Surgery - spay and castration

Question 1

Why do we neuter small animals?

Answer 1

• Prevent breeding (population control)
• Control behaviour / behavioural problems
• Prevent disease (e.g., neoplasia, pyometra, etc.)

Question 2

what happens to the body after neutering?

Answer 2

• 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
• LH receptors found in UT and prostate, vascular endothelium and smooth muscle in heart and spleen, skin, lymphoid tissue, GIT, pancreas, thyroid, head of femur, CCL, CNS and hippocampus, hypothalamus

Question 3

What are the benefits and negatives of neutering a female?

Answer 3

benefits:
* Pyometra
* Neoplasia (mammary, ovary, uterus)
* Oestrus
* Puppies/kittens

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

Question 4

what are the benefits and negatives of neutering males?

Answer 4

benefits:
* Reduce roaming
* Reduce aggression
* Prevent BPH
* Prevent perianal adenoma
* No testicular neoplasia
* ↓ histiocytic TVT

negatives:
* Prostatic carcinoma
* Increase aggression
* Urinary incontinence
* Hair coat
* Obesity
* Neoplasia
* Joint disease

Question 5

Waht is the difference in the suspensory ligaments inthe bitch and queen?

Answer 5

in the queen it is very lax an easy to break

Question 6

What is needed for a pyometra to occur and how does this influence surgery?

Answer 6

you need ovaries and uterus for pyometra, you need the hormones form the ovaries the pyometra (progesterone), therefore you can jsut remove the ovaries (ovariectomy) and there will be no risk of pyometra, as long as the patient does not receive any
exogenous progesterone!

Question 7

what are the indications and contraindicatinos for flank approach?
what are the advantages and disadvantages?

Answer 7

Indications for flank
Enlarged mammary gland due to lactation
Mammary gland hyperplasia

Contraindications
Pregnancy
Pyometra
Oestrus
Obesity
Patient age younger than 12 weeks

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

Disadvantages
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 8

what are the surgical complication of spays?

Answer 8

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

Question 9

what suture material should you not use in the subcuticular tissues?

Answer 9

vycril - can cause wound inflammation

Question 10

what do you need to do in a case of haemorrhage?

Answer 10

• Increase exposure
• Use suction
• Convert flank to midline approach
• Stay calm, try not to panic
• Ask for assistance
• Use mesenteric dam manoeuvres to look at ovarian pedicles
• Retract bladder caudally to look at cervical stump

Question 11

what condition are dobermans highly likey to suffer from and what is the worry with this?

Answer 11

von willebrand - coagulopathy, worry that will bleed during surgery, good idea to do a Buccal mucosal bleeding time test before surgery

Question 12

what are the signs of residual ovarian tissue (ovarian remnant syndrome)

in which side is this more common?
how is this investigated?

Answer 12

Continued cycling activity

• R more common than L (?)
• 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

Question 13

what is a stump granuloma?

Answer 13

infection within the stump after surgery
* Signs consistent with infection (e.g., pyrexia, lethargic, etc.)
* Vaginal discharge (often bloody - owner might mistake for being in season)
* Attractive to male dogs
* Neutrophilia with left shift
* (?) Vaginal swab
* Abdominal u/s
* Vaginoscopy

• To resolve condition further surgical intervention will be required – most commonly associated with pyogranulomatous response in associated with suture material (catgut)
• Also, in most cases, a course of broad spectrum ABx

Question 14

what can occur with an infection of the ovarian pedical after a spay?
why does this occur?

Answer 14

sinus tract/discharging sinus

Soft, painful swelling with or without
discharging beneath the skin of:
* Flank (ovarian pedicle ligature)
* Inguinal region, medial thigh, pre-crural region (cervical ligature)

Suture material:
Permanent, braided (nylon)
Catgut
Swab (gossypiboma, textiloma)

Question 15

why does uretral entrapment occur in relation to spaying?
how would you investigate this?
how would you fix this?

Answer 15

Crush injury vs ligation vs transection

investigate:
Serum biochemistry analysis including electrolytes
Abdominal ultrasonography
Abdominocentesis – fluid analysis
CT scans

fix:
Serum biochemistry analysis including electrolytes
Abdominal ultrasonography
Abdominocentesis – fluid analysis
CT scans

Question 16

what are the complication of castration?

Answer 16

Wound complications
Haemorrhage
Scrotal haematoma