Chap 31 - Soft Tissue Surgery: Ferrets Flashcards
Best pre-op work up? (ferret)
Minimum database + rads/echo as cardiac disease and insulinoma are common.
What about cutaneous neoplasia in ferrets?
Most are benign (MCT, BCT), but FNA is recommended beforehand to ensure type and necessary margins.
How do you use cryosurgery?
Use 2 freeze thaw cycles, don’t close area, be sure to get definitive diagnosis before removal due to destruction of tissue architecture.
Salivary mucocele: name the 5 salivary glands in a ferret and which are most often affected?
Parotid, mandibular, sublingual, molar (aka buccal), zygomatic. Molar and zygomatic are most often affected. Mucoliths common in the parotid gland but often asymptomatic.
Surgical option for salivary mucocele? Prognosis?
Marsupialize the mucocele to drain into the mouth or resect the gland. Good prognosis with gland resection.
If you suspect inflammatory bowel disease in a ferret , what might you find on biopsy? Where do you take samples?
Lymphoplasmacytic gastroenteritis - samples from stomach then intestines (multiple, wedge biopsy of anti-mesenteric side)
Do young or old ferrets get foreign bodies?
BOTH!
Young are more likely to eat hard rubber or foam.
Older are likely to develop a gastric trichobezoar from normal to excessive grooming.
What are your options for an esophageal foreign body?
1) Endoscopy, 2) Push into stomach and gastrotomy, 3) Esophagotomy via R lateral thoracotomy, Median sternotomy, or midline cervical but risk of post-op leakage and stricture formation.
Closures for gastrotomy and enterotomy?
4 to 5-0, 2 layer inverting closure for gastrotomy, single layer full thickness for enterotomy. Test for leakage.
Options for liver biopsy?
1) Guillotine edge of lobe & excise tip, 2) Two transfixing ligatures in an inverting V-pattern, or 3) 6mm biopsy punch but caution to not go through capsule on other side, near the hilus, and no more than 1/2 thickness. Needs gelfoam or cruciate to close.
Describe the ferret biliary system.
Gall bladder lays between R medial & quadrate liver lobes. Variable in pattern: right, left, and central hepatic ducts join to form common bile duct, which joins the pancreatic duct before entering the duodenal papilla 2-3 cm aboral to the pylorus.
How to handle gall bladder stones or bile duct obstruction?
Retropulse/milk stones back into GB, flush duct patent from papilla, then remove GB to prevent recurrent inflammation. Also culture & sensitivity.
Normal appearance to ferret adrenal glands?
2-3mm wide by 6-8mm long, white-pink
What can happen if you manipulate the adrenal and what can you do about it?
Tachycardia due to catecholamine release.
Esmolol 0.25-0.5 mg/kg slow IV
How to ligate to remove the left adrenal?
Ligate the phrenicoabdominal vein (adrenolumbar) that courses ventrally over gland, then lift along the lateral aspect, ligate vein & artery.
How to remove the right adrenal?
Vascular clamp on side of CdVC, dissect off the gland or resect part of the vessel, suture with 9 or 10-0 suture & gelfoam. Limit clamp occlusion to 20 min.
What if the right adrenal invades too much of the CdVC?
May need to RNA the VC, sometimes successful, 30% renal failure.
Why does resecting part of the CdVC work?
Paravertebral venous plexus exists, can see with venography.
What are the statistics for adrenal disease/involvement?
16-68% of cases have bilateral involvement (depending which study), 32% of cases with unilateral disease presents within 1 yr later with contralateral disease.
