Ovariectomy/ovariohysterectomy and castration – including complications

Question 1

List 3 reasons we neuter small animals

Answer 1

Prevent breeding (population control)
Control behaviour / behavioural problems- this is variable
Prevent disease (e.g., neoplasia, pyometra, etc.)

Question 2

List 6 possible disadvantages of neutering females

Answer 2

Sometimes increased risk of:

Urinary incontinence
Hair coat changes
Obesity
Neoplasia
Immune-mediated disease
Joint disease

Question 3

List 6 potential advantages of neutering male dog

Answer 3

Reduce roaming
Reduce aggression
Prevent Benign prostatic hyperplasia
Prevent perianal adenoma
No testicular neoplasia
↓ histiocytic TVT

Question 4

List 7 potential disadvantages of neutering a male dog

Answer 4

Prostatic carcinoma- incidence is very low
Increase aggression
Urinary incontinence
Hair coat
Obesity
Neoplasia
Joint disease

Question 5

where does the blood supply to ovary sit

Answer 5

caudal pole of the kidney on each side

Question 6

can pyometras occur after ovariectomy

Answer 6

no unless the patient receives any exogenous progesterone

Question 7

List 2 indications for flank approach to spay

Answer 7

Enlarged mammary gland due to lactation
Mammary gland hyperplasia

Question 8

List 2 advantages of flank approach to spay

Answer 8

Evisceration is less likely if the body wall incision breaks down
Ability to observe incision from a distance

Question 9

List 3 disadvantages of flank approach to spay

Answer 9

Limited exposure to the patient’s contralateral side if complications arise
Difficulty identifying a previous OHE if the animal is not properly marked
Possible imperfections in hair colour or regrowth on the flank

Question 10

what is the surgical complication rate related to

Answer 10

body weight
surgical time

Question 11

what can happen if linea alba wound dehiscence after spay

Answer 11

hernia

Question 12

what should you do to prevent ovarian remnant syndrome

Answer 12

Always open ovarian bursa after surgery to check whole ovary has been removed

Question 13

List the signs of uterine stump granuloma

Answer 13

signs consistent with infection
vaginal discharge
attractive to male dogs

Question 14

what is uterine stump granuloma associated with

Answer 14

cat gut suture material

Question 15

describe how to treat uterine stump granuloma

Answer 15

surgical intervention
and course of broad spec ABs

Question 16

List 3 complications of surgical castration

Answer 16

wound complications
haemorrhage
scrotal haematoma

Question 17

Physiologically what happens after neutering

Answer 17

Sudden drop in levels of testosterone/oestrogen
Low testosterone or oestrogen stimulates GnRH from hypothalamus
Triggers the release of luteinizing hormone (LH) from pituitary
LH levels remain high as there is no negative feedback from testosterone/oestrogen production

Question 18

Where do we ligate in a spay

Answer 18

Ovarian pedicle - veins and arteries
Uterine body, veins and arteries

Question 19

What structure do we break in order to exteriorise the ovary in a bitch

Answer 19

suspensory ligament

Question 20

What type of ligature do we place on the cervix and why

Answer 20

Transfixing ligature
Cervix is wider than the uterus and vagina - a normal encircling ligature tends to slip

Question 21

List 7 complications from a spay

Answer 21

Wound complications
Haemorrhage
Residual ovarian tissue
Stump or pedicle granulomas
Stump pyometra
Swab retention
Ureteral entrapment

Question 22

What 3 wound complications can occur after a spay

Answer 22

Suture reaction
Wound infection
Wound dehiscence => hernia or evisceration if both skin and linea alba break down

Question 23

What to do if you get bleeding during a spay

Answer 23

Increase exposure
Use suction
Convert flank to
Use mesenteric dam manoeuvres to look at ovarian pedicles
Retract bladder caudally to look at cervical stump

Question 24

Common causes of a sinus tract/discharging sinus

Answer 24

Foreign material left in
=> Permanent, braided suture material e.g. nylon
=> Leaving swabs in

Question 25

Signs of a ureteral entrapment

Answer 25

Crush injury vs ligation vs transection
Azotaemia
Uroabdomen (if transection)

Question 26

Where do we incise for a castration

Answer 26

Pre-scrotal region

Question 27

open vs closed castration

Answer 27

Open = incision through vaginal tunic
Closed = not entering vaginal tunic

Question 28

What is the negative of a closed castrate

Answer 28

Much more structures included in the ligature => need a much more secure ligature e.g. modified millers

Question 29

Positives of a closed castrate

Answer 29

Haven’t entered peritoneal cavity - less chance of a peritonitis