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24 Cards in this Set
- Front
- Back
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What land marks do we use for a flank ovariohysterectomy? |
A triangle with the- Wing of ilium Greater trochanter. |
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How do we prep the skin for a flank ovariohysterectomy and start the incision? |
Quarter drape- 4 drapes around each side of the site. Incise through skin and subcutaneous tissue to abdominal musculature |
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In the cat why do we not cut too much subcutaenous fat away? |
Cats take longer to heal |
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Steps in flank OVH? |
1)Incise through skin through subcutaneous layer. 2) When get to abdominal musculature tent up and using mayo scissors incise. 3) Lift edge of skin and find intraabdominal fat. 4) Lift fat using forceps allowing access to abdominal cavity. 5) Locate uterus using a spay hook. 6) Exteriorise ovary. 7) Triple clamp technique- circumferential proximally and transfixing distally 8) In cat ligate both horns. Next horn circumferential distally and transfixing proximally. 9)Check for bleeding. 10) close up. |
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From which side do we perform a flank OVH and reasoning for this? |
Approach left hand side as intestines and guys tend to be on the right. |
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What is the most common intraoperative complication of a spay? How do we deal with it? |
Haemorrhage 1) Extend incision, pick duodenum up. 2) Tuck all organs behind duodenum and lift CHECK For bleeding if is clamp and wait. 3) Check left gutter and do same 4) Bladder and colon for uterine stump and check. |
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What are the commonest post operative complications of OVH? |
Weight gain- no evidence OHE leads to obesity if animal fed properly and excercised. Acquired incontinence- low oestrogen levels, granulomas/adhesions to bladder. |
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What should we do to check that we haven't left an ovary behind? What can leaving ovarian tissue behind lead to? |
Open the ovarian bursae and check we have the ovary as if leave in get ovarian remnant syndrome. |
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What are indications for caesareans? |
Dystocia. Oversized or poorly positioned foetuses. Small pelvic canal. Uterine inertia. Foetal death and decay. Brachycephalic breeds. Pelvic fractures. Previous dystocia. |
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Step by step go through a caesarean in a dog? |
1) Midline colieotomy. 2) Exteriorise the uterus and isolate from abdomen. 3) Incision in uterine body or each horn. 4) Milk each puppy out. 5) Clear nose then Clamp and cut umbilicus. 6) Hand pups to an assistant 7) Check you have all puppies 8) Placenta leave it not detached 9) Close using one or two layered closure. |
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How can we isolate the uterus from the abdomen during a caesarean? |
Exteriorising it and placing in on a laparotomy pad. |
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Best way to close a caesarean? |
Two layered closure 1) Simple appositional pattern 2) Inverting Then close skin with intradermal so pups don't damage when they suckle. |
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How do we resuscitate neonatal puppies? |
Clear their nostrils. Suction airways small urinary catheter. Centrifugal clearance. Stimulate respiration with a rub or pharmacologically. If bitch was given an opioid may need to antagonize with Naloxone. Ligate and clean umbilicus. Warm and feed, send home same day. |
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What is a pyometra and its cause? |
Pyometra is the accumulation of purulent material in the uterus or in a stump left behind following OHE. Fluid accumulates in uterus lumen over time. This leads to lack of contraction of myometrium. Stagnant fluid and bacteria build up. |
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What part of a dogs oestrous cycle and what age of dog usually gets pyometra?
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6-8 weeks after season in dioetrous. Oestrous priming followed by: Luteal phase- progesterone. Cystic endometrial hyperplasia. |
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How does pyometra arise in a spayed animal? |
Stump left behind |
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Signalment of a dog with pyometra and clinical signs? |
>6 years usually Dull, toxaemic, +/- vaginal discharge. (Depends if open or closed) Enlarged abdomen. Peritonitis. " Out of season 6 weeks ago drinking lots and flat " SMELL PYOMETRA |
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Which type of pyometra carriers the better prognosis? |
Open. |
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Diagnosis of pyometra is based on? |
1) Clinical presentation 2) Uterine enlargement radiograph 3) Ultrasound big micky mouse ears. |
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Classic image on ultrasound of a pyometra? |
Micky Mouse ears |
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What is the usual insulting organism that causes pyometra? |
E-coli which has an affinity for the myo and endometrium. Vagina and vulva also close to anus. 20% concurrent with UTI also. |
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What other system can be affected in pyometra? What does this cause? |
Renal system. Hypovolaemia leads to Chronic renal failure and azotaemia. |
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How do we deal with pyometra? |
Place on IVFT. DO standard spay procedure but without need to breakdown suspensory ligament. Exteriorise as much. Once removed lavage and pack with omentum. |
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With any case of torsion or twisting what must we not do and why? |
We must not untwist as this can release toxic necrotic factors and lead to shock |
