Neutering in practice: are your anaesthesia, analgesia and surgical protocols up to scratch?

31 Pages·2012·4.26 MB·English

Neutering in practice: are your
anaesthesia, analgesia and surgical
protocols up to scratch?
David Yates BVSc MRCVS
Hospital Director
RSPCA Greater Manchester Animal Hospital
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Outline of talk
● Surgical methods for population control in female cats
● Tips for success
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OVE or OVH
It ain't what you do it's the way
that you do it
It ain't what you do it's the time
that you do it Puberty
Flank or
It ain't what you do it's the
midline
place that you do it
And that's what gets results
Bananarama 1982
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The way that you do it?
Ovariohysterectomy (OVH) Ovariectomy (OVE)
● May not be achieved via flank ● More widely practised outside the UK
approach ● Incision closer to the umbilicus -
● Longer incisions or traction to reducing traction on the ovarian
exteriorise the cervix (pain & GA suspensory ligament (pain & GA
depth) depth)
● Ligation of ovaries* & ● Ligation of the ovaries* + proper
uterine/cervical/vaginal stump ligaments (maximum of 4 ligatures)
(minimum of 3 ligatures) ● No long term difference between
OVE & OVH (oestrogens &
progestogens unlikely to be
prescribed in cats)
* pedicle ties do not require suture material
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The time that you do it?
Prepubertal / ‘Ideal’ (4 months) ‘Conventional’ (> 6 months)
● Small incision ● Morbidity linked to age and mass of
● Minimal fat (s/c, abd. & broad ligt.) patient (surgical time)
● Peritoneal fluid - low SG ● May need to respond to
● Simple ligatures ● Pregnancy (30%)
● No complicating factors - pd+ve, etc. ● Vascular tract
● Rapid healing & recovery ● Already spayed
● Low morbidity ● Fat
● Optimum time for population control
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Prepubertal Postpubertal
Rapid induction and recovery if BSA Recovery linked to size and condition
dosing (NB. pregnancy)
Incision placed according to age Incision variable length
Predictable and simple haemostasis Complications - mammary vessels,
pregnancy, etc.
Less affective pain & NSD sensory Morbidity linked to age and weight
pain
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The place that you do it?
Flank Midline
● Progress to bitches
● Rapid
● Reduced pain
● Excellent exposure of L ovary (OVE)
● Improved exposure (OVH)
● Mammary development
● Need to empty bladder
● Ideal method to respond to problems
● Students
● Unicornuate uteri
● Haemorrhage
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Top 10 tips for cat spays
● Body surface area dosing
● Empty the bladder - comfort & surgery (alpha-2)
● Landmarks to locate the incision
● Traction in the right direction
● Recovery temperature
● Elective procedure (standard growth charts, cryptorchidism)
● Full colon
● Cat castrations - practise pedicle tie
● Littermates - minimise stress
● Multimodal analgesia
Kamil Slachciak
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1) Body surface area dosing
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Kitten anaesthesia
● Cat Group Policy Statement
● Intramuscular - i/v difficult
● Reversible - safety
● BSA dosing - precision
● Appropriate pain prevention - 24 hours
● Kitten Quad App - iPhone, Android, Windows
o Medetomidine
o Ketamine
o Midazolam
o Buprenorphine or methadone
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