Neutering Flashcards
The testicle is the male _______ gland that produces _____.
reproductive, sperm
What are the terms used to describe the surgical removal of both testicles [regardless of location.
– Neuter
– Castration
– Orchiectomy
– Orchidectomy
Why Neuter?
- Sterilization
- Population control
- Permanent birth control - Elimination of male characteristics
◦ Removes primary source of
testosterone
- Prostate gland; under testosterone, prostate gland enlarges over time, some dogs may never have a problem, others are affected in terms of comfort level, issues defecating. Prostate of an intact male mostly in dog predisposes them to infection, any type of infection in the prostate is impossible to clear up.
◦ Roaming behaviors (go off to try and find female)
◦ Aggression [cats vs. dogs]
◦ Odor or urine [cats]
- Tend to live longer, fewer behavioral problems, less likely to be relinquished back to a shelter. - Disease control/treatment
Two situations in which you Neuter:
- Routine/Elective
◦ Usually young, happy, healthy
patients
◦ No clinical signs - Medical Treatment
* Patients with some sort of disease
process
* Typically involving testicles and/or
epididymis
* Clinical signs relate to underlying disease process and treatment of choice tends to be neutering
When do you Neuter your pet?
- Happy Healthy Pets!
◦ Canine
◦ 6 months – 2 years* - Feline
◦ 6 months - 1 year in a cat
Usually at 6 months for cats because likelihood of people bringing their cats back is slim.
Dogs: depends on breed, lifestyle. Shelter med always does as soon as possible b/c we don’t want them to end up back in shelters or contributing to increase in population. Bigger dogs/large breed dogs should be neutered later in life due to bone development. For females, if you wait longer they are going to go through a heat cycle.
GS, GR = 12 to 18 month mark
Cryptorchidism
◦ ____ or ___ testicles do not descend from the _____
◦ Retained testicles can be either:
◦ _____
◦ _____
*Need to be neutered _____; there is a _____ component. The one that is retained has a greater risk of testicular ____ (_____ cell tumor that secrete ____ –> ______ gland development, more ______ behaviors in a male dog)
–> Physical examination
◦ You may be able to palpate testicle in the ______ ____.
◦ Some may present as an abdominal ____
◦ If secondary to Sertoli cell tumor, you can find ______ and ______ mammary glands
◦ ______ may be helpful to make surgery plan.
One, both, abdomen, Inguinal, Abdominal, ASAP, genetic, cancer, sertoli, estrogen, mammary, feminine, inguinal, canal, mass, alopecia, enlarged, Ultrasound
When to Neuter?
◦ Testicular ______/_____
◦ Usually there are __ clinical signs unless associated to certain _____
◦ _____ development
◦ __________
◦ Becomes ______ in size; you see _______ changes
Hypoplasia, Atrophy, no, neoplasia, Poor, Degeneration, smaller, microscopic
Cryptorchid
When to Neuter?
◦ Scrotal or Testicular ____
◦ May show scrotal _____ or _______, testicular _____
or _____, _____, and/or pain
Trauma, swelling, discoloration, swelling, discoloration, hemorrhage
When to Neuter?
◦ Testicular _______
◦ Spermatic chord ______ on itself which leads to _______ tissue
◦ Acute scrotal/testicular _____
◦ _____
Torsion, rotates, ischemic, swelling, Painful
When to Neuter?
1. Prostatic Diseases (3)
2. What is the driving source of these prostatic diseases?
–> Clinical Signs
◦ ______
◦ Straining to ______ [______]
◦ _____ pain
◦ ______ to urinate
◦ _____/______ of urine
- ◦ Prostatitis
◦ Prostatic cyst and abscess
◦ Prostatic hypertrophy (one of the most common ones in intact male dogs).
◦ Prostatic cancers; can happen secondary to transitional cell carcinomas in the bladder. Priary may be in bladdder and prostatc cancer secondary to that - rare, but possible. - Testosterone
Constipation, defecate, tenesmus, Abdominal, Straining, Hematuria, discoloration
When to Neuter?
1. Neoplasia. List the examples.
–> Variety of clinical signs
◦ Enlargement of __ or ____ testicles
◦ Enlargement of ______
◦ ____
◦ ____ loss
◦ Mammary gland _______ depending on what is going on.
◦ Testicular Neoplasia
◦ Scrotal Neoplasia
◦ Perianal Gland Adenoma is very common. Neuter the dog, fix the problem.
1, both, scrotum, Pain, Hair, enlargement
Testicular neoplasia
When to Neuter?
1. Orchitis
◦ _______/______ of testicle
2. Epididymitis
◦ Inflammation/infection of _______
–> Clinical signs:
◦ Testicular/scrotal ____ and _____
(4)
Inflammation, infection, epididymis, pain, swelling, ◦ Depression
◦ Lethargy
◦ Fever
◦ Anorexia
When to Neuter?
1. Perineal Hernia
◦ Secondary to ______ weakness and failure
of the ______ ______;
Usually occurs in intact males, so if you neuter at a reasonable age chances of this is less likely; actual correlation is unknown, only a handful of cases in neutered male dogs.
◦ ______ or _____
–> Clinical signs:
◦ Swelling _____ to the rectum
◦ ______
◦ Straining to _______
◦ Straining during _____
In both cats and dogs
progressive, pelvic diaphragm, Unilateral, bilateral, adjacent, Constipation, defecate, urination
Label accordingly
What are the Canine Neuter Approach Options?
What do you do in the case of a cryptorchid patient?
- Prescrotal
◦ Routine/elective neuter - Scrotal
◦ Routine/elective neuter
◦ Faster than Prescrotal - Scrotal Ablation
◦ Removal of scrotum
Scrotal/testicular neoplasia or trauma
◦ Secondary to non-resolving scrotal hematoma
(pendulous scrotum)
–> Cryptorchid Patients
◦ Inguinal vs. abdominal approach
Differences between prescrotal and scortal?
Prescrotal
- heal in ___-___ days
- _________ acceptable way to neuter
- encapsulating ______, _____ runs through it so if it is in closure –> _______. High possibility.
Benefits to scrotal?
- studies coming out and is now more popular
- _______ approach than prescrotal
- if in a high volume shelter, _____ is everything; older dog, ____ is everything
Cons to scrotal?
More ________ from incision site than with prescrotal. (Post-op drainage).
If there is a _______, don’t want to take infected tissue into surgery site.
Prescrotal
- heal in 10-14 days
- original acceptable way to neuter
- encapsulating prepuce, urethra runs through it so if it is in closure –> complications. High possibility.
Benefits to scrotal?
- studies coming out and is now more popular
- faster approach than prescrotal
- if in a high volume shelter, time is everything; older dog, time is everything
Cons to scrotal?
More discharge from incision site than with prescrotal. (Post-op drainage).
If there is a pyoderma, do ont want to take infected tissue into surgery site.
Surgical Preparation
◦ _____ technique
◦ ____ hair carefully
◦ Avoid razor ____
◦ _______ + _____ skin prep
◦ ______ testicular block (___ mg/kg dose, split between both testicles). Once you feel _______, stop administering.
Aseptic, Clip, burn, Chlorhexidine, alcohol, Lidocaine, 2, firmness
There are two Neuter Techniques: Closed and Open.
1. Closed
◦ Is the Parietal vaginal tunic incised?
◦ ___ time?
◦ Less post-op _____/ ____
◦ ___ or __ ligature to tie
2. Open
◦ Is the Parietal vaginal tunic incised?
◦ ____ visualization of individual
components of testicle
◦ Communication with _____
cavity
◦ More risk of abdominal _______? Not established.
◦ ___ to ___ ligature to tie
Ligating individually? in which option?
It is not incised
Less, swelling, oozing, 1, 2
It is incised
Direct, abdominal, infection, 2, 4
Draped patient
3 Clamp Technique
Continued…
◦ 1 st Ligature (A)
◦ Placed on “crushed” tissue once proximal hemostat is removed
◦ Circumferential
◦ Miller’s knot
◦ Modified miller’s knot **
◦ Surgeons knot
◦ Square knot
What can be seen in the image below
2nd Ligature (B)
◦ Placed between 1st ligature and middle
hemostat
◦ Loosen the forceps while first 2 throws of ligature
are being secured (aka “flash) and then re-clamp
◦ Circumferential
◦ Miller’s knot
◦ Modified miller’s knot
◦ Square knot
◦ Transfixing - Only applied on most distal ligature
◦ 2 knots
◦ Transect testicular pedicle between 2
clamps
2nd Ligature (B)
◦ Placed between 1st ligature and middle
hemostat
◦ Loosen the forceps while first 2 throws of ligature
are being secured (aka “flash) and then re-clamp
◦ Circumferential
◦ Miller’s knot
◦ Modified miller’s knot
◦ Square knot
◦ Transfixing
◦ Only applied on most distal ligature
◦ 2 knots
◦ Transect testicular pedicle between 2
clamps
DO NOT CUT TESTICLE BEFORE PLACING LIGATURE.
Which approach was used for this neuter procedure?
Scrotal
Which approach was used for this neuter procedure?
Scrotal
Stripping fascia down is not shown here.
After the initial incision, the steps are exactly the same for pre scrotal and scrotal.
What approach is being used for this neuter procedure?
Scrotal
What technique is being used in the cat neuter procedure pictured?
Auto-ligation (cord tie)
What technique is being used in the cat neuter procedure pictured?
Figure 8 Tie
What is pictured below?
Use shredded paper or Yesterday’s News
instead of regular littler for post-op recovery from cat neuter.
Scrotal hematoma
Dehiscence
Infection
Hemorrhage
Skipped
