Lecture 8: Spay & Neuter 1 (Exam 2) Flashcards
What does neuter refer to
- Ovariohysterectomy (OHE)
- Ovariectomy (OVE)
- Orchiectomy
Define ovariohysterectomy (OHE)
Surgical removal of the ovaries & uterus
Define Ovariectomy (OVE)
Surgical removal of the ovaries
Define orchiectomy
Surgical removal of the uterus
Define castration
Surgical removal of either the male or female sex organs (most commonly used interchangeably for orchiectomy)
Define hysterotomy
Surgical incision into the uterus
Define gonadectomy
Excision of the ovary or testis
What are repro sx designed to do
- Alter the animal’s ability to reproduce
- Aid in parturition
- Treat or prevent dx of the repro organs
What are the indication for repro & genital sx
- Primarily to limit reproduction
- Has lots of other indications
- Can use neutering to prevent or alter behavioral abnorms
What are the clinical sx of genital & reproductive tract conditions
- Highly variable & dep on the dx or condition affecting the px
- Clinically norm to sepsis
What is inspected in the mammary glands
- Symmetry
- Texture
- Size
- Mobility
- Discharge
- Presence of masses
Describe abx considerations
- Norm not necessary for a routine OHE/Castration
- Pyometra - abx efficacious against e. coli until C&S
- Prostate - consider need for blood prostate barrier penetration (lipid soluble, nonprotein bound, high pKa)
What is the goals of neutering
To remove the ovaries +/- the uterine horns & body or the testes w/ secure ligature placement
What is the diff in OHE & OVE
- OHE it the traditional method in the US
- OVE is the traditional method in European countries
- No significant diff
- OHE is tech more complicated & time consuming
- OVE is quicker, smaller incision, & less traction on genital tract
T/F: OHE & OVE are both considered appropriate for neutering healthy female dogs
True
Describe early age/ prepubertal gonadectomy
- Safe in dogs & cats over 7 wks of age
- Most commonly done to reduce likelihood of repro in animals adopted from shelters
- decreased anesthetic & material req
- Simplicity of procedure
- Rapid recovery
- Reduced complication rate
What is early age gonadectomy not associated w/
- Increased obesity
- Amount of daily food consumption
- Activity level
- Lower urinary tract dx
- Long bone fractures
- Arthritis
- Immune suppression
- Small urethra
Describe early age/prepubertal gonadectomy in male cats
- Doesn’t decrease urethral diameter
- Doesn’t increase the incidence of lower urinary tract dx & obstruction
- if before 5 1/2 month it can decreases aggression, sexual behavior, urine spraying, & bite wound abscesses from fighting
What are the benefits of doing an early age gonadectomy in cats
- Reduced incidence of asthma
- Reduced incidence of gingivitis
- Reduced incidence of hyperactivity
What are the potential side effects of early age gonadectomy in cats
- Increased shyness
- Increased immaturity of external genitalia
- Physeal closure may be delayed
What % does early age gonadectomy reduce incidences of mammary neoplasia in female dogs
- By 95% if before for the first heat
- By 25% after the 3rd heat
What are some potential side effects of early age gonadectomy in dogs
- Urogenital abnorms
- female dogs are @ greater risk for urinary incontinence
- Delayed physeal closure by 8 to 9 W
- Joint incongruity
What is early age gonadectomy associated w/
Lower morbidity & quicker ax recovery
Describe px prep for feline castration
- Position in dorsal or lateral recumbency
- Pelvic limbs are pulled cranial
- Hair is plucked from the scrotum
- Aseptic prep of the scrotum
What are the techniques used for feline castration
- Feline square know
- Overhand hemostat tech
- Figure of eight hemostat
- Ligature (encircling & transfixation)
- Stainless steel clips
- Multifunctional tissue sealing systems
List the steps of the feline square know
- Make cranial to caudal skin incisions over each testicle
- Incise & separate the parietal tunic from the testicle & then transect the ductus deferens near the testicle
- Tie two or three square knots w/ the ductus deferens & the spermatic vessels
List the steps of the figure eight hemostat tech
- Place a curved hemostat on top of the cord and wrap the spermatic cord over it
- Direct the hemostat’s tip dorsally & then ventrally around the cord opposite of the testicle
- Grasp the cord near the testicle
- Transect the testicle & pull the end of the cord through the wrap
- Digitally snug the knot
List the steps of the overhand hemostat tech
- Transect the cord close to the hemostat
- Hold the hemostat tips parallel to the remaining cord & slide the cord oof of the of the hemostat
- W/ a finger & thumb placed btw/ the throw in the cord & the hemostat slide the throw toward the cat to tighten
What does canine castration inhibit & in return reduces overpopulation
- Male fertility & decreases male aggressiveness
- Roaming
- Undesirable urination behavior
What diseases does canine castration help to prevent
Androgen related dx like prostatic disease, perianal adenomas, & perineal hernias
What are indications for canine castration
- Congenital abnorms
- Testicular or epididymal abnorms
- Scrotal neoplasia
- Trauma or abscesses
- Inguinal scrotal herniorrhaphy
- Scrotal urethrostomy
- Epilepsy control
- Control of endocrine abnorms
- Testicular infection, torsion, or trauma
- Perianal adenomas
- Prostatitis
- Benign prostatic hyperplasia
- Prostatic abscesses
- Sex hormone associated w/ alopecia
What % of testicular tumors occur in intact males
29%
What can occur in dogs w/ uncomplicated BPH
- Prostate size decreased by 50% in 3 W
- Clinical sx resolve in 2 to 3 M
What % of perianal adenomas are resolved
95%
What do castrated K9s have a higher risk for
- Prostatic carcinoma
- Hemangiosarcoma
- Osteosarcoma
- Transition cell carcinoma
What are the diff approaches for canine castrations
- Prescrotal
- Perineal
- Scrotal
- Abdominal
Which canine castration approach is most common & easier
Prescrotal approach
Which canine castration approach is used to avoid repositioning when px is already in perineal position but it can be more difficult to exteriorize the testicles
Perineal approach
Which canine castration approach is sometimes used if the px is prepubertal
Scrotal approach
Which canine castration approach if there is a retained testicle
Abdominal approach
For a right hand surgeon which side is easier to perform a castration on
- The dog’s left side
- Left hand pushes the testicle forward
- Right hand makes the incision
When can a closed castration be used
In any size dog as long as the spermatic cord (stretched & stripped) < 1 cm diameter
Which cords are easier to transfix if they are not clamped
Large cords
When is a scrotal ablation performed concurrently in dogs
- Scrotal dermatitis
- Neoplasia
- Dogs w/ thin pendulous scrotal sacs
- Dogs that live in kennels (on the floor
T/F: The scrotum will regress sufficiently in most dogs
True
When is an open castration performed
The spermatic cord (stretch & stripped) > 1 cm diameter
When is a closed castration done
Can be used in any size dog as long as the spermatic cord (stretched & stripped) < 1 cm diameter
What is a modified open castration
Combo tech where the parietal vaginal tunic is opened, the structures are externalized, ligated, & placed back inside the tunic which is then closed
What is formed by the remnant of the embryonic structure called the gubernaculum
The scrotal ligament (lig of the epididymis)
What type of ligature may be placed proximal to the transfixation ligature for add security
A circumferential (encircling) ligature
Explain the three clamp tech use in the pic
- Cut btw/ clamps 2 & 3
- Transfixation ligature placed proximal to clamp 2 (flash)
- Encircling ligature in the crush of clamp 1
What should be inspected before replacing the cords in the px
Inspect the cords for hemorrhage
In a closed prescrotal canine castration what should be avoided when closing
The urethra
List the steps of a open prescrotal canine castration
- Advance on etesticle into the prescrotal area by applying pressure over the scrotum
- Make an incision over the testicle
- Incise the spermatic fascia & parietal vaginal tunic
- Place a hemostat across the tunic where it attaches to the epididymis & digitally separate the ligament of the tail of the epididymis from the tunic
- Ligate the ductus deferens & vascular cord indiv & then encircle both w/ a proximal circumferential ligature
- Apply a carmalt forcep distal to the ligatures & transect btw/ the clamp & ligatures
Describe an open prescrotal conine castration
- Inspect the cord for hemorrhage & replace the cord w/in the tunic
- Encircle the cremaster muscle & tunic w/ a ligature
- Advance the second testicle into the incision
- Incise the fascial covering & remove the testicle
Describe the steps of an modified open prescrotal castration
- Push the testicle cranially & incise the overlying prescrotal skin & subQ to the level of the parietal tunic
- Break down the scrotal lig
- Identify the junction btw/ the spermatic cord & the surrounding soft tissues
- Lift the testicle upwards while stripping the base of the cord w/ a sponge. The cord will elongate ase it separates from the soft tissues @ the junction noted in the previous slide
- Incised the spermatic fascia & parietal vaginal tunic creating a window into the spermatic cord
- Extract the ductus deferens & vascular cord through the window
- Ligate the ductus deferens & vascular cord indiv & then encircle both w/ a proximal circumferential ligature
- Apply a carmalt forceps distal to the ligatures & transect btw/ the clamp & ligatures
- Place the ligated ends of the ductus deferens & vascular cord back through the window in the parietal tunic
- Place an encircling ligature around the spermatic cord, distal to the ligated structures inside
- Transect the cord distal to the encircling ligature, removing the testicle & overlying tunic
