SURGICAL PROCEDURES

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SURGICAL PROCEDURES
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ELECTIVE VS. NONELECTIVE

• ELECTIVE PROCEDURES performed at the
  veterinarian and owners convenience
• Patients are usually healthy
• Examples spay, neuter, declaw
• NONELECTIVE PROCEDURES procedure MUST be done
  urgently to improve patients life
• Usually emergency procedures
• Animals are usually compromised
• Examples intestinal foreign body removal,
  pyometra

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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

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ELECTIVE PROCEDURES
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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

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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

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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

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TAIL DOCKING

• POSTOPERATIVE CONSIDERATIONS
• Return to mother quickly
• Dont 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
• 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

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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)

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DEWCLAW REMOVAL

• POSTOPERATIVE CONSIDERATIONS
• Return to mother quickly
• Dont 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?vSyxfYK9dV5E
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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

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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

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DEW CLAW AMPUTATION
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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

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TAIL AMPUTATION
http//www.youtube.com/watch?vTeKAojeDb4I
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(No Transcript)
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TAIL AMPUTATION AND DEWCLAW REMOVAL - adults

• POST-OPERATIVE CONSIDERATIONS
• Tail bandaging is difficult
• Monitor site for hemorrhage/swelling/drainage/redn
  ess/self-trauma/dehiscence
• Consider placing an Elizabethan Collar
• Skin sutures generally removed in 10-14 days
• Pain meds are important