World Veterinarian Quiz 36

OVARIOHYSTERECTOMY  IN BITCH

v  A surgical procedure consisting of laparotomy with ablation of both ovaries and the uterus.

Indication :

v  To avoid Breeding & Heat

v  Neoplasm & Ovarian cyst

v  Uterine diseases (Pyometra, metritis, chronic endometrial hyperplasia, Prolapse)

v  Minimize the risk of mammary gland tumours

v  Prevention of hormonal changes that interferes with therapy for dermatitis, diabetes or Epilepsy, Dystocia (>24-36Hrs)                                                                                                 

   (Roberts ,1971)

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Normal Anatomy

Arteries and veins of the genital apparatus of the bitch

Pre-Operative Care : 

1. Elective OHE: Normal healthy animal and would require complete Blood count.

2. Whereas in disease condition stabilize the disease and safe anesthesia 

v  Bitch presents with a generalized condition with hypothermia, dehydration, and mydriasis.

v  Hepatorenal insufficiency should not undergo general anesthesia if the urea levels are >0.6 g/L and the creatinine is >10 mg/L, such animals are associated with poor peri- and postoperative survival.

o   Essential to perform a complete, detailed preoperative clinical examination, with blood tests and serum biochemistry.

(Bencharif et al.,2010)

v Surgical Approaches :

At the linea alba; the incision starts at the umbilicus and ends 2 to 3 cm cranial to the anterior border of the pubis.

Animal Restrain & preparation of Surgical site :

v  Ensure that the bitch has been fasted since the previous day  in elective surgery

v  In an emergency situation, after induction of anaesthesia rapid intubation with a cuffed endotracheal tube should prevent aspiration of stomach contents due to gastric reflux

v  Surgical site should be clipped, shaved & scrubbed several times with disinfectant solutions

The bitch is positioned in dorsal recumbency with her front legs pulled forward and tied to the table, and the back legs tied back; the bitch is then put on a drip with previously warmed normal saline (0.9%).

Anaesthesia:

ü  Various protocols are available,

ü  Anesthesia should be choose depending upon condition of animal

IV premedication - Morphine @0.1mg/kg/hr

followed by General Anesthesia -Propofol @ 5 mg/kg,

For Maintenance - Isoflurane gas 2%

What we use at Our Clinic….

v  Xylazine (sedative)-1to2mg/kg I/M

v  Dissociative anaesthetic –

                 Ketamine @ 5mg/kg. I/V

                                                &

                                    diazepam @0.5mg/kg. I/V (Muscle Relaxant)

v  Lignocain Hydrochloride 2%

Sterilization of Surgical set before surgery should be done.

SURGICAL PROEDURE:

Laparotomy (opening of abdominal cavity)

1st palpate the uterine loop (of any side) and separate the ligament  Rupture the ovarian ligament with your finger or Spaying Hook and pulled out uterus and ovary outside the abdominal cavity.

     

Application of 3 Forceps (Clamp the ovarian artery and vein together, with long curved artery forceps)

    

Ligature the vessels with help of Suture Material

     

After the proper ligation cut the Tissue Between 2^nd & 3^rd Forceps and Ensure about no bleeding from clamp & remove 1^st Forcep.

Repeat this Procedure for two ovarian end and one cervical end

Then suture muscles with absorbable suture material and suture the skin with non-absorbable suture material. Muscle suture & Skin suture should be done in routine manner.

Post-operative care:

v  Proper management of surgical wound with daily dressing with antiseptic solutions.

v  Give appropriate antibiotics and analgesic to prevent secondary bacterial infection and pain management.

v  Elizabeth collar for prevention liking of surgical wound.

Complications:

v  Internal bleeding

v  Stump Pyometra

v  Maggot wound

v  Peritonitis

v  Pus draining from surgical wound

v  Secondary bacterial infections.