Female Urogenital Flashcards
Blood supply to ovaries
Ovarian artery comes right off the aorta
On the right it drains to the right vena cava
On the left ovarian vein drains into the renal vein
Vessels in fat is called
A vascular pedicle
Incision for ovarian hysterectomy
Caudal abdomen in thirds from the umbilicus to the caudal abdomen
Dogs, you incise in the cranial 3rd
Cats you incise in the middle third
Go through lina alba
OH surfer
Start left run hook along abdominal wall as far as you go 180 degrees Re-orient vertically pull out
Complications
dropped pedicle
clamping/ligating ureters
incisional complications (seroma, dehescense)
OVarian remnant
Uterine stump pyometra
Urinary incontenance
Fistulous tracts with non-absorbable suture.
Pyometra bacterial causes
e.coli - but culture & sensitivity
Can cause toxicity (sepsis)
Pyometra - Diagnosis/Signs
based on clinical signs/discharge, PU/PD, may or may not be toxic
Pyometra occurs when?
dogs: 4-8 weeks post-heat
cats: 1-4 weeks post-heat
Treatment for pyometra
Stabalize with fluids & antibiotics & spay
Ampicilin & enrofloxacin (fluoroquinolone)
Spaying with pyometra
do not use car malts Prevent spillage Don't over sew (don't invert) Can use momentum Lavage abdomen as much as possible
C-section - when
dystocia (small pelvic canal Uterine inertia Fatigue Rupture Puppies are overdue
C-section - how?
Clip, prep & then induce Ventral midline (bigger) lift the uterus, don't pull Pack the abdomen Incise the uterine body, milk out puppies, break placenta Ligate and cute the umbilical vessels Pass to assistant Placenta comes off easily, remove Close in 2 layers with 2-0/3-0 absorbable monofilament, simple continuous, then inverting second layer (cushing's lembert) Clean incision, Discard towels Close OHE--> do this after removing puppies or at a later date
Episiotomy
Difficult Expose urethral papilla, For reducing vagial prolapse Openieng dorsal aspect of the vuvla 2 layers Catheter
vaginal mass or protrution
Vaginal hyperplasia
Vaginal prolapse
Neopalis
Uterine prolapse
vaginal mass or protrution - how to differentiate
Age
Stage
Paplation
Size shape
Vaginal hyperplasia - what is it, how to treat
Floor of the vagina
Edema/hyperplasia - due to estrogen
Lift up floor, can see the urethral papilla
May resolve after heat but can happen the next time
OHE/resection recommended
Vaginal prolapse
Circumferetial Rare, may or may not be edema Manual reduction/purse-string sutures or surgical reduction or amputation to avoid breeding or birthing problems Spay recommended (good prognosis) If not removed - poor prognosis
Peri-vulvar dermatitis
Estra skin that covers the vulva
Episo-plasty -remove the extra skin around the vulva and sew
Mammary neoplasia
Most common tumour of female
Bening/mixed/adenocarcinoma/inflammatory carcinoma
Cats –> usually adenocarcinoma &
Treatment of cats with progesterone increases the risk
Metatstatsis & size doesn’t prognosis
Treat with ovariohysterectomy (spay before the first heat in dogs, cats under a year)
Mammary neoplasia - work up
Pay attention to lymph nodes
non-specific CBC/biochem changes
Mets to lung possible
Look for iliac lymph node if caudal mamary tumours
FNA to tell between benign/malignant tumours
Mammary neoplasia - prognosis
Bigger is badder for dogs
Size, speed of growth, number of nodules
Lymph node involvement, distant mets,
Ulcers
Treatment Mammary neoplasia
surgery, except for inflammatory carcinoma
dogs cure = 50% (still send for histology & re-evaluate
Contraindicated for inflammatory carcinoma, metastasis or other medical issues
Surgeries for mammary neoplasia
Lumpectomy or partial mamectomy (< 5mm at the edge of a gland) - include a 1cm margin and 1 fascial plane deep
2. Local mastectomy - simple (1 gland) or regional (glands that drain together) - 1,2,3 or 3,4,5 -> most
3. Unilateral mastectomy (1-5 on one side)
4. Bi-lateral (4-6 weeks apart)
(Can treat with ovariohystorectomy before removing, prevents uterine disease, and decreases size of mammary glands)
Drainage for Mammary lymph nodes
1-3 sternal lymph nodes
3-5 popliteal lymph nodes
