Treatment of Fracture and Luxation on Bali Cattle’s Leg With General Anesthesia

Treatment of Fracture and Luxation on  Bali Cattle’s Leg With General Anesthesia

I Gusti Agung Gde Putra Pemayun

Veterinary Surgery  Laboratory

Udayana University Faculty of Veterinary Medicine

Jl. P.B. Sudirman, Denpasar, Bali, Indonesia 80234 phone/Fax: (0361) 223791

Email: putrapemayun@unud.ac.id

Bali cattle is a germplasm protected from extinction in addition to Kintamani dog and Bali pigs. The cattle population of Bali is increasingly declining years so that it takes efforts to increase its population such as remarriage (artificial insemination), prohibiting the slaughter of pregnant cattle, and prohibiting export or delivery of a female Bali cattle. It aims to keep the population even to raise as a germplasm from Bali. In the old days Bali cattle were used to help farmers hijack both in the paddy fields and in gardens, but now the function has been taken over by the use of tractors given the number of Bali cattle population continues to decline. So big the role of Bali cattle in people's life in ancient times so that almost every family in Bali kept the Bali cattle, especially those living in rural areas to help farmers in addition as family savings that can at any time be sold when there is urgent need.

But now very few people who want to nurture Bali cattle, can only be found in areas far from the countryside, it is possible because there is a shifting order of society from the Agrarian Society to the industry especially the tourism industry. Therefore, the Government encourages the establishment of rural cattle groups that aim to keep the population of Bali cattle not kept to a reduced population even until the extinction occurs. To raise farmers to nurture Bali cattle in addition to the formation of livestock groups also with the assistance of the breeding of Bali cattle and regular vaccination programs and health care incentives especially those who join the cattle group.

Bali cattle are susceptible to diseases, especially Jembrana disease and snoring  disease. After the vaccination program, the Balinese cattle are rarely found infected by the disease. However, other non-infectious disorders often found in the calf are traumatic disorders such as fracture and luxations in the legs. The presence of traumatic disturbance in the legs can cause low selling even until it is not sold. If you happen to the calf often cause death when not receiving correct and fast handling.

Fractures and luxations in Bali cattle are often found in the time when cattle are transported to animal markets, especially at the time when cattle are established or derived from vehicles. In the calf when fractures or luxations will not be sold, so it often causes death because it is left by the owner. In the adult cow is often sold at a cheap price because the game of the trader is usually cut to consume meat. Amputation on cow's legs is rarely done differently in animals like dogs and cats, because cows are unable to stand by using three feet let alone increasingly bigger animals will not be able to sustain a bigger weight. The only way to save calves from death due to broken bones/wounds is by surgery to reposition the bones or joints and is given fixation using internal or external fixation so that the animal is able to walk with its four legs.

The external fixation using gypson in the Bali cattle suffered some obstacles or difficulties in the animals while walking because it is too heavy and often leads to the end of the leg when the gypson  is too strict which can cause gangrene at the foot. The weakness of the use of external fixation in large animals is the best choice with the  internal fixation using plate  or pins. The installation of plates or pins as bone fixation, of course cows must be carried out by general anesthesia. There are several general anesthesia agents recommended in cattle namely ketamine and propofol with the maintenance of anesthesia using inhaled anesthesia. The use of ketamine and propofol in Bali cattle has not been attempted because surgery in the Bali cattle is very rarely done in addition to economically do not lead. Ketamine and propofol are already used for surgical purposes in cattle abroad and produce a short anesthesia duration so that it is required to maintain anesthesia using inhaled anesthesia. To save a Balinese cattle experiencing traumatic disorders on the feet, the surgical action is absolutely done by first doing anesthesia. Surgery on the bones of both large and small animals takes a long time to learn the physiological response that is inflicted during anesthesia in small animals such as dogs and cats to produce the duration of the long anesthesia need to maintain anesthesia during surgery, which is using inhaled anesthesia. The use of inhaled anesthesia in large animals is not practical, expensive and very complicated especially surgery in the field in addition is very difficult in the inclusion of endotracheal tube in cattle.

Bali cattle are a type of cow that is difficult to be restrained so that the injection of intravenously difficult to do, therefore it is necessary to give xyazine premedication to soothe before the anaesthesia is done. Xylazine is a premedication of anesthesia in small animals and large animals that can be administered intramuscularly (IM) and intravenously (IV). Ruminants are very sensitive to xylazine so that with small doses can soothe in the cow can even fall until it facilitates the injection of intravenous anesthesia such as propofol and ketamin. The recommended xylazine dose in cattle is 0.1 mg/kg of BB  IM that can cause cows to collapse so as to facilitate the injection of the IV. The side effects of xylazine administration in cattle is the occurrence of bloating in the stomach (bloat) and hypersalivation so that it needs to be administered atropine sulfate to prevent bloat. As a premedication the recommended atropine sulfate dose in cattle is 0.05-0.1 mg/kg of BB. In some literature recommended fasting for 24-48 hours in cows before being adopted is common so that the content of rumen is completely empty. This is different from single-leared animals such as dogs and cats that are destroyed 12-18 hours before being adopted.

The results of the study in Bali cattle showed the introduction of xylazine premedication dose 0.1 mg/kg BB IM and induction with ketamine dose 2 mg/kg BB IV produce an induction time of 4.75 ± 1.73 minutes, the duration of anesthesia 13,03 ± 1.15 minutes, and recovery time 12,10 ± 5.05 minutes. When induced with propofol dose 2 mg/kg BB IV produces an induction time of 2.50 ± 0.58 minutes, anesthetic duration 15.50 ± 1.91 minutes and recovery time 2.75 ± 0.96 minutes, while induced with a combination of ketamine and propofol (1 mg/kg of ketamine BB and 1 mg/kg of BB propofol) IV produces an induction time of 5.00 ± 1.41 minutes, the duration of anesthesia 14,00 ± 1.83 minutes and recovery of 4.50 ± 0.58 minutes. Anesthesia with a combination of ketamine and propofol has several advantages including it can reduce the dose of propofol. A single propofol can cause respiratory and cardiovascular depression, with the combination of ketamine can reduce the dose of propofol so that it can avoid respiratory depression and cardiovascular in animals. The combination of ketamine and propofol can cover one's deficiency with the other, ketamine causes an increase in muscle tone and has a good exhibits effect whereas propofol poses perfect muscle relaxation but lacks an exhibits effect so that both are ideal combinations. The excess use of propofol is to produce a short recovery time compared to the ketamine so that it does not harm the cow because during the period of recovery of cows banging the head to the soil that is anatomically neck in the long cow. During anaesthesia with ketamine and propofol there is no extreme physiological changes in both respiration and cardiovascular system.

For prolonged surgery, such as fracture treatment and foot injuries in both large and small animals during surgery, need maintenance with inhalation anesthesia. The use of inhaled anesthesia to maintain the anesthesia stadium is already common in humans and animals like dogs and cats. In large animals such as Bali cattle use inhalation anesthesia is less practical, very expensive and difficulty in installing endotracheal tube so there needs to be an alternative method. The use of gravimetric anesthetic methods through infusion drops can be used as an alternative to expensive and impractical substitute inhalation anesthesia when used for surgery in the field. In a pet use gravimetric anesthesia through infusion drops already done research and the result is safe to use does not cause extreme physiological changes to the respiratory system or cardiovascular during anesthesia. Gravimetric anesthesia method uses parenteral anesthetic agents such as ketamine and propofol mixed in infusion fluid bags that are administered based on the gravitational force with a certain dose and speed of drops. The extent of the physiological response to the respiratory and cardiovascular system that is inflicted on Bali cattle within a certain time will need further research. Cows are  ruminants that different with single-leaved dogs (monogastric), inhaled anesthesia in cows has some disadvantages such as the occurrence of hypersalivation and larynk anatomical form of the difficult in endotracheal-intubation tube. Alternative anesthetic methods are required to avoid hypersalivation side effects of inhaled anesthesia and costly and complex anesthesia equipment and are not practical to use for field surgery.