8 and 9- Spay Neuter 1 & 2

ovariohysterectomy (OHE)

___ describes the surgical removal of the ovaries and uterus

ovariectomy (OVE)

___ describes surgical removal of the ovaries

orchiectomy

___ describes surgical removal of the testicles

castration

____ describes surgical removal of male or female sex organs (interchangeable for orchiectomy)

hysteotomy

___ describes surgical incision into the uterus

gonadectomy

___ describes excision of ovary or testis

limit reproduction

primary goal of reproductive and genital surgery

not normally necessary

when it comes to antibiotic considerations during OHE/castration

abx. efficacious against E. coli

what kind of antibiotics are typically used in pyometra sx.

blood-prostate barrier penetration

when performing a sx. on the prostate we should consider the need for _____

remove ovaries with or without uterine horns and body or testes with secure ligature placement

though there are a variety of techniques for neutering dogs and cats, the goals are still the same...

ovariohysterectomy (OHE)

what is the the traditional method of surgical sterilization of female dogs in the United States and technically a longer and more complicated procedure

ovariectomy (OVE)

what is the traditional method of surgical sterilization of female dogs in European countries and is typically a quicker procedure with a smaller incision

OHE technique

what is shown here

7 weeks

early gonadectomy is safe in dogs and cats over _____ old and is done to reduce reproduction in shelter animals

1. increased obesity

2. amount of daily food consumption

3. activity level

4. lower urinary tract disease

5. long bone fractures

6. arthritis

7. immune suppression

8. small urethra

early age gonadectomy (>7wks old) is not associated with....

1. does NOT decrease urethral diameter

2. does NOT increase incidence of lower urinary tract disease and obstruction

in terms of early age gonadectomy in male cats, it does not cause...

95%

reduced incidence of mammary neoplasia by ____ if early age gonadectomy is done before first heat

25%

reduced incidence of mammary neoplasia by ____ if early age gonadectomy is done after 3rd heat

increased bone length

early age gonadectomy can cause delayed physeal closure by 8-9 wks resulting in...

lower morbidity; quicker anesthetic recovery

early age gonadectomy is associated with _____ and _____

1. overhand hemostat technique

2. figure of eight hemostat technique

3. encircling or transfixation ligature

what surgical techniques are used in feline castration

overhand hemostat technique

what feline castration technique is shown here that we use at LMU

1. male fertility and decreased male aggressiveness

2. roaming

3. undesirable urination behavior

indications for canine castration to reduce overpopulation by inhibiting...

1. prostatic diseases

2. perianal adenomas

3. perineal hernias

canine castration can help prevent androgen related diseases such as...

there are many (congenital abnormalities, testicular/epididymal abnormalities, scrotal neoplasia, trauma or abscess, inguinal-scrotal herniorrhaphy, scrotal urethrostomy, epilepsy control, control of endocrine abnormalities, testicular infection, testicular torsion, testicular trauma, perianal adenomas, prostatic cysts, prostatitis, benign prostatic hyperplasia (BPH), prostatic abscesses, sex-hormone associated alopecia)

when it comes to indications for canine castration indication...

29%

testicular tumors occur in ____ of intact males

1. 50% in 3 weeks

2. 2-3 months

in dogs with uncomplicated benign prostatic hyperplasia (BPH) canine castration will decrease prostate size by ______ and clinical signs will resolve in ____

95%

canine castration will lead to resolution of ____ perianal adenomas

1. prostatic carcinoma

2. hemangiosarcoma

3. osteosarcoma

4. transitional cell carcinoma

canine castration with have a higher risk for...

prescrotal

what canine castration approach is easiest and most common

perineal

what canine castration approach is used to avoid repositioning patient but can cause testicles to be more difficult to exteriorize

scrotal

what canine castration approach is sometimes used in prepubertal patients

abdominal

what canine castration approach is used when there is a retained testicle

left side

for right handed surgeons, castration of adult dog is easier when performed on the _____ of the dog

(stretched and stripped) <1 cm diameter

closed castration can be used in any size dog as long as spermatic cord is...

gubernaculum; ligament of the epididymis

the scrotal ligament is the embryonic remnant of ___ and was once referred to as ___

proximal

in a closed castration, a circumferential (encircling) lig. is placed ____ to the transfixation lig.

a three clamp technique for a closed castration

what is shown here

inspect cords for hemorrhage

when performing a closed castration, it is important to inspect what before replacing in patient

the urethra

when closing a castration you should avoid...

(stretched and stripped) >1cm diameter

open castration is used when spermatic cord...

open castration

what procedure is shown here

they are not clamped

when it comes to canine castration, large cords are easier to transfix if...

1. scrotal dermatitis

2. neoplasia

3. dogs with thin, pendulous scrotal sacs

4. dogs that live in kennels

5. enlarged testicle

6. severe scrotal dermatitis

when might scrotal ablation be performed

1. plan incision to leave ample skin

2. penis/urethra deep to excision

when considering technique for a scrotal ablation, what are two important things to keep in mind

ovariohysterectomy

traditional method of surgical sterilization of female dogs in the US defined as surgical removal of the ovaries and uterus

1. prevent estrus/unwanted offspring

2. prevent mammary tumors or congenital anomalies

3. prevention/tx. of pyometra, metritis, neoplasia, cysts

4. uterine trauma/torsion/prolapse

5. subinvolution of placental sites

6. vaginal prolapse or vaginal hyperplasia

7. control of endocrine abnormalities like diabetes or epilepsy

8. control for dermatoses like demodex

indications for ovariohysterectomy

1. dogs: cranial 1/3

2. puppies/kittens: middle 1/3

3. cats: middle 1/3

where are the ovariohysterectomy incision points for dogs, puppies, and cats when drawing an imaginary line from the umbilicus to the pubis***

at the linea alba (midline)

where is the actual incision placed when performing an OHE

linea alba and external rectus sheath

what layers are you cutting through and closing (ideally) when performing a spay

right ovary

which ovary is considered to be "tighter" when trying to break the suspensory ligament

1. "this feels too tight"-hook snags and doesn't want to pull

2. "this feels too loose"-hook comes out of incision with omentum or loop of small intestines

3. "this feels just right"-if it feels right its there

what is Dr. Thompsons "Goldilocks Theory" of spay hook usage when determining if you are hooked around the right structure

modified 3-clamp technique

what technique is shown on the left side and is indicated if there is not space to apply all three clamps so you leave one clamp on the proper ligament

3-clamp technique

what technique is shown on the right side and is the standard method that applied all three clamps on the same side of the ovary

circumfrental lig. closer to heart and transfixing lig. farther from heart

specifics of ligating the uterus

if uterine body is friable and appears unhealthy such as when it is post-partum

when might the use of clamps have the same effect as scissors in an OHE procedure and lead to severing the uterus

3 layer closure using monofilament absorbable suture

closure for OHE and castration

clots

though seeing some blood at the site of an OHE is normal, ____ are an indication that there is a problem

disorder characterized by C/s related to functional residual ovarian tissue after an OHE

what is ovarian remnant syndrome

1. dogs dx. with baseline progesterone concentrations

2. cats dx. with progesterone concentrations 7d after administration of HCG

how can we dx. ovarian remnant syndrome in dogs vs. cats

surgically explored while in estrus

when it comes to ovarian remnant syndrome, affected animals should be ______