Page 2350 - Cote clinical veterinary advisor dogs and cats 4th

Sterilization, Surgical: Gonad Sparing 1163

• Monitor contact points of bandage materials, • Ease of application and risk of complications SUGGESTED READING
especially around bony prominences and have improved with the use of commercially Swaim SF, et al: Small animal bandaging, casting,
joints.
VetBooks.ir Pearls Ehmer sling and DogLeggs Velpeau sling, and splinting techniques. Ames, IA, 2011,
available alternatives (DogLeggs vest with
Wiley-Blackwell.
DogLeggs Therapeutic Rehabilitative Prod-
• Well-adhered tape stirrups are essential for
preventing slippage and loss of Robert Jones ucts, Washington, DC). AUTHOR: Peter Moak, DVM
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
bandages and casts. Thompson, DVM, DABVP

Sterilization, Surgical: Gonad Sparing Client Education
Sheet

Difficulty level: ♦♦ ○ If any part of the uterus remains after ■ These landmarks help the surgeon Procedures and Techniques
surgery, the dog will be at risk for develop- decide where to create a window
Synonyms ing a stump pyometra (p. 854), which can through the broad ligament so that
• Ovary-sparing spay be life-threatening. the cranial vasculature to the uterine
• Hysterectomy ○ Leaving the ovaries may contribute to an horn may be transfixed and ligated.
• Vasectomy increased risk of mammary tumors (p. ❏ Place a transfixing ligature across the
623) in the future. uterine tubes.
Overview and Goals • Vasectomy ■ Take time to ensure that all uterine
• Prevention of pregnancy ○ Sperm granulomas tissue is caudal to the ligatures and can
• Sterilization ○ Short-term possible complications include be removed when transected.
• Preservation of hormones infection, bruising, and bleeding into the ■ Transect distal to the ligatures, and
scrotum, resulting in a hematoma. repeat this procedure on the contra-
Indications ○ In rare cases, the ductus deferens may lateral side.
Method of surgically sterilizing dogs without recannulize. ○ After both horns are free from the ovaries,
removing gonads, for which the beneficial follow the uterus caudally to identify the
health impacts are only recently beginning to Procedure cervix.
be understood • Ovary-sparing spay ■ The cervix is identified as a firm, white
○ The anesthetized patient is positioned in bulge demarcating the lower extent of
Contraindications dorsal recumbency, and the surgical site the uterine body.
Dogs used for breeding programs is sterilely prepared and draped. ■ Ligatures can be placed on the cervix
○ Before beginning an incision, the incision or distal to the cervix (cranial vagina).
Equipment, Anesthesia site should be carefully planned. ❏ A large, crushing clamp is tempo-
• General anesthesia ■ The incision will typically be made rarily placed across the cervix or
• Surgical pack directly over the midline, 1-3 finger vagina to demarcate the intended
• Spay hook widths caudal to the umbilicus, depend- cut line.
• #10 scalpel blade ing on the size of the patient. A larger, ❏ A transfixing ligature is tied in the
• Suture (surgeon’s discretion) more caudal incision will be made than crushed tissue at the site of the
• Sterile gown/gloves for a traditional spay, allowing the previously placed clamp.
• Surgical scrub complete uterus and cervix to be fully ❏ A clamp is then placed approximately
• Clippers exteriorized from the incision. one-half inch further down the cervix
○ With a #10 scalpel blade, a midline or vagina cranially to act as a guide
Anticipated Time incision is made through the skin, sub- for cutting as the entire uterine body
• Will depend on experience of the surgeon cutaneous tissues, and linea alba, similar is excised, again taking the time to
• Ovary-sparing spay to a traditional spay. ensure that all the uterine tissue is
○ Due to the importance of making sure ○ After the abdomen is entered, the uterus removed.
that all uterine tissue has been removed must be located. ■ Before beginning the routine abdominal
and the additional suture time for a longer ■ This can be done using a spay hook or closure, the abdomen is evaluated to be
incision, the procedure may take slightly the surgeon’s finger. certain that no bleeding is evident.
longer than a routine spay. ■ To confirm that the uterus has been • Vasectomy
• Vasectomy located, trace the structure crani- ○ The anesthetized patient is positioned in
○ Relatively quick procedure; shorter than ally to the ovary or caudally to the dorsal recumbency, and the surgical site
a routine castration bifurcation. is sterilely prepared and draped.
■ After the uterine horn is identified, it ○ With a #10 blade, make a 1-2 cm inci-
Preparation: Important should be exteriorized while leaving sion into the skin over the spermatic
Checkpoints the ovary in the abdomen. NOTE: do cord between the scrotum and inguinal
Preanesthetic bloodwork not break down the ovarian suspensory ring.
ligaments. ■ This incision is midway between
Possible Complications and ■ Gentle traction is placed on the horn and parallel to both spermatic cords,
Common Errors to Avoid upward while the ovary is palpated permitting blunt dissection of these
• Ovary-sparing spay digitally. After the ovary is isolated, structures.
○ As with any surgery, complications may identify the ovarian bursa and uterine ■ The spermatic cord is identified by
arise from the use of general anesthesia. tube. direct observation and exteriorization

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