elective procedures

‘OHE’ or ‘Spay’

• Ovario = ovary

• Hyster = uterus

• Ectomy = removal

Removal of the ovaries and uterus

Benefits of Ovariohysterectomy

• Cannot become pregnant

• Eliminates estrus cycles (‘heat cycles’)

• If done before the first heat, virtually eliminates risk of mammary cancer

• Eliminates risk of pyometra and cancer of ovaries

• Eliminates risk of pseudopregnancy

Mammary Tumors

• Risk of malignant mammary tumors is almost non-existent in dogs spayed prior to their first heat cycle (0.05%)

• For a dog spayed after one heat cycle, the risk goes up to 8%

• For dogs spayed after their second heat, it goes up to 26%!!!

• Study by Dr. Race Foster, DVM

Pyometra

• py/o - pus

• metr/o - uterus

• Pus in the uterus = uterine infection

Cases can be open or closed

• Both are emergencies

• Treatment = spay

Surgical Timing

• Can be performed at anytime …

• Easier and safer to do prior to first heat cycles

  • Uterus is small and has limited blood supply

• Recommended age is ~6 months

• Can be done at time of a caesarean section (once puppies/kittens are removed with owner permission)

• In-heat spay procedures are possible, but avoid if can

  • Enlarged uterus with increased blood flow

  • Tissues are friable

  • Extra cost to owner for extra time and materials

Overweight Animals

• May be required to lose weight prior to surgery

• Large amounts of abdominal fat make tissue handling difficult

• Bleeding is hard to control

Surgical Preparation

• Animal is placed under GA

• Express bladder (before surgical scrub)

• Dogs - shave abdomen from xyphoid to pubis and slightly outside nipple line

• Cats - shave from umbilicus to pubis

• Perform surgical scrub as per protocols

Surgical Technique

• Positioned in dorsal recumbency on sx table

• Ventral midline incision

• Identify one uterine horn, locate ovary (spay hook)

• Break down ovarian and broad ligament

• Ligate and incise ovarian pedicle

• Same procedure used for second ovary

• Uterine body is ligated and incised just proximal to cervix

Completion

• Uterus (horns and ovaries) are then removed as one unit

• Final check to ensure no bleeding from stump

• Final check for gauze sponges (as per count)

• Abdomen is closed in 3 layers

  • Linea alba

  • SQ tissues

  • Skin

Orchiectomy

‘Neuter’ or ‘Castration’

• Orchi/o = testicle

• Ectomy = removal

Removal of the testicles

Castration

• No longer sire offspring

• Reduces level of the hormone testosterone

  • Responsible for male sex characteristics

  • Decrease in fighting, roaming, and urine marking

• Eliminates risk of testicular cancer

Timing of Surgery

• Usually recommended around 6 months of age

  • Results in prevention of behavior problems

• Castration of mature males may result in some reduction of these behaviors, however they likely become learned behaviors

• Postponing castration …??

Surgical Preparation

• Dog - clip small amount of hair prescrotal (DO NOT clip the scrotum)

• Cat - clip or pluck hair from scrotum

• Perform surgical scrub as per protocol

Positioning and Technique

• Positioning

  • Dorsal - dogs

  • Lateral - cats

• Technique

  • Dogs - closed

  • Cats - open

Cryptorchid

• Testicle/s do not descend into scrotum

• Retained in abdomen

• Part way into inguinal region

Equine

• Field surgery

• Open incisions

• Cryptorchid ...