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Principles of Surgery > Spays > Flashcards

Spays Flashcards

1
Q

This is the term used to describe the surgical removal of the ovaries and uterus.

A

Ovariohysterectomy (OVH)

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2
Q

An Ovariohysterectomy is characterized by the _______ removal of female reproductive
tract, which includes?

A

complete
Oviducts, ovaries, uterine horns, uterus

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3
Q

An __________ is the surgical removal of the ovaries only and is a ______ procedure.

A

Ovariectomy, quicker

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4
Q

A _________ is also referred to as a Caesarian section. You are opening _____ uterus surgically and removing _____.

A

Hysterotomy, gravid, feti

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5
Q

List the reasons you would spay your patient.

A
  1. Sterilization
    - Population control
  2. Disease control/treatment
    - Prolongs life span
  3. Decrease incidence of hereditary defects
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6
Q

SPAY
1. _______/______
- Usually _____, ______, ______ patients
- ____ clinical signs
2. Medical treatment
- Patients with some sort of disease process; Typically involving?
3. Clinical signs relate to _______ disease
process

A

Routine, Elective, young, happy, healthy, No, ovaries, uterus, and/or mammary glands, underlying

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7
Q

List the situations in which you would spay your patient.

A
  1. Happy/healthy patient
  2. Ovarian disease
  3. Prolapsed uterus
  4. Uterine disease
  5. Pyometra
  6. Uterine torsion
  7. Metritis
  8. Uterine and Ovarian Neoplasia
  9. Mammary gland neoplasia prevention
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8
Q

When spaying happy Healthy Pets, remember:
- In canines:
- Common between ___ months – __ years; _______ specific: Large breed dogs with hip issues (closer to __-__ years)
- Always spay!
- In Felines: studies show ___ difference for cats; so spay _____
- __ months+ ?

A

6, 2, Breed, 1-2, no, whenever, 6

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9
Q

Ovarian Disease - Cystic Ovaries
- _____ filled structures that develop within _____
- Leads to:
1. A ________ secretion of estrogen
2. Continued signs of _______ or _____
3. Prolonged ________ to males

A

Fluid, ovary, prolonged, proestrus, estrus, attractiveness

progesterone and estrogen are the main players for female heat cycles and pregnancies.

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10
Q

A Prolapsed Uterus is common after _____. - - Remember, if tissue is viable ______ !
- REMEMBER – ______ IS THE SOLUTION TO POLLUTION!
- Reduce swelling with _______
- Manually _______ tissue and then _____!
–> What if tissue isn’t viable or you are unable to replace it?

A

birth, lavage, DILUTION, dextrose, replace, spay
Amputation and then spay

If tissue is black and green = not viable

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11
Q

How does dextrose help reduce swelling of a prolapsed uterus?

A

Reduce swelling using dextrose because osmotically draws out fluid from edematous tissue.
Same with rectal and vaginal prolapses

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12
Q

What condition can be seen in this image?

A

Cystic ovaries

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13
Q

What condition can be seen in this image?

A

Prolapsed uterus

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14
Q

Uterine Disease is usually influenced by _____________. Several examples include?

A

progesterone
1. Cystic Endometrial Hyperplasia
- Thickening of uterine tissue
- Results: cysts leak fluid into uterus; typically will see a hydrometra; fluid filling up (water usually) so no infection; if does not get resolved, becomes a mucometra –> pyometra .
2. Hydrometra: clincial signs absent
3. Mucometra: clincial signs absent
3. Pyometra: clinical signs; endotoxemia risk and sepsis when there is rupture of pyometra; body ends up attack itself.

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15
Q

What condition can be seen here?

A

Hydometra

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16
Q

What condition can be seen here?

A
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17
Q

Pyometra is an accumulation of _______ (WBC and bacteria) in ______. This usually occurs ______ a heat cycle and can be a _____ threatening condition

A

pus, uterus, after, life

Left = cat pyo
Right = dog pyo
open pyo is a bit better because infection is going somewhere; closed pyo infection is stagnant and greater risk for rupture.

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18
Q

What is the most common bacteria isolated from a pyometra? List some other bacterium that can be found here as well.

A

E. coli is the most common bacteria isolated here , Staphylococcus spp., Streptococcus spp., Proteus spp.

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19
Q

Pyometras are most common in?

A

Intact female mature adults

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20
Q

A closed pyometra is characterized by:
1. ___ vaginal discharge,
2. ____/____
3. __________
4. ____ mm
5. Abdominal _______
6. Usually ______ compared to an open pyometra.

A

No, PU, PD, lethargy, Pale, distention, sicker

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21
Q

An open pyometra is characterized by:
1. Vaginal _________
2. _________
3. _________
4. _________
5. ____/_____
6. ____ mm

A

distention, Vomiting, diarrhea, Anorexia, PU, PD, Pale

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22
Q

In the case of a pyometra, radiographs and ultrasound reveal _______ uterus. Always ________ first and then cut!

A

enlarged, stabilize

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23
Q

What condition can be seen here?

A

Pyometra

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24
Q

Uterine Torsion occurs when the uterus has rotated ________ its _____ axis, usually between the _____ and ____. The patient is ________ sick (Signs?)

A

around, long, cervix, horn, clinically, anorectic, febrile, lethargic, painful

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25
Q

What condition can be seen here?

A

Uterine torsion?

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26
Q

Metritis is a _____ partum infection of the _______.

A

post, uterus

Abdominally you should be able to feel a flabby? uterus, lactating from nipples, etc.

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27
Q

What bacteria can be found in a patient suffering from metritis?

A

Bacteria isolated is the same for a pyometra

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28
Q

List the characteristic signs of metritis?

A

-. Vaginal discharge, lethargy, anorexia, neglecting offspring
- Sometimes large flaccid uterus can be palpated
- Stabilize and then cut

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29
Q

Uterine and Ovarian Neoplasia
- ___________ are tumors that develop from smooth muscle cells of uterus.
- ______________ ____________

A

Leiomyomas, Endometrial Adenocarcinoma

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30
Q

Mammary Gland Neoplasia Prevention
- Mammary gland neoplasia is a tumor(s) associated with _______ tissue
- This condition is seen in ____-______ animals after their ______ heat cycle.

A

mammary, un-spayed, first

Decrease by 99.99% if you spay patient before first heat cycle.

Malignancy rate for mammary tumos: 50% benign 50% malignant in dogs; cats = 90% malignant

In cats, once it has ulcerated, the likelihood of it metastatizing to the chest is very high; not as high in dogs.

Very painful; need pain meds on board

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31
Q

The likelihood of an animal developing __________ _________ neoplasia decreases if spayed before first estrus.

A

mammary gland

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32
Q

Are adenomas benign or malignant?

A

Benign

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33
Q

Are carcinomas benign or malignant?

A

Malignant

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34
Q

Are adenocarcinomas benign or malignant?

A

Malignant

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35
Q

Many pets do not show clinical signs
until mammary gland tumor has ?

A

metastasized or ulcerated

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36
Q

What condition can be seen in the image below?

A

Mammary gland tumor

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37
Q

Label accordingly

A
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38
Q

The right ovary is ______, so it will be more difficult to get to

A

higher

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39
Q

Label the image accordingly.

A
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40
Q

What is the Proper Ligament’s function?

A

Connects uterine horn to ovary

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41
Q

What is the Suspensory Ligament’s function?

A

Connects ovary to body wall

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42
Q

What is the Mesovarium’s function? What does it contain?

A
  1. Portion of broad ligament of uterus that supports ovaries
  2. Contains ovarian vessels +/- fat
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43
Q

What is the function of the Mesometrium? What does it contain?

A
  1. Portion of broad ligament of uterus that supports uterine horns and uterine body
  2. Contains uterine vessels +/- fat
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44
Q

The ovaries are located at the ______ pole of kidneys

A

caudal

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45
Q

The Uterine horns are _____-_____ in body cavity

A

dorsal, lateral

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46
Q

The Uterine body is located between the _______ _____ and _____ and is adjacent to the ________.

A

urinary bladder, colon, ureters

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47
Q

What can be seen in this image?

A
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48
Q

What can be seen in this image?

A
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49
Q

Describe the spay procedure step by step.

A

¡ Cut skin/sq/body wall
¡ Find uterine horn and expose ovary
¡ Break down suspensory ligament
¡ Clamp, ligate, and cut ovary/ovarian
pedicle (2x)
¡ Clamp, ligate, cut uterine body/uterine
vessels
¡ Check “gutters”
¡ Close up

50
Q

SPAY PREP
1. ______ technique
2. Clip hair _______
- Avoid razor ____
- Clip from ______ to ____
- Make sure razor isn’t _______.
- Width of clip should be to the level
of the ________ ____ or _____
3. _______ + _____ skin prep

A

Aseptic, carefully, burn, xiphoid, pubis, pubis, mammary, chain, beyond, Chlorhexidine, alcohol

51
Q

What approach is being used in the image below? What is the difference between the two ?

A

Ventral midline approach

Top = adult dog
Bottom: peds / cat
in dog: ovary is hardest part to expose
cat = uterine body

52
Q

Things to remember about using the ventral midline approach in the dog:
1. Incision is ____ _____ to the umbilicus
2. _________ __/___ of the caudal abdomen
3. Extended incision _________
- Small incisions are great but remember longer incisions (when extending cranially) allow more _________.

What are some important things to remember in big, barrel chested dogs? Older dogs?

A

just, caudal, Cranial 1/3, caudally, exposure

Think about how big the dog is, barrel chested, etc.
The older and the bigger, stick to caudal. If younger, typically do where cat incision is

53
Q

Things to remember about using the ventral midline approach in the cat:
1. Incision is ______ to the umbilicus
2. _______ __/__ of caudal abdomen
- Middle point between _______ and brim of ________.
3. Extend incision _________.

A

caudal, Middle 1/3, umbilicus, pelvis, caudally

54
Q

What approach is being used in the image below? Name the species in each photos.

A
  1. Ventral midline approach
  2. cat, dog, puppy
55
Q

The lateral flank approach is used when there’s _______ mammary development. This usually occurs secondary to ________ vs. mammary gland _________.

A

excessive, lactating, hyperplasia

literature: applied more to cats than dogs

56
Q

Things to remember when using the lateral flank approach in dogs:
1. The Incision should be made in a ____________ direction.
2. Start _________ to the midpoint between the _____ rib and ______ _____.

A

dorsoventral, caudal, last, iliac, crest

57
Q

Things to remember when using the lateral flank approach in cats:
1. Incision should be made in a _________________ direction
2. Start ________ to the midpoint between the _____ rib and ________ ______.

A

dorsoventral, caudal, last, iliac crest

58
Q

In the canine spay, it is important to pick the appropriate incision _________ depending
on patient.

  • Use a 10-15 blade to incise ?
  • Use ____-_____ hand to apply tension
    across incision site, cut smoothly with _____
    pressure.
  • __________ sometimes used to control
    subcutaneous bleeders; ______ works too
  • Can also use ______ and ____ to control
    subcutaneous bleeders.
A

placement, skin and subcutaneous tissue.

non-dominant, firm, Mosquitos, cautery, gauze, dab

59
Q

Extend subcutaneous tissue incision to expose ________ rectus fascia
- You can either use ____ or _________.
- Removal of too much subcutaneous tissue increases __________ _________
- Be careful with ______ subcutaneous fat dissection. Removing too much will increase _______ _____. There is a limit to what is necessary to remove to identify the _______ ________.

A

external, Blade, Metzenbaum’s, dead space, lateral, dead space, linea alba

60
Q

The Linea alba is a _____, ____ ____ line that runs vertically down ______ of the abdomen. Upon palpation, it feels like a ________ area between _________ ________ ________ muscles

A

thick, white, fibrous, midline, depressed, paired rectus abdominis

It is an aponeurosis where are abdominal muscles meet; not really any vasculature there, so it is not as painful to cut through.

61
Q

How wide is the linea alba in dogs? Cats? Difference between the two?

A

2-3 mm wide in dogs; wider and
more transparent in cats

62
Q

The linea alba is the thickest and easiest to see at the __________ and thinner and harder to identify near the _______.

A

umbilicus, pubis

63
Q

The _________ _______ ________ is the holding
layer of abdominal incisions.

A

External rectus fascia

64
Q

The _________ _________ _________ must be included in each suture to avoid dehiscence

A

External rectus fascia

65
Q

What can be seen in this image

A

The linea alba

66
Q

What can be seen in this image?

A
67
Q

During the spay procedure, you want to grasp the linea alba with thumb ______ and create a ____. This creates distance between body ____ and internal _____. Then, make stab incision through ____ muscle layers with scalpel blade facing ____. Once you have made it through all muscle layers _____ incision using thumb _____ and ______ OR ______ scissors

A

forceps, tent, wall, organs, all, up, extend, forceps, blade, Mayo

Tent = stab incision with blade; blade pointed upwards, stab throguh linea, used to make sure you are not hitting any underlying organs.

68
Q

Surgeons usually go for ___ ovary first because it is easier to get to.

A

left

69
Q

What can be seen in the image below?

A

Linea alba

70
Q

When using the spay hook, ____ body wall using fingers or thumb forceps. Place spay hook into the ______ _____ and point tip _____ from body contents Start with the ____ uterine horn. Once you hit ________ of body wall rotate spay hook ____ degrees, raise ___, and engage uterine ___. Once you have identified the uterine horn, follow it ________ to the ovary. You now have to exteriorize __________ ________ so you can place clamps and ligatures.

A

tent, body wall, away, left, bottom, 180, up, horn, cranially, ovarian pedicle

Hold body wall gently because it gets angry quickly

71
Q

What can be seen in this image below?

A

Spay hook going against body wall. Go down until reach gutters, switch hook over towards organs and then pull up.
If you feel much tension, you may be grabbing kidney/ureter, take spay hook out and try again.

72
Q

Once the ovary is identified, place a _______ on the _______ ligament to manipulate ovary. Use a _______ ______ or other type of hemostat and place it between ______ and uterine ______. Then, identify the _________ ligament

A

clamp, proper, Curved, mosquito, ovary, horn, suspensory

73
Q

What can be seen in this image?

A
74
Q

Label the image accordingly

A
75
Q

suspensory ligament, ovary, also have ovarian pedicle (ovarian artery and vein) be careful because when breaking down suspensory ligament can cause damage to ovarian pedicle.

A
76
Q

The suspensory ligament is broken down to elevate the _______ out of body and expose ________ ________. Can use either the ______ breakdown or “strumming ______ string” method with ______ to ______ force.

A

ovary, ovarian pedicle, digital, guitar, Lateral, medial

77
Q

Placing a hemostat on the proper ligament helps pull ovary in a ____________ direction and will create tension on the _____________ ligament [SL]

A

caudomedial, suspensor

78
Q

After breaking down suspensory ligament, the ovary should be ____________, and vessels (?) should be appreciated. Make a window in the ________ ligament _______ to ovarian pedicle (in _________ area) to put clamps; if put clamps in vascular area, you are going to have to tie it off. You can remove clamp on _______ ligament. Next place __________.

A

exteriorized, ovarian pedicle, broad, caudal, avascular, proper, hemostats

79
Q

____ hemostats are applied _______ to the
ovary on pedicle. If using curved hemostats make sure they are pointing ________ towards ______.
- ____ ligatures are applied
- 1st ligature = ____________ (in ______ of __ st clamp)
- 2nd ligature = _________ (only on most ______ ligature) vs circumferential
The ________ _________ is then transected between _____ and ____ hemostat. Why?

A

3, proximal, upwards, ovary, 2, Circumferential, crush, 1, Transfixing, distal, Ovarian pedicle, middle, distal

b.c if there is oozing and bleeding, still have clamps in there to fix that ligature.

Hemostats: proximal, middle distal.

Pointing towards ovary, not body (up)

80
Q

The 1st Ligature is placed on “_________” tissue once _______ hemostat is removed. The suture patterns that can be used are?

A

crushed, proximal
Circumferential, Miller’s knot, Modified miller’s knot

81
Q

The 2nd Ligature is placed between the ligature and _______ hemostat. It is important to ______ forceps while first ___ throws of ligature are being secured (aka “______”) and then __-_____. The suture patterns that can be used here are?

A

1st, middle, loosen, 2, flash, re-clamp

¡ Circumferential - Miller’s knot, Modified miller’s knot
¡ Transfixing - Only applied on most distal ligature

Flash: when you place transifizng, want to loosen middle clamp for the first two throws and then reclamp b/c if you have a fatty pedicle, if you are too clos4 ot it or it is stil ckamped off, suture will not fall as nicely and potentially fall off.

82
Q

There is always going to be ____ clamps on the pedicle.

A

two

83
Q

OVARIES ARE REMOVED…NOW WHAT?
Need to remove _______ body.
Remember ___________ has uterine vessels on lateral aspects

A

uterine, mesometrium

Right uterin atery and vein on lateral aspects.

84
Q

BREAKING BROAD LIGAMENT
- ___ vs ____
- Allows from more _______ of uterine body
- In obese dogs or dogs in heat _______ vessels

A

Cut, tear, exposure, ligate

won’t typically do this in cats

85
Q

UTERINE BODY
- Ligate and transect uterus ______ to cervix
- Use the __ clamp technique

A

cranial, 3

86
Q

Uterine body
Use the ___ clamp technique.
Place the distal hemostat at least ___ ___ away from cervix. Place the 2 nd hemostat
___ ___ away from proximal one and same for the ____ one.
Place a Circumferential ligature within ______ of most ________ clamp. Place the 2 nd ligature, which can be either _________ vs. __________ vs. modified ___________

A

3, 1 cm, 5 mm, distal, crush, proximal, circumferential, transfixation, transfixation

87
Q

Modified transfixation = __________ ligatures are placed around _____ uterine vessel (L and R)

A

separate, each

88
Q

Label the image accordingly.

A
89
Q

Once everything is out, double check _______ for bleeders. If bleeding is noted, you will need to extend incision _________.
You do no want _______ pooling of blood; if that is the case, extend _______ becasue blood is usually coming from ovarian ______ and check the gutters with hemostats and gauze –> if see dark, blood = ____. Now you are ready to close!

A

pedicles, cranially, active, cranially, pedicle, BAD

if can’t find bleeder in 2-3 minutes, finish spay and go back.

90
Q

The _________ _________ _______ is the holding layer for body wall. When closing, it is difficult to not get muscle, but do not take _____ thickness bites into muscle because this will only increase ________ and post-op -____.

A

external rectus fascia, full, inflammation, pain

91
Q

What suture patterns would you use to close the body wall?

A

Simple interrupted vs continuous vs cruciate

92
Q

What suture patterns would you use to close the subcutaneous tissue space? Closing the subcutaneous space holds what purpose?

A

Subcutaneous tissue closure
- Simple continuous = common
- Decreases dead space

93
Q

Label the image accordingly

A
94
Q

When closing the skin, what suture patterns should you use?

A

¡ Intradermal = go for an intradermal if patient is not going to show u to recheck exam rather than doing a suture you need to remove
¡ Simple interrupted
¡ Cruciate

95
Q

Describe the post-op care procedure for spays.

A
  1. Exercise restriction
    - 7-14 days ideal
    - Suture removal at day 10-14
  2. E-collar
    - Keep on at least 1 week!
  3. NSAID’s to go home (~5-7 days)
    - Rimadyl
    - Metacam
  4. +/- Gabapentin

if happy and comfortable, do not have to do 7 days

96
Q

The feline spay is _______ than dog spay, however, tissues are more ________.

A

easier, delicate

97
Q

Feline Spray prep
- ______ technique
- Clip hair ______ to avoid ?
- Clip from ______ to _____
- Width of clip should be to the _____
of the mammary chain or beyond
- ________ + ______ skin prep

A

Aseptic, carefully, razor burn, xiphoid, pubis, level, Chlorhexidine, alcohol

Excise a small amount of sub cu because they do not have a lot; if take too much = seroma

98
Q

For the feline spay, pick appropriate incision placement depending on ______. Use a 10 – 15 blade incise ?
Use ____-_____ hand to apply tension
across incision site, cut smoothly with
firm pressure

A

patient, skin and subcutaneous tissue, non-dominant

99
Q

Dogs tend to have a lot more at around ?

A

ovaries and pedicle

100
Q

Label the following image accordingly.

A

Find linea alba and make stab incision through all muscle layers
¡ Using spay hook and locate L uterine horn

101
Q

You can cut suspensory ligament with _____ or _______. If clamping place 1 or 2 hemostats on the _________ _______ _____ the ovary.

1 circumferential ligature is placed on the _______ if __ hemostats placed. If only 1 hemostat place, ligature ______ hemostat

+/- __ nd ligature circumferential below
middle/2nd hemostat

Before transecting place hemostat on ________ ligament ( _______ to ovary) and
transect above ______ hemostat

A

blade, scissors, ovarian pedicle, below, crush, 2, below, 2, proper, distal, proximal

102
Q

Label the images accordingly.

A
103
Q

OVARIAN BODY
To clamp or not to clamp?
- If you clamp only place ?

If you place ligatures, what suture pattern will you use?

Uterus is ligated and transected at the ________ __/___ of uterine body

A

1-2, Circumferential (Miller’s or Modified Miller’s), 1 vs. 2 ligatures, caudal 1/3

Uterus is more friable, so be careful when clamping with kitties

104
Q

Label the image accordingly

A
105
Q

Use __________- on the ovarian body.
- Instead of clamping and placing individual ligatures you make a window in the _____ ligament and perform a pedicle tie.

A

autoligation, broad

106
Q

What suture pattern would you use to close the Body wall in a feline spay?

A

Simple interrupted vs. continuous
vs. cruciate

107
Q

What suture pattern would you use to close the subcutaneous tissue in a feline spay?

A

Subcutaneous tissue closure
- Decreases dead space
- Simple continuous

108
Q

What suture pattern would you use to close the skin in a feline spay?

A

Skin closure
Intradermal
Simple interrupted
Cruciate

109
Q

Feline spay post op care ?

A
  1. Exercise restriction
    ¡ 7-10 days ideal
    ¡ Suture removal at day 10-14
  2. E-collar
    ¡ +/- depends on patient
    ¡ NSAID’s to go home (~5-7 days)
    ¡ Robenacoxib (Onsior)
    ¡ Meloxicam (Metacam) –> off label for cats but still works!
  3. +/- Gabapentin
110
Q

List all of the spay complications?

A
  1. Hemorrhage
  2. Dehiscence
  3. Seroma
  4. Ligation of Ureter
  5. Recurrent Estrus
  6. Uterine stump pyometra
  7. Uterine stump granuloma
  8. Obesity?
  9. Perivulvar dermatitis?
  10. Urinary incontinence?
111
Q

Describe the spay complication - hemorrhage

A
  1. Hemorrhage
    ¡ Most fatal complication
    ¡ Intraoperative or immediate post op abdominal bleeding
    ¡ May need abdominal exploratory
    ¡ Pedicle ligation failure
    ¡ Go back in a re-ligate pedicles
112
Q

Describe the spay complication - dehiscence

A
  1. Dehiscence
    ¡ Abdominal vs. subcutaneous vs. skin
    ¡ Linea alba was not closed appropriately
    ¡ Failure to restrict exercise
    ¡ Lavage abdomen debride and reclose incision
113
Q

Describe the spay complication - seroma

A

¡ Seroma
¡ Fluid accumulation at incision area
¡ Cold vs. warm compress depending on who you ask.

114
Q

What can be seen in this image?

A

A seroma

115
Q

Describe the spay complication - ligation of ureter

A

¡ Ligation of Ureter
¡ Uncomfortable patient
¡ Hydroureter +/- hydronephrosis
¡ Exploratory surgery and removal of ligature or kidney
¡ Prevent by careful identification of uterus before ligating
+ having empty bladder

116
Q

Describe the spay complication - recurrent estrus

A

¡ Recurrent Estrus
¡ Remnant ovarian syndrome
¡ Failure to remove all of ovarian tissue
¡ Go back in and remove ovarian tissue

117
Q

Describe the spay complication - Uterine Stump Pyometra

A

¡ Inflammation and bacterial infection of remnant uterine tissue aka “stump”
¡ Can be do to poor aseptic technique, suture reaction, devitalized tissue at stump, residual infection (if pyo present)
¡ Remove all remaining tissue

118
Q

Describe the spay complication - Uterine Stump Granuloma

A

¡ Focal inflammation of remnant uterine tissue
¡ Associated with using multifilament nonabsorbable sutures or poor aseptic technique

119
Q

SPAY COMPLICATIONS
Describe the spay complication - Obesity?

A

when lose sex hormones –> decrease metabolic rate –> obeses

120
Q

Describe the spay complication - Perivulvar dermatitis?

A

–> some vulva regress –> dermatitis in that area –> UTIs

121
Q

Describe the spay complication -Urinary incontinence?

A

–> associated with spayed dogs about 2-3 years after spay; urethral sphincter mechanism inconctinence; estrogen helps LUT deal wtih sphicnter muscle tone, so decrease in estrogen that should have been here reduces bladders ability to hold as much urine –> involuntary leaking.

122
Q

Test Questions taken from here:
* Define ovariohysterectomy, ovariectomy, and cesarian section
* State disease processes where a spay would be indicated as medical treatment
* State benefits of a spaying patients
* Be knowledgeable of ages when patients should be spayed
* Name and identify important structures associated with canine and feline spay
* Cite steps and have a general understanding of a routine spay surgical procedure
* State post operative care associated to spay
* Cite surgical complications

A

Principles of Surgery (13 decks)

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