflammatory drugs and supportive care. The alpaca and llama were discharged from the hospital 16 and 8 days after surgery, respectively. The alpaca was euthansed due to recumbency of unknown aetiology 2 months later, while the llama was doing well 4 months after discharge. This report shows the usefulness of abdominal radiographs in camelids presenting with unspecific clinical signs and demonstrates that hardware disease should be considered as a differential diagnosis.
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