Transcript SURGICAL PROCEDURES

SURGICAL PROCEDURES
ELECTIVE VS. NONELECTIVE
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ELECTIVE PROCEDURES – performed at the
veterinarian and owner’s convenience
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Patients are usually healthy
Examples: spay, neuter, declaw
NONELECTIVE PROCEDURES – procedure MUST be
done urgently to improve patient’s life
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Usually emergency procedures
Animals are usually compromised
Examples: intestinal foreign body removal, pyometra
ELECTIVE VS. NONELECTIVE
NOTE: some surgeries are necessary to improve
quality of life, but are not urgent and it is ok if
the procedure is delayed until conditions are
favorable
EXAMPLES: cruciate repair, entropion, ear canal
ablations from chronic otitis, cancer resection
ELECTIVE PROCEDURES
TAIL DOCKINGS (PUPPIES)
DEFINITION
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Partial amputation of the tail
INDICATIONS
Usually for aesthetic purposes (however can be
done in instances of trauma)
 Breed standards set by AKC
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TAIL DOCKING
PREOPERATIVE CONSIDERATIONS
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Always consider the dam
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Is she protective?
Usually provides the warmth/
food
Schedule to be performed
at age 3 -5 days.
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General anesthesia is not performed at this age
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Pick location of procedure carefully-puppies have a
weak immune system
TAIL DOCKING
TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS
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Puppy should be supported in the palms with the
hind limbs supported between the middle and index
fingers
Rear of puppy is toward the surgeon
Site is aeseptically prepared
Exact location is determined and tail is excised distal
to desired location
Hemorrhage is controlled
Suture placed to oppose the ends of the tail
Problems with amputating too much of the tail
TAIL DOCKING
POSTOPERATIVE CONSIDERATIONS
Return to mother quickly
 Don’t allow dam to lick sutures out!
 Observe for hemorrhage/early
removal of
sutures/redness/drainage/open
surgery site
 Area can get infected
 Some have to be re-done
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DEWCLAW REMOVAL
(PUPPIES)
DEFINITION
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Amputation of the claw on the medial aspect of each limb – if
present
INDICATIONS
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Aesthetic purposes
Usually performed at time of tail docking – if necessary
Also perform if there is a known risk of trauma for the patient
(particularly hunting dogs)
Some breeds, such as Great Pyrenees, require the declaws to
be present for showing
DEWCLAW REMOVAL
PREOPERATIVE CONSIDERATIONS
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Same as for tail dockings
TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS
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Aeseptically prepare surgery site
Cradle puppy on its side and extend one leg at a time toward
the surgeon
Dewclaw is excised
Hemorrhage is controlled (pressure, electrocautery)
Can either heal by second intention or sutured closed (silver
nitrate, surgical glue)
DEWCLAW REMOVAL
POSTOPERATIVE CONSIDERATIONS
Return to mother quickly
 Don’t allow dam to lick surgical area!
 Observe for hemorrhage/early removal of
sutures/redness/drainage/open surgery site
 Area can get infected
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Tail Docking & Dewclaw
removal video
http://www.youtube.com/watch?v=SyxfYK9dV5E
TAIL AMPUTATION AND
DEWCLAW REMOVING - adults
INDICATIONS
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Aesthetics, trauma, infection, neoplasia
PREOPERATIVE CONSIDERATIONS
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What is reason for surgery?
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Neoplasia – Obtain clean margins, submit tissue for
histopathology
Trauma – Stabilize patient before procedure
Infection – Culturing of area may be warranted
DEWCLAW REMOVAL - adults
TECHNIQUE AND INTRAOPERATIVE
CONSIDERATIONS – dewclaw removal
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GENERAL ANESTHESIA required
Clip, aeseptically prepare site
Dewclaw is excised at the base (excision extends
through joint, not bone)
Hemorrhage is controlled, skin edges are apposed
with suture
Paw is bandaged to prevent swelling, self trauma
DEW CLAW AMPUTATION
TAIL AMPUTATION - adults
TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS – tail
amputation
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May also be performed in other animals
Clipped, aseptically prepared
Some surgeons prefer for tail to positioned in air (vertically)
Tourniquet at base of tail is useful for hemorrhage
Skin is incised, tail is disarticulated at the joint that was
specified (usually skin incision is distal to disarticulation site to
facilitate closure)
Ligation of blood vessels
Skin is sutured to cover caudal vertebrae that is now exposed
TAIL
AMPUTATION
http://www.youtube.com/watch?v=
TeKAojeDb4I
TAIL AMPUTATION AND
DEWCLAW REMOVAL - adults
POST-OPERATIVE CONSIDERATIONS
Tail bandaging is difficult
 Monitor site for
hemorrhage/swelling/drainage/redness/selftrauma/dehiscence
 Consider placing an Elizabethan Collar
 Skin sutures generally removed in 10-14 days
 Pain meds are important
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