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Reproduction > Common surgical procedures of the reproductive tract in the dog and cat > Flashcards

Common surgical procedures of the reproductive tract in the dog and cat Flashcards

1
Q

How do you locate the uterus for OVH?

A

Push intestines cranially and bladder caudally. Locate ovaries by following uterine horns

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2
Q

What is ovarian release?

A

In OVH, the ovaries can be released by breaking down the suspensory ligament (cut>tear), create window in mesovarium.

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3
Q

How do you do pedicle clamping in OVH?

A

Haemostasis using 3 artery forceps (either 3 dorsal to ovary OR 2 dorsal and 1 ventral)

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4
Q

What should you use to do an ovarian ligature?

A

SYNTHETIC ABSORBABLE MATERIAL:
Vicryl
One/two/instrument tie
Encircling ligature/figure of 8

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5
Q

Why must ovarian ligature be tight?

A

Ovarian a arises from aorta. Reduce risk of slippage by leaving 0.5cm between ligature and cut edge.

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6
Q

What should you use for a broad ligament ligature?

A

Synthetic absorbable material cases in all cases except very immature/ small dogs and cats (Vicryl ideal)

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7
Q

What should you use for a cervical ligature?

A

Synthetic absorbable material (Vicryl)
3 forcep technqiue
EITHER: encircling ligature, transfixing ligature, stick ties

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8
Q

How do you check the right ovarian pedicle?

A

Elevate descending duodenum

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9
Q

How do you check the left ovarian pedicle?

A

elevate descending colon

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10
Q

How do you check the right broad ligament pedicle?

A

elevate descending duodenum/ more SI to left

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11
Q

How do you check left broad ligament pedicle?

A

elevate descending colon

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12
Q

How do you check the cervical pedicle?

A

elevate bladder and reflect caudally

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13
Q

Complications of OVH?

A

GENERAL - wound breakdown, infection, haemorrhage, retained swab
SPECIFIC - ureteral injury, retained ovarian remnant
OTHER - SMI, weight gain, anaesthetic complications

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14
Q

What variations are there in the technique to perform an OVH?

A

FLANK SPAY - usually L flank, care with oriental cats and the regrowth of their fur (darker)
OVARIECTOMY VERSUS OVH - latter commoner in UK, ovariectomy used in many EU countries routinely, more logical for elective sterilisation but not appropriate for management of uterine disease
LAPAROSCOPIC DISEASE - ovariectomy with a vessel sealing device (i.e. no ligature), gaining popularity, quicker recovery but high capital cost to set up

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15
Q

How common are c-sections?

A

64% dogs with dystocia treated this way
80% cats with dystocia treated this way
Base decision based on dam, foetuses and owner

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16
Q

What are some causes of dystocia?

A 
Primary uterine inertia (>70d)
Incomplete primary uterine inertia refractory to medical management
Secondary uterine inertia (exhaustion)
Relative/absolute foetal oversize
Anatomical abnormality of maternal pelvic canal
Foetal monstrosity
Uncorrectable fetal malpresentation
Foetal death
Previous CS?
17
Q

What are pre-op considerations for CS?

A

Electrolyte and other metabolic abnormalities
Foetal death increases significantly after 5 h since onset of labour
Owners should be advised of surgical risks to dam and neonate
NRCW classification variable

18
Q

What are anaesthesia considerations for CS?

A 
Regurgitation and aspiration
CV and resp. compromise
Depression of neonates
Good analgesia for dam (local block, epidural post procedure, avoid alpha 2 agonists, ketamine and thiobarbiturates)
Minimise time taken to remove foetuses
19
Q

What are the 2 approaches for CS?

A

MIDLINE - take care

EXTERIORISE UTERUS - you may want to incise both uterine horns if many foetuses

20
Q

How do you detach the umbilical cord?

A

Clamp it. Only remove placentas if come freely.

21
Q

How do you stitch back the uterus after a CS?

A

Synthetic absorbable material - Monocryl ideal
Simple appositional OR inverting pattern
Single OR double layer

22
Q

What are potential complications of CS?

A

GENERAL surgical
Remove ALL foestusess
POST-PARTURIENT PROBLEMS: uterine haemorrhage, retained placenta/foetuses, acute metritis, subinvolution of placental sites, uterine rupture, uterine prolapse, toxic milk syndrome, agalactia, galactostasis, acute mastitis, puerperal tetany, disturbed maternal behaviour

23
Q

What is an en bloc OVH?

A

Hysterectomy performed prior to hysterotomy and removal of neonates. Review of 63 cases (dogs/cats) concluded it was a safe and effective alternative to CS (neonatal survival comparable). BUT all neonates need resuscitating IMMEDIATELY.

ADVANTAGES: minimised anaesthesia time, minimal peritoneal contamination, effective population control and no need for second surgery.

24
Q

How does castration differ between dogs and cats?

A

DOG - single pre-scrotal incision

CAT - paired scrotal incisions

25
Q

Indications for castration

A 
Population control
Behavioural modifications
Testicular neoplasia
Cryptorchidism
Testicular torsion
Orchitis/epididymitis
Testicular trauma
Anal adenoma (dog)
Perineal rupture (dog)
Prostatic disease
Repair inguinal/scrotal hernia
26
Q

What is the NRCW classification for clean and closed castration techniques?

A

CLEAN

27
Q

What is the open dog castration technique?

A

Ligate using synthetic absorbable material (Vicryl)
3 forcep technique
Encircling or transfixing ligatures

28
Q

What is the difference between an open and a closed castration?

A

OPEN - tunic and associated structures are incised an deach structure is ligated separately. vaginal tunic not repaired.
CLOSED - tunic not incised –> vessels, vas deferens and associated structure ligated at once, usually with 2 or 3 separate knots to prevent bleeding.

29
Q

Advantages of closed and open castration are?

A

OPEN - may reduce post-op swelling and reduce the risk of ligature slippage
CLOSED - reduces risk of internal herniation

30
Q

T/F: cat castrates are usually done as a clean rather than aseptic procedure.

A

True (open castration - two scrotal incisions)

31
Q

Are ligatures regularly used for cat castrations?

A

No:
Vas deferens and spermatic vessels are knotted together
Overhand knot in spermatic cord

32
Q

What is scrotal ablation?

A

Removal of scrotum as well as testes (relatively unusual)

33
Q

When is scrotal ablation indicated?

A 
Scrotal diseae (MCT or trauma(
Improved cosmesis and reduced complications (bruising and swelling) in mature dogs
Part of a scrotal/ perineal urethrostomy procedure
When scrotum is used as a skin donor site.
34
Q

What are the surgical approaches for cryptorchid castration?

A

Inguinal or caudal midline laparotomy

35
Q

Where a places to look in a cryptorchid castration if you can’t find the testes?

A

Examine the gutter from the caudal pole of the kidney to the inguinal ring

Does vas deference enter the inguinal ring from the abdomen?

36
Q

Complications of castration?

A

GENERAL SURGICAL - wound breakdown, infection, haemorrhage
SPECIFIC COMPLICATIONS - scrotal swelling, urethral injury, failure to locate retained testicle
OTHER SEQUELAE - weight gain, SMI, anaesthetic complications

37
Q

What is the RCVS advice on castration?

A

RVNs aren’t allowed to perform dog/cat castration under Schedule 3 ammendment of Vet Surgeons Act as it involves a body cavity.

Use of prosthetic testicles deemed unethical by RCVS

Reproduction (42 decks)

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