Surgical Procedures

Ovariohysterectomy

• Def: Removal of ovaries, fallopian tubes and uterus down to cervix
• Indications: Prevent pregnancy, pyometra, estrus and reduce risk of mammary cancer
• Prep: Manually express bladder, shave from xiphoid to pelvic inlet
• Incision: Ventral midline between umbilicus & pubis
• Removal of ovaries, uterus,
• Instruments: Spay hook, groove director, forceps to clamp uterine stump and blood vessels (angiotribe or rochester-carmalt)
• Post-Op: Restrict activity for 7-10 days, then remove suture, analgesics, E-collar

Cesarean Section

• Def: Surgical removal of fetus; incision into uterine horn, fetus removed, horn sutured
• Indications: dystocia, dead fetus, previous c-sections, pelvic fracture, requested
• Surgical prep: Manually express bladder, clip then scrub entire abdomen, local anesthesia
• Incision: Ventral midline
• Instruments: Spay hook, groove director, angiotribe or rochester-carmalt
• Considerations: Avoid barbiturates and pre-anesthetics, gas anesthesia best, do quickly because anesthetic gas will travel through placenta
• Post-op: Analgesics, Reduced activity 7-10 days, E-collar, may give oxytocin to expel placenta

Mastectomy

• Def: Surgical removal of 1 or more mammary glands
• Indications: Mammary tumors
• Surgical Prep: Clip entire abdomen including cranially to to the axillary areas and caudally to the inguinal areas, surgical scrub
• Special instruments: Electrocautery, several hemostats, penrose drains
• Post-op: Remove drains after 3-5 days, E-collar, analgesics and antibiotics, send tissue for histopathology

Castration

• Def: Surgical removal of the testicles and spermatic cords, orchidectomy
• Indications: prevent overpopulation, prevent marking, aggression, etc., prevent prostate, anal and testicular disease, cryptorchidism
• Surgical prep: CATS - pluck hair from testicles, do not clip ; DOGS - clip area anterior to scrotum to end of prepuce and 1-2" laterally
• Incision: CATS - two incisions through scrotal skin; spermatic cords tied or knotted, heal by 2nd intention
• DOGS - one incision over area anterior to scrotum; spermatic cords ligated with absorbable suture
• Post-op: Analgesics, E-Collar, ice packs, watch for hematoma

Exploratory Laparotomy

• Def: Exploratory surgery in abdomen
• Indications: explore/visualize abdomen, performed alongside other abdominal surgeries
• Surgical Prep: Clip entire abdomen and caudal thorax, surgical scrub
• Special instruments: None, depends on findings
• Post-op: Depends on findings, E-collar

Gastrotomy

• Def: Incision into the stomach
• Indications: Removal of foreign bodies, correction of pyloric stenosis, feeding tube placement
• Surgical Prep: Clip entire abdomen and caudal thorax, surgical scrub
• Incision: Cranial ventral midline
• Special Instruments: Moist gauze sponges, radiopaque sponges, laparotomy sponges, warmed sterile saline, suction unit, change of gloves
• Post-op: Analgesics, antibiotics, restrict activity, NPO 24 hrs, soft food for 1 week, E-Collar

Gastrectomy

• Def: Removal of part of the stomach
• Indications: GDV, neoplasia, may perform gastropexy
• Surgical Prep: Clip entire abdomen and caudal thorax, surgical scrub
• Special Instruments: Moist gauze sponges, radiopaque sponges, laparotomy sponges, warmed sterile saline, suction unit, change of gloves
• Post-op: Analgesics, antibiotics, restrict activity, NPO 24 hours, soft food 1 week, E-Collar
• GDV: High-fiber diet, multiple times a day, minimize excitement, no water at feeding

Enterotomy

• Def: Incision into intestine, no tissue removed, sutured closed
• Indications: Removal of foreign objects, intestinal anastomosis, surgical biopsy
• Surgical prep: Clip entire abdomen, surgical scrub
• Incision: Ventral midline
• Special Instruments: Allis tissue forceps (foreign objects), moist gauze sponges, warmed sterile saline, suction unit, change of gloves
• Post-op: Analgesics, antibiotics, NPO for 24 hours, soft food for 1 week, restrict activity, E-Collar

Intestinal Anastomosis

• Def: Removal of part of the intestinal tract, then reattaching to the remaining tissue
• Indications: Necrotic intestinal tissue, neoplasia, intussusception, torsion, volvulus
• Surgical Prep: Clip entire abdomen, surgical scrub
• Incision: Ventral midline
• Special Instruments: Allis tissue forceps, doyen intestinal clamps, moist gauze sponges, warm sterile saline, suction unit, change of gloves
• Post-op: Analgesics, antibiotics, restrict activity, NPO 24 hrs, soft food 1 week, E-collar

Splenectomy

• Def: Removal of the spleen
• Indications: Neoplasia, rupture, torsion, GDV
• Surgical Prep: Clip entire abdomen and caudal thorax, surgical scrub
• Incision: Ventral midline
• Special instruments: Hemoclips or several hemostats, moist gauze sponges, warmed sterile saline, suction unit, change of gloves
• Post-Op: Analgesics, antibiotics, restrict activity, NPO for 24 hours, soft food for 1 week, E-Collar

Anal Gland Ablation

• Def: Removal of the anal glands
• Indications: Chronic abscesses or infection
• Special considerations: preserve external sphincter
• Surgical Prep: Clip entire perineum including base of tail and upper thighs, surgical scrub
• Incision: Over anal glands
• Special Instruments: Several hemostats, electrocautery
• Post-Op: Analgesics, antibiotics, Stool softener (2-3 weeks), E-Collar
• Complications: Fecal incontinence

Abscesses & Bite Wounds

• Wounds = injury to living tissue
• Abscess = immune system doesn't clear bacteria properly, wound becomes collection of infected tissue, makes pus!
• Bite wounds may cause serious internal injury and are prone to infection b/c cats carry pasteurella
• Surgical Prep: Clip large area (5-15cm around wound), use KY jelly to prevent contamination of hair in wound
• Treatment: Irrigate with sterile saline, flush with iodine or chlorhexidine, suturing not common, penrose drains, analgesics & antibiotics
• Post-op: Drains must be monitored and flushed PRN, removed 3-5 days later, recheck appointments

Dental Abscess

• Def: Usually includes carnassial tooth, draining area under the eye
• Indications: Root decay, more common in small dogs
• Pack open wound with sterile gauze and put animal on antibiotics before surgery
• Surgical prep: Clip draining area (5-15 cm around), use antiseptic
• Special instruments: Dental instruments, periosteal elevator, tooth extractors, #15 blade (periodontal ligament)
• Post-op: Antibiotics 10-14 days, remove gauze 2-3 days

Hernias

• Def: The protrusion of part of an organ through the wall of a body cavity
• Ex: Umbilical, Scrotal, Inguinal, Perineal, Diaphragm
• Surgical Prep: Clip large area (5-15 cm around hernia), surgical scrub
• Special Instruments: None
• Post-op: Restrict exercise, stool softeners

Onychectomy

• Def: Removal of entire nail and 3rd phalanx
• Surgical Prep: Feet cleaned with alcohol, chlorhexidine or povidine/iodine, tourniquet above elbow
• Special instruments: Resco nail trimmer or #12 scalpel blade, suture, CO2 laser
• Post-op: Analgesics & antibiotics, shredded paper instead of litter, well bandaged feet, restrict activity, discuss aftercare

Aural Hematoma

• Def: A collection of blood between the skin and ear cartilage in pinna; secondary cause of self-mutilation, trauma, infection, etc.
• Surgical Prep: Clean inside ear, pack with cotton, clip both sides of pinna, surgical scrub entire ear
• Procedure: Incision made to drain fluid, flush the inside of the incision, sutures or clips placed to prevent blood accumulation
• Special Instruments: Aural hematoma kit
• Post-op: Treat underlying cause, tape ear over the head, potential tranquilizers

Lateral Ear Resection

• Def: Removal of the ventral portion of the ear canal
• Indications: Chronic ear infections; allows for adequate circulation, administration of meds, etc.
• Surgical prep: Clean inside of ear, pack with cotton, surgical clip and scrub lateral ear canal below opening of ear
• Special Instruments: None
• Post-op: Bandage over surgical area, E-collar, ear cleaned daily, topical antibiotics, analgesics

Ear Crop

• Def: Surgical removal of part of the ears for cosmetic appearance (boxers, bostons, great danes, etc.)
• Surgical Prep: Surgical clip and scrub both sides of the pinna, pack ear with cotton
• Special Instruments: Special scissors, ear forms
• Post-op: Tape up ears, recheck every 7-10 days

Cystotomy

• Def: Bladder exteriorized then sutured closed
• Indications: Removal of cystic calculi, neoplasia, biopsy
• Surgical prep: Clip from xiphoid to pelvic inlet and 1" lateral to nipples, surgical scrub
• Special Instruments: Urinary catheter, moist gauze sponges, warmed saline, suction unit, change of gloves
• Post-op: Antibiotics, urinary acidifiers, prescription diet, E-Collar

Perineal Urethrostomy

• Def: Surgical removal of the feline penis and widening the urethra to expose the widest point
• Indications: Cats with repeated urinary blocks
• Surgical prep: Clip the entire perineal area proximal rear limbs, surgical scrub
• Special Instruments: Small iris scissors, urinary catheter
• Post-op: Antibiotics, urinary acidifiers, prescription diets, E-Collar

Equine Castration

• Def: Surgical removal of testicles and spermatic cords, performed in lateral, dorsal or standing
• Special considerations: Make sure both testicles have descended, place crushing side of emasculator toward the horse "nut to nut"
• Anesthesia: Xylazine, Ketamine
• Incision: Two large incisions on ventral scrotum
• Indications: Improve behavior, will not use for breeding,
• Surgical prep: Usually do not clip, betadine scrub over scrotum, lateral recumbency
• Special Instruments: Rope (to tie up leg), emasculator, Henderson tool, dental equipment if removing wolf teeth
• Post-op: Analgesics, antibiotics, daily walking
• Vaccinations: Tetanus antitoxin (immediate), tetanus toxoid (after 2-3 weeks)

Caslick's Procedure

• Def: Suturing of the labial margins, vulvoplasty
• Indications: Poor perineal conformation, prevents aspiration of air or feces into vagina
• Surgical Prep: Tail wrap, Clip and scrub vaginal area
• Special Instruments: None
• Post-op: Must be opened prior to breeding or foaling!!

Colic

• Def: Abdominal surgery, animal in dorsal recumbency, usually exploratory
• Indications: Unrelenting abdominal pain, torsion, volvulus, impactions, obstructions, etc.
• Surgical Prep: Clip & Scrub entire abdomen
• Special Instruments: Depends on procedure
• Post-op: Analgesics, antibiotics, IV fluids, NPO, Tetanus prophylaxis

Left Displaced Abomasum

• Def: abomasum sutured to abdominal wall to prevent recurrence
• Considerations: Abomasum usually on right side @ 7th to 11th ribs - displaced will be moved under the rumen, to the left flank
• Surgical Prep: Clip from last rib to top of ilium and wing of lumbar vertebrae to ventral midline
• Special Instruments: Long tubing with attached needle to deflate abdominal gas prior to re-positioning of the abomasum
• Post-op: Gradually increase food, antibiotics

Bovine C-Section

• Def: Removal of a fetus
• Indications: Dystocia, large fetus, debilitated cows
• Surgical Prep: Clip from the last ribs to the ilium and from the curve of lumbar vertebrae down to the ventral midline, entire ventral abdomen, surgical scrub
• Post-op: Antibiotics, quiet area, make sure calf nurses