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Procedure where the stomach is opened up, usually to retrieve foreign bodies. The surgery can also be used to explore the gastric lumen and to decompress and evacuate stomach air and contents before positioning a patient with GDV.

Mainly carried out on cats and dogs.

Complications are uncommon when the tissue viability and quality are normal. Healing can be compromised with neoplasia. Secondary peritonitis can occur due to intraoperative contamination. Incisional dehiscence can occur as well as tissue necrosis.

Post op: IVFT to keep hydrated and to replace losses from vomiting and from surgery. Post op analgesia, frequent pain scoring. Maropitant. Keeping an eye on surgical site, prevent self mutilation and interference, use BC or MPS. Feed bland food.

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Image of intra-abdominal mass observed during explorative laparotomy

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What is it?

VS will make incision on abdomen, perform evaluation of abdominal organs and tissues

Helps to assess whether FB is present

Allows conclusive visualisation of abdominal contents to ascertain what the issue is, e.g. can assess whether known tumour has spread

Assess mucosal damage

Enterectomy, enterotomy, gastrotomy would then follow if FB is present

Species/breed?

Can occur in any species

Post op care:

Large wound

Risk of dehiscence- adequate nutrition

Visceral traction causes discomfort

Wound management- dressings? prevent patient interference

Pain score and appropriate analgesia

Antibiotic cover if infection has been noted- could send away swabs for C&S

Monitor for haemorrhage- CRT, MM colour, RE/RR, heart rate

Urinary catheter maintenance as can be placed to allow for space whilst assessing abdomen

Risks & complications:

Damage surrounding tissues/organs when moving about bodily contents

Wound dehiscence

Internal haemorrhage

Hypothermia due to potential lavage and bodily contents exposed to external environment

GA risks

Reference: https://www.thesurgicalrvn.co.uk/exploratory-laparotomy

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WHAT IS IT? Blockage of the urethra usually caused by stones dislodging from the kidneys and passing to the urethra.

Most commonly seen in cats with calcium oxalate uroliths

Usually more commonly seen in males due to their urethra being narrower

In male cats urethral obstruction can also occur due to mucoid plugs or uretheral spasm.

TREATMENT:

- Passing of a urinary catheter/cystocentesis to empty the bladder, and then flushing the urolith/plug back in to the bladder with sterile saline. Sometimes a bypass device is fitted between the kidneys and bladder to stop further blockage.

-SCROTAL urethrostomy (male intact dogs)- castration and total scrotal ablation are performed and then an incision is made at this level into the urethra and is sutured to the skin edges.

-PERINEAL urethrostomy (male cat)-the penis is amputated and the urethra is opened out and sutured to the skin edges.

RISKS AND COMPLICATIONS:

1. rupturing of the bladder( which can lead to spillage in the abdomen that causes azotemia and then usually death

2. Ascending UTI's

3. Haemorrhage

4. Urinary scalding

5. Surgical site infection (especially due to location)

POST-OP CARE

1. Observation of surgical site

2. Hygiene maintenance of surgical site (esp. urinary scalding)

3. Awareness the animal will need to learn to urinate differently- extra staff/support when taking out

4. Px interference- buster collar at all times

5. Analgesia and pain scoring

6. Monitoring of fluid intake and output

7. Monitor for excessive bleeding when urinating

8. Hospitalise until bleeding when urinating has reduced.

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What is a pyometra?

Accumulation of pus in uterus, which may be infected or sterile.

The preferred treatment is to surgically remove the uterus and ovaries by performing an ovariohysterectomy (spay).

Species/sex:

common in older entire female dogs and occasionally cats. Occurs secondary to hormonally induced changes an is commonest about 5-6 weeks after season.

Post op care:

monitor blood pressure, analgesia, shock, dehydration, and infection, ivft, pain score, AB's and pain relief as needed, monitor vitals

Risks/complications:

severe toxaemic shock,peritonitis and cervical stump abscessation, wound infection, wound swelling, fistulous tract development, sepsis, haemorrhage, uveitis, conjunctivitis, pyelonephritis, arrhythmia, urinary tract infection and myocarditis

If the cervix is open there is a vaginal discharge and patient will be less ill. A closed pyo all the pus is retained in the cervix.

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What is it?

An ovariohysterectomy is the complete removal of the uterus and ovaries.

Species / sex?

In bitches, does, and sows this is commonly done via a midline coeliotomy, whereas in queens this is more commonly done via lateral flank ovariohysterectomy.

Post-op care:

Increased post-operative pain has been widely reported in ovariohysterectomy when compared with laparoscopic ovariectomy. Restricted exercise is essential for recovery.

Risks & complications:

Complications included haemorrhage, abdominal-wall dehiscence and seroma formation.

file:///C:/Users/saman/OneDrive/Documents/Vet%20Nursing%20(Vet%20Skill)/VN09/Week%206%20-%20Post%20Operative%20Nursing%20Considerations%20Part%201/Additional%20Reading%20-%20Articles%20for%20Task/Bitch%20Spay%20Techniques_%20Risks%20and%20Benefits%20Article.pdf

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Orchiectomy - surgical procedure to remove one or both testicles

Cryptorchid Castration - surgical procedure to remove one or two retained testicles found usually in the inguinal or abdominal cavity.

A surgical procedure done on male animals on any species, routinely done on dogs, cats, rabbits and guinea pigs.

Surgical procedure is performed to eliminate sexual behaviours and causes the animal to be sterile.

Reduces the risk of prostatic hyperplasia and prostatitis.

reduces the risk of hormone based diseases such as perianal adenomas and perianal hernias.

Reduces the chance of getting testicular cancer.

Neutering reduces the metabolism rate so can increase the risk of obesity.

It is important to neuter larger breeds once finished growing to reduce the risk of bone related injuries such as cruciate ligament tear.

The risk of developing testicular cancer is estimated roughly 10 times greater in dogs with retained testicles compared to normal.

Retained testicles can be difficult to find but surgery is mostly always advised.

Post op care:

Should be kept rested for 10-14 days post op.

Reduce jumping, running and excessive playing.

Keeping buster collar or medical pet suit on when unattended.

Could develop seromas, swelling and bruising of the scrotum as a complication.

Cold compressing may be advised.

Post op infections could occur.

Risks of procedure:

Main risk is the general anaesthetic and the risks involved with that.

Post op wound breakdown.

Post op infections.

Patient interference.

Scrotal hematoma

Haemorrhage

Bruising

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GDV - Is an acute, life threatening condition most commonly affecting large and giant breed dogs, particularly those which are deep chested. Usually affects middle aged to older dogs.

Pre-operative management for patients includes management and stabilisation of shock and assisting in the passing of stomach tube to aid deflation of the stomach. Right lateral radiographs are usually taken to confirm rotation.

Surgical intervention usually involves correction of the stomach rotation by gastropexy, where a permanent adhesion is made between the pylorus pf the stomach and right side body wall. The aim of doing this is to prevent rotation of stomach occurring again. In some cases a gastronomy tube is also placed to help with decompression and can also be used for feeding the patient post operatively if required.

Post op care requires close monitoring of the patient and continuation of fluid therapy and monitoring of electrolyte losses. Vital parameter monitoring is also very important as GDV cases will often experience ventricular arrhythmias therefore performing ECG traces post operatively is recommended.

Risks and Complications

Ventricular arrhythmias

Stomach wall may not be viable for Gastropexy

Gastric necrosis and GI disturbances

Permanent damage to cardiovascular system.

Damage to spleen from restricted blood supply.

Reoccurrence between 55-75% without gastropexy surgery.

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WHAT IS IT?- a congenital condition where one or both ureters implant distal to the bladder so that urine flows directly into the urethra and results in constant urinary incontinence

Usually seen in young dogs. Common breeds include golden retrievers, labradors and poodles

SURGERY

Where the ureter and kidney are healthy it is possible to reimplant the ureter surgically into the bladder

It can be done endoscopically and an incision is made to adjust the opening

RISKS/COMPLICATIONS:

1. Surgery on the ureter can result in spasming that can cause the kidney to stop producing urine for up to 48 hours. Therefore only one side should be done at a time.

2. Ureters may be enlarged due to infections which can result in severe pyelonephritis. This would then need to be a ureteronephrectomy instead

3. Unable to pass urine

4. Incontinence can still persist if other issues are at play.

POSTOP CARE:

1. Analgesia and pain scoring

2. Very close monitoring of fluid in put and output

3. Monitor surgical site

4. Px interference- buster collar

5. Px hygiene