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38 Cards in this Set

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What are 7 indications for castration?
1) Overpopulation
2) Behavior
3) Prostatic disease
4) Perianal adenomas
5) Perineal hernias
6) Testicular neoplasia
7) Orchitis
-brucella serology required (zoonotic!!!)
What are the 3 components of pre-operative work-up for a castration?
1) Complete history & PE
-palpate testicles
2) Pre-anesthetic diagnostics
-PCV/TP/BUN/BG vs CBC/chem
3) Peri-op antibiotics?
-debatable
*What category of surgery is a routine castration based on the degree of contamination? Is peri-op antibiotics recommended?
Clean procedure-so debate on whether or not to use antibiotics, if break sterile technique though recommended antibiotics
The scrotum is prone to severe irritation and ______ so you must be very careful when clipping the scrotum.
Edema
-don't need scrotum in field unless doing scrotal ablation
What must you do if the penis is included in the surgical field?
Flush prepuce 3x w/ dilute chlorhexidine
What does an open vs closed castration refer to?
Whether vaginal tunic is opened or closed
-not related to anatomic location
What is ligated with an open castration?
-Ductus deferens and pampiniform plexus double ligated and placed into tunic
-Tunic and cremaster muscle ligated distal to ductus/pampiniform pedicle
What is ligated in a modified open castration?
-pampiniform plexus double ligated and replaced into tunic
-tunic, ductus deferens and cremaster muscle ligated together distal to the pampiniform pedicle
What is the most common incision location used for canine castrations?
Prescrotal
What are 3 indications for performing a scrotal ablation?
1) Trauma
2) Pendulous
3) Hematoma
Where do you make the incision for a scrotal ablation?
Elliptical skin incision around base of scrotum
-save enough skin for closure!
-castration portion is save as pre-scrotal
-closure is performed in 2 or 3 depending on SQ tissues
When is a testicle considered to be cryptorchid?
At 6 months of age
-normal at 2 months
When you have a crytorchid testicle, which testis is removed first?
ALWAYS THE CRYPTORCHID
FIRST
What are the 2 approaches (incisions) that are used to remove a cryptorchid testicle?
1) Inguinal
-linear skin incision, very similar to prescrotal
2) Abdominal
-Ductus deferens & testicular artery are your guides!!!!!!!
-CAUTION: prostate and ureters
What should you always do after removing a cryptorchid testicle?
Submit for histopathology
Why should you always remove a cryptorchid testicle?
If don't remove= prone to Sertoli cell tumor
How do you prep a feline castration?
Scrotal hair is "peeled" off using your thumbs
Routine aseptic scrub & drape
Where do you incise for a feline castration?
Linear incision through scrotum over testicle
How do you exteriorize a feline testicle during castration?
Exteriorize by breaking down spermatic fascia
How do you ligate during a feline castration?
Ligation via encircling ligature or "auto-ligation"
What are 3 components of post-op care of a castration?
1) Prevent self-trauma
-inoculates in bacteria
2) Keep wound clean
3) analgesia
-NSAIDs or opioids
What are 2 potential complications of a castration?
Infection & hemorrhage
What are 3 indications for surgery of the prostate gland?
1) Prostatis/abscess
2) Cysts- can be prostatic or paraprostatic
3) Neoplasia?
-controversial
What are 6 clinical signs that the prostate gland needs surgery?
1) Stranguria
2) Hematuria
3) Obstipation
-constipation: compression of rectum
4) Pyuria
5) PU/PD
6) Dyschezia
If you are dealing with a neutered dog and the dog is showing signs of prostate trouble, which of the 3 differentials is highest?
Neoplasia
How can a neoplastic process result in infection?
A lot of time tumor outgrows blood supply---> necrosis--> infection
What is the highest differential for an intact dog with symmetrical nonpainful prostatic enlargement?
Probably benign prostatic hypertrophy
What is the prioritized differential list for an intact dog with asymmetrical nonpainful prostatic enlargement?
Probably cysts, less likely prostatitis/abscess
What is the prioritized differentials for an intact male with asymmetrical or symmetrical prostatic enlargement, painful and patient is maybe febrile?
Probably prostatitis/ abscess
-less likely cysts
What is the most likely differential for a neutered male with asymmetrical or symmetrical prostatic enlargement and it may or may not be painful?
Probably prostatic neoplasia
What are the 3 components of a pre-op workup for prostatic surgery?
1) Minimum database
-CBC, chem, UA
2) Urine culture/sensitivity
3) Abdominal ultrasound
-alt: CT, MRI or rads
Is a FNA or traumatic urethral catherization used for clinicopathologic testing when performing pre-op work for prostatic surgery?
if poke then can spread if cancer so people recommend traumatic urethral catheterization where use guidance and poke catheter in and someone sucks at the same time -FNA seeding is pretty rare so can do if catheterization isn't working
What should be done before prostatic surgery if neoplasia is suspected?
Met check (3 views thoracic rads)
**Skeletal palpation (axial & femur/ humerus): metastasis includes skeletal system
Where do you incise for prostatic surgery?
Caudal ventral midline celiotomy
What 2 procedures are done during surgery of the prostate gland? Why?
1) Omentalization
-take omentum and drag it into prostate and wrap it around
2) castration
-gonads secrete androgens which cause hypertrophy and predispose to prostate problem
What is the point of performing an omentalization during prostatic surgery?
Full of blood vessels so by doing this you bring in a ton of blood vessels and can now deliver antimicrobials to the inside of prostate and also adds lymphatics to help drain area
During prostatic surgery tissue samples should be collected for what?
Histopathology
Culture + sensitivity (aerobic & anaerobic)
What is the purpose of "stenting"?
Makes the dog feel better- allows it to pee
-can stent the colon or urethra to keep dog from being obstructed