title: Postoperative complications in a lamb after major surgery.
abstract: BACKGROUND
  Anaesthesia in lambs undergoing experimental surgery may develop problems associated with age-related immune incompetency: a postoperative complication in a 3 week old Scottish blackface lamb after spinal surgery is presented. CASE HISTORY AND MANAGEMENT: Both lamb and ewe were in good condition. The ewe was vaccinated against Clostridium perfringens and Clostridium tetani 5 weeks pre-partum. There were no apparent problems with the lamb's intake of colostrum. Pre-anaesthetic medication was intramuscular medetomidine (10 μg kg(-1)). Anaesthesia was induced and maintained with sevoflurane in oxygen. Morphine (0.5 mg kg(-1)), meloxicam (0.6 mg kg(-1)) and ketamine (1 mg kg(-1) followed by 10 μg kg(-1) minute(-1)) were administered intravenously (IV) for perioperative analgesia. Atracurium (0.5 mg kg(-1) IV, followed by 0.17 mg kg(-1) injected when the first twitch of the four, train-of four count was palpated) was used to improve muscle relaxation. The lamb's trachea was intubated and the lungs mechanically ventilated to maintain normocapnia. Intrathecal morphine (0.2 mg kg(-1)), IV meloxicam (0.3 mg kg(-1)) and edrophonium (0.5 mg kg(-1)) were administered before recovery. Operative and initial recovery periods were unremarkable. Three hours after surgery the lamb became depressed. Tachycardia (180-250 beats minute(-1)), tachypnoea (30 breaths minute(-1)), poor peripheral perfusion and cold pelvic limb extremities were present mimicking severe pain, and/or hypovolaemic shock. Analgesics - morphine (total dose 1.3 mg kg(-1)) - and IV fluid therapy boluses - crystalloids (300 mL), colloids (120 mL) and fresh whole blood (60 mL) - failed to ameliorate clinical signs and so the lamb was euthanized 10 hours after surgery. Post-mortem findings supported a possible diagnosis of peracute Clostridium perfringens enterotoxaemia.
  
  
  CONCLUSIONS
  Clostridium perfringens enterotoxaemia should be considered when clinical signs of severe pain and/or hypovolaemic shock fail to respond to analgesics and fluid resuscitation in lambs after major surgery.
authors.affiliation: Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian, EH25 9RG, UK. enzovetto@libero.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Vettorato
authors.forename: Gudrun
authors.initials: G
authors.lastname: Schoeffmann
authors.forename: Philippa
authors.initials: P
authors.lastname: Beard
authors.forename: R Eddie
authors.initials: RE
authors.lastname: Clutton
mesh_terms: D000758:Anesthesia / Q000662:veterinary*; D000777:Anesthetics / Q000008:administration & dosage / Q000494:pharmacology*; D000818:Animals; D003015:Clostridium Infections / Q000209:etiology / Q000382:microbiology / Q000662:veterinary*; D003016:Clostridium perfringens; D004767:Enterotoxemia / Q000382:microbiology*; D005260:Female; D011183:Postoperative Complications / Q000662:veterinary*; D012756:Sheep; D012757:Sheep Diseases / Q000209:etiology / Q000382:microbiology*
chemical_list: D000777:Anesthetics