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57 Cards in this Set
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Ovariohysterectomy
(OHR,spay,spayed OVH) |
major abdominal surgery. Most common surgical procdure performed in small animal clinic
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Indications: Elective
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prevent heat cycles
decreased risk of mammary tumors no risk of pyometra, no risk of uterine cancer fewer behavioral problems no risk of pregnancy pregnancy termination |
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Non-Elective; Emergency
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Pyometra
Uterine/ovarian cancer Mammary cancer |
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Contraindications
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Breeding animal
too young anesthetic risk late pregnancy combining with non-sterile surgery |
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age
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prior to 1st heat is ideal: 5 months in cats and 6 months in dogs
pre-puberal gonadectomy - soaying at 6-8 wks of age |
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Technique:
Pre-op |
preanesthetic work up
general anesthesia express the bladder |
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Surgical prep:
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#40 blade clipper
clip fom the xiphoid process to pubis lateral to nipples or beyone Routine surgical scrub and rinse |
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Proceedure
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Ventral midline incision through linea alba(white line where muscles connect)
isolate right or left uterine horn with spay hook Double ligate and transect ovarian artery and cein Isolate uterine body - Ligate uterine arteries and transect uterus check stump for bleeding close linea alba close subcuticular layer close skin |
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Complications
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Abdominal hemorrhage:
Ligature slips off uterine or ovarian vessels Von Willebrands Disease - clotting disorder in several dog breeds: Dobermans G. Shepards, Welsh Corgies monitor patient 3-6 hrs post-op hemorrhaging Bladder irritation from uterine stump Peritonitis Infection Dehiscence _incision opening up |
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Client instruction
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restrict activity for 48 hrs
surture removal 10-14 days check incision for redness swelling discharge or if animal is licking excessively at incision do not bathe until sutures removed |
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Role of CVT
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may manipulate the ovarian pedicle clamps to ease placement of ligatures
retract tissue load hemoclip forceps (blade) swab surgery site Cut sutures as directed by surgon |
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Cesarian section (C-section)
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dystocia: difficulty birthing, large fetus, small pelvis, fractured pelvis, uterine inertia, certain breeds (bulldogs big heads)
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technique
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be prepared want anesthetic period to be as short as possible
light plane, adjust dosage to pre pg weight - Ketamine/Isoflurane not atropine (thickens mucus in neonates) |
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Neonatal care -
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be prepared rub with towel to dry and stimulate respiration
reverse narcotic with naloxone aspirate mouth keep warm use drugs as needed (doxopram) check and tie umbilicus check for abnormalities place with momma asap send home together |
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complications
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infection pups chewing on sutures
respiratory depression |
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Pyometra
signs |
Pus in the Uterus
anorexia, lethargy, PU/PD vomoting, discharge |
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treatment
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fluids, antibiotics,supportive care monitoring
prostaglandin available for open pyometra but spat treatment of choice |
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Castration(canine)
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prevent breeding decrease undesirable male behavior
prevent some prostativ disease prevent testicular disease decrease roaming, fighting |
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age
pre-op |
6-9 months can be 6-8 weeks
clip from prepuce to margin not on scrotum |
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Cryptorchid
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more common in dogs than cars
castration recommended due to increased risk of testicular cancer and it is an inheritable trait |
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Onychectomy(declaw)
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amputation of P3, 3-6 months of age
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procedure
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pain mgmt - fentanyl patch
apply tourniquet proximal to elbow remove P3 with Rescoe nail trimmer of scalpel dissection laser dissection leave open surgical adhesive or suture +- bandage |
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complications
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Neuritis from tourniquet, pain, bleeding , infection, nail regrowth, behavior changes abnormal stance on feet
chronic pain referred pain phantom pain use yesterday's news instead of litter 5-7 days |
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Otoplasty - Ear Cropping
age 8wks to 6 mths |
AVMA - cosmetic reasons are not medically indicated or of benifit to animal - cause pain and distress Bet should consel dog owners before agreeing to perform surgeries
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Caudectomy (tail docking)
age - puppies 1-5 days old |
pups cut tail off with mayo sissors
hematoma or seroma if dead space |
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Feline Perineal Urethrostomy (PU)
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recurrent urethral obstruction in male cats
make it so cat will pea like a girl - incise urethra suture skin to urethral mucoa |
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Anal Gland Abalation(removal)
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recurent inpactions or infections - ferret descenting
put plaster of paris in parts so dr can cut around |
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Abscess
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establish ventral frainage(lowest spot) lance drain flush wound
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Aural Hematoma (ear)
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check ear for ear infection - drain seroma- have ears heal together prevent dead space
incisional - s-shaped incision and suture teat cannula - drain placed on hairless surface of pinna suture needle aspiration - high incidence of recurrence- may use steroids bandage ear to head |
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Tumors
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benign - remove mass itself
malignant - wide margins of normal tissue removed with tumor |
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Common tumors seen in SA practice
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Mammory
Limpoma Mast cell tumor Squamous cell carcinoma Thyroid adenoma Perianal gland adenoma |
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Mammary Neoplasia
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Usually seen inolder, intact dogs/cats or animals spayed late in life - 50% malignant in dogs 90% malignant in cats protective bendfit if animal is spayed prior to 1st or 2nd heat
frequently matestazes to lungs |
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Limpoma Removal
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usually occur in older, overweight animals. SQ soft moveable masses. When aspirated droplets of oil form - handle all the way around and move- behind front leg - lots of dead space
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Mast Cells
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Malignant - grade I II or III based on likelihood to metastasize(basofil granules)- do not squeeze will release histamine give benedryl prior to surgery (boxers known for this)
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Opthalmic Surgery(eye)
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do not use chlorhexidine or alchol use dilute betadine solution or steril saline.
A branch of the vagus nerve innervates the eye Manipulation of the eye can activate this nerve resulting in activation of the parasympathetic nervous system and bradycardia may result. Premeditate with atropine of glycopyrrolate to avoid bradycardia |
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Nictitating Membrane flap placement (3rd eyelid flap)
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pulling the 3rd eyelid to cover the corneal surface
indicatrions: Corneal ulcers - Proptosis(eye pops out) a horizontal mattress suture is placed through the 3rd eyelid and uper lid |
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Conjunctival membrane Flap
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Pulling the conjunctiva over part of the cornea
Indication- Sever corneal ulcers antibiotics without steroids steroids make ulcers worse |
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Prolapsed Gland of 3rd eye lid (cherry eye)
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Cocker Spaniels.
Replacement of the gland of 3rd eyelid by sutureing to periosteu of ventral orbit - a pocket is created in 3rd eyelid and gland is inverted into pocket may happen in other eye also |
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Entropion
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lid rolls inward eyelashes touch eyes
surgery on lids to pull them in opposite direction of defect |
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Ectropion
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lid rolls outward - dry eye
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Distichiasis
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abnormal eyelashes - need to remove with electrolysys or cryosurgery
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Enucleation
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Removal of the eye- Glaucoma, trauma, Neoplasia, Refractory infections
complcations- swelling hemorrhage infections dehiscence draining tracts sunken appearance Optic nerve damage to remaining eye |
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Proptosis
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protrusion of the globe from the orbit with associated muscle and nerve damage . Is an Emergency situation tarsorrhapy involves suturing the eyelids shut - enucleation is an option if wont go in- epeniphrin - reduces swelling
may end up with strabismus(eye shooting off in odd direction) Atrophy of eye bilndness chronic pain |
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Gastrointestinal Surgery
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-otomy - to open cut into
-ectomy - to remove Resection: to remove anastomosis: to reattach fre ends stenosis: narrowing or stricture of a canal or lumen Volvulus: twisting of organ abound blood supply (GVD) |
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Types of GI surgery
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Foreign Body Removal - cats string look under toung gets caught at base intestinse bunch up (plicate)- do not u=pull string can saw through intestional wall= foreign bodies are easiest to remove from stomach - intestine-colon and lastely esophagus
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Gastric Dilation and Volvulus (GVD or bloat)
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Life Threatening Emergency!
Challenge for technicians: must be fast at catherers, anesthesia and surgery set up and prep. may need to pass stomach tube surgery incolces large cranial abdominal incision repositioning the spleen and stomach and fixing stomach to body wall - may have cardiac arrhythmais and may rebloat |
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Feeding tube placement
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Esophgastomy
Gastrostomy Duodenostomy Jejunostomy-bypass pancreas diet must be broken down |
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Intervertebral Disk Disease
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Weakness in the outer capsule of the disk leads to bulging or rupture and pressure on the spinal cord
Ovvurs most commonlu in the cervical vertebrae(beagles, dassets) or in the T-L junction (dachshunds, cockers) leads to pain, ataxia(out of balance) with loss of conscious proprioception, paralysis loss of dep pain. One of the more common neurological diseases in dogs - treatment - strict cage rest - steroids or NSAIDS - surgery laminectomy - fenestratrion of adjacent disks |
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Orthorpedic Surgery
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Luxation - dislocation of a joint
Subluxation - partial dislocation Articular: a fracture through a joint Comminuted: 3 or more fx lines which interconnect Open(or compact) fx which penetrates the skin Epiphyseal(psalter): fracture line involves a growth plate Greenstick: an incomplete fx Tranverse: fx line is perpendicular to long axis bone Oblique: fx line is at an angle to long axis of bone Spiral: fx line twists up bone shaft Multiple: 3 or more dx lines that do not interconnect Inpacted: fx due to compressive forces Aculsion: fx at a point where ligament or tendon atach to bone Stable: does not displace under force(tranverse) Unstabel: displaces easily under force(oblique) |
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External fixation devices
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Kirschner apparatus
Cast Splint |
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Internal fixation devices
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Intramedullary pins
Rush pins K-wire Plates Screws Cerclage wire |
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Osteolyelitis
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Infection of bone and marryo cavity
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Callus
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a collar of new bone which bridges the fx to repaif the fx formed by periosteum
Cancellous bone- soft lattive like bone at the end of long bone good for frafting trabecular bone Cortical bone - compact hard bone which makes up the shaft of a bone |
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Luxations
Sunovial joints are most frequently involved (hips, shoulder) if hip pops out it goes dorsal cranial leg that is shorter is the one that is out |
Luxation and dislocation - separtation or change in the relationship of the articular surfaces of bone
Articular separation:luxations Incomplete dislocations subluxations Complete dislocation: total luxation Acute luxation: result of direct or indirect force of a simple recent occurrence Chronic or recurrent luxation: long standing luxation or a recurrence following a reduction from degeneration of restraining structures of joing(joint capsule and ligaments) |
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Cranial Cruciate Ligament Repair(ACL)
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Actual ligament cannot be repaired (wire installed)
fragments of tissue in joint removed to minimize post op degenerative joint disease - will most likely happen to other leg |
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Hip Displasia
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Proceedure
Triple pelvic osteotomy - young animals with out degenerative joint changes - 3 cuts made into pelvis to restructure acetabulum Femoral head and neck resection (osteotomy) older animals with joint changes removal of femoral head proximal remainder of fenur creates false joint salvage provedure totla him replacement artifical hip replaces bone |
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Elbow
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Ununited Anconeal Process
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