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