Small animals 3 Flashcards
1
Q
What are some indications for flank spay?
A
Enlarged mammary gland due to lactation
Mammary gland hyperplasia
2
Q
What are some contraindications of a flank spay?
A
Pregnancy Pyometra Oestrus Obesity Patient age younger than 12 weeks
3
Q
What are some advantages of flank spay?
A
Evisceration is less likely if the body wall incision breaks down
Ability to observe incision from a distance
4
Q
What are some disadvantages of flank spay?
A
- 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
5
Q
How can you check whole ovary is removed?
A
Open ovarian bursa after surgery
6
Q
What is the most common complication of OVH?
A
Haemorrhage
7
Q
What should you do in a case of haemorrhage during OVH?
A
- Increase exposure
- Use suction
- Convert flank to midline approach
- Stay calm, try not to panic
- Ask for assistance
- Use mesenteric dam manoeuvres (colonic and duodenal) to look at ovarian pedicles
- Retract bladder caudally to look at cervical stump
8
Q
What are some complications of OVH?
A
Haemorrhage Fistulous tract/ discharging sinus Residual ovarian tissue Uterine stump granuolma Urinary tract issues
9
Q
What is a fistulous tract/discharging sinus?
A
Soft, painful swelling with or without
discharging beneath the skin of:
10
Q
Where can fistulous tract/discharging sinus occur?
A
Flank (ovarian pedicle ligature)
Inguinal region, medial thigh, pre-crural region (cervical ligature)
11
Q
Why do you get fistulous tract/ discharging sinus?
A
Suture material: Permanent, braided (nylon), Catgut
Swabs (gossypibomna, textiloma)
12
Q
How can you diagnose residual ovarian tissue?
A
CT scan (usefulness of u/s dependent on user)
May be easier to find residual tissue when in oestrus
May see enlarged ovarian vessels on affected side
Submit tissue for histopathology
13
Q
What are some of the signs of uterine stump granuloma?
A
pyrexia, lethargic Signs consistent with infection Vaginal discharge- often bloody attractive to males Neutrophillia with left shift
14
Q
How can you diagnose uterine stump granuloma?
A
C/S Neutrophilia with left shift Vaginal swab (?) Abdominal u/s Vaginoscopy
15
Q
How can you treat a uterine stump granuloma?
A
To resolve condition further surgical intervention will be required
Also, in most cases, a course of broad spectrum ABx
16
Q
What are the causes of urinary tract issues post spay?
A
Adhesions associated with uterine stump
Accidental ligation of a ureter (maybe more likely if bladder distended (?))
Accidental ligation of bladder neck
17
Q
What are some disturbances animals with a pyometra may suffer?
A
Fluid deficits (PU/PD, V++) Pre-renal failure SIRS Acid base disturbances (can be acidotic as result of +++ hypovolaemia or alkaltic due to v++ and Cl loss) Anaemia Diabetes
18
Q
What does an increased PCV and TP indicate?
A
Fluid deficit
19
Q
What does an increase PCV but normal or decrease plasma protein indicate?
A
Splenic contraction (pcythaemia, hypoproteinaemia)
20
Q
What does a decreased PCV and decrease plasma protein indicate?
A
Blood loss,
Anaemia and hypoproteinaemia
Overhydration
21
Q
How can you work out drops/min?
A
Drops/min = (ml/kg/hr) X (kg bodyweight) X (infusion set drops/ml)/60
22
Q
What can be done in intra op low ABP occurs?
A
Can supplement plane of anaesthesia with iv opioids (short acting), fentanyl SPC for dogs granted 5.3.12
Give colloids (i.e. starch)
Try a bolus, and see if it improves
If no colloid, can increase crystalloid rate
23
Q
What should you do if CO2 goes up intra op?
A
Tilt slightly head up, weight taken off diaphragm
Switch down inhalant (resp depression)
24
Q
What is the most common reason for incomplete ovariectomy?
A
Entire right ovary remains
25
What are some conditions that result in male attractiveness?
```
ovarian remnant syndrome
Atrophic vaginitis
Urinary incontience
Anal gland disease
(sometimes skin disease)
```
26
What are some conditions resulting in clinical signs of oestrus?
Oestrogen secreting adrenal tumour
| Ovarian remnant syndrome
27
What are the forms of uterine stump disease?
Most commonly granuloma
| Rarely pyometra
28
How does a granuloma present post spay?
Usually presents within a few weeks post surgery as haemorrhagic/purrulent vulval discarge
29
How can you diagnose granuloma post spay?
Palpation
Radiography
Ultrasonography
30
How can you treat uterine granuloma?
Laparotomy and resection
31
What are the different ways to treat persistent hymenal bands?
Depends on thickness:
- may be broken with finger pressure
- may require lassoing and ligation
- may require episiotomy
- may not be amenable to surgery
32
When is surgery of persistent hymenal bands performed?
Oestrus
33
How can you treat prolapse of hyperplastic vagina?
Conservative management and spay during anoestrus usually all that is required
If animal wanted for breeding mass can be removed during oestrus
34
What is vulval hypoplasia associated with?
Skin fold dermatitis (peri-vulval deramtitis)
| May be associated with pre-pubertal neuter
35
What is the surgical procedure to treat vulva hypoplasia?
Episioplasty - horse-shoe incision
36
What percentage of mammary tumours are malignant in the dog and cat?
50% dog
| 85% cat
37
What should you initially do when presented with a mammary tumour
1. Biopsy (or incise if small)
2. Stage tumour using 2 lateral radiographs and FNAs of local LNs
3. Submit resected tissue for histopathology
38
What are the surgical options for mammary neoplasia?
Lumpectomy
Single mastectomy
Regional mastectomy
Complete mastectomy
39
Which 5 factors determine which surgical method is used for mammary neoplasia?
1. Size and number of tumours
2. Location of tumour
3. Reported rate of growth
4. Condition of the animal
5. Dog or cat?
40
How should mammary masses less than 1cm in diameter and firm on palaption be treated?
Lumpectomy
41
How should masses greater than 1cm and attached to skin or deeper tissue be treated?
Mastectomy
42
How should multiple masses of the mammary gland be treated?
Regional masectomy
43
If masses of mammary gland drain to different LNs what surgical option should be used?
Complete mammary strip (radical mastectomy)
44
What is the anatomy of the lymphatics in the mammary gland?
Axillary and inguinal lymph nodes
Lymphatic drainage runs cranial from 1 and 2 (and 3)
Lymphatic drainage runs caudal from (3) and 4 and 5
45
If the second mammary gland is affected by neoplasia what glands need to be removed also?
First gland
46
If the third mammary gland is affected by neoplasia what other mammary glands need to be removed also?
Consider removal of all glands
47
If the fourth mammary gland is affected by neoplasia what other mammary glands need to be removed also?
Remove with 5
48
When treating mammary tumours in cats what surgical option should you undertake?
Radical (Complete mammary strip)
49
Which mammary gland is the most difficult to remove and why?
5
Extends all the way to vulva in bitch
Has an extra arterial branch caudally from the external pudendal a.
Inguinal LN usually comes with it
50
What is the overal prognosis of mammary neoplasia surgery?
Overally death rate about 10%
51
What are common conditions of the mammary gland?
```
Galactostasis
Agalactia
Mastitis
Mammary Tumours
Pseudopregnancy
Fibro-epithelial hyperplasia in queens
```
52
What is galactostasis?
Congestion of the mammary gland
53
When is galactostasis seen?
Close to parturition/after weaning/ rarely in pseudopregnancy
54
What are the clinical signs of galactostasis ?
Engorgement and pain of the gland
55
How can you treat galactostasis?
Reduce food intake
Cold packs
Encouraging of sucking or milking
56
What are the two causes of agalactia?
Failure of milk production
Failure of milk let down
(Metritis, systemic infection and
mastitis can lead to agalactia and
requires treatment of the underlying
cause)
57
Why do you get failure of milk production?
Inadequate mammary development
| Early caesarean
58
How can you treat failure of milk produciton?
Metoclopramide
59
What is the main cause of failure of milk let down in the bitch?
Nervousness- adrenline blocks oxytocin release
60
How can you treat failure of milk let down?
Oxytocin
61
What species are commonly isolated in mastitis cases?
E.coli, Streps and Staphs
62
When may mastitis be seen in SA?
May be seen with prolonged galastostasis after weaning, following teat trauma and in poor sanitary conditions
63
What are the clinical signs of mastitis in SA?
Swelling, heat, pain
| In severe cases may get absceessation
64
What is the treatment of mastitis in SA?
Broad spec antibiotics
| Bathing/stripping of the gland or allowing neonates to suck (unless frankly purulent)
65
What causes pseudopregnancy?
Elevated prolactin as a result of decline in progesterone
Spaying in luteal phase
66
What are signs of pseudopregnancy?
mammary enlargement
some milk production
some behavioural changes
67
How can pseudopregnancy be described?
Overt
| Covert
68
What is the treatment of pseudopregnancy?
Most cases- none required
Galastop - prolactin inhibitor
Can do conservative
Cases of iatrogenic pseudopregnancy require long period (21days) of prolactin inhibitor (galastop) tapering the dose.
69
What are the conservative options for treatment of pseudopregnancy?
Sedatives
Bathing the mammary gland
Diuretics and reducing fluid and food intake
70
How effective is treatment of pseudopregnancy using cabergoline (galastop)?
80% effiacy
Rapid resolution of behavioural changes
Rapid reduction of milk production
71
What is fibroepithelial hyperplasia?
Significant mammary enlargement caused by local growth hormone production in response to progesterone (like a local acromegaly)
72
When can queens get fibroepithelial hyperplasia?
Young queens- pregnancy or pseudopregnancy
| Older queens- administration of exogenous progestagens
73
What are the clinical signs of fibroepithelial hyperplasia?
Glands are very firm and may succumb to secondary mastitis or traumatic ulceration
Can be massive, oedematous, bilateral, ulcerated.
74
What is the treatment of fibroepithelial hyperplasia?
Remove progesterone stimulation!
- intact female- spay or glastop or alizin
- female on oral progestogens- stop administration, galastop or alizin
- female on depot progestogens- galatop or alizin
75
What are the bacteriological/ virological screenings used in dogs and cats?
None in the dog.
| Tom cat may be screened for FeLV prior to mating
76
Testicular size has a good correlation with....
Total sperm output
Onset of puberty
Testicular degeneration
Advanced testicular pathology
77
What is the normal testicular ultrasound appearance?
Moderately hypoechoic parenchyma with echogenic stippling
Linear mediastinum testis in sagittal plane
Circular mediastinum testis in transverse plane
78
What are some conditions of focal testicular lesions?
Testicular tumours
| Testicular cysts
79
When doing a rectal palpation what are you assessing?
```
Gland size
Pain
Moveability (free and movable normal)
Sublumbar lymph nodes (ventral)
Other structures (rectal wall, pelvic wall)
```
80
What is the common sequelae of chronic prostatitis
Lower urinary tract infection
81
What is the first fraction ejaculated during foreplay?
Prostatic fluid, contains no sperm.
| Flushes urethra clear of urine
82
What is the second fraction rejaculated during intromiussion?
Sperm rich
| Deposited into cranial vagina
83
What is the third fraction ejacualted during the tie?
Prostatic fluid and no sperm
| Washes sperm into uterus
84
What do you look for in breeding soundness exam in the male?
```
Conformation and temperament
External genitalia
Libido
Semen evaluation
Ultrasound of reproductive tract
Endocrinological testing?
Other diagnostic tests?
```
85
What is the normal ultrasonographic appearance of the prostate?
Bufferfly 2 lobed appearance
| Colon cause cause acoustic shadowing ventrally
86
What is benign prostatic hyperplasia?
Hyperplasia of the prostatic epithelium begins early in life associated with altered androgen/oestrogen ratios
87
What are the clinical signs of BPH?
Often present without clinical signs, may have blood in ejaculate in earlier stages
In later stages may get faecal tenesmus, haematuria, haemospermia
88
What will palpation of BPH be like?
Symmetrical, freely mobile, non-painful
89
What radiographic features are present with BPH?
Prostatomegaly, dorsal displacement of colon, cranial displacement of bladder, narrowed prostatic urethra, urinary retention
90
What ultrasonographic features are present with BPH?
Prostatomegaly, hyperechoic regions, narrowed prostatic urethra, small cystic lesions
91
What other/ less used diagnostic techniques can be used to diagnose BPH?
Prostatic massage to obtain semen - poor harvest of cells
Semen evaluation- normal except haemospermia
Prostatic aspiration- normal cells
92
What is the treatment for BPH?
Castration best
Progestogens or GnRH agonist
Finasteride
93
What are the disadvantages of using progestogens and GnRH depot agonists?
Affects FSH production --> reduced spermatogenesis, spem quality will decline --> may become infertile
94
What is acute bacterial prostatitis?
Ascending infection commonly E. coli.
| Often young adult dogs
95
What are the clinical signs of acute bacterial prostatitis?
systemic illness, with vomiting and caudal abdominal pain
96
How would acute bacterial prostatitis feel when doing a rectal palpation?
Asymetrical, moveable associated with great pain
97
What is the radiographic appearance of acute bacterial prostitis?
normal size or marginally increased, loss of detail in caudal abdomen indicating local peritonitis
98
What is the ultrasonographic appearance of acute bacterial prostitis?
large, hypoechochoic / marbled, sub-capsular oedema
99
What are some other diagnostic features of acute bacterial prostitis?
Not usually capable of producing ejaculate
Bacteria on urinalysis
High white cell count and bacteria of prostatic aspiration
Acute and profound leucocytosis
Blood culture may be positive if patient has become bacteraemic
100
What is the treatment of acute bacterial prostatitis ?
3-4 week duration antibiotic therapy - potentiated sulphonamides
Urinalysis and examination of prostatic fluid to ensure that does not become chronic
Castration
101
What is chronic bacterial prostatitis?
When acute bacterial prostitis become chronic
| Often in the form of micro-abscesses and diffuse inflammation
102
What are the signs of chronic bacterial prostatitis?
Recurrent cystitis
103
How would chronic bacterial prostatitis feel when doing a rectal palpation?
firm and fibrotic in parts, moveable eliciting some pain
104
What is the radiographic appearance of chronic bacterial prostitis?
irregular outline, local peritonitis, prostatic gas, narrowed urethra (contrast), large
105
What is the ultrasonographic appearance of chronic bacterial prostatitis?
normal or slight increase in size, focal microabscesses, areas of increased and decreased echogenicity
Occasionally significant calcification
106
What is the treatment for chronic bacterial prostatitis?
6 weeks antibiotic therapy
Hormonal therapy - GnRH and progesterone to decrease size of gland
Castration
