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Small Animal - Surgery Flashcards

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1
Q

What is the aim of an ovariohysterectomy?

A

Safely remove ovaries and uterus

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2
Q

What is an ovariohysterectomy usually performed via?

A

Ventral midline incision

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3
Q

What is more common approach to an ovariohysterectomy in cats?

A

Flank incision

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4
Q

What are the indications for an ovariohysterectomy?

A 
Elective sterilisation
Pyometra
Ovarian cysts
Hydrometra/mucometra
Uterine torsion/uterine proplapse
Uterine rupture
Ovarian/uterine neoplasia
Metritis
Improved control of diabetes mellitus
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5
Q

What is the NRCW classification of an ovariohysterectomy?

A

Clean/contaminated

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6
Q

How do you locate the uterus in an ovariohysterectomy?

A

Push intestines cranially and bladder caudally

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7
Q

How are the ovaries located in an ovariohysterectomy?

A

Follow uterine horns

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8
Q

How can the ovaries be released in an ovariohysterectomy?

A

Breaking down the suspensory ligament - cutting more controlled than tearing, do close to the kidney

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9
Q

What should be done after breaking down the suspensory ligament?

A

Create a window in the mesovarium

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10
Q

What method of haemostasis should be used in an ovariohysterectomy?

A

Three forcep technique

Remove most proximal forcep to leave crush mark

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11
Q

What material should be used as a ligature in an ovariohysterectomy?

A

Synthetic absorbable material - vicryl ideal, one/two/instrument tie, encircling ligature/figure of eight

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12
Q

What must the ovarian ligature be in an ovariohysterectomy?

A

Tight

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13
Q

Where do you make the final cut to remove the ovary in an ovariohysterectomy?

A

Between two remaining clamps

Make sure whole ovary removed

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14
Q

What material should be used to ligate the broad ligament?

A

Synthetic absorbable material in nearly all cases - vicryl ideal

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15
Q

When shouldn’t you use synthetic absorbale material to ligate the broad ligament?

A

Very immature or small dogs and cats

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16
Q

What material should be used for the cervical ligature?

A

Synthetic absorbable material - vicryl ideal

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17
Q

What technique should be used for the cervical ligature?

A

Three forcep technique

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18
Q

What animals do you need to take care in when ligating the cervix?

A

Cats in season - tissue becomes very friable and can just break down when clamped, test further up to ensure that the forcep technique is good to use

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19
Q

How do you check the right ovarian pedicle and the right broad ligament pedicle?

A

Elevate descending duodenum

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20
Q

How do you check the left ovarian pedicle and the left broad ligament pedicle?

A

Elevate descending colon

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21
Q

How do you check the cervical pedicle?

A

Elevate bladder and reflect caudally

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22
Q

What are the major steps in performing an ovariohysterectomy?

Study These Flashcards
A 
Ventral midline incision
Locate uterus
Locate ovaries
Release ovaries
Clamp pedicles
Ligate ovarian artery
Ligate broad ligament
Ligate cervix
Remove
Check pedicles
23
Q

What are some complications that can occur during an ovariohysterectomy?

Study These Flashcards
A

General complications - wound breakdown, wound infection, haemorrhage, retained swab
Specific complications - ureteral injury, retained ovarian remnant
Other sequelae - urinary incontinence, weight gain, anaesthetic complications

24
Q

What are the three surgical variations to a ventral midline ovariohysterectomy?

Study These Flashcards
A

Flank spay
Ovariectomy
Laparoscopic techniques

25
What should the decision to perform a caesarean section be based on?
Interests of - dam, unborn foetuses and owner
26
What are the indications for caesarean sections?
Foetal distress Dystocia - primary uterine inertia, incomplete primary uterine inertia, secondary uterine inertia, relative/absolute foetal oversize, anatomical abnormality of pelvic canal, foetal monstrosity, uncorrectable foetal malpresentation, foetal death, previous caesarean section
27
What are the preoperative considerations for a caesarean section?
Electrolyte and other metabolic abnormalities Foetal death increases significantly after 5 hours of labour onset Advise owners about surgical risk to dam and neonates Variable NRCW classification
28
What anaesthesia considerations are there for caesarean sections?
``` Regurgitation Aspiration CV compromise Respiratory compromise Depression of neonates Good analgesia for dam - local block, epidural post procedure, avoid alpha 2 agonists, ketamine and thiobarbiturates Minimise time taken to remove foetuses ```
29
What is the main approach for a caesarean section?
Midline approach
30
What are the main steps in a caesarean section?
``` Midline incision Exteriorise uterus Cut into uterus Gently squeeze to move foetus down uterine horn Clamp umbilical cord Only remove placentas if come freely Repair uterus Close wound ```
31
What material and pattern should be used for uterine repair?
Synthetic absorbable material - monocryl ideal | Simple appositional/inverting pattern - single or double layer
32
Describe care of neonates after a caesarean section
Ensure plenty of help available Facilities to - dry and warm pups/kits, suction airways Consider drug administration to aid resuscitation Check for congenital abnormalities Ensure dam recovers Ensure dam looks after young
33
What are the potential complications with a caesarean section?
General surgical complications Not all foetuses removed Possible post-parturient problems - uterine haemorrhage, retained placenta/foetuses, acute metritis, subinvolution of placental sites, uterine rupture, uterine prolapse, toxic milk syndrome, agalactia, galactostasis, acute mastitis, puerperal tetany, disturbed maternal behaviour
34
What is a safe and effective alternative to a caesarean section?
En bloc ovariohysterectomy
35
What is the major disadvantage to an en bloc ovariohysterectomy?
All neonates need resuscitating at once
36
What are the advantages to an en bloc ovariohysterectomy?
Minimised anaesthesia time for dam Minimal peritoneal contamination Effective population control No need for second surgery
37
What is an en bloc ovariohysterectomy?
Hysterectomy performed prior to hysterotomy and removal of neonates
38
What is the aim of castration?
Safely remove testes
39
What is castration usually performed via?
Single pre-scrotal incision in the dog | Paired scrotal incisions in the cat
40
What are the indications for castration?
``` Population control Behavioural modification Testicular neoplasia Cryptorchidism Testicular torsion Orchitis/epididymitis Testicular trauma Anal adenoma Perineal rupture Prostatic disease Repair inguinal/scrotal hernia ```
41
What is the NRCW classification of castration in the dog?
Clean
42
What are the two techniques for castration in the dog?
Open | Closed
43
What material is used for ligation in castration of the dog?
Synthetic absorbable material - vicryl ideal
44
What are the main stages of the open castration technique in the dog?
``` Incision Cut into vaginal tunic Remove testes Digitally separate the ligament 3 forceps applied Ligature applied Remove testicle Close incision ```
45
What is the difference between open castration and closed castration?
Open - vaginal tunic cut, not repaired | Closed - vaginal tunic left intact
46
What are the benefits of open and closed castration?
Open - reduce post operative swelling, reduce risk of ligature slipping Closed - reduces risk of intestinal herniation
47
Describe castration in the cat
``` Clean rather than aseptic procedure Open castration Two scrotal incisions Ligatures rarely used Vas deferens and spermatic vessels knotted together Overhand knot in spermatic cord ```
48
What is scrotal ablation?
Removal of scrotum as well as testes
49
When is scrotal ablation indicated?
``` Scrotal disease Improved cosmesis Reduced complications in mature dogs Scrotal/perineal urethrostomy procedure Scrotum used as a skin donor site ```
50
What must be determined with cryptorchid castration?
Where testicle is
51
What are the two approaches to a cryptorchid castration?
Inguinal | Caudal midline laparotomy
52
What is cryptorchid castration usually combined with?
Scrotal testicle removal
53
What are the complications with castrations?
General surgical complications - wound breakdown, wound infection, haemorrhage Specific complications - scrotal swelling, urethral injury, failure to locate retained testicle Other sequelae - weight gain, urinary incontinence, anaesthetic complications

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