Unit CLINICAL VETERINARY SURGERY I

VETERINARY ANESTEHESIOLOGY

Code	85008702
CFU	2
Teacher	Sara Nannarone
Teachers	Marco Pepe (Codocenza) Sara Nannarone
Hours	3 ore (Codocenza) - Marco Pepe 23 ore - Sara Nannarone
Learning activities	Caratterizzante
Area	Discipline cliniche veterinarie
Academic discipline	VET/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	The aim of the course is to provide students with the basic knowledge required to choose the more appropriate anesthetic protocol according to the type of surgery, the ASA status of the patient (i.e. its clinical condition) and the species. Basic knowledge of pharmacology and drugs useful in anesthesia will be discussed, beside the practical management of anesthetic protocols in several clinical settings (surgery, diagnostic, emergency) .
Reference texts	Main text: Bufalari Antonello & Lachin Adriano: Anestesia cane, gatto e animali non convenzionali Other text useful for consultation of all other animal species: Lumb & Jones' Veterinary anesthesia and analgesia. for a deeper consultation on equine anesthesia: Muir & Hubbel: Equine Anesthesia - monitoring and emergency therapy. 2009, 2nd ed. Saunders Francesco Staffieri: Anestesia e analgesia locoregionale del cane e del gatto. Poletto editore 2013
Educational objectives	D1 - KNOWLEDGE AND UNDERSTANDING ABILITY The student must - have knowledge of the molecules that can be used in anesthesiology, in terms of times and routes of administration, as well as their desired and undesired effects; - have knowledge of the clinical and physiological parameters to be evaluated during the preanesthetic examination and their subsequent continuous monitoring, both clinical and instrumental, during anesthesia; - know how the anesthesia machine works and the characteristics of the main respiratory systems that can be used for maintenance of general anesthesia; - know the possible anesthetic maintenance techniques and the main loco-regional anesthesia techniques as an important analgesic aid. D2 - ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING At the end of the training the student must: - Know how to perform a preanesthetic examination and assign the ASA status class; - know how to do the functional test of an anesthesia machine by recognizing its main components; - know how to choose the appropriate respiratory system to perform general anesthesia according to the patient - know how to apply intra-operative instrumental monitoring D3 - AUTONOMY OF JUDGMENT At the end of the training the student will be able to: - know how to choose the most appropriate perioperative anesthetic and analgesic protocol, based on the visit and any collateral exams performed; - evaluate and interpret intra-operative clinical and instrumental monitoring - know how to respond to tackle an intra-operative complication using drugs or particular clinical attention D4 - COMMUNICATION SKILLS At the end of the training the student will be able to: - know how to organize, prepare and exhibit, to an audience composed of peers, a presentation on a hypothetical clinical case (animal to be chosen among small or large animals) with a specific history requiring anesthesia for diagnostic investigations or surgery (elective or in emergency), or able to explain a clinical case has personally handled during the rotation, starting from the clinical examination to the choice of the protocol to the intraoperative maintenance until the awakening of the animal. - Support an adversarial process with people of equal preparation and experts on different issues, of a regulatory, scientific, procedural and / or technological nature; D5 - LEARNING SKILLS At the end of the training the student will be able to: - consult and understand scientific texts, even innovative ones, bibliographic updates, - possess a sufficient mastery of the subject to guarantee an acceptable basis for continuing professional development throughout life, through ongoing lifelong learning
Teaching methods	THEORETICAL ACTIVITY: - lectures in classroom on all the subjects of the course. PRACTICAL ACTIVITY: - practical activities with clinical cases referred to the OVUD where the group of students involved will have to: * visit the patient and define its ASA status * identify and discuss possible problems which could arise during anesthesia due to the concurrent disease and /or the surgical procedure * define an anesthetic protocol which fit to the case, choose the moleculs and calculate the amount to administer * surgically prepare the area and insert the intravenous catheter, administer preoperative medical tretment required (i.e. antibiotics and antinflammatory drugs) *assist during premedication and induction phases, as well as during maintenance while recording vital parameters by means of clinical and instrumental support, recognizing the adequate phyiologic range in order to provide a safe anesthesia devoid of risks for the animal and the operators - According to the availability of cadavers, wet-lab would be perform to improve skillness on : * tracheal intubation, * venous catheterization If cadavers would not be available, dummies will be used. SELF-DIRECTED LEARNING ACTIVITY: - preparation of an "anesthetic plan" based on an hypothetic patient according to its history, lab exams and occurring disease and surgeli to be performed, so that they will provide description of: possible complications, anesthetic protocol (drugs selected for each anesthetic phase: premedication, induction, maintenance, moreover drugs and fluids of support), perioperative analgesia, breathing circuit and elective monitoring.
Extended program	- introducution to the course : preanesthetic examination, preoperative instrumental exams, ASA status (1,5h) - Phases of anesthesia and balanced anesthesia. Anesthetic depth (1,5h) - The anesthetic machine - notes on instrumental monitoring (2h) - Breathing systems linear and circular (1,5h) - Preanesthetic drugs: phenothiazines and benzodiazepine (1,5h) - Preanesthetic drugs: alpha2 agonists and opioids (1,5h) - Induction drugs: barbiturates, cycloexamines (1,5h) - Induction drugs: propofol and alfaxolone. Inhalant anesthetics: halogenates (1,5 h) - Introduction on pain evaluation on domestic animals (1,5h) - Notes on farm animals anesthesia: equids, ruminants, swines (2,5h) - Local anesthetics and main loco-regional techniques (1,5h)

DIAGNOSTIC IMAGING

Code	85008903
CFU	3
Teacher	Rodolfo Gialletti
Teachers	Antonio Di Meo (Codocenza) Rodolfo Gialletti
Hours	4.5 ore (Codocenza) - Antonio Di Meo 34.5 ore - Rodolfo Gialletti
Learning activities	Caratterizzante
Area	Discipline cliniche veterinarie
Academic discipline	VET/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Allow students to improve the knowledge on the diagnostic imaging, the diagnostic possibilities of different diagnostic techniques such as radiology, ultrasound, CT, MRI and scintigraphy in domestic animals.
Reference texts	Reef: Equine diagnostic ultrasound. Kidd: Atlas of Equine ultrasonography. Butler: Clinical Radiology of the Horse Bertoni Brunetti Pozzi: Radiologia Veterinaria.
Educational objectives	The course is the first step all dedicated to the management of diagnostic means for usable images in small and large animals. (know and know how) The main objective of the course is to provide theoretical and practical sessions with the basis for tackling good diagnostic tests by the use of different systems available in Veterinary medicine. Through the knowledge first and then trough the use of different diagnostic procedures students will have the possibility to follow the correct diagnostic procedures. The knowledge and use of radiology, ultrasound, the CT, MRI and scintigraphy are fundamental tools in veterinary clinical practice. The main skills (ie the ability to apply their knowledge) will be the acquisition by the student to manage virtually clinical cases in small and large animals
Teaching methods	The course is organized as follows. Lectures on some of the topics of the module programme Tutorial in operating theaters and examination rooms of OVUD. The students according to the number are divided into groups for the practical work and for the Clinical Rotation and, possibly with the OVUD caseload, as regards the clinical routine cases while a group take place directly on the patient diagnostic procedures, another with the teacher, address conventional diagnostic procedures. Particular attention will be paid to the logical approach of the diagnostic procedure in emergency or elective cases from the referred animals until the therapy and possible discharge of the case.
Other information	This course could includes also complementary didactic activity represented by meetings and seminars with PhD students, interns by planning and agreeing with the students without overlapping with other courses and activities during the semester
Extended program	Introduction to the course of diagnostic imaging; Procedures and rules for the examination; Teaching materials.(60') sonographic artifacts (60') abdominal ultrasound (90') Ultrasound abdominal parenchymal organs(90') Outbuildings umbilical foal(60') Ultrasound soft tissues of the neck(60') Principles of ultrasound tendon and articular (90') Ultrasound hock and knee in the dog (60') Ultrasound shoulder dog (60') foot(60') fetlock(60') metacarpus(60') carpus(60') hock(60') stifle(60') OCD radiographic signs(60') Neck and back (60') muscle injury(60') thoracic ultrasound(90') Interpretation of radiographic signs(60') CT (60') Magnetic Resonance(60') scintigraphy (60') Use image intensifier(60') eye ultrasound(60')

OPERATIVE MEDICINE

Code	GP005396
CFU	2
Teacher	Marco Pepe
Teachers	Marco Pepe Sara Nannarone (Codocenza)
Hours	23 ore - Marco Pepe 3 ore (Codocenza) - Sara Nannarone
Learning activities	Caratterizzante
Area	Discipline cliniche veterinarie
Academic discipline	VET/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Knowdlege of the main surgical procedures in all apparatus of the domestic animals. The emphasis of this course is development of advanced understanding of relevant surgical procedures in small and large animals that lead to appropriate decision making. There will be particular attention on the principles of reconstructive surgery, intestinal surgery and determination of intestinal viability and postoperative care and complications associated with abdominal surgery. There are also an overview of upper respiratory airway, all procedures af the muscoloscheletral apparatus, uro-genital system, nervous system and eye and adenexa. The lessons will be held by the professor and, for some particular topics, by other teachers who are experts in the subject to be discussed.
Reference texts	Auer: Equine Surgery, IV edition Saunders Ed. ISBN 0 7216 2860 5 Fossum: Chirurgia dei piccoli animali, Masson Ed. ISBN 88 214 2684 X Slatter: Chirurgia dei piccoli animali, III Ed., Antonio Delfino Ed. Roma ISBN 88 72873347 The topics discussed on classes will be available on unistudium platform: https://www.unistudium.unipg.it/unistudium/
Educational objectives	The course is the first dedicated to teaching all operative medicine of small and large animals. D1 - KNOWLEDGE AND UNDERSTANDING ABILITY The student must - have knowledge of surgical procedure of small and large animal . D2 - ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING D3 - AUTONOMY OF JUDGMENT The main objective of the course is to provide theoretical and practical sessions to address the knowledge and techniques of surgical instrumentation an materials, and most common procedures in domestic animals. The main focus of the knowledge gained will be mainly for the knowledge of operating rooms and surgical environments, the concepts of sterilization, antisepsis, surgical patient preparation and surgical instruments as well the knowledge of the techniques and conventional and minimally invasive surgical procedures The main skills (ie the ability to apply their knowledge) will be the acquisition by the student to know practically instrumentations and surgical procedures in small and large animals. D4 - COMMUNICATION SKILLS At the end of the training the student will be able to: - to organize, prepare and exhibit, to an audience composed of peers of equal, a presentation on a surgical pathology of pets with their own evaluations supported by appropriate arguments, - support a cross-examination with people of both equal preparation (licensed professional) and experts in different subjects, of a regulatory and scientific nature, procedural and / or technological, - demonstrate language properties in both written and oral form as well ability to employ sufficiently appropriate terminology for a correct approach to the profession, also important for the purposes of interviews of work. D5 - LEARNING SKILLS At the end of the training the student will be able to: - consult and understand scientific texts, including the innovative ones, bibliographic updates, so as to employ them in contexts not only usual for the practical profession, including research, but also originals, - possess a sufficient mastery of the topic in order to guarantee an acceptable basis to continue updating throughout his career through continuous education
Teaching methods	The course is organized as follows .. Classroom lectures on the topics of the course 18 hours Exercises in ambulatory and surgical suites of the OVUD. The students based on the number will be divided into groups and, possibly with the OVUD caseload, one group take place directly on the patient diagnostic procedures, another will be involved under the teacher supervision in the surgical procedures or therapies and critical care as appropriate. Particular attention will be focused to the logical approach of the clinical case from the referred animals until the therapy and possible discharge of the case necessary. 8 hrs student divided in small groups
Extended program	Introduction to the surgery Surgery facilities sterilization, Antisepsis Preparation on the surgical patient sepsis; Sterilization; Post Operative management (1 hr) Shock Patient with trauma Endotoxiemia (1 Hr) Biomaterials Surgical theatre (1 Hr) Surgical instrumentations Surgical techniques Suture Materials and patterns surgical techniques, (1 Hr) Surgical implants and instruments Laser in veterinary surgery Wound management and repair Surgical site infection and treatment Drains, Bandages, External Coaptation (1 Hr) Musculoskeletal surgical techniques: method of internal and external fracture fixation (1 Hr) Gastrointestinal surgical techniques: surgery of oral cavity, oesophagus, salivary glands, stomach, intestine, rectum and anus, liver and biliary system (2 Hr) Respiratory surgical techniques: upper and lower respiratory tract in large and small animals (3 Hr) Urinary and reproductive system surgical techniques: surgery of kidneys, bladder, urethra, in small and large animals testicles, ovarian and perineum Laparoscopy (1 Hr) Opthalmic surgery (1 Hr) Arthroscopy, tenoscopy, concept of joint treatments (1 Hr) Rectal and rectovaginal tears (1 Hr) Knee elbow and ankle disease small animals Equine hoof diseases (1 Hr) Tendons and Ligament diseases (1 Hr) Angular limb Deformity (1 Hr)