Unit 3- Spay

Question 1

Ovariohysterectomy

Answer 1

Removal of ovaries and uterus, complete removal of female reproductive tract

Question 2

Ovariectomy

Answer 2

Removal of only ovaries, removes chance of pyometra

Question 3

Hysterotomy

Answer 3

Cesarean section, opening gravid uterus and removing fetuses

Question 4

Why Spay?

Answer 4

Population control, disease control, prolongs lifespan, decreased incidence of hereditary defect

Question 5

Routine Spay

Answer 5

Young healthy patients with no clinical signs

Question 6

Medical Spay

Answer 6

Patient has disease process and clinical signs related to process

Question 7

When to spay canine

Answer 7

6 months to 2 years

Question 8

When to spay cats

Answer 8

6 months

Question 9

Cystic Ovaries

Answer 9

Fluid filled cysts develop in ovaries, prolonged secretion of estrogen, continued signs of estrus, prolonged attractiveness to males

Question 10

Prolapsed Uterus

Answer 10

Common after birth, lavage if tissue is viable, reduce swelling with dextrose, manually replace tissue and then spay, amputate before spay if tissue is not viable, high chance of reoccurence

Question 11

Cystic Endometrial Hyperplasia

Answer 11

Thickening of uterine tissue

Question 12

Hydrometra

Answer 12

Fluid filled uterus progresses to mucometra

Question 13

Mucometra

Answer 13

Mucous filled uterus progresses to pyometra

Question 14

Pyometra

Answer 14

Accumulation of pus after a heat cycle, can be life threatening, E. coli, staph, strep, proteus

Question 15

Cause of uterine disease

Answer 15

Progesterone

Question 16

Closed Pyometra

Answer 16

No vaginal discharge, PU/PD, lethargy, pale mucous membranes, abdominal distention, more sickness and chance of rupture

Question 17

Open Pyometra

Answer 17

Vaginal distention, vomiting, diarrhea, anorexia, PU/PD, pale mucous membranes

Question 18

Uterine Torsion

Answer 18

Uterus rotates around long axis between the cervix and the horn, patient is clinically sick

Question 19

Metritis

Answer 19

Postpartum infection, vaginal discharge, lethargy, anorexia, neglecting offspring, may palpate flaccid uterus, stabilize and then cut

Question 20

Neoplasia

Answer 20

Leiomyoma or endometrial adenocarcinoma

Question 21

Leiomyoma

Answer 21

tumor from uterine smooth muscle

Question 22

Mammary Gland Neoplasia

Answer 22

Seen in unspayed animals, adenoma, carcinoma, or adenocarcinoma, 90% malignant in cats, 50% malignant in dogs, clinical signs appear after metastasis

Question 23

Proper Ligament

Answer 23

Connects uterine horn to ovary

Question 24

Suspensory Ligament

Answer 24

Connects ovary to body wall

Question 25

Mesovarium

Answer 25

Portion of broad ligament supporting the ovaries with ovarian vessels and fat

Question 26

Mesometrium

Answer 26

Portion of broad ligament supporting uterine horns and body with uterine vessels and fat

Question 27

Ovary Location

Answer 27

Caudal to the kidneys

Question 28

Uterine Horn Location

Answer 28

Dorso-lateral in the body

Question 29

Uterine Body Location

Answer 29

Between urinary bladder and colon, adjacent to ureters

Question 30

Spay Procedure

Answer 30

Cut skin, find uterine horn and expose ovary, break down suspensory ligament, clamp, ligate, cut ovarian pedicles, clamp, ligate, cut uterine body and vessels, check gutters, close

Question 31

Spay Prep

Answer 31

Aseptic, clip from xyphoid to pubis level with mammary chain, chlorohex and alcohol

Question 32

Canine Ventral Midline Approach

Answer 32

Incise caudal to umbilicus in the cranial third of the caudal abdomen, incising caudally

Question 33

Feline Ventral Midline Approach

Answer 33

Incision caudal to the umbilicus in the middle third of the caudal abdomen, between umbilicus and pelvis

Question 34

Puppy Incision

Answer 34

Same as feline, hard to visualize uterine body

Question 35

Lateral Flank Usage

Answer 35

Excessive mammary development, secondary to lactating vs mammary hyperplasia

Question 36

Lateral Flank Incision

Answer 36

Start caudal to midpoint between last rib and iliac crest and extend dosoventrally

Question 37

Canine Spay

Answer 37

Incise, expose external rectus fascia, create tent in linea alba, stab, extend using blade or mayo scissors, tent body wall, use spay hook on left side, clamp proper ligament, break suspensory ligament, ligate, ligate and transect uterus cranial to cervix, check gutters, close

Question 38

Dog Blade Size

Answer 38

10

Question 39

Cat Blade Size

Answer 39

15

Question 40

Holding Layer of Abdominal Incisions

Answer 40

External rectus fascia

Question 41

Breaking Suspensory Ligament

Answer 41

Guitar strumming, lateral to medial, pull caudomedially using hemostat, avoid pedicle

Question 42

Ovarian Pedicle

Answer 42

In broad ligament, clamped using 3 clamp technique

Question 43

Uterine Body Clamping

Answer 43

Proximal hemostat 1cm from cervix, 2nd hemostat 5mm away, distal hemostat 5 mm away, circumferential in proximal crush, transfixed in between crush and hemostat

Question 44

Modified Transfixation

Answer 44

Separate ligatures around the L and R vessels in the uterine body

Question 45

Spay Closure

Answer 45

External rectus fascia holding layer, no full thickness bites in muscle, appositional, simple continuous subcutaneous closure, skin closure

Question 46

Post Op Care

Answer 46

7-14 day exercise restriction, 10-14 day suture removal, 1 week e collar, 5-7 days of rimadyl or metacam NSAIDs and gabapentin

Question 47

Feline Ovary Clamping

Answer 47

Clamp ovarian pedicle, circumferential ligature distal to pedicle, place hemostat on proper ligament and transect distal to

Question 48

Autoligation

Answer 48

Perform a pedicle tie in the window of the broad ligament

Question 49

Cat Uterus Transection

Answer 49

Ligate and transect at caudal third of uterine body

Question 50

Spay Complications

Answer 50

Hemorrhage most fatal, dehiscence, seroma, ureter ligation, recurrent estrus, uterine stump pyometra, uterine stump granuloma

Question 51

Cause of hemorrhage

Answer 51

Pedicle ligation failure

Question 52

Seroma

Answer 52

Fluid build up, cold or warm compress

Question 53

Ureter Ligation

Answer 53

Remove ligature or kidney, hydroureter and hydronephrosis

Question 54

Recurrent Estrus

Answer 54

Muellerian syndrome, failure to remove all ovarian tissue