Soft Tissue: 8-9 Spay/neuter

OVE

sx removal of ovaries (ovariectomy)

• traditional sx sterilization method in EU

• quicker, smaller incision

OHE

sx removal of ovaries and uterus (ovariohysterectomy)

• traditional sx sterilization method in U.S.

sx neutering

goal to r/m ovaries ± ovaries or testes w/ secure ligatures

prepubertal gonadectomy, when is it safe?

in dogs and cats > 7 weeks old

prepubertal gonadectomy is NOT associated with:

• obestity

• amt of DER

• activity level

• lower urinary tracy dz/decreased urethral diameter (cats)

• long bone fx

• arthritis

effects on obesity, amt of DER, activity level are all the same as:

postpubertal gonadectomy

expectations with prepubertal gonadectomy:

lower morbidity and quicker anesthetic recovery

feline castration techniques:

• square knot

• figure 8 hemostat

• overhand hemostat

square knot feline castration

cranial—> caudal incision over each testicle

image of square knot feline castration

figure 8 hemostat feline castration

• place curved hemostats on top of cord and wrap over cord

• direct hemostat tips dorsally and then ventrally around cord and grab cord near testicle

• transect testicle and pull grasped cord through

overhand feline castration technique

figure 8 feline castration image

indications for canine castration =

reduces overpopulation via

• 0 male fertility

• decrease male aggression

• decrease roaming

• decrease undesirable urination/marking

prevents androgen-related dz:

• prostatic dz

• perianal adenoma

• perineal hernias

testicular tumors occur in ___ % MI dogs

29 %

Effects of castration on testicular tumors

• benign prostatic hyperplasia (BPH)

• prostate decreases size by 50 % in 3 weeks

• cs resolve in 2-3 months

95 % of perianal adenomas resolve

• uncastrated male dogs increases risk of:

  • prostatic carcinoma

  • hemangiosarcoma

  • osteosarcoma

  • TCC

Canine castration methods and scrotal ablation methods:

prescrotal (most common)

perineal

scrotal (prepubertal)

abd (retained testicle)

scrotal ablation performed concurrently in dogs with:

scrotal dermatitis

neoplasia or enlarged testicle

thin, pendulus sacs (old dog)

dogs that live in kennels

scrotal hematoma

scrotum sufficiently ______ in most dogs

regresses

closed canine castration:

spermatic cord (stretched/stripped) < 1 cm diameter

no entrance into spermatic fascia and perital vaginal tunic

inspect for hemorrhage before replacing cords!

what size spermatic cord can you do a closed castration?

<1 cm

what is the scrotal ligament formed by?

gubernaculum remnant

open canine castration:

spermatic cord (stretched/stripped) > 1 cm diameter

involves incising spermatic fascia and parietal vaginal tunic

encircle cremaster muscle and tunic with ligature

how big must the spermatic cord be for a closed canine castration:

> 1 cm

sx closure of close castration

appose incised dense fascia on either side of penis

avoid urethra when closing

close subq

appose skin

closing during a scrotal ablation

penis and urethra deep to excision of skin

indications for OHE:

• prevent estrus and babies

• prevent mammary tumors

• prevent pyometra, metritis, neoplasia, and cysts

• uterine trauma

• vaginal prolapse and hyperplasia

• control of endocrine abnormalities (diabetes and epilepsy)

OHE Incision:

draw the ubmilicus —> pubis

divide line into thirds

OHE incision for dogs:

cranial ½

OHE incision line for puppies and cats:

middle 1/3

3 clamp technique of the ovarian pedicle:

3 clamos placed on the pedicle

modified 3-clamp technique of the ovarian pedicle

1 clamp above ovary

2 clamps on pedicle below ovary

used if pedicle is short!

which ovary is tighter?

right!!!

steps of OHE:

1) locate uterine horns

2) place clamp on 1st proper ligament (vessels caudal and medial to lig)

3) retract proper lig. caudally to strop suspensory lig (press caudally and medially with index finger)

4) make window to broad lig (parallel to ovarian vessels)

5) 3-clamp or modified 3-clamp to transect ovary

6) repeat steps 2-5 for other ovary

7) locate cervix and ligate vessels/uterine body proximal to it

if uterine body is friable or appears unhealthy; use of clamps or ligature may have the same effect as what other instrument?

scissors!!!

some blood may pool on top of intestines or in paraspinal region due to sq bleeding however, if it ____ there is a problem

clots

ovarian remnant syndrom is:

disorder characterized by CS related to functional residual ovarian tissue post OHE

dx ovarian remnant syndrome in dogs:

baseline progesterone concentration

dx ovarian remnant syndrome in cats

progesterone concentration 7 days post HCG

P’s effected by ovarian remnant syndrome should be surgically explored while in _____

estrus