Canine/Feline OHE

Question 1

Where to start skin incision in dogs versus cats

Answer 1

Dogs: 1-2cm caudal to umbilicus

Cats: more caudal for uterine body exposure, centered midway b/w umbilicus & pubis

umbilicus located just below xiphoid

Question 2

How to incise the SC tissue to expose linea alba?

Answer 2

incised sharply (with scissors)

Question 3

How to incise through linea alba to enter the abdomen

Answer 3

1. grasp linea w/ forceps & tent upwards
2. stab incision w/ scalpel parallel to body wall + blade facing UP, avoiding spleen & bladder

Question 4

How to locate the suspensory ligament

Answer 4

1. locate the proper lig (white in color - connecting suspensory & round ligg.)
2. clamp down on the proper lig.w/ mosquito forceps
3. ID bands of suspensory lig. digitally/feel the tension – “strumming” with dominant hand (and making sure not to tug too hard with non-dominant hand/one holding mosquito forceps)

suspensory: taut fibrous band located @ cranial aspect of pedicle

Question 5

Post-op complications

Answer 5

1. Hemorrhage (ovarian pedicles, uterine pedicle, broad lig., abd. wall muscle, sc tissue)
2. Incisional (seroma, dehiscence, self trauma, swelling)
3. Ureteral Ligation (poor technique/inadequate exposure – DON’T JUST GRAB THINGS!!)

1. Incisional complications (infection, seroma, abdominal wall hernia / evisceration). These are the same as those associated with any other abdominal incision.

2. Inadvertent ureteral ligation can occur at the level of the uterine body if the surgeon does not carefully identify the structures being ligated (typically with a full bladder) or when a dropped or bleeding ovarian pedicle is clamped and ligated without carefully identifying the structures included in the clamp/suture.

3. Ovarian remnant. An animal that has been ovariohysterectomized and develops signs of heat weeks to months postoperatively typically has an ovarian remnant due to incomplete ovarian tissue resection. This often results from transecting too close to the ovary but can also occur with fragmentation of the ovarian tissue and revascularization into the omentum or mesentary

4. Erosion of the uterine vessels causing intermittent vaginal bleeding in the days/weeks that follow ovariohysterectomy. Typically the result of a single ligature along the uterine body. This generally requires revision surgery to ligate the bleeding uterine vessel.

5. Uterine stump pyometra requires that a source of progesterone be present (i.e. incomplete ovariectomy or external administration.

6. Urinary incontinence (especially in dogs)

7. Fistulous tracts and granulomas. Described with the use of non-absorbable, braided suture.