Neutering Flashcards
When should we spay bitches?
Perform during anoestrus - avoid seasons
Typically at 6 months (before first season) or 3 months after end of first season/any season after that
Most benefit in terms of prevention of mammary cancer if performed before or after first season
3 months after end of season is to avoid false pregnancy
When should we castrate dogs?
Frequently at 6-9 months, common to consider waiting longer especially with larger breeds (commonly >1yr) unless behavioural issues associated with male behaviours
When should we spay cats?
Usually at 4-6 months, before coming into season
Can spay at any time after that, even if in season but uterus is more friable if in season at time of operation
When should we castrate cats?
Usually done from 4-6 months, provided testicles are big enough
What are some reasons for spaying?
Population control
Prevention/treatment of health conditions, e.g. pyometra, mammary cancer, false pregnancy
Control hereditary diseases
What are some reasons for castration?
Population control
Management/behavioural modification, e.g. roaming, male aggression, unwanted sexual behaviour, spraying/smell in tom cats
Prevention/treatment of disease e.g. testicular disease, perineal rupture, perianal adenoma, prostatic diseases
Infectious disease control e.g. FIV/TVT
What are some possible side effects of spaying?
Weight gain Coat change Urinary incontinence Perivulvar dermatitis Hypoplasia of external genitalia Increased risks of orthopaedic diseases and some cancers - unclear evidence
What are some possible side effects of castration?
Weight gain, increased appetite and decreased activity
Coat change
Behavioural - nervous dogs may get worse after castration
Some evidence of increased risk of development of bladder and prostate cancer (rare)
Delayed closure of growth plates with early neutering, especially giant breeds
What techniques can we use to spay?
Surgical - ovariohysterectomy (removal of both ovaries and uterus) or ovariectomy (removal of both ovaries) Medical possible (use of the drug Delvosteron) - temporary but not common
What surgical approaches can we use to spay?
Via a midline laparotomy
Laparoscopically - increasingly common, ovariectomy performed, more expensive, uses smaller incisions (faster return to normal activity, reduce post-op discomfort)
How do we position for bitch spay?
Midline approach (for both traditional or lap spay) Dog in dorsal recumbency, surgeon usually has dog's head to their left
How do we clip and prep for a bitch spay?
Clip includes umbilicus and reaches pubis, usually approx. 2/3rds width of animal
Wide clip important as drapes move and incision may need to be extended
Routine aseptic skin prep
What instruments do we need for a bitch spay?
Standard soft tissue kit
Must include at least 3 large artery forceps (either curved or straight)
Some vets might like a spay hook
How do we position for a cat spay?
Flank approach most common in UK, midline used if pregnant or not known if already neutered
Cat lies in right lateral recumbency, surgeon has cat’s head to their left
Hindlegs often tied back
How do we clip and prep for a cat spay?
Incision site is found by making a triangle between wing of the ilium and the greater trochanter
Wide area surrounding this should be prepped in case incision needs extending
Routine aseptic skin prep
What instruments do we need for a cat spay?
Standard soft tissue kit
Must include at least 3 small artery forceps (either curved or straight)
Spay hook use can be more common in cats
What possible complications can we see after a spay?
Haemorrhage Ovarian remnant syndrome Stump granuloma/pyometra Urinary tract injury Abdominal hernia Wound infection
What should we be monitoring for post-spay?
Standard GA monitoring and post-GA care
Signs of internal haemorrhage - dropping BP, pale MMs, lethargy
Problems with wound - oozing, swelling, discomfort
Ensure no patient interference with wound
What post-op care plan should we have for spay patients?
Pain relief - opioids and NSAIDs injections, oral NSAIDs taken home
Use of buster collar/bodysuit
Rest for ~10 days
Bland diet immediately post-GA, then back to normal food but need to reduce calorie intake in the long term (consider transition to neutered food)
Post-op checks - 2-3days and 10 days post-op
What techniques can we use for castration?
Surgical - orchidectomy (removal of testicles), or rarely vasectomy
Medical - chemical castration (Suprelorin implant) in dogs, temporary
Describe open vs closed castration.
Open = vaginal tunic incised
Closed = vaginal tunic left intact
Both can be used, but surgeons may choose one over the other
How do we position for a dog castration?
Pre-scrotal midline approach
Dog in dorsal recumbency, surgeon may stand on either side depending on preference
Check both testicles present
How do we clip and prep for a dog castration?
Clip area between tip of penis and scrotum and several cm on either side
Avoid clipping too close on the scrotum itself - skin very sensitive, beware clipper rash!
Routine aseptic skin prep
Local anaesthetic sometimes used - injected in testicles/incision area during prep
What instruments do we need for a dog castration?
Standard soft tissue kit - at least 3 haemostats
How do we position for a cat castration?
Scrotal approach - 2 incisions, one on each testicle
Cat lies in lateral recumbency
Check both testicles present
How do we clip and prep for a cat castration?
Clip just the scrotum and surrounding area, plucking also possible but can cause more bruising
Routine aseptic skin prep, but usually no drapes used
Local anaesthetic sometimes used - injected into testicles during prep
What instruments do we need for a cat castration?
Surgeon dependent
Common to only use a scalpel blade and no kit
Some surgeons prefer to use a pair of haemostats
Do we use suture material for a cat castration?
Usually, no - the cords are often tied on themselves rather than using ligatures, and incisions are left to heal on their own
Describe cryptorchid castration.
If testicles not descended by 6 months, surgical removal of both testicles is advised due to increased risk of neoplasia
Retained testicle can be anywhere along normal path of descent - pre-scrotal/inguinal/abdominal
Unilateral (more common) or bilateral
If testicle is abdominal then an exploratory laparotomy is required (or can be done laparoscopically)
What are some possible complications due to castration surgery?
Scrotal bruising/swelling
Haemorrhage - scrotal haematoma/haemoabdomen
Infection
Self-trauma
What should we be monitoring for after a castration?
Standard GA monitoring and post-GA care
Signs of haemorrhage - internal (dropping BP, pale MMs, lethargy) or external (swelling/bruising of scrotum)
Problems with wound - oozing, swelling, discomfort
Ensure no patient interference with wound
What should we include in a post-op care plan for castration patients?
Pain relief - opioid and NSAID injections, dogs sent home with oral NSAIDs
Use of buster collar (bodysuit less reliable), cats usually do not need a collar
Rest - dogs ~10 days, cats usually ~2 days
Feeding - bland diet immediately post-GA, then back to normal food but warn owners about need to reduce calorie intake long term (consider transition to neutered food)
Post-op checks - dogs usually 2-3 days and 10 days post-op, cats variable but usually one check at 2-3 days post-op
