Veterinary Medicine and Clinical Surgery II

• Suitable knowledges about the different diseases that can be surgically treated. This knowledge includes etiology, symptoms, diagnosis, prognosis, and treatment.
• Student should be able to make basic surgical procedures such as sutures, hemorrhage control, drains, bandages, and basic surgeries.

A) THEORETICAL SESSIONS (30 sessions)

Part I: Thoracic surgery (2 hours)
Lesson 1: BASIC PRINCIPLES OF THORACIC SURGERY. Thoracotomy, thoracocentesis and thoracic drainage. Pleurodesis.
Lesson 2: THORACIC WALL, STERNUM AND DIAPHRAGM. Anatomy and physiology reminder. Perforations of the thoracic wall. Fractures of the ribs and sternum. Neoplasia. Traumatic diaphragmatic rupture. Diaphragmatic hernia.

Part II: Surgery of the respiratory system (2 hours)
Lesson 3: TRACHEA AND BRONCHUS. Collapse and tracheal stenosis. Reparation methods. Foreign bodies. Tracheobronchitis. Tumours. Tracheotomy and tracheostomy. LUNGS AND PLEURA. Anatomy and physiology reminder. Lung lobe torsion. Pulmonary abscesses. Tumours. Pleural cavity. Pneumothorax, hydrothorax and hemothorax.

Part III: Cardiovascular surgery (2 hours)
Lesson 4. HEART AND MAIN BLOOD VESSELS. Congenital abnormalities: patent ductus arteriosus and persistent right aortic arch. Pericardiectomy.

Part IV: Abdominal wall surgery (2 hours)
Lesson 5. BASIC PRINCIPLES OF ABDOMINAL SURGERY. Laparotomies.
Lesson 6. HERNIAS. Umbilical, inguinal, scrotal and perineal. Principles of hernial suture. Complications. Prosthetic implants.

Part V: Surgery of the digestive system (6 hours)
Lesson 7. ESOPHAGUS. Trauma. Foreign bodies. Dysphagia. Neoplasia. Idiopatic megaesophagus and acquired achalasia. Esofageal surgery.
Lesson 8. MONOGASTRIC STOMACH. Gastroesophageal reflux. Gastric dilatation-volvulus syndrome. Retard gastric evacuation, pyloroplasty, Billroth I and Billroth II. Gastric rupture.
Lesson 9. PRE-STOMACH AND STOMACH IN RUMINANTS. Foreign bodies. Traumatic reticulitis. Abomasum torsion and displacement. Rumenocentesis. Rumenotomy, Abomasopexy. Omentopexy.
Lesson 10. SMALL AND LARGE INTESTINE. Foreign bodies, invagination and volvulus. Enterotomy and enterectomy. Impactation. Torsion of the colon. Mesenteric thrombosis. Equine colic surgery.
Lesson 11. RECTUM AND ANUS. Anal atresia. Diverticula. Rectal prolapse. Anal sac surgery. Neoplasia and hyperplasia of rectum and anus.
Lesson 12. ABDOMINAL PARENQUIMATIC ORGANS. LIVER. Trauma. Liver biopsy. Hepatectomy and cholecystectomy. Cholecystoenterostomy. PANCREAS. Pancreatitis. Pancreatic biopsy. Pancreatectomy. SPLEEN. Anatomo-physiologic reminder. Trauma. Splenic torsion. Splenic biopsy. Splenectomy.

Part VI: Surgery of the urinary and reproductive system (6 hours)
Lesson 13. KIDNEY AND URETER. Congenic abnormalities. Trauma. Nephrolithiasis. Nephrotomy and nephrectomy. Neoplasias. Renal transplantation. Ureter surgery.
Lesson 14. BLADDER AND URETHRA. Congenic anomalies. Cystic calculi. Trauma. Cystitis. Cystocentesis. Urethrotomy. Surgery of the feline urologic syndrome.
Lesson 15. TESTICLE AND SPERMATIC CORD. Anatomo-surgery reminder. Chryptorchide. Orchytis. Tumours. Orchiectomy in the different domestic species. Spermatic cord torsion. Deferectomy.
Lesson 16. PROSTATE. PREPUCE. PENIS. Congenic anomalies. Trauma. Benign prostatic hyperplasia. Prostatitis. Prostatic abscess and cysts.
Tumours. Prostatectomy. Phimosis and paraphimosis. Penile amputation.
Lesson 17. OVARIES AND UTERUS. Anatomo-physiologic reminder. Ovariectomy and ovariohysterectomy. Salpinguectomy. Pyometra. Torsion of the uterus. Neoplasia. Cesarean section.
Lesson 18. VAGINA AND VULVA. Congenital abnormalities. Rectovaginal fistulas. Pneumovagina. Vulvar alterations. Tumours.

Part VII: Surgery of the nervous system (2 hours)
Lesson 19. CRANIOENCEPHALIC PROCESSES. Traumatism. Cranial nerve examination. General neurologic examination. Encephalic trunk syndromes. CSF extraction. Hydrocephalia. Neoplasia. Principles of the Intracranial surgery.
Lesson 20. SPINAL CORD PROCESSES. Cervical, cervical-thoracic, thoracolumbar and lumbosacral syndromes. Atlantoaxial instability. Spinal cord approaches. Intervertebral disc pathology. Laminectomy and hemilaminectomy.

Part VIII: Cirugía del Sistema Músculo esquelético (8 horas)
Lesson 18: BONE SURGICAL PATHOLOGY I. Anatomo-physiological reminder. Bone traumatology. Fractures. Fracture healing processes.
Lesson 19. BONE SURGICAL PATHOLOGY II. Osteitis. Osteomyelitis. Periostitis. Bone dystrophies. Bone tumors.
Lesson 20. FRACTURES TREATMENT I. General procedures of reduction and fixation of fractures. Material and techniques.
Lesson 21. FRACTURES TREATMENT II. General procedures of reduction and fixation of fractures. Material and techniques.
Lesson 22. HIP. Dislocations of the hip. Hip dysplasia. Pelvic osteotomy. Hip arthroplasty. Hip fractures.
Lesson 23. ELBOW. Dysplasia. Ununited anconeal process (UAP), fragmented coronoid process. Osteochondritis dissecans of the medial humeral condyle. Dislocations. Fractures.
Lesson 24. KNEE. Rupture of the anterior cruciate ligament: TTA, TPLO, TWO, TTO, extra-articular techniques, intra-articular techniques. Meniscus. Collateral ligaments. Posterior cruciate ligament. Fractures.
Lesson 25. OTHER ORTHOPEDIC CONDITIONS. Femur. Tibia. Fibula. Humerus. Scapula. Tarsus. Carpus. Ulna. Radius. Metatarsus. Metacarpus. Phalanges.

B) HANDS ON SESSIONS (20 hours)

The practical activities will be done in the Surgery Service of the Veterinary Hospital. Attendance will be MANDATORY.

ACTIVITY CIRX II C1 (15 hours): OP room and consulting practices in small animals. In groups of seven students three consecutive days from 9AM to 2PM.
ACTIVITY CIRX II C2 (5 hours): Equine. Groups of 7 students from 9AM to 2PM.

In addition, students have to spend one night in the Emergency Service to complete the practices, from 21 to 8 AM hours.

Basic bibliography:
Auer JA. Equine Surgery (5ª ed). Saunders. 2019
Fossum TW. Small Animal Surgery (5ª ed). Mosby. 2018.
Hendrickson A, Turner and McIlwraith’s Techniques in Large Animal Surgery (4ª ed). Wiley-Blackwell. 2013
Slatter DH. Texbook of Small Animal Surgery (3ª ed). Saunders. 2003

Complementary bibliography:
Brockman, DJ. BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery (2ª ed). BSAVA. 2018
Orton EC. Small Animal Thoracic Surgery. Wiley. 2017.
Hall E. BSAVA Manual of Canine and Feline Gastroenterology (3ª ed). BSAVA. 2020.
Elliott J. BSAVA Manual of Canine and Feline Nephrology and Urology. BSAVA. 2017.
Johnson KA. Piermattei´s Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat (5ª ed). Saunders. 2014
DeCamp C. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair (5ª ed). Saunders. 2015
Houlton JE. BSAVA Manual of Canine and Feline Musculoskeletal Disorders. BSAVA. 2006
Platt S. BSAVA Manual of Canine and Feline Neurology (5ª ed). BSAVA. 2022.
Shores A. Current Techniques in Canine and Feline Neurosurgery. Wiley. 2017.
Weaver AD. Bovine Surgery and Lameness (3ª ed). Wiley-Blackwell. 2018.

General competences
o GVUSC01. Capacity to learn and adapt.
o GVUSC02. Capacity to analyze and synthesize.
o GVUSC03. General knowledge of the field of work.
o GVUSC04. Planning and management of work.
o GVUSC05. Capacity to put knowledge onto practice.
o GVUSC06. Capacity to work both autonomously and in group.
o GVUSC07. Ability to work in an international context.
o GVUSC08. Leadership, initiative and entrepreneurship.
o GVUSC09. Capacity to communicate in different spheres of activity.
o GVUSC10. Ethic compromise to assume responsibilities.
Specific competences of the subject (Knowledge):
o CEDVUSC 08. Knowledge and diagnosis of diferents animal diseases.
o CEDVUSC 09. General basis of medical and surgical treatment
Specific competences of the profession (how to do, day-one skills):
o D1VUSC 01. Make history and clinical examination of animals.
o D1VUSC 02. Collect and ship samples with its report.
o D1VUSC 03. Perform basic analytical techniques and interpreting results of clinical, biological and chemical.
o D1VUSC 04. Diagnose the most common diseases by using those complementary diagnostic procedures and techniques.
o D1VUSC 06. Deal with emergencies and perform first aid in Veterinary Science.
o D1VUSC 07. Perform basic medical and surgical treatments in animals.
o D1VUSC 08. Prescribe, manage and properly manage veterinary medicines.
o D1VUSC 17. Perform technical reports related to veterinarian competence.
Specific academic competences (will to do):
o CEAVUSC 01. Analyze, synthesize, solving of problems and taking of decisions in the different spheres of activity of veterinarians.
o CEAVUSC 02. Keep ethic behavior while exercising his/her responsibilities to the veterinary profession and the society.
o CEAVUSC 03. Spread the information reached while practicing as veterinarian in a fluent way, both orally and by writing, with other colleagues, authorities and the society
o CEAVUSC 04. Search and manage the information related to veterinary activity.
o CEAVUSC 05. Know and apply the scientific method while practicing, including evidence based medicine.
o CEAVUSC 06. Know how to look for professional help and advice.
o CEAVUSC 07. Have basic knowledge of a foreign language, especially in those technical aspects related to Veterinary Science.
o CEAVUSC 08. Be aware of the necessity to keep updating of knowledge, skills and professional competences by following continuing education.
Transversal competences:
o CTVUSC 01 Capacity to reason out and argue.
o CTVUSC 02 Capacity to obtain appropriate, diverse and updated information by the different media as bibliographic search by Internet, being able to analyze it with criticism.
o CTVUSC 03 Capacity to elaborate and present an organized and comprehensive text.
o CTVUSC 04 Capacity to expose to the public in a clear, consistent and concise way.
o CTVUSC 05 Ability to use ITs.
o CTVUSC 06 Use of information in a foreign language.
o CTVUSC 07 Capacity to solve problems by applying the integration of his/her knowledge.

The students receive 3 weekly lectures (in total 30) of Veterinary Surgery and Clinical Medicine II in the second semester according with the Schedule approved by the Faculty Assembly. The lectures will be of 50 minutes long according to the program. Students will use the electronic resources “Aula virtual” as teaching support because presentations of the lectures will be downloaded with images and videos of the surgical procedures.

Practical sessions are 20 hours divided in 3 main activities:

Activity CIRX II C1 (15 hours):OP room and consulting practices in small animals. In groups of seven students two consecutive days from 9AM to 2PM. The students will learn the following facts:
• Fill the medical record of every patient. Students may make the general examination of the patient from a clinical standpoint, analyzing date and focusing a possible diagnosis.
• Made the complementary diagnostic tests to achieve a definitive diagnosis and establish the treatment. It could be conservative or surgical.
• When a surgical treatment was necessary, students may know how to manage with the owners explaining them with detail all the surgery risks and the following surgical steps (stabilization of the patient, appropriate anesthetic protocol, selection of the best surgical technique and postsurgical control of the animal).
• Preparation of the patient and instruments. Inside the operating room students are going to prepare in an adequate way the surgical field by positioning of the patient in the most comfortable way for each surgery, administrating antiseptics to the field and dressing the patient with sterile clothes. We are going to practice the correct way for preparing the surgical personal (hand wash, gowning and gloving). We would see everything related to the instruments and the auxiliary equipment for every surgery learning the best way to use it, their functions and distribution.
• Students are going to participate in the surgical procedures which are going to develop in the hospital acting as surgical assistants helping in the surgery and in the wound suturing.
• Animals which need hospitalization are going to be served by the student or students who have followed the clinical case and, coordinated and oriented by the veterinarian resident, the students are going to administrate the adequate therapy to the patient and they are going to be responsible of the animal’s vigilance.
• The professor in charge is going to supervise the hospitalization and the student information advising the students in everything necessary
Activity CIRX II C2 (5 hours): Horses. In groups of 7 students from 9AM to 2PM. The student will learn techniques of nerve blocks in skull and diagnostic of lameness in horses.

In addition all students have to spend one night in the Emergency service VTH Rof Codina. Every night (21 to 8 am hours). Students must collaborate in the assistant of the Emergency Service and hospitalized animals.

To participate in the practical sessions, the students must wear surgical clothes, surgical mask, hair caps and boot swabs.
Before the first lecture, the subject will be presented in a tutorial (CIRX II T) and the evaluation method.
At the end of the semester, reduced students number tutorial (CIRX II PE) will be done to explain doubts.

- A partial exemption of class attendance may be granted, based on Instruction No. 1/2017 of the General Secretary. In this way, the students to whom it is granted will not have the obligation to attend the expository classes, but the obligation to attend the clinical practices is maintained, as it is necessary to attend them in person.

- The evaluation system for the activities for which the partial exemption is granted will be the same as for the rest of the students and the continuous evaluation will be carried out online.

Final qualification is composed by the sum of 2 independent parts. To surpass the matter is necessary to approve each one of them:

- 30% corresponds to the continuous evaluation of both the expository and interactive sessions. The student's personal work during classes will be assessed through different tests: completion of written exercises -scheduled or not-, active participation in the classroom, etc. The student will also be assessed individually in each of the practical sessions (participation, skills acquired, practical application of theoretical knowledge, dedication, effort, resolution of cases, etc.) through rubrics (the models remain available in the virtual classroom). This part is passed by obtaining 5 points out of 10.

To take the final exam (and pass the subject) it is necessary to attend 100% of the practical sessions. Qualification of the practices will be saved during 5 years.

- 70% theoretical written exam that evaluates the knowledges purchased in the sessions and interactive. The examination will consist of ask type test of multiple answer (with 4 answers, where, like minimum, one is true) and short questions. This part surpasses obtaining 5 points out of 10.

In case of plagiarism, fraud or improper use of technologies during the realization of the telematic tests, the provisions of the "Regulation of avaliación do rendemento académico dos estudantes e de revisión de cualificacións" will be applicable.

52 Learning hours under docent supervision:

30 hours of lectures.
20 hours of hands on sessions.
1 hour of blackboard practices.
1 hours of tutoring.

60,5 Self-directed learning hours:

45 hours for individual study.
2 hours of literature review.
10 hours of management of clinical cases or complications.
2 hours for exam.

Total hours per student: 112,5.

We consider neccesary the attendance to the lecturers to pass the subject.
Tutorials are important to resolve doubts before to prepare the study of the tests.
We recomend the use of Clinical Capacities Classroom before to start the hands on sessions.