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