Small animals 3 Flashcards
What are some indications for flank spay?
Enlarged mammary gland due to lactation
Mammary gland hyperplasia
What are some contraindications of a flank spay?
Pregnancy Pyometra Oestrus Obesity Patient age younger than 12 weeks
What are some advantages of flank spay?
Evisceration is less likely if the body wall incision breaks down
Ability to observe incision from a distance
What are some disadvantages of flank spay?
- 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
How can you check whole ovary is removed?
Open ovarian bursa after surgery
What is the most common complication of OVH?
Haemorrhage
What should you do in a case of haemorrhage during OVH?
- 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
What are some complications of OVH?
Haemorrhage Fistulous tract/ discharging sinus Residual ovarian tissue Uterine stump granuolma Urinary tract issues
What is a fistulous tract/discharging sinus?
Soft, painful swelling with or without
discharging beneath the skin of:
Where can fistulous tract/discharging sinus occur?
Flank (ovarian pedicle ligature)
Inguinal region, medial thigh, pre-crural region (cervical ligature)
Why do you get fistulous tract/ discharging sinus?
Suture material: Permanent, braided (nylon), Catgut
Swabs (gossypibomna, textiloma)
How can you diagnose residual ovarian tissue?
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
What are some of the signs of uterine stump granuloma?
pyrexia, lethargic Signs consistent with infection Vaginal discharge- often bloody attractive to males Neutrophillia with left shift
How can you diagnose uterine stump granuloma?
C/S Neutrophilia with left shift Vaginal swab (?) Abdominal u/s Vaginoscopy
How can you treat a uterine stump granuloma?
To resolve condition further surgical intervention will be required
Also, in most cases, a course of broad spectrum ABx
What are the causes of urinary tract issues post spay?
Adhesions associated with uterine stump
Accidental ligation of a ureter (maybe more likely if bladder distended (?))
Accidental ligation of bladder neck
What are some disturbances animals with a pyometra may suffer?
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
What does an increased PCV and TP indicate?
Fluid deficit
What does an increase PCV but normal or decrease plasma protein indicate?
Splenic contraction (pcythaemia, hypoproteinaemia)
What does a decreased PCV and decrease plasma protein indicate?
Blood loss,
Anaemia and hypoproteinaemia
Overhydration
How can you work out drops/min?
Drops/min = (ml/kg/hr) X (kg bodyweight) X (infusion set drops/ml)/60
What can be done in intra op low ABP occurs?
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
What should you do if CO2 goes up intra op?
Tilt slightly head up, weight taken off diaphragm
Switch down inhalant (resp depression)
What is the most common reason for incomplete ovariectomy?
Entire right ovary remains
What are some conditions that result in male attractiveness?
ovarian remnant syndrome Atrophic vaginitis Urinary incontience Anal gland disease (sometimes skin disease)
What are some conditions resulting in clinical signs of oestrus?
Oestrogen secreting adrenal tumour
Ovarian remnant syndrome
What are the forms of uterine stump disease?
Most commonly granuloma
Rarely pyometra
How does a granuloma present post spay?
Usually presents within a few weeks post surgery as haemorrhagic/purrulent vulval discarge
How can you diagnose granuloma post spay?
Palpation
Radiography
Ultrasonography
How can you treat uterine granuloma?
Laparotomy and resection
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
When is surgery of persistent hymenal bands performed?
Oestrus
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
What is vulval hypoplasia associated with?
Skin fold dermatitis (peri-vulval deramtitis)
May be associated with pre-pubertal neuter
What is the surgical procedure to treat vulva hypoplasia?
Episioplasty - horse-shoe incision
What percentage of mammary tumours are malignant in the dog and cat?
50% dog
85% cat
What should you initially do when presented with a mammary tumour
- Biopsy (or incise if small)
- Stage tumour using 2 lateral radiographs and FNAs of local LNs
- Submit resected tissue for histopathology
What are the surgical options for mammary neoplasia?
Lumpectomy
Single mastectomy
Regional mastectomy
Complete mastectomy
Which 5 factors determine which surgical method is used for mammary neoplasia?
- Size and number of tumours
- Location of tumour
- Reported rate of growth
- Condition of the animal
- Dog or cat?
How should mammary masses less than 1cm in diameter and firm on palaption be treated?
Lumpectomy
How should masses greater than 1cm and attached to skin or deeper tissue be treated?
Mastectomy
How should multiple masses of the mammary gland be treated?
Regional masectomy