Basic repro surgery (Case)

Question 1

Gonadectomy Indications

Answer 1

• pet overpopulation
• sex-based aggression
• mammary neoplasia
• pyometra
• uterine/ovarian neoplasia
• prostatic disease
• herniation

Question 2

Mammary neoplasia reduced if

Answer 2

• before 1st or 2nd cycle in female dog
• before 6 months of age in female cat

Question 3

pyometra

Answer 3

25% of intact female dogs affected by 10 yrs old

Question 4

Uterine/ovarian neoplasia

Answer 4

• risk of malignant neoplasia 1/30,000

Question 5

Prostatic disease

Answer 5

• Benign prostatic hyperplasia (BPH) 50% of intact dogs by 5 years of age

Question 6

Perineal hernia

Answer 6

• Gonadectomy is preventative and therapeutic
• high surgical failure without castration

Question 7

Testicular neoplasia

Answer 7

• Sertoli cell, leydig cell and seminomas common
• Castration is preventative and therapeutic

Question 8

Friction knots

Vascular pedicles

Answer 8

• Strangle knot - yes
• Millers knot - yes
• Surgeons knot - less secure
• Modified Millers - less secure

Question 9

Terminal knots

Continuous subcuticular/intradermal

Answer 9

• Aberdeen knot - yes
  
  • cosmetic
• Square throws - 10X larger volume
  
  • self trauma
  • SSI (surgical site infection)

Question 10

Preparation

Physical exam

Answer 10

• cardiovascular
• systemic
• hydration
• body condition
• integument

Question 11

preparation

Preoperative diagnostics

Answer 11

• PCV & TS
• BG and BUN
• Chemistry, CBC & UA
• Extoparasites, fecal exams & viral screen
  
  • make sure deparasitized and not anemic

Question 12

Castration

complications

Answer 12

• Hemorrhage
• urethral/ureteral ligation
• prostatic ligation
• surgical site infection

Question 13

Ovariectomy

complications

Answer 13

• hemorrhage
• ureteral ligation
• ORS (ovarian remnant syndrome)
• sphincter mechanism incontinence

Question 14

Scrotal hemorrhage

Answer 14

• poor tissue handling and general hemostasis
• coagulopathy

Question 15

hemoabdomen

Answer 15

poor ligatures

surgeons knot with large suture is bad

Question 16

Urethral ligation

Answer 16

• stray dissection: prescrotal region
• deep bites: prescrotal closure

Question 17

Ureteral ligation

Answer 17

poor visualization/exposure

Question 18

Prostatic ligation

Answer 18

• Paramedia approach: poor visualization/exposure
• Caudal midline approach preferred

Question 19

ovarian remnant syndrome

Answer 19

• poor visualization/exposure
• Right ovary is more crania
• Make bigger incision if necessary

Question 20

Sphincter mechanism

incontinence

Answer 20

• Collagen and muscle: lower urinary tract
  
  • intact vs gonadectomized dogs
  • inc collagen and dec muscle intact dogs
    
    • esp in proximal urethra
• GAGs - lower urinary tract
  
  • intact vs gonadectomized dogs
  • inc HA, CS, HS intact dogs
    
    • all regions of bladder & urethra

Question 21

Post spay incontinence

Answer 21

• 12-20% clinically
• up to 75% by UPP
• Risk if spayed before 3 months?

Question 22

Surgical site infection

Answer 22

• Erythema, discharge, swelling, pain, heat
  
  • traumatic tissue handling
  • excessive dissection
  • poor tissue apposition

Question 23

If bad skin

Answer 23

• cephalexin
• flea tx
• zd

Question 24

Summary

Answer 24

• Indications for elective gonadectomy
  
  • overpopulation and disease prevention
• Knowing basic gonadal anatomy ligatio methods critical for surgical procedures
• Preparation of dogs and cats for gonadectomy important in improving outcome
• Must anticipate and prevent complications as well as be able to treat them