Small Animal Medical Nursing Flashcards
(183 cards)
1
Q
Abdominocentesis
A
Sampling of free fluid within the peritoneal space.
2
Q
Anastomosis
A
Reconnecting/suturing of bowel after resection of a portion of bowel.
3
Q
Arthrodesis
A
Surgical fusing of a joint together such that motion at the joint is lost.
4
Q
Capillary refill time
A
Time required for blood to refill the small capillary beds of the mucous membranes after digital blanching.
5
Q
Celiotomy
A
Surgical opening of a coelomic cavity e.g. the abdominal cavity.
6
Q
Cellulitis
A
Sterile or non-sterile inflammation of the intestinal tissue
7
Q
Cystotomy
A
Incision into the urinary bladder
8
Q
Dehiscence
A
Loss of integrity of the sutured layers of an incision.
9
Q
Enterotomy
A
Incision into the a small intestinal lumen
10
Q
Evisceration
A
Uncontrolled exposure of organs through an incision as a result of dehiscence or trauma.
11
Q
Gastrotomy
A
Incision into the stomach
12
Q
Hydrometra
A
A condition in which the uterus fills with sterile fluid that causes mild to moderate distention
13
Q
Ileus
A
Functional loss of intestinal motility
14
Q
Intussusception
A
Telescoping of a portion of the bowel into another
15
Q
Mucometra
A
Sterile mucus within the uterus causing mild to moderate to distention
16
Q
Onychectomy
A
Removal of a claw
17
Q
Orchidectomy
A
Removal of the testicles
18
Q
Ostectomy
A
Removal of a portion of bone
19
Q
Osteochondrosis
A
Defect in cartilage matureration that causes lack of ossification of maturing cartilage
20
Q
Ovariohysterectomy
A
Spay; removal of the uterus
21
Q
Pseudocyesis
A
False pregnancy
22
Q
Pyometra
A
Bacterial infection of the uterus with purulent fluid accumulation
23
Q
Seroma
A
Sterile fluid accumulation beneath an incision after surgery
24
Q
Strangulation
A
Encircling of a tissue with the suture or internal sutures such that blood supply to the tissue is lost and death of the tissue ensues, unless the tissue is released and blood flow can resume.
25
Urethrostomy
A surgical procedure that creates a permanent opening in the urethra. This procedure is most commonly performed in male cats that have a history of multiple urethral blockages. In this species, a urethrostomy is made in the perinuem
26
Prophylactic antibiotics
Decrease the risk of infection and clean or clean-contaminated surgeries. Will not entirely eliminate surgical site infections.
27
Indications for prophylactic anabiotics
Operative time longer than 90 minutes.
Patient is immunosuppressed.
A hollow viscus is to be entered e.g. G.I. tract, urinary bladder etc.
Sx site is difficult to aseptically prepare.
Orthopedic implants are placed or a joint is entered.
28
For anabiotics to be effective what needs to be present?
Therapeutic drug levels in the wound fluid at the time of the surgical incision.
29
Prophylactic anabiotic’s must be given at least –
20 minutes before the surgical incision is made.
30
Anabiotic’s given three or more hours before the procedure –
Select for resistant bacteria.
31
Anabiotic’s given 3 to 5 hours after the incision has been made will likely –
Not be effective in preventing infection.
32
There is no advantage in continuing anabiotic’s beyond 6 to 24 hours after surgery unless:
Necessary to treat an active infection or a break in sterile technique occurred during surgery.
33
Signs of blood loss in the post operative patient:
Possible continued hypothermia or drop in body temp.
Rapid HR with weak peripheral pulses.
Rapid RR.
Pale/white MM
Incisional swelling or oozing of blood.
Abdominal distention if intra-abdominal hemorrhage occurs.
Decreased lung sounds if intrathoracic hemorrhage occurs.
34
A surgical incision is ideally covered with an adhesive or a wrap bandage for the first few days to:
Keep it clean, prevent contact with the hospital environment and absorb seepage.
35
Pointman’s and creams should not be placed on the incision because
This can cause irritation, and components of the pointman and can delay wound healing.
36
Abnormalities in the early postoperative period (1-3 days) include:
Redness, swelling, drainage, dehiscence
37
Swelling secondary to surgical trauma will usually resolve within
3 to 7 days after surgery
38
Animals usually lake or chew at the incision only if
Character of the incision site is irritating.
39
Contributors to incision irritation include:
Sutures placed too tight, Traumatic tissue handling, suture reaction, tension on the suture line, clipper burn, prepping irritation, incision infection and seroma formation.
40
Seromas can form if:
Extensive surgical dissection occurred beneath the incision. Tissue planes could not be or were not adequately closed or excessive motion occurs at the incision site.
41
So aromas are recognized as
Localized areas of fluctuant swellings, not usually painful or warm to the touch.
42
What made in resolution of seromas?
Warm compresses, Hydrotherapy and bandaging
43
Drainage of a seroma is warranted if
It is very large and/or causing impairment
44
Possibility of infection or cellulitis must be considered if:
Incision swelling occurs 4 to 6 days postoperatively, is warm to the touch, is associated with an elevated body temperature, or is reddened and/or draining.
45
Abscess or infection must be treated with:
Drainage, warm compresses and systemic anabiotics.
46
Factors that contributed to wound dehiscence include:
Use of inappropriate suture to close a wound, inappropriate suturing technique, tension on the incision line, incision infection, seroma formation, and disease and/or drug therapy leading to delayed wound healing.
47
Removal of skin sutures
Suture scissors, simple to use and allow removal with minimal discomfort. Suture should be grasped with thumb forceps. Gentle traction is placed on the suture, suture is cut near the skin surface. Suture is manually pulled out of the skin after cutting.
48
Metal staples removal
Staple remover should be used to allow removal with minimal discomfort. Placed under the stapler according to manufacturer instructions and squeezed to bend stable ends up and out of the skin.
49
The technician must have a working knowledge of common surgical procedures to:
Properly prepare the animal for surgery, act as an efficient surgical assistant, have a discussion with the owner, and manage immediate and long-term post operative care.
50
Elective surgeries
Performed at the veterinarian’s and the owner’s convenience, usually in healthy animals.
Some are done to improve the animals quality of life, not necessarily urgent.
51
Non-elective surgeries
Must be done urgently. Usually emergency procedures performed on compromised animals.
52
Indications for tail docking and declaw removal in puppies
Primarily performed for a static reasons and to meet breed standards set forth by the AKC.
Or to prevent drama. E.g. hunting dogs
53
Indications for tail docking and dewclaw removal in adult dogs
Aesthetics, drama, infection and neoplasia
54
Indications for Onychectomy:
An elective procedure done to prevent cats from scratching owners and household items.
55
Three techniques used to declaw a cat:
The nail trimmer technique (Rescoe), the scalpel blade, and the carbon dioxide laser technique
56
The nail trimmer technique (Rescoe)
Guillotine type nail trimmer is positioned snuggly onto the dorsal surface of the total between the 2nd phalanx and 3rd phalanx. Cutting edge is positioned at the cranial edge of the footpad. As it is advanced, pad is moved caudally while nail is rotated dorsally and caudally. 3rd phalanx excised, taking care not to cut the footpad, a portion is usually left behind but the entire germinal layer is removed to prevent regrowth.
57
The blade technique
Amputate the entire third phalanx using a 12 scalpel blade. Phalanx is disarticulated dorsolaterally, by cutting through the joint capsule between the 2nd and 3rd phalanges then by cutting the collateral ligaments. The nail is cut away from the underlying tissue and digital pad. Pad is moved out of the way by positioning the blade more dorsal to prevent inadvertent laceration of the pad.
58
The laser technique
Similar to the blade tech nique except he uses laser energy to dissect the 3rd phalanx free from the 2nd phalanx. The site usually does not bleed so a Turnock it is not necessary.
59
Postoperative considerations for Onychectomy:
Administer pain medication postoperatively. Bandages, kept in place for 24 hours, hospitalize well bandage is in place. Use paper or paper alternative litter. Don’t re-introduce normal litter until 10 days after. Monitor pause for a hemorrhage, swelling, drainage and redness.
60
Early complications of cat declawe
Loose bandages, self bandage removal and postoperative bleeding. Infection, generally evident within the first 3 weeks of surgery.
61
Late complications of Onychectomy
Regrowth of the clause, chronic lameness or both.
62
Other complications of Onychectomy
Radial nerve damage secondary to Torna kit placement and skin sloughing secondary too tight, prolonged bandage placement.
63
Celiotomy
Surgical incision into the abdominal cavity. Can be made at several locations: ventral midline, paramedian, para costal, parapreputial and flank. Most commonly used incision is ventral midline.
64
Elective celiotomy includes:
Ovariohysterectomy, Organ biopsy, cystolithotomy, planted cesarean delivery, gastropexy, removal of retained abdominal testicles.
65
Non-elective celiotomy procedures include
Emergency cesarean delivery, GDV, intussusception, G.I. foreign bodies, ruptured spleen, penetrating foreign bodies, severe abdominal bleeding and diaphragmatic hernia.
66
Exploratory celiotomy
Often performed to treat abdominal masses of unknown origin and to obtain biopsies for disease diagnosis
67
Pre-operative considerations for a celiotomy
Area should be clipped widely. Sick or traumatized animals may have to be stabilized.
Ensure that the appropriate supplies are available.
68
Postoperative considerations for Celiotomy
Examine incision for the first 24 hours for swelling, drainage, excessive redness, dehiscence and evidence of self trauma.
Some may be in app attend or may vomit after. Intestinal and pancreatic manipulation can lead to intestinal issues, nausea and/or pancreatitis.
69
Indications for Gastro intestinal surgery
Foreign body lodgment, Neil plasia, biopsy, GDV, G.I. trauma, G.I. obstruction
70
Pre-operative considerations for G.I sx
Patient should be stabilized and dehydration addressed before sx. Intubate as soon as possible with a cuffed endotracheal tube. Ensure that extra instruments and gloves are available. Prophylactic antibiotics are used if G.I. tract is entered.
71
Characteristics of intestinal devitalization
Lack of motility; gray, green or black discoloration; severe thinning of the visceral wall; lack of bleeding on cut section; lack of fluorescein die uptake; lack of Doppler blood flow
72
Gastric Dilatation-Volvulus
Dilatation of the stomach with ingesta and gas, with rotation of the stomach into an abnormal position. Life-threatening, typically in deep chested, large and giant breed dogs.
73
Classic clinical signs of GDV
Vomiting, retching and bloating.
74
The enlarged stomach compresses the caudal vena cava and affects venous return to the heart, leading to -
Hypovolemic shock
75
Pre-op considerations for GDV:
| Large-bore catheters should be placed immediately in the front legs or jugular vein because –
Venous return from the caudal half of the body is impaired by the dilated stomach.
76
Primary indication for OVAH
Prevention of pregnancy and subsequent production of unwanted litters
77
Other indications for OVAH
Endocrine in balance, infection, injury, cyst, tomorrow, prevention of unwanted behavior and congenital abnormalities
78
Endocrine disturbances are associated with -
Varied clinical manifestation I stare lady, skin lesions, memory tumors, pseudocyesis and nymphomania
79
OVAH before the 1st heat cycle-
Greatly reduces the chance of memory neoplasia in dogs.
80
Uterine disease that may require OVAH include
Metritis, pyometra, uterine prolapse, endometrial hyperplasia, neoplasia, injury, neglected dystopia and congenital abnormalities
81
OVAH skin incision in the dog
Extends caudally 3 to 6 cm from the umbilicus
82
OVAH skin incision in cats
From 2 cm caudal to the umbilicus caudally 3 to 4 cm
83
Leaving ovarian tissue behind can lead to -
Recurrent heat cycles and stump pyometra because of the presence of hormones that can influence any remaining uterine tissue.
84
Intraoperative complications of OVAH include
Hemorrhage and anesthetic problems
85
Left ovarian pedicle is evaluated by
Retraction of the descending colon to the right and viewing the pedicle just caudal to the left kidney
86
Right pedicle is evaluated by
Retraction of the descending duodenum to the left and viewing the pedicle just caudal to the right kidney
87
The uterine stamp is visualized
Between the urinary bladder ventrally and the colon dorsally
88
OVAH is the recommended treatment for
Pyometra
89
Conservative management for open pyometra it should be discouraged because of
The risk of septicemia and endotoxemia, and the incidence of reoccurrence is high.
90
Conservative management of closed pyometra is is not recommended because
Of the risk of uterine rupture, septicemia and endotoxemia, and possibly death.
91
Which dogs should be evaluated carefully for pyometra?
Intact female dogs with fever, lethargy, polyuria, polydipsia, vaginal discharge, abdominal pain, abdominal enlargement, inappetence, vomiting and/or diarrhea
92
Left untreated, pyometra can result in
Septicemia and/or endotoxemia and possible death. Additionally, uterine rupture and peritonitis are possible
93
Cysto to collect urine in animals suspected of having pyometra should be
Avoided
94
Preparation for a pyometra surgery
Prepped for a ventral midline celiotomy. Incision should extend from the xiphoid to the pubis so that excess of tension is not placed on the uterus during manipulation.
95
Pyometra
| Uterine contents
Should be cultured for aerobic and anaerobic bacteria and a sensitivity test performed. Done via a septic aspiration of fluid with a needle and syringe before the uterus is contaminated and after it is removed from the surgical field.
96
Post operative considerations for pyometra
Monitored as for OVAH
Special considerations include continued antibiotics for 7-10 days.
Electrolyte and metabolic abnormalities can continue postoperatively, monitoring for this is important and should be corrected. IV fluids should be given until stable, eating and drinking.
97
Indications for canine castration
To help prevent roaming, aggressiveness, unwanted breeding or a combination of these.
98
Medical problems treated by castration
Prostate disorders, anal and perianal tumors, perineal hernias and testicular tumors
99
Which animals should undergo scrotal ablation and why?
Older dogs with a well-developed scrotum and animals with scrotal abnormalities. To prevent severe scrotal swelling, improve postoperative aesthetics and/or treat disease
100
Technique for canine castration
Testicle push to cranial beneath the pre-scrotal skin. Midline incision made in the pre-scrotal skin sensually and over the cranially displaced testicle. Testicle is exteriorized through the incision by carefully and sizing over the common tunic. Testicle pulled away for ligation as remaining scrotal ligament is gently dissected from the testicle.
101
Ligation of the testicle using a closed technique
To ligatures are placed external to the tunics of the pedicle such that the vessel and the vas deference are ligated as a unit. Fast, but if not carefully done, the vascular pedicle can slip inside of the tunics and into the abdomen causing uncontrolled hemorrhage. Best used on a very small patients.
102
Testicle ligation using the open technique
Allows individuals ligation of the vas deferens and its blood supply and the pampiniform plexus. Testicle is then removed with sharp severance distal to the ligatures.
103
Canine castration
| Incision is closed with
A continuous subcuticular suture pattern. Best to bury the suture here due to potential irritation increasing the urge to lick.
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Scrotal ablation
Incision is made circumferentially. Subcutaneous tissue is bluntly dissected it to expose the testicles and associated structure. Castration is carried out via ligation of these structures. Testicle and scrotum are removed and the incision closed in 2 to 3 layers.
105
Indications for feline castration
To prevent fighting, roaming, urine spraying and to decrease urine odor.
106
Technique for feline castration
Generally placed in dorsal recumbency and see with the legs tied craniad. The scrotum is the site of the primary incision.
Testicle and spermatic cord or exteriorized with gentle traction and stripping. Spermatic cord may be ligated with suture, metal clips or tied in a knot on itself. Vessels can be separated from the vas deferens and tied in a square knot. Testicle is then removed by severing the spermatic cord with a blade distal to the ligation site. Scrotum is left unsutured.
107
Intraoperative considerations for feline castration
Avoid putting alcohol on the scrotum. Scrotal hairs are gently plucked. Scrotum is then scrubbed and draped in an a septic manner.
108
Cesarean delivery
Involves making an incision into the abdominal cavity and then the uterus to deliver a neonate. Usually performed on animals experiencing dystocia (difficult birth)
109
Common causes of dystocia
Maternal factors:
Contraction forces
```
Uterine inertia (lack of contractions)
-First degree
Uterine muscle defect
Oxytocin deficiency
Premature birth
-Second degree
Abdominal
-Age
-Pain
-Hernia of the uterus
-Uterine rupture
```
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Common causes of dystocia
Maternal factors:
Birth canal
```
Inadequate pelvis
-Immature
-Fracture
-Breed
-Disease
Insufficient dilatation
-Uterus
-Cervix
-Vagina
-Vulva
```
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Common causes of dystocia
Fetal factors:
Oversize fetus
Faulty pelvic presentation
- Caudal simultaneous
- Head flexion
- Limb flexion
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The aim of a Cesarean delivery
Successful delivery of live and undamaged puppies or kittens without harm to the dam.
113
Selected anesthetics for a cesarean delivery should have
Minimal effects on the newborn and should be safe for the dam.
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Preparation for a cesarean delivery
Clipping is performed before Anastasia. Avoid damaging in large to memory glands and nipples. After induction and maintenance, placed in dorsal recumbency.
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Important to remember that increased weight of the gravid uterus
On the diaphragm may compromise the normal breathing capacity. Intermittent manual respiration or a ventilator should be considered.
116
OVAH at the time of delivery by En Block resection
Entails clamping both ovarian pedicles and the uterine body, cutting the gravid uterus out of the dam, then going back and ligating all vasculature in the dam. Gravid uterus is given to an assistant, who cuts each neonate carefully from the uterus and ligates or clamps the umbilicus.
117
Removal of the uterus and ovaries at the time of neonate delivery does not
Affect milk production or motherly instinct.
118
Indications for cystotomy
Most common: removal of cystic calculi/bladder stones.
Also to remove tumors, correct congenital defect, repair traumatic rupture of the bladder. Placement of a cystostomy tube to provide an alternate outlet in case of tumor, calculi or scar tissue obstructing urine flow.
119
Cystostomy tube
A tube exiting the urinary bladder and abdominal wall.
120
Pre-operative considerations for cystotomy
If urinary flow was obstructed, should be stabilized before anesthesia.
Severe metabolic and/or electrolyte abnormalities might be present.
Imaging studies may be necessary to identify the extent of the disease and its exact location.
121
Preparation for Cystotomy
Abdomen is widely clipped from the xiphoid to the pubis.
Males: hair is a clip from the prepuce. Preputial orifice and penis or gently flushed with a 1% povidone iodine solution. Incision will curve laterally to avoid the prepuce.
122
Bladder expression before celiotomy may result in:
Inadvertent bladder rupture and should be avoided when urinary bladder wall fragility is expected.
123
Which artery and vein will be encountered during a cystotomy in a male?
The caudal superficial epigastric artery and vein lateral to the prepuce.
124
After cystotomy the animal should be placed on IV fluids to:
Help dilute blood clots and flush the urinary bladder.
125
Cystotomy: Postop
Urine production monitored. If the incision was close to or involved the proximal urethra, post up swelling can obstruct urine flow. Blood clots can accumulate in the bladder and migrate into the urethra obstructing urine flow.
Some straining can be expected.
126
During the first week after Cystotomy
Mild hematuria, with or without blood clots, and frequent urination can be expected.
127
An animal that couldn’t urinate before cystotomy and had BW abnormalities, should
Have blood work reassessed serially to ensure that values are returning to normal.
128
If the animal is not producing urine or is producing minimal urine and abdominal distention is detected, a complete bio chemistry panel, CBC and paracentesis should be performed. Fluid taken from the abdomen should be
Spohn for a PCV determination. Value is higher than Ciara and values indicate a problem and should be reported to the vet.
129
Indications for a perineal urethrostomy
Multiple episodes of obstruction in association with feline urologic syndrome. Less common: rupture of the penile urethra secondary to dramatic catheterization or blunt trauma, structure of the penile urethra and obstruction secondary to cancer.
130
Presentation for urinary obstruction depends on
The duration and completeness of the urinary obstruction. Common factor is straining
131
If brought for an examination early
There is little chance that other organ systems are affected.
132
Brought in 12 to 24 hours after a complete obstruction
Severe electrolyte abnormalities, cardiac arrhythmias, kidney dysfunction and shock can be present
133
Clipping for urostomy
Hair on the perineum and external genitalia is clipped
134
Perineal urethrostomy -cat
Placed in ventral recumbency with the perineum elevated approximately 30°. The tail is extended directly over the dorsal midline and immobilized with tape. A purse-string suture is placed in the anus to eliminate contamination. Standard skin prep is performed
135
Scrotal urethrostomy in male dogs
Placed in dorsal recumbent sea, area is prepped as for castration and a scrotal ablation.
136
Perineal urethrostomy in cats
Elliptical incision made around the scrotum and prepuce. Testicles removed if the cat is intact. Penis is dissected free from its pelvic attachments. Catheter is placed in the urethra, longitudinal incision made through the penile urethra extending craniad to the level of the pelvic urethra. Urethral mucosa is sutured to the skin. Remaining portion of the penis is amputated during urethral suturing, urinary catheter is removed. Results in a new permanent opening that will accommodate the excess mucus and crystals. Bladder expressed at completion to ensure good urine stream is obtained.
137
Scrotal urethrostomy in male dogs
Skin incision is made in the area of the scrotum, followed by a urethral incision over a preoperatively placed urethral catheter, suturing of the urethral mucosa to the skin follows. Penis is not amputated.
138
Most common late postop complication of urethrostomy
Stricture, a narrowing of the urethral opening caused by excessive scar tissue formation. Self-mutilation can increase the chance of stricture and must be prevented. Typically manifest as chronic stranguria. Complete obstruction of urine flow maybe noted. Requires reoperation
139
Hernia
Protrusion of tissue from its normal cavity through a congenital or acquired defect in the wall of that cavity
140
Common hernias in the dog and cat include;
Umbilical, inguinal and diaphragmatic hernias
141
Umbilical hernia
Bowel or, more commonly, omentum and intra-abdominal fat protrude through a defect in the abdominal wall under the skin at the umbilicus.
Most commonly congenital, recognized by the presence of swelling at the umbilicus.
142
Inguinal hernia
Intestine nine, uterus, broad ligament, intra-abdominal fat and/or another abdominal Oregon protrudes through the inguinal canal as a result of a defect in the constraints of the canal.
143
Pre-operative considerations for inguinal hernia repair
Opposite inguinal ring, palpated for weakness. Owners, told that hernias can develop a bilaterally. Also that reoccurrence is rare but possible.
144
Preparation for inguinal hernia repair
Abdomen is widely clipped from the umbilicus to and including the inguinal area. Placed and dorsal recumbency, standard skin prep is performed.
145
Technique for inguinal hernia repair
Midline incision made in the caudal abdomen between the inguinal folds. Abdominal cavity, not entered. Lateral dissection performed carefully to expose the affected inguinal ring with its hernial sac and external pudental vessels. Hernial sac, emptied of its contents, excised and sutured along with the margin of the inguinal ring. Avoid the external pudental vessels that exit from the caudal medial aspect of the ring. Skin is closed as for celiotomy.
146
Diaphragmatic hernia
Abdominal contents protrude through an opening in the diaphragm into the thoracic cavity. Maybe congenital or caused by trauma.
Can be life-threatening or insidious and difficult to identify.
147
Classic signs of a diaphragmatic hernia
Tucked up abdomen, intestinal sounds in the chest, muffled heart and lung sounds and dyspnea. Some have only decreased lung sounds over the area of the hernia and mild exercise intolerance. DX confirmed by thoracic radiographs
148
Animals with a diaphragmatic hernia should
Have oxygen and cage confinement to achieve maximum oxygenation, minimal stress and constant monitoring for respiratory insufficiency before surgery.
149
Immediate diaphragmatic hernia repair is necessary in cases of:
Severe respiratory distress, gas distention of herniated viscus is in the chest or intestinal strangulation
150
One of the most critical times for an animal with a diaphragmatic hernia is:
Anesthetic induction
151
Positioning of an animal for a diaphragmatic hernia repair
Dorsal recumbent sea on an incline, with the head slightly higher than the hindquarters.
152
Preparation for diaphragmatic hernia repair
Skin widely clipped from about 3 inches cranial to the xiphoid to the pubis. Lateral thoracic wall on at least one side clipped and aseptically prepared for potential chest tube placement or thoracocentesis.
153
Technique for diaphragmatic hernia repair
Ventral midline celiotomy from xiphoid to near the poopers is performed. Edges of incision are protected with laparotomy pads, a Balfour self-retaining abdominal retractor is placed to enhance visualization. Thorough inspection of abdominal and thoracic viscera is made to rule out organ rupture and vascular compromise.
154
Diaphragmatic defect is sutured in a simple continuous suture pattern to create
And air-tight and watertight seal.
155
Lumpectomy
Local surgical resection of a mass. Often refers to cutaneous or subcutaneous masses.
156
Indications for lumpectomy
Masses of cancerous origin, masses that appear to be changing over time, rapidly growing masses, ulcerative masses or masses that impair function
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Mastectomy
Removal of a memory gland
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Radical mastectomy
Removal of a chain of memory glands on one or both sides
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Memory tumor malignancy in dogs
About 50%
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Memory tumor malignancy in cats
About 80 to 90%
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In dogs there appears to be no advantage of radical glad resection versus lumpectomy unless:
The tumor is incompletely excised
162
Mastectomy
| More radical excision is warranted if:
The tumor is centralized with in a grande, multiple tumors are present with in a gland or a chain of clans, tumor is large and/or fixed.
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Mastectomy
| In cats recurrence is decreased if a
Unilateral mastectomy is performed
164
If bilateral radical mastectomy is necessary the procedure must be staged to
Allow less tension on the skin closure.
165
Indications for limb amputation
Appendicular cancer not amenable to local excision or another treatment modality; severe neurologic dysfunction resulting in repeated trauma to a limb; nonunion fractures that will not result in limb function with orthopedic repair; irresolvable osteomyelitis; vascular disease of the limb i.e. thrombosis or arteriovenous fistula; severe trauma to the lamb; Congenital deformity resulting in a non-functional limb that is not amenable to orthopedic repair
166
Thoracic limb amputation can be done by:
Removal of the scapula and entire for alarm, disarticulation of the scapulohumeral joint; ostectomy of the proximal humerus.
167
Forequarter amputation offers the advantages that
Major vessels and nerves are well visualized, sectioning of the bone is not required, prominent scapular spine will not be present as the scapular muscle mass atrophies.
168
Pelvic limb amputation can be accomplished by
Disarticulation of the coxofemoral joint or by proximal femoral ostectomy.
169
Neoplastic disease of the femur will require
Disarticulation to obtain a normal margin of tissue.
170
Most common neurologic disorder in dogs
Intervertebral disc rupture
171
Discs are normally found
Between the ventral bodies in the spine and act as a shock absorbers during spinal movement and also provide structural support.
172
Over time, disks can undergo degeneration and calcification when this occurs –
The normal shock absorber-like effect is impaired, and extrusion/rupture of disc material into the spinal cord can occur which puts pressure on the spinal cord and can cause an array of neurologic deficits or pain.
173
Other neurologic disorders include
Atlantoaxial subluxation(abnormal articulation between the 1st and 2nd cervical vertebrae); acute spinal trauma; Lumbosacral stenosis/Mel articulation or cauda equina(compression of the lumbosacral nerve roots); Cervical vertebral malarticulation/malformation(Wobblers); Spinal cyst; cancer of the brain, nerves or spinal cord; malformation of the caudal brainfossa; hydrocephalus
174
Intervertebral disc fenestration
Each disc that is calcified or that may become calcified is removed/scraped from the intervertebral space. Performed to help deter rupture of the disc material into the spinal cord, benefit is unproven.
175
Dogs may develop spontaneous intervertebral disc extrusion is in the
Cervical spine or the thoracolumbar spine
176
If the desk has already ruptured
The ability to ambulate is effective, decompressive procedure can be performed to alleviate compression on the spinal cord.
177
The most common decompressive procedures are
Ventral slot for cervical disc rupture; Hemilaminectomy for thoracolumbar disc rupture
178
For acute disc herniation the most commonly affected breed is
The Dachshund. Other breeds include the beagle, pekingese, poodle, spaniel and terrier
179
Animals undergoing cervical disc surgery are placed in
Dorsal recumbency with the head and neck in slight extension.
180
Animals undergoing thoracolumbar disc surgery are placed in
Ventral recumbency
181
Post operative considerations and care of neurologic patients depends on
There in neurologic status and the type of neurologic disease that they have
182
Neurologic patients are subject to
Bedsores, urinary infections, joint stiffness, muscle atrophy, pneumonia and G.I. ulceration
183
Steps for proper post operative management include
- Passive range of motion exercises atleast 3 times a week.
- Urinary bladder expression four or five times per day.
- Flip the completely down animal frequently, every four hours.
- Monitor daily for fever, cough or respiratory distress.
- Keep it clean and dry.
- Observe the stool daily.
- Observe the vomitus.
- Monitor animals with lost pain sensation carefully.
- Animals that cannot walk should not be allowed to roam free.
- Encourage animals to get up at least three times a day and use their limbs if they have some motor function and a stable spinal injury.
