• 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

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.

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

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

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.

• 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