Unit VETERINARY SURGERY II

ORTHOPAEDIC SURGERY

Code	GP005397
CFU	2
Teacher	Antonello Bufalari
Teachers	Antonello Bufalari
Hours	26 ore - Antonello Bufalari
Learning activities	Caratterizzante
Area	Discipline cliniche veterinarie
Academic discipline	VET/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	On the first day of class, after the presentation of the course and the aims of the course, the teacher will use the first lesson hours to explain the complete diagnostic / therapeutic path and to evaluate some basic clinical aspects: anamnesis, etiology, diagnosis, therapy and prognosis The topics of subsequent lessons will mainly focus on clinical cases of dogs and cats. The topics of Orthopedics of the Large Animals will be treated in other specific courses (CIP and ADE) This course provides specialized training in the process of learning the anatomical, physiological and pathological aspects of orthopedic diseases in particular in pets. The emphasis of this course is on the development of advanced knowledge of relevant orthopedic problems, both surgical and non, in carnivores that lead to the choice of the most appropriate therapy based on a logical and rational decision-making process. In consideration of the limited number of frontal hours available, only some topics of the orthopedics program will be treated. The topics not covered in the frontal or practical lessons must be prepared by the student referring to the recommended textbooks. The lessons will be held by the teacher in charge and, if necessary, and only for some particular topics, 1 or 2 lessons could be held by other teachers who are experts in the subject to be discussed. Allow to the student to acquire basic knowledge on orthopedic diseases with particular reference to the knowledge of pathological mechanisms, diagnosis and therapy even in emergency conditions, especially in small animals. Acquisition of the ability to face the orthopedic surgical patient in emergency and not, in small animals. On the first day of class, after the presentation of the course and the aims of the course, the teacher will use the first lesson hours to explain the complete diagnostic / therapeutic path and to evaluate some basic clinical aspects: anamnesis, etiology, diagnosis, therapy and prognosis The topics of subsequent lessons will mainly focus on clinical cases of dogs and cats. The topics of Orthopedics of the Large Animals will be treated in other specific courses (CIP and ADE) This course provides specialized training in the process of learning the anatomical, physiological and pathological aspects of orthopedic diseases in particular in pets. The emphasis of this course is on the development of advanced knowledge of relevant orthopedic problems, both surgical and non, in carnivores that lead to the choice of the most appropriate therapy based on a logical and rational decision-making process. In consideration of the limited number of frontal hours available, only some topics of the orthopedics program will be treated. The topics not covered in the frontal or practical lessons must be prepared by the student referring to the recommended textbooks. The lessons will be held by the teacher in charge and, if necessary, and only for some particular topics, 1 or 2 lessons could be held by other teachers who are experts in the subject to be discussed
Reference texts	Lectures will be available on unistudium platform: https://www.unistudium.unipg.it/unistudium/ Textbooks: Permattei D, Flo G. Ortopedia e trattamento delle fratture nei piccoli animali. Masson, 2004. Fossum: Chirurgia dei piccoli animali, Edizioni EV Stashak: La zoppicatura nei cavalli, Ed. it. Ed. SBM,Noceto (Parma).
Educational objectives	The emphasis of the Orthopedic course is to furnish sufficient clinical knowledge and skills to practise veterinary orthopedic surgery in small and large animals (horses), and also to provide with the scientific background to respond to future trends and advances in veterinary Orthopedics. Practical classes provide instruction and practice in basic Orthopedic procedures such as Bones and Joints approach, fracture fixation (internal and external fixation), cruciate repair, patella luxation and other common orthopedic surgical procedures. The student must be able to make a correct diagnostic path in the main orthopedic diseases of companion animals. This course is the first course dedicated to the management of orthopedic surgery of small and large animals. The main objective of this course is to provide theoretical and practical sessions for addressing the main orthopedic diseases in domestic animals. The main knowledge gained will be those focused mainly on patient assessment (history and signalling), to follow the diagnostic and surgical planning to treat the pathology. The main skills (the ability to apply knowledge acquired) will be the acquisition by the student to manage virtually orthopedic cases in small and large animals from diagnosis to surgical treatment D1 - KNOWLEDGE AND UNDERSTANDING ABILITY The student must - have knowledge of orthopedic emergencies and elective surgical therapies regarding the main osteo-articular pathologies in small animals. D2 - ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING The main objective of the course is to provide, through theoretical and practical sessions, the basics to face the main elective orthopedic problems and urgencies in small animals. The main knowledge acquired will focus mainly on: assessment of the critical orthopedic patient, management of the patient with orthopedic emergencies such as exposed fractures, multiple fractures in the traumatized patient etc. At the end of the training the student must: - being able to recognize orthopedic emergencies - be able to implement emergency maneuvers in the presence of a multi-traumatized critical patient with multiple fractures - know how to discern between urgent and non-urgent surgical problems - know how to indicate the main therapeutic procedures in animals with orthopedic surgical pathologies 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 people of equal level of preparation, a presentation on an orthopedic pathology of pets with their own evaluations supported by appropriate arguments, - support an adversarial process with people of equal preparation who are experts in different issues, of a regulatory and scientific nature, procedural and / or technological, - demonstrate language properties in both written and oral form, as well as the ability to use terminology that is sufficiently appropriate for a correct approach to the profession, which is also important for job interviews. 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, normative dictations, so as to employ them in contexts not only usual for the profession, including research, but also originals, - possess a sufficient mastery of the subject to guarantee an acceptable basis for continuing professional development throughout life, through ongoing lifelong learning The emphasis of the Orthopedic course is to furnish sufficient clinical knowledge and skills to practise veterinary orthopedic surgery in small and large animals (horses), and also to provide with the scientific background to respond to future trends and advances in veterinary Orthopedics. Practical classes provide instruction and practice in basic Orthopedic procedures such as Bones and Joints approach, fracture fixation (internal and external fixation), cruciate repair, patella luxation and other common orthopedic surgical procedures.
Teaching methods	Frontal and practical classes The course is organized as follows: Classroom lectures on some course topics Groups of common exercises and Clinical Rotation: Exercises in the surgical rooms and surgeries of the OVUD Surgery. Students on the basis of the number will be divided into groups and, compatibly with the case load of the OVU, with regard to orthopedic cases while one group will carry out directly on the patient the diagnostic procedures aimed at acquiring information related to the orthopedic case, another together with the teacher, he will deal with orthopedic surgical procedures or appropriate therapies. Particular attention will be paid to the logical approach of the orthopedic case and surgical planning.
Extended program	Review of the most common orthopedic diseases of the large and horses. In particular, will be discussed: a) Lameness of the shoulder: with particular emphasis on Osteochondritis dissecans of the shoulder. It will be considered the following aspects: history and signaling, etiology, diagnostic imaging, and surgical treatment. b) Lameness of the elbow with particular emphasis on elbow dysplasia (FCP, OCD, UAP). It will be considered the following aspects: history and signaling, etiology, diagnostic imaging, and surgical treatment. c) Lameness of the distal part of the leg with particular emphasis on the Instability of the carpal/tarsal. It will be considered the following aspects: history and signaling, etiology, diagnostic imaging, and surgical treatment. d) Lameness of the Hip with emphasis on dysplasia of the hip. It will be considered the following aspects: history and signaling, etiology, diagnostic imaging, and surgical treatment. e) Lameness of the knee with emphasis on Patellar Dislocation and Rupture of the anterior cruciate ligament. It will be considered the following aspects: history and signaling, etiology, diagnostic imaging and surgical treatment. g) Basics for the treatment of fractures. It will be considered the following aspects: history and signaling, etiology, diagnostic imaging and surgical treatment. For each condition is indicated: Diagnostic aspects, orthopedic examination and differential diagnosis, method BOA (Breed Oriented Approach), Therapeutic options List the differential diagnosis Surveys side and their interpretation diagnostic confirmation The report outlines the main surgical techniques In particular, we will run a workshop on cadavers where the students will perform the following techniques a) Surgical approach to the major long bones for the treatment of fractures; approach to the bones to perform Ostectomy/osteotomy. b) Basic techniques for the application of external fixation and internal fixation (screws and plates) d) approach to the hip joint for ostectomy of the femoral neck and head e) Approach to the knee joint inspection and execution of extracapsular suture and execution of techniques to correct patella luxation; f) Approach to the bone fractures of equine extremities

SURGICAL CLINIC AND EMERGENCY SURGERY OF LARGE ANIMALS

Code	GP005399
CFU	3
Teacher	Marco Pepe
Teachers	Marco Pepe
Hours	39 ore - Marco Pepe
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 improve the knowledge of the student on most common surgical disorders in different system organs and surgical emergencies in large animals Treatment of surgical emergencies or elective surgery, recognition of the clinical condition of the animal; stabilization of the patient; emergency and non-surgical emergency treatment; Acquisition of the ability to address the surgical patient in all its main aspects. The first day of class, after the presentation of the course and its aims, the teacher will use the first lesson hours to explain the complete diagnostic / therapeutic path and to evaluate some basic clinical aspects: anamnesis, etiology, diagnosis, therapy and prognosis. The topics of the other lessons will be on the most common surgical disease for every apparatus
Reference texts	Auer: Equine Surgery, IV edition Saunders Ed. ISBN 0 7216 2860 5 Orsini & Divers Equine Emergiencies, treatment and Procedures; 5th Edition Elsevier
Educational objectives	The course is the first course entirely dedicated to the management of surgical elective and emergencies of large animals. D1 - KNOWLEDGE AND UNDERSTANDING ABILITY The student must - have knowledge of surgical emergencies and elective surgical therapies regarding the main surgical pathologies in large animals. D2 - ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING D3 - AUTONOMY OF JUDGMENT The main objective of the course is to provide theoretical and practical sessions of the surgical elective and emergencies in large animals. The main focus of the knowledge acquired will be evaluation of the critical patient, preparation for surgical procedures in elective and emergiencies such as colic, management of the superficial and deep wound; management of the disorders digestive system, management of the disorders of the upper and lower respiratory tract; management of the disorders of the nervous system;;management of the disorders of the eye; management of the disorders of the muscoloskeletal system; management of the disorders of the urinary system. General emergency procedures and diagnostics, emergency imaging, endoscopy, laboratory diagnostic and monitoring The main skills (ie the ability to apply their knowledge) will be the acquisition by the student to manage elective surgery and emergencies in small and large animals from diagnosis to surgery and follow-up 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. Lectures on some of the topics of the module program 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 surgical diagnostic procedures, another with the teacher, address conventional surgical procedures Particular attention will be paid to the logical approach of the elective surgical patient of emergency cases from the referred large animals until the therapy and possible discharge of the case.
Extended program	introduction to Surgery; Exam methods and rules; Teaching material Traumatized patient, Recognition of the clinical condition of the animal; Treatments in shock, chest, abdominal, nervous; Stabilization of the patient; Hemorrhage treatment and hemocagulation principles (1 hours) orthopedic emergencies I: Early interventions undergoing musculoskeletal disorders Specific orthopedic emergencies II (3 hours) Equine foot diseases (2 hours) Joint and tendon Sheath Surgery (Arthroscopy and Tenoscopy) (2 hours) LA Tendon and Ligament surgery (1,5 ore) Developmental Orthopaedic Diseases (2 hours) Equine Gastro-enteric disorders and their treatment: Part I Equine Gastro-enteric surgical diseases and their treatment: Rectal Lacerations: Internal External hernia Post-operative treatment of colic (4.5 hours) Large Animal Laparoscopy (2 hours) LA Ophthalmological emergencies and eye surgery (1.5 hours) Foal Emergency and surgery; (1.5 hours) Urinary System Emergency and surgery (1.5 hours) LA Respiratory Emergencies and Surgery I (1.5 hours) LA Respiratory Emergencies and Surgery II (3 hours)

SURGICAL CLINIC AND EMERGENCY SURGERY OF PETS

Code	GP005398
CFU	3
Teacher	Antonello Bufalari
Teachers	Antonello Bufalari
Hours	39 ore - Antonello Bufalari
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 improve the knowledge of the student on most common surgical disorders in different system organs and surgical emergencies in small animals Treatment of surgical emergencies or elective surgery, recognition of the clinical condition of the animal; stabilization of the patient; emergency and non surgical emergency treatment; Acquisition of the ability to address the surgical patient in all its main aspects. The first day of class, after the presentation of the course and its aims, the teacher will use the first lesson hours to explain the complete diagnostic / therapeutic path and to evaluate some basic clinical aspects: anamnesis, etiology, diagnosis, therapy and prognosis The following topics and relative surgical procedures will be evaluated Surgery of skin wounds and annexa (ear, etc) Hernias: abdominal, diaphragmatic, hiatal and perineal hernias Respiratory system: surgery of upper and lower respiratory tract Urinary system: surgery of bladder and urethra ropture Gastrointestinal system: All the patologies that require an emergency approach Hepatic system: epatic surgery such as lobectomy or partial lobectomy, gallbladder pathologies In consideration of the limited number of frontal hours available to the teacher, only some topics of the surgical clinic and emergency surgery of small animals will be treated The topics not covered in the frontal or practical lessons must be prepared by the student referring to the recommended textbooks. 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	The topics discussed on classes will be available on unistudium platform: https://www.unistudium.unipg.it/unistudium/ Textbooks: Bufalari A: Malattie Respiratorie del Cane e Gatto, Ed. Poletto, 2009, ISBN 978-88-95-033-24-2 Stashak: La zoppicatura nei cavalli, Ed. it. Ed. SBM,Noceto (Parma). Auer: Equine Surgery, 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
Educational objectives	D1 - KNOWLEDGE AND UNDERSTANDING ABILITY The student must - have knowledge of surgical emergencies and elective surgical therapies regarding the main surgical pathologies in small animals. D2 - ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING The main objective of the course is to provide, through theoretical and practical sessions, the basics for facing elective and emergency surgeries in small animals. The main knowledge acquired will focus mainly on: critical patient assessment, patient management with surgical emergencies such as Gastric Torsion Dilation, Small Intestine Intussusception and Invaginamento, Splenic Injuries, Traumatic Tracheal or Thoracic Lesions, etc. At the end of the training the student must: - know how to recognize surgical emergencies - be able to implement emergency maneuvers in the presence of a critical patient - to be able to discern between emergency and urgent surgical problems - know how to indicate the main therapeutic procedures in animals with surgical pathologies D3 - AUTONOMY OF JUDGMENT At the end of the training the student will be able to: - to evaluate the most appropriate surgical therapies for a patient (Dog or Cat) with common surgical pathologies - Evaluate the most appropriate surgical therapies for a patient (Dog or Cat) with equal / emergency surgical pathologies - The main skills (ie the ability to apply the knowledge acquired) will be the acquisition by the student of practically managing elective surgical cases and in emergencies in large animals from diagnosis to therapy up to follow-up 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 and lectures on some topics (considering the low number of hours available for theoretical lessons) of the course + clinical Rotation in the surgical rooms and Medication Rooms of the OVUD. Students will be divided into groups based both on the caseload present in the OVUD and on the number of active operating theaters. The student, under the strict supervision of one of the instructors in charge, will perform directly on the patient the diagnostic procedures, elective surgical procedures, and/or the appropriate therapies. Particular attention will be paid to the logical approach of the clinical case from the acceptance to therapy and the possible discharge of the patient. The emphasis of the Surgery course is to give to the students sufficient clinical knowledge and skills to practice veterinary surgery in small animals, and also to provide them with the scientific background to respond to future trends and advances in veterinary surgery. Practical classes provide instruction and practice in basic procedures such as general dieresis and sintesis, gastrointestinal biopsy and resection, cystotomy, dissection, and other common surgical procedures. 1. Practical sessions are organized as clinical work and wet lab 2. The size of 2 groups of 6 students for each session of Clinical Rotation 3. The practical session is performed in OVUD during the clinical routine 4. There is the academic staff who performs also the theoretical courses and at least 2-3 internal students or 2-3 post-doctoral veterinarians who support the teacher 5. The practical session are performed in the section of Clinical Surgery 6. Time distribution of practical sessions is 5/6 hours in 4 rounds 7. Attendance at practical sessions is compulsory (min. required 70%) 8. The practical sessions are not written up
Extended program	This course provides specialized training in the anatomic, physiologic, and pathologic process of musculoskeletal diseases in small animals, with special emphasis on treatment of surgical diseases (also in Emergency) gastrointestinal, thoracic, pulmonary, cardiovascular and Urinary apparatus.There are also largely discussion format and examines surgical principles and surgery of wounds. It is designed to review and discuss urogenital surgical procedures such as nefrotomy, nefrectomy, cistotomy, cistectomy, uretral obstruction, in small animals and the rational basis for their treatment. Pathophysiology will be stressed. The course provides specialized training in thoracic surgery techniques such as thoracic approach, polmunary lobectomy, exploratory thoracotomy etc. The course provides some discussions in cardiopulmonary diseases such as pericardiectomy, Persistent Ductus Arteriosus (PDA), Persistent IV Aortich Arch, etc. Normal anatomy and physiology of the gastrointestinal system in carnivores is presented initially. This is followed by in-depth discussion of the pathophysiological mechanisms and sequelae of gastric dilatation and volvulus, intestinal volvulus and intussusception, gastrointestinal obstructions including reperfusion injury, peritonitis, adhesions, and short bowel syndrome. The emphasis of this course is development of advanced understanding of surgically relevant gastrointestinal problems in carnivores that lead to appropriate decision making. Also the course will focalize on surgical treatment of Hernias: abdominal, diaphragmatic, hiatal and perineal hernias. In view of the limited number of hours available for the teacher, the classes will only cover some of the topics of Veterinary Surgery program. Any topics not covered during theoretica or practical lesson should be prepared by the student referring to the recommended textbooks. Classes will be taught by the official lecturer and, in rare cases and for some specific topics, by other faculty experts in the field to be treated. In particular, the arguments for small animals will be carried out: Surgery of skin wounds and annexa (ear, etc) Hernias: abdominal, diaphragmatic, hiatal and perineal hernias Respiratory system: surgery of upper and lower respiratory tract Urinary system: surgery of bladder and urethra ropture Gastrointestinal system: All the patologies that require an emergency approach Hepatic system: epatic surgery such as lobectomy or partial lobectomy, gallbladder pathologies The course, compatibly with the limited number of hours available for the teacher will focuses on General emergency procedures such as: Gastro-intestinal surgical emergencies; Urinary emergencies; Integumental emergencies; Muscolo-skeletal emergencies (fracture., joint and tendons), Opthalmic emergencies and Neurological emergencies will be held in other specific courses such as ADE. Module: Veterinary Surgery Clinic and Small Animal Emergency Surgery 2019-2020 16 September 15:18 Presentation of the teacher; Introduction to the surgery course; Exam methods and rules; Teaching materials. • Cervical mucocele 17 September 9:11 Oral cavity and first airway surgery. Part I: • Brachycephalic syndrome 18 September 14:16 Oral cavity and first airway surgery. Part II: • Tracheal collapse • Management of Respiratory Emergencies 19 September 14:16 Oral cavity surgery and first airways. Part III: • Tracheal traumatic injury • Laryngeal hemiplegia: corrective techniques September 24th 9:11 Thoracic cord surgery Part I: • Thoracotomies and access to the thoracic cord • Chylothorax 1 October 14:16 Thoracic cord surgery Part II: • PDA and IV Aortic Arch: surgical treatment October 8th 9:11 Thoracic cord surgery Part III: • Pericarditis and Pericardiectomy 15 October 14:16 Thoracic cord surgery Part IV: • Diaphragmatic Hernia October 22nd 9:11 Abdominal cord surgery Part I: • Hernias and their treatment 29 October 14-16 Surgery of the abdominal cavity Part I: • Traumatic and neoplastic splenic injuries • Gastric Torsion Dilation Syndrome (Part I) November 5, 9-11 Abdominal Cord Surgery Part II: • Gastric Torsion Dilation Syndrome (Part II) 12 November 14:16 Surgery of the Abdominal Cord Part III: • Intestinal volvulus • Intestinal Intussusception • Bowel obstruction • Intestinal Neoplasia 18 November 14: 30-17: 30 Exercise Group D 19 November 14: 30-17: 30 Exercise Group C 20 November 14: 30-17: 30 Exercise Group B 21 November 14: 30-17: 30 Exercise Group A 19 November 9:11 Surgery of the perineal region in dogs and cats Part I: • Rectal prolapse • Rectal tumors • Anal sacculitis