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SURGICAL PROCEDURES

SURGICAL PROCEDURES. ELECTIVE VS. NONELECTIVE. ELECTIVE PROCEDURES – performed at the veterinarian and owner’s convenience Patients are usually healthy Examples: spay, neuter, declaw NONELECTIVE PROCEDURES – procedure MUST be done urgently to improve patient’s life

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SURGICAL PROCEDURES

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  1. SURGICAL PROCEDURES

  2. ELECTIVE VS. NONELECTIVE • ELECTIVE PROCEDURES – performed at the veterinarian and owner’s convenience • Patients are usually healthy • Examples: spay, neuter, declaw • NONELECTIVE PROCEDURES – procedure MUST be done urgently to improve patient’s life • Usually emergency procedures • Animals are usually compromised • Examples: intestinal foreign body removal, pyometra

  3. 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

  4. ELECTIVE PROCEDURES

  5. TAIL DOCKINGS (PUPPIES) DEFINITION • Partial amputation of the tail INDICATIONS • Usually for aesthetic purposes (however can be done in instances of trauma) • Breed standards set by AKC

  6. TAIL DOCKING PREOPERATIVE CONSIDERATIONS • Always consider the dam • Is she protective? • Usually provides the warmth/ food • Schedule to be performed at age 3 -5 days. • General anesthesia is not performed at this age • Pick location of procedure carefully-puppies have a weak immune system

  7. TAIL DOCKING TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS • 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

  8. 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

  9. DEWCLAW REMOVAL (PUPPIES) DEFINITION • Amputation of the claw on the medial aspect of each limb – if present INDICATIONS • 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

  10. DEWCLAW REMOVAL PREOPERATIVE CONSIDERATIONS • Same as for tail dockings TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS • 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)

  11. 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

  12. Tail Docking & Dewclaw removal video http://www.youtube.com/watch?v=SyxfYK9dV5E

  13. TAIL AMPUTATION AND DEWCLAW REMOVING - adults INDICATIONS • Aesthetics, trauma, infection, neoplasia PREOPERATIVE CONSIDERATIONS • What is reason for surgery? • Neoplasia – Obtain clean margins, submit tissue for histopathology • Trauma – Stabilize patient before procedure • Infection – Culturing of area may be warranted

  14. DEWCLAW REMOVAL - adults TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS – dewclaw removal • 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

  15. DEW CLAW AMPUTATION

  16. TAIL AMPUTATION - adults TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS – tail amputation • 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

  17. TAIL AMPUTATION http://www.youtube.com/watch?v=TeKAojeDb4I

  18. TAIL AMPUTATION AND DEWCLAW REMOVAL - adults POST-OPERATIVE CONSIDERATIONS • Tail bandaging is difficult • Monitor site for hemorrhage/swelling/drainage/redness/self-trauma/dehiscence • Consider placing an Elizabethan Collar • Skin sutures generally removed in 10-14 days • Pain meds are important

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