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Reproduction > Small Animal - Surgery > Flashcards

Small Animal - Surgery Flashcards

1
Q

What is the aim of an ovariohysterectomy?

A

Safely remove ovaries and uterus

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2
Q

What is an ovariohysterectomy usually performed via?

A

Ventral midline incision

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3
Q

What is more common approach to an ovariohysterectomy in cats?

A

Flank incision

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4
Q

What are the indications for an ovariohysterectomy?

A 
Elective sterilisation
Pyometra
Ovarian cysts
Hydrometra/mucometra
Uterine torsion/uterine proplapse
Uterine rupture
Ovarian/uterine neoplasia
Metritis
Improved control of diabetes mellitus
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5
Q

What is the NRCW classification of an ovariohysterectomy?

A

Clean/contaminated

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6
Q

How do you locate the uterus in an ovariohysterectomy?

A

Push intestines cranially and bladder caudally

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7
Q

How are the ovaries located in an ovariohysterectomy?

A

Follow uterine horns

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8
Q

How can the ovaries be released in an ovariohysterectomy?

A

Breaking down the suspensory ligament - cutting more controlled than tearing, do close to the kidney

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9
Q

What should be done after breaking down the suspensory ligament?

A

Create a window in the mesovarium

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10
Q

What method of haemostasis should be used in an ovariohysterectomy?

A

Three forcep technique

Remove most proximal forcep to leave crush mark

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11
Q

What material should be used as a ligature in an ovariohysterectomy?

A

Synthetic absorbable material - vicryl ideal, one/two/instrument tie, encircling ligature/figure of eight

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12
Q

What must the ovarian ligature be in an ovariohysterectomy?

A

Tight

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13
Q

Where do you make the final cut to remove the ovary in an ovariohysterectomy?

A

Between two remaining clamps

Make sure whole ovary removed

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14
Q

What material should be used to ligate the broad ligament?

A

Synthetic absorbable material in nearly all cases - vicryl ideal

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15
Q

When shouldn’t you use synthetic absorbale material to ligate the broad ligament?

A

Very immature or small dogs and cats

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16
Q

What material should be used for the cervical ligature?

A

Synthetic absorbable material - vicryl ideal

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17
Q

What technique should be used for the cervical ligature?

A

Three forcep technique

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18
Q

What animals do you need to take care in when ligating the cervix?

A

Cats in season - tissue becomes very friable and can just break down when clamped, test further up to ensure that the forcep technique is good to use

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19
Q

How do you check the right ovarian pedicle and the right broad ligament pedicle?

A

Elevate descending duodenum

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20
Q

How do you check the left ovarian pedicle and the left broad ligament pedicle?

A

Elevate descending colon

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21
Q

How do you check the cervical pedicle?

A

Elevate bladder and reflect caudally

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22
Q

What are the major steps in performing an ovariohysterectomy?

A 
Ventral midline incision
Locate uterus
Locate ovaries
Release ovaries
Clamp pedicles
Ligate ovarian artery
Ligate broad ligament
Ligate cervix
Remove
Check pedicles
23
Q

What are some complications that can occur during an ovariohysterectomy?

A

General complications - wound breakdown, wound infection, haemorrhage, retained swab
Specific complications - ureteral injury, retained ovarian remnant
Other sequelae - urinary incontinence, weight gain, anaesthetic complications

24
Q

What are the three surgical variations to a ventral midline ovariohysterectomy?

A

Flank spay
Ovariectomy
Laparoscopic techniques

25
Q

What should the decision to perform a caesarean section be based on?

A

Interests of - dam, unborn foetuses and owner

26
Q

What are the indications for caesarean sections?

A

Foetal distress
Dystocia - primary uterine inertia, incomplete primary uterine inertia, secondary uterine inertia, relative/absolute foetal oversize, anatomical abnormality of pelvic canal, foetal monstrosity, uncorrectable foetal malpresentation, foetal death, previous caesarean section

27
Q

What are the preoperative considerations for a caesarean section?

A

Electrolyte and other metabolic abnormalities
Foetal death increases significantly after 5 hours of labour onset
Advise owners about surgical risk to dam and neonates
Variable NRCW classification

28
Q

What anaesthesia considerations are there for caesarean sections?

A 
Regurgitation
Aspiration
CV compromise
Respiratory compromise
Depression of neonates
Good analgesia for dam - local block, epidural post procedure, avoid alpha 2 agonists, ketamine and thiobarbiturates
Minimise time taken to remove foetuses
29
Q

What is the main approach for a caesarean section?

A

Midline approach

30
Q

What are the main steps in a caesarean section?

A 
Midline incision
Exteriorise uterus
Cut into uterus
Gently squeeze to move foetus down uterine horn
Clamp umbilical cord
Only remove placentas if come freely
Repair uterus
Close wound
31
Q

What material and pattern should be used for uterine repair?

A

Synthetic absorbable material - monocryl ideal

Simple appositional/inverting pattern - single or double layer

32
Q

Describe care of neonates after a caesarean section

A

Ensure plenty of help available
Facilities to - dry and warm pups/kits, suction airways
Consider drug administration to aid resuscitation
Check for congenital abnormalities
Ensure dam recovers
Ensure dam looks after young

33
Q

What are the potential complications with a caesarean section?

A

General surgical complications
Not all foetuses removed
Possible post-parturient problems - uterine haemorrhage, retained placenta/foetuses, acute metritis, subinvolution of placental sites, uterine rupture, uterine prolapse, toxic milk syndrome, agalactia, galactostasis, acute mastitis, puerperal tetany, disturbed maternal behaviour

34
Q

What is a safe and effective alternative to a caesarean section?

A

En bloc ovariohysterectomy

35
Q

What is the major disadvantage to an en bloc ovariohysterectomy?

A

All neonates need resuscitating at once

36
Q

What are the advantages to an en bloc ovariohysterectomy?

A

Minimised anaesthesia time for dam
Minimal peritoneal contamination
Effective population control
No need for second surgery

37
Q

What is an en bloc ovariohysterectomy?

A

Hysterectomy performed prior to hysterotomy and removal of neonates

38
Q

What is the aim of castration?

A

Safely remove testes

39
Q

What is castration usually performed via?

A

Single pre-scrotal incision in the dog

Paired scrotal incisions in the cat

40
Q

What are the indications for castration?

A 
Population control
Behavioural modification
Testicular neoplasia
Cryptorchidism
Testicular torsion
Orchitis/epididymitis
Testicular trauma
Anal adenoma
Perineal rupture
Prostatic disease
Repair inguinal/scrotal hernia
41
Q

What is the NRCW classification of castration in the dog?

A

Clean

42
Q

What are the two techniques for castration in the dog?

A

Open

Closed

43
Q

What material is used for ligation in castration of the dog?

A

Synthetic absorbable material - vicryl ideal

44
Q

What are the main stages of the open castration technique in the dog?

A 
Incision
Cut into vaginal tunic
Remove testes
Digitally separate the ligament
3 forceps applied
Ligature applied
Remove testicle
Close incision
45
Q

What is the difference between open castration and closed castration?

A

Open - vaginal tunic cut, not repaired

Closed - vaginal tunic left intact

46
Q

What are the benefits of open and closed castration?

A

Open - reduce post operative swelling, reduce risk of ligature slipping
Closed - reduces risk of intestinal herniation

47
Q

Describe castration in the cat

A 
Clean rather than aseptic procedure
Open castration
Two scrotal incisions
Ligatures rarely used
Vas deferens and spermatic vessels knotted together
Overhand knot in spermatic cord
48
Q

What is scrotal ablation?

A

Removal of scrotum as well as testes

49
Q

When is scrotal ablation indicated?

A 
Scrotal disease
Improved cosmesis
Reduced complications in mature dogs
Scrotal/perineal urethrostomy procedure
Scrotum used as a skin donor site
50
Q

What must be determined with cryptorchid castration?

A

Where testicle is

51
Q

What are the two approaches to a cryptorchid castration?

A

Inguinal

Caudal midline laparotomy

52
Q

What is cryptorchid castration usually combined with?

A

Scrotal testicle removal

53
Q

What are the complications with castrations?

A

General surgical complications - wound breakdown, wound infection, haemorrhage
Specific complications - scrotal swelling, urethral injury, failure to locate retained testicle
Other sequelae - weight gain, urinary incontinence, anaesthetic complications

Reproduction (14 decks)

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