Hello and thank you for tuning in to this webinar on goat field anaesthesia techniques. My name's Ben Dustin and I'm the director of Tann Farm Vets Limited based in Cumbria and I'm also the honorary secretary of the Goat Veterinary Society. This is the first in a series of webinars where we're going to take a closer look at field anaesthesia and common surgical techniques in the goat.

We're gonna start today's session off by having a very quick look at the outline of the current UK goat industry before moving on to have a look at the types of anaesthetic agents available for use in the field, how we can stay legal. Then we're gonna have a think about how we can prepare ourselves fulfil anaesthesia and reduce the risks and avoid the pitfalls that may be involved. We'll move on to have a look at sedation, when sedation may be appropriate or where general anaesthetic is a safer bet.

And finally discuss some of the regional anaesthetic technique approaches that we have available for use in the field. So the UK goat population is increasing year on year. Current Derastats estimate the adult goat population to be around 110,000.

The actual number of goats in the UK is likely to be significantly higher, as there are a lot of goats which are kept in small numbers in backyards and probably are not registered with DRA. There are something like 60, possibly 70,000 dairy goats in the UK at the moment. There's only a relatively small number of true commercial units, meaning that the herd size is pretty variable.

Average looking around 600 head, but obviously herd size can increase dramatically, anything over 5, 6000 goats. Main breeds within the UK areannins, Toggenberg, alpines, and crosses. The meat population is interesting.

That's increasing quite markedly over recent years, probably slightly over 17,000 commercial meat goats in the UK, mostly Berber cross, and an increasing trend to see some of the dairy surplus males heading into the meat market with an average kill outage of around about 9 months. Fibre goats make up the smallest commercial sector of the UK goat population, probably getting lower, each year, something like 5000 fibre goats, and very small numbers of commercial units in the UK now, less than a handful. The main breed is Angora.

And then the and then the rest of the UK goat sectors sort of made up of a mismash of smallholders, pedigree, show stock. That was a whistle stop tour of the UK goat industry, and we'll move straight on now to have a look at the available anaesthetic agents for use in the goat when we're looking at field situations. So goats are food producing animals, and as a result of that, er, drugs that we use within the species must have a maximum residue limits set.

All the licenced products available for goats in the UK are contained within the Noah Compendium, and at the moment, I think I checked this yesterday, there are 17 licenced products available for use in goats which include things like intravenous fluids, water for injection. There is a drug licenced for euthanasia. There are now two epinenemectin-based wormers, one being a poon which you can't actually get hold of and another being an injectable version.

There are a couple of oxytocin preparations. There are various vaccines. There's also one topical antibiotic spray, and rather unhelpfully when we think about our antimicrobial responsibilities, there is also an injectable fluroquinolone.

The thing about goats and medicines within the UK is that if we haven't got a licenced product and most things aren't licenced for use in goats, then we are obliged to follow the cascade requirements. The cascade specifically says that any pharmacologically active substance included in a medicinal product administered to a food producing animal, i.e.

Our goats, under the cascade must be listed in table one in the annex to Commission Regulation EU number 372,010. Essentially, that narrows down even further our legal options when it comes to anaesthetic agents for use in goats. The most commonly available, legal anaesthetic agents, which are probably going to be used within the UK settings would include xylazine, which is an alpha 2 agonist.

There are marked differences in the individual goat response to xyzine. We'll touch on that a little bit later as well, which means that things like topping up a dose is quite difficult. You often don't see any greater sedative effect if you're going to add onto your dose, especially if you give that intramuscularly.

You need to make sure that you give plenty of time for the xyzine to work. And xyzine is associated with many side effects including things like bradycardia, hypertension, hypoxia, pulmonary edoema. You do not want to use this really in potential uroethiasis cases as it increases urinary output.

It also has oxytocin-like effects. So if the goat is in late gestation, there is a risk of abortion. I've included things like omidine in the list, which has slightly fewer side effects than xyzine but probably isn't as commonly used in the field.

Ketamine is, is, was licenced. I don't think there's a licenced product available currently in the UK, but does feature, obviously, on cascade use and there's a dosage there as well. Procaine is our licenced, local anaesthetic for food producing animals within the UK, although not specifically licenced for use in goats.

And, however, things like lignnicaine, lidocaine are licenced on the continent for use in food producing animals. The thing we have to be careful with local anaesthetics is there's a relatively low safety threshold when it comes to using these drugs. Which means we quite quickly going to get to levels in the goat which could be associated with toxicity.

So we're going to try and keep the volume of local anaesthetics that we use as low as possible. That often means that we would dilute our local anaesthetic around about 50/50, 1 to 1 ratio with sterile water for injection. There actually isn't any data that I can find on the toxic threshold for procaine, although there is some information available on lgbicaine, but procaine isn't, isn't suitable for intravenous or epidural, deposits.

Signs of local anaesthetic toxicity would include things like nystagmus, muscle twitching, convulsions, epistheosis, hypertension, and even respiratory arrest. Off licence, you could use some diazepam, at a low dose rate, to reverse the side effects of local anaesthetic toxicity if they're persisting for more than 2 to 3 minutes. In terms of reversal agents for things like alpha 2, so xyzine in particular, the drug which you will probably be aware of is apimazole, but there is no MRL set and it doesn't feature, on the EU regulation lists and annexes.

So in theory within the UK setting, that would be an illegal drug to use. So having looked at the available anaesthetic agents that we can use in goats in the field, we're going to move on now and have a think about how we can prepare ourselves for anaesthesia out in the field, how we can reduce the risks and avoid the pitfalls that might be associated with these kinds of situations. Firstly, we're gonna think about the environment.

It needs to be clean, warm, it needs to have a decent light. And it should be dry and draught free. You need to give some careful consideration to the bedding materials available, particularly if the procedures or the anaesthesia involved will result in the animal becoming recumbent.

And if you're thinking about doing, say, laparotomies on a recumbent animal, it might be best not to have a dusty sawdust type bedding around you and think about whether you can actually raise your patient up. We'll touch on that in a moment as well. The animal itself, you need to think carefully about your Clostridial cover, whether that includes things like tetanus antitoxin being available or if vaccinated, how recently was that Clostridial vaccination done?

It wants to have been boosted at least 14 days before the procedure. You want to give some consideration to the types of analgesia, antibiosis, that might be required for the procedure that you're going to do. Starvation in terms of avoiding or withdrawing concentrate, forage and water intake before on-farm sedation is quite important.

As a rule of thumb, if I'm thinking that I'm going to have to any more than moderately sedate my goat where I'm planning on some form of general anaesthesia, I'll remove concentrate 24 hours beforehand. I'll remove the forage ration around about 12 hours beforehand. And I'll ask the owners to remove water from about 6 hours beforehand.

That's in adults and weaned animals. If these animals are neonates, then clearly they're not going to be in a position to be able to do that. So I normally ask if it's neonate, say, for disbudding, and we'll be doing a general anaesthesia, that they're kept away from milk for around about 1 hour, 1 hour and a half before I get there.

The handling needs to be as little as possible, but as much as necessary. Goats really don't tolerate significant, physical restraint, which will have an impact on whether you need to think in terms of sedation versus general anaesthesia. Neck collars can be really useful and the experience of a familiar handler is really worthwhile and important.

Think about how long the procedure is likely to take, how much sedation or general anaesthesia will be required, because the duration will have a big knock-on impact on things like the risk of hypothermia. Goats are really sociable animals, so it's often important, in terms of keeping your animals as stress free as possible, that they're always kept within sight of pen mates, even if they're not in direct contact. If we're working in the summer months, then having some form of of fly control that would be useful.

When it comes to sort of operator considerations, the height at which you're going to be working can be quite important. Now, goats, as you know, are good, agile climbers. They're often not phased by being up on, infrastructure.

In fact, I tend to prefer to do my caesareans, for example, or my laparotomies in the standing goat, and I'll often have a low level table or stool which the goat will stand on, very similar to a hand milking, stand. And they'll stand quite happily on there, with their head, resting or being held by an experienced handler, and then you can sort of operate and do the procedures that you're performing at a decent height for your own back, and the goat is often quite calm and, amenable at that height. When it comes to recovery, the duration that that recovery will take is quite important.

So if you've used sedatives such as xyzine, whether they're in combination as a general anaesthetic or stand-alone sedation, the recovery, particularly with xyzine could be quite prolonged. It's going to be essential. That you provide additional warmth for the recovering animal, whether that be via heat lamps or blankets, extra bedding, sort of hot water, bottles or blankets, even with kids, things like the little lamb jackets or calf jackets on an adult goat can be quite useful.

Goats, suffer from hypothermia very quickly and their temperature will drop to sort of 375 within 15 minutes of significant sedation, or anaesthesia and continue to fall if you don't put mitigating factors in place. Be careful if you do put something like a lamb jacket on a kid. As they recover, they'll often tend to try and, heat it, which wouldn't be ideal.

And particularly when we think about the fully anaesthetized or general anaesthetic patient or neonatal animals recovering from anaesthesia, they're going to need some kind of maybe glucose or warm fluids or a nice milk feed pretty much as soon as they can swallow to try and get back their temperature homeostasis mechanisms. So we've given some thought now to how we're gonna prepare ourselves for field anaesthesia and some risk mitigation. So now let's move on to look at sedation of the goat patient in the field.

I've said already that goats are generally less tolerant of physical restraint than other ruminants, and that really does explain why an experienced handler is so important if there's one available. It has a big impact on whether or not you're going to be able to perform the procedure that you intend to under sedation plus or minus a local anaesthetic, or whether a general anaesthetic might be more appropriate, again, whether or not you use a local anaesthetic alongside that general anaesthetic. Goats generally get or would be more susceptible to things like apnea, under sedation.

So we have to be very, considered with where our nose position is in regard to the level of the throat, the risks of aspiration of saliva, and keeping a clear airway. The level of sedation obviously has a significant impact on how we can position, the goat. Think about the likely duration the procedure might take.

If it's longer than 60 minutes or likes to be longer than 60 minutes, then it probably isn't suited to a field general anaesthetic. We're not likely in the field to have things like our inhalation or anaesthetic agents, ET tubes, or the careful monitoring that might be required, in which case some form of moderate to heavy sedation plus or minus your local anaesthesia agent is going to probably be the way we approach it. Once again, we're going to be thinking about our starvation, if we're going to need a longer procedure or or more than a moderate sedation.

Again, the same rule of thumb I discussed in the last slide, so 24 hours for the removal of concentrate, 12 hours for forage and around 6 hours for water. Having a blindfold, a nice quiet environment, post administration of sedation, particularly things like Xylazine, is really important. I said before that the xylazine response in individual goats, is very variable.

And if you can keep the external stimuli. To an absolute minimum and leave, the, the amount of time before you do anything with the goat once you've given the iazine as long as possible, and easily sort of 10 to 15 minutes and that will give you your, your best chance of successful sedation really with yzine. I mentioned some of the risks already, things like apnea, ruminal bloat, as we know of.

In an emergency situation, clearly we can, we can use a needle centesis to let some of that gas out if we had to. Regurgitation and aspirations, obviously a risk, and we've already touched upon hypothermia on the, on the previous slide. Here are some of the dose rates, which are available and listed in the literature.

Often in the field, despite its risks, I'm using Xylazine, often in combination with things like buorphenol, for a little bit of added analgesia. And I'm aware of the risks associated with the Xylazine use, and I just make very carefully sure that I've got mitigating factors in place, so particularly hypothermia and things like that to try and safeguard the patient. Having looked at some of the issues surrounding sedation in the field, we'll move now to have a look at general anaesthetic considerations, including things like pre-meds, the type of agents we might use and specifically the recovery.

As I've said before in the previous slide, we need to give some careful consideration as to whether or not the procedure that we want to do in the field is better performed under sedation plus or minus local anaesthetic or whether a general anaesthetic is more suited. If we're going down the general anaesthetic route, then I would suggest we have an IV access in place, whether that's a cannular catheter in the jugular, cephalic, cephalus, or even the ear vein really. We're gonna need to have implemented our starvation policy, as we've discussed over the previous slides.

And for the actual induction, the area needs to be really quiet. I often do the induction in the pen with pen mates or at least in direct sight of pen mates because the goat's going to be a little bit calmer and reducing the stress levels on the goat. Types of induction agents.

Well, we've got things like single or combination, ideas. I would generally use a combination and tend to do a zyzine and butterphenol, as I've said previously. Intravenously And then to actually anaesthetize the animal completely, give ketamine intravenously slowly to effect.

There are other agents, injectable agents available which you'll see listed in the literature things like propofol and Al axelon, but when it comes to sort of the legal status of these agents, they don't have MRL set, so if we're following the cascade, then in theory they shouldn't be used. Once the animal is fully anaesthetized, we need to make sure we've given thought to how we're going to position it to make sure we're not going to get any sort of neuro or myopathies. If we've got bony provinces lowermost, then they should be padded if at all possible.

We need to keep our head position, if in lateral, so that the nose is lower than the level of the throat to reduce the risk of things like aspiration. If you do have access to ET tubes, you could place an ET tube to try and protect that airway and reduce the risk of aspiration. Maintaining the general anaesthetic in the field is usually done in one of two ways.

We can top up our, ketamine agent with, time top-up injections, usually of around about 1/3 to 5% of the induction dose, given a fixed time periods. Now, I generally work on around about a 20 minute fixed time period. Or you can put ketamine, in a 2% drip, so roughly 200 mg of ketamine in 100 mLs of physiological saline, and then you can run that in the dose rate of 1 mL per minute in the average 60 kg goat, and that should maintain your your goat in a nice plane of anaesthesia.

This kind of general anaesthetic in the field is really only going to be suitable for procedures which are going to be less than or up to about an hour's duration. Beyond that, if it's required, if general anaesthesia is required, you might be thinking about taking it into sort of a hospital scenario where you can use inhalation anaesthesia to maintain or revert to things like a regional anaesthetic under under sedation and local anaesthesia. Monitoring whilst the goats are under general anaesthesia is obviously really important.

We can look at things like our heart rate, pulse quality, respiratory rate, blink reflex. Mucous membrane colour is quite good in goats. Generally speaking, it remains a nice pale pink, and it shouldn't be becoming either a white, cyanotic or sort of brick red.

Eye position is a funny one in goats. I don't find that particularly useful. Their eye position seems to, to vary, quite markedly, regardless of where their surgical plane of anaesthesia is.

Recovery, yeah, I try and get my general anaesthetic patients, supported into the sternal recumbency as quickly as possible, so propped up on a bail or something like that. Hypothermia is one of our biggest risks as we've already talked about, in the recovery period. So I always like to try and have heat lamps available or blankets or some form of, warming for the animal.

When we're dealing with little tiny kids, then I've said before, I like to have a milk feed ready to give them. And adults, often I try and, give them either a glucose or electrolyte solution which has been warmed, just seems to really, get them back up to temperature nice and quickly. Other risks obviously that we've talked about and are the same for things like straightforward sedation would include ruin or bloat, regurgitation and aspiration.

In future webinars, we're gonna look a lot more at when we would use general anaesthetic or a regional anaesthetic approach for a specific surgical or, non-surgical procedure. So don't worry that you don't feel that we've covered those just yet. That will be coming up in, in webinar 2 and webinar 3.

We've now looked at sedation and general anaesthetic of goats in the field, so we'll move on to look at the regional anaesthetic techniques that we could use in the field. First up for consideration is a paravertebral technique. Probably not used in the field as much as it could be or or should be.

In my opinion, it provides really good anaesthesia of the entire flank, generally speaking. Procaine would be appropriate here. The only thing to consider really here is that it has a lower tissue distribution and things like lignnicaine.

So it's really important that where we place our anaesthetic agent is as accurate as possible. Indications for it use would include things like caesareans, ruinotomies, any kind of flank, laparotomy really. Sort of equipment that we're going to be looking to use would be a 5 mil syringe, 19 gauge, 1-inch needle, or if they're dealing with sort of meat goats or very well conditioned goats, probably 1 to 1 inch and a half, maybe even 2 inch, 19 gauge needle.

We're looking to block spinal branches or spinal nerves T13 through to L2, possibly L3 if we're looking for very caudal flank anaesthesia. The risk with going as far as L3 is that frequently in goats, if you block L3, they'll Lie down and become recumbent, which might be absolutely fine if you'd like to do your caesareans with the animal in natural recumbency. Because I've mentioned already, I quite like doing my caesareans in the standing goat, so I would routinely just use T13, L1 and L2.

You would clip and spirit the clipped area which goes between the spine and the edge of the transverse processes, which is what you can see in the photograph. I put little blue boxes above where L5, L3, L2, L1 are situated. L5 because it's the one which is most easily palpable just in front of the ileal wings, and L1 is the one which is often shorter and a bit squatter just behind the angle of the last ribs.

So those are your sort of defining landmark areas. Once you've clipped spirited, you can. Got your midpoint really, your, your midpoint for your needle entry is between dorsal midline and the edge of the transverse processes.

You're going to pass your needle down onto the transverse process and walk it off the front of L1 to take out T13 off the back of L1 for L1 off the back of L2 for L2. When you've walked off the front or back of your transverse process, you'll start to feel your needle pushed through what's known as the intransverse ligament. It feels slightly greater resistance to your needle and then it'll just suddenly ease off very slightly.

At this point, this is where I like to do a hanging drop. This is what that needle is attempting to show you in the photograph. So you have a needle and you would deposit just a very small volume of your local anaesthetic and A sterile water combination in the top, so that you can physically see the fluid sitting on the top.

If as you push through the intransverse ligament, that drop gets sucked down, you've pushed your needle just slightly too far and you've penetrated the peritoneal cavity, so you need to withdraw ever so slightly so that that hanging drop remains in situ and isn't drawn down. Once you have that in situ, you're looking to place around 3.5 mLs of your local anaesthetic and sterile water combination at that level.

And as you withdraw just above dorsal, just above the level of the intertransverse ligament, you would deposit the remaining 1.5 mLs of your local anaesthetic and sterile water combination, and you repeat that at each of the locations for T13, L1, L2. The signs of a successful para vertical block would include desensitisation of the entire flank area.

You'll get some spinal curvature, i.e. The spine, would become convex on the blocked side.

You'll get some vasodilation or or possibly even see the skin sort of sweating or steam rising from the clip skin of the flank, on the blocked side. Some of the pros. Of this particular technique is the rapid onset of desensitisation.

The nice large area of desensitisation, so your incision or surgery can perform pretty much anywhere within that flank. You don't have any local anaesthetic in your surgical field and you're using a relatively small volume of local anaesthetic in, in, in overall. Cons included slightly more technically difficult, I guess.

There is the risk of greater haemorrhage in the surgical field because of this superficial vasodilation. And you will find that the goat will be wobbly, particularly, as I say, if you include, a block of L3, in which case the goat might even, even lie down. A line block for flank infiltration, essentially, the indications for this type of techniques use are the same as the para vertebral.

Technique, we're gonna be looking for a 19 or 20 gauge. Usually one inch needle is sufficient unless the animal is really obese or heavily conditioned. We're basically going to place a straight line of local anaesthetic or sterile water infiltrated through the subcut tissue, muscular tissue and peritoneal layer.

Each needle pass should be directed both subcutaneously along the intended incisional line as well as then perpendicularly through the muscles to reduce the number of skin penetrations. Keep the volume of your local anaesthetic and sterile water to an absolute minimum. This is where it's really important to have, the combination of sterile water and and local anaesthetic together really.

Procaine would be appropriate here though as well. Some of the pros associated with this is that it's, it's direct anaesthesia. It really is going exactly where you want it to go, so it's very targeted.

So you don't need to use any more anaesthesia than you would actually need. Rapid onset of action, obviously, you're putting it exactly where you need it to be. Small volumes because of that, and technically it's very simple, it's quick and easy to perform.

Some of the cons though, it does provide you with only a very narrow surgical field or area of desensitisation. You can get quite marked local tissue distortion because of the volume of local anaesthetic that you end up putting in the tissues, which can often be very thin in a, in a dairy goat. You don't really get much in the way of muscle relaxation away from that direct incisional line.

And because you put volumes of local anaesthetic where your incision is, you can get increased postoperative swelling or or risks of wound breakdown where the muscle layers don't heal quite as well as you might expect. A slight variation to the straightforward line block would be to do an inverted L or perhaps it's sometimes known as reverse 7 flank infiltration. Indications again are are the same as those for paravers rule or line blocks.

Again, procaine would be appropriate here in our combination with sterile water. Same sort of needle size would be appropriate, 19 gauge, 1 inch or perhaps a 1.5 inch for the fit individual.

But where is the line block was one single straight line, in this instance we're looking for two straight lines of local anaesthetic sterile water infiltrated again through the subcut muscular and peritoneal layers. I generally start with the first one running vertically adjacent to the last rib, so my fingers on that photograph are demonstrating where the last rib is, and the vertical line would be the line of anaesthetic that I would put in first. Similar or exactly the same as you would apply the line block as described.

And then I would go back and I would do the horizontal line running parallel to the transverse process after I'd done that vertical line. Each needle pass, as in the line block previously, should be directed subtaneously along the intended incisional line or or anaesthetized line as well as perpendicularly through the muscle layers. What you achieve by doing this is the area of tissue in this photograph to the right hand side, so below the level of the inverted L and becomes your desensitised area and you can then make your incision anywhere underneath that inverted L if you like.

Prose again, very rapid onset of action. It gives you a slightly wider area of desensitisation on that flank compared with just a straight line block. And you've still got your local anaesthetic and sterile water solution away from your actual incision site here.

The downside though, again, you don't really get very much in the way of decent muscle relaxation. And you are gonna be using larger volumes of your local anaesthetic and sterile water here. It can take you a little bit longer to place this block as well, will certainly take you longer than a straightforward line block and probably would take a similar sort of time to, to doing a para vertebral really.

So we're going to consider an epidural now and in this instance a local anaesthetic agent which contains adrenaline isn't really appropriate. So there are lignnicaine preparations available without adrenaline which you could use on Cascade, and that's probably preferable. So we're mainly looking at things like the caudal or sacrococcygeal or intercoccygeal indications here.

They would include things like dystopia, vaginal uterine or or even rectal prolapse, perineal and tail surgery. By giving more of the local anaesthetic agent in an epidural, the dose, travels further along that epidural space. So you then start blocking higher and higher levels of anatomy as you go up.

So keeping your doses relatively small and small volumes means that you keep the block just to the levels that you actually require. Often in adult goats, I'd be using, around about a 1 mL, local anaesthetic, mix. You can add things like Xylazine at the dose rate shown there to prolong the effect.

Most of the epidurals that I would be doing would be in adult animals, and I would be using a 20 gauge 1 inch needle. By moving the tail head up and down, you can usually identify the most cranial moving joint and that's where you would then clip and spirit. My thumb is placed in in where the joint space starts and the star is over where I would place the needle.

You want to advance your needle, midline with the hub sort of angle that sort of a 10 to 15 degrees, cordially, until you feel it contact the floor of the spinal canal, basically. Then you withdraw very slightly and that's where you'll inject. There shouldn't be any resistance, to injection.

And that's what I'm trying to show you here, with this syringe. So although it doesn't show up massively well, I'm sorry about that. The plunger of the syringe is situated at the 3 mil marker, which is the top orange line.

The fluid is at the lower orange line, and as you depress the plunger, the bubble between the two shouldn't move. You shouldn't be compressing that bubble in any shape or your form. And the fluid should just effortlessly glide into the epidural space.

You can do things like a lumber sacral epidural, and this would desensitise the flank, pelvis, and hind limbs. Once you've achieved the level of block that you want to, it's a good idea to elevate the front end of the goat though, because over time that block can travel further forwards and you can end up with a recumbent goat, well, recumbent goat or a goat struggling with breathing difficulties as the block moves higher and higher up the spinal column. This is often where you would choose to collect cerebrospinal fluid.

But in my opinion, I would rather this done in the sort of hospital or surgery environment. It's a little bit more anatomically delicate. You need to have good landmark appreciation and you need to be able to, collect your CSF in in a sterile way.

So personally, I would prefer to do this in the, in the hospital environment. And our final regional anaesthetic technique for this webinar is the intravenous regional anaesthetic. This is really useful for interventions of the lower limb and foot, so below the level of the carpus and tarsus, including things like digit amputations, joint lava, removal of growths, thylomas, granulomas, or sort of significant treatment of, of pedal bone sepsis, that kind of thing really.

We're putting our anaesthetic agent directly into vasculature, so we don't want to have a local anaesthetic including adrenaline. If the tourniquet is placed dorsal to the tarsus, then it's important that we pad the depressions either side of the Achilles tendon. So on the photograph you see here where the yellow line is by the level of my finger, we would want to pad that either side of the Achilles tendon to make sure that we include all the vasculature below satisfactory.

We don't want any local anaesthetic agent escaping into the general circulation. So this photograph does show a hind limb and my tourniquet is below the level of the tarsus. Once your tourniquet is in place and you've done the procedure, you want to make sure that the tourniquet remains in place for at least 20 minutes to avoid any of that local anaesthetic, getting out into the general circulation.

Placed a tourniquet, I would use a short, so sort of looking like a 5/8 of an inch type needle, 20 to 23 gauge needle, nice and thin, and we're going to put it directly into a superficial vein below the level of the tourniquet. So having clipped and spirited the skin, you can see on the right hand photograph, my finger is pointing, the dilated and raised. A superficial vein that we're gonna be aiming for.

Volume wise, we're looking at relatively low volumes of a local anaesthetic and sterile water combination. Generally speaking, 5 to 7 mLs is plenty if you can find a decent superficial vein like that. And giving that a little bit of time will allow it to circulate around the around the foot and the distal limb, and you can pretty much do what you need to do then, including things like digit amputation.

So to summarise today's webinar, we've very briefly looked at the UK goat population and noted that it's growing annually, but the official stats probably do underestimate its actual population numbers. We've looked at the legal options for sedative and anaesthetic drugs for use in goats. They have acknowledged that they're relatively limited within the UK and we need to use the cascade principles wherever possible.

Goats are relatively less tolerant of physical restraint than other ruminants, which does have implications when we consider how we're going to restrain them and whether we need to use sedation alongside things like our regional anaesthetic techniques or general anaesthesia. Hypothermia is a very real risk, in most situations, with dealing with sedation or general anaesthetic of goats in the field. General anaesthesia of goats in the field, we do need to be thinking carefully about how we plan our procedures, and they should be lasting for less than 60 minutes.

And we then discussed various regional anaesthetic techniques which are suitable for use in the field. As I've alluded to, this is the first in a series of webinars. The next webinars will focus on common field surgical techniques and the types of anaesthesia you might use to do those surgical techniques, as well as looking at the actual procedure itself.

So laparotomy, caesareans, and castrations coming up next. And the final webinar in the series will look at other field surgical techniques such as disbudding, digit amputations, in nucleation, that kind of thing. Here is some useful further reading and references, for the areas that we've covered, in this webinar.

Particularly useful, would be things like the goat medicine and surgery textbook, and also access to the goat veterinary. Society journal, via GVS membership, which I'll touch on in the next slide. A lot of the articles relating to anaesthesia in goats and common surgical procedures that we talk about in future webinars, there's very good papers writing up these things in the Goat Veterinary Society journal.

So how can we access some of these papers that I've just mentioned in the previous slide? Well, access to the Goat Veterinary Society journal is a member benefit for any member of the Goat Vet Society, which is a specialist division of the British Veterinary Association. Full membership is open to all veterinary surgeons, vet students and research fellows.

We also have associate memberships for all those interested in goat husbandry, so goat farming, hobbyists, everybody's welcome. We have meetings each year. As I said, we published the GVS journal and member newsletters, and you can find out lots more information about the GVS or online goat husbandry, medicine biosecurity via the Goat Veterinary Society website.

The address is listed there on the slide. We also operate a goat inquiries. Email address.

So if you have specific inquiries about goats or any questions about this presentation or webinar, please use the GBS. [email protected] email and I'll respond to you just as quickly as I can.

Some quick thank yous if I may. So thank you all very much for tuning in, and I hope you found this webinar useful. And thank you to all those who've contributed to the presentation and particularly my Goat Bet Society colleagues David Harwood, Nick Perkins, Briy Kendall, and John Matthews.

And just to repeat, if you have any questions at all, please do feel free to email me at GBS. [email protected] address.

And hopefully I'll see you on the next webinar.