SURGICAL PROCEDURES

ELECTIVE VS. NONELECTIVE ELECTIVE PROCEDURES – performed at the veterinarian and owner’s convenience ELECTIVE PROCEDURES – performed at the veterinarian and owner’s convenience Patients are usually healthy Patients are usually healthy Examples: spay, neuter, declaw Examples: spay, neuter, declaw NONELECTIVE PROCEDURES – procedure MUST be done urgently to improve patient’s life NONELECTIVE PROCEDURES – procedure MUST be done urgently to improve patient’s life Usually emergency procedures Usually emergency procedures Animals are usually compromised Animals are usually compromised Examples: intestinal foreign body removal, pyometra Examples: intestinal foreign body removal, pyometra

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

ELECTIVE PROCEDURES

TAIL DOCKINGS (PUPPIES) DEFINITION Partial amputation of the tail Partial amputation of the tailINDICATIONS Usually for aesthetic purposes (however can be done in instances of trauma) Usually for aesthetic purposes (however can be done in instances of trauma) Breed standards set by AKC Breed standards set by AKC

TAIL DOCKING PREOPERATIVE CONSIDERATIONS Always consider the dam Always consider the dam Is she protective? Is she protective? Usually provides the warmth/ Usually provides the warmth/food Schedule to be performed Schedule to be performed 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 weak immune system Pick location of procedure carefully-puppies have a weak immune system

TAIL DOCKING TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS Puppy should be supported in the palms with the hind limbs supported between the middle and index fingers 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 Rear of puppy is toward the surgeon Site is aeseptically prepared Site is aeseptically prepared Exact location is determined and tail is excised distal to desired location Exact location is determined and tail is excised distal to desired location Hemorrhage is controlled Hemorrhage is controlled Suture placed to oppose the ends of the tail Suture placed to oppose the ends of the tail Problems with amputating too much of the tail Problems with amputating too much of the tail

TAIL DOCKING POSTOPERATIVE CONSIDERATIONS Return to mother quickly Return to mother quickly Don’t allow dam to lick sutures out! Don’t allow dam to lick sutures out! Observe for hemorrhage/early removal of sutures/redness/drainage/open surgery site Observe for hemorrhage/early removal of sutures/redness/drainage/open surgery site Area can get infected Area can get infected Some have to be re-done Some have to be re-done

DEWCLAW REMOVAL (PUPPIES) DEFINITION Amputation of the claw on the medial aspect of each limb – if present Amputation of the claw on the medial aspect of each limb – if presentINDICATIONS Aesthetic purposes Aesthetic purposes Usually performed at time of tail docking – if necessary 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) 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 Some breeds, such as Great Pyrenees, require the declaws to be present for showing

DEWCLAW REMOVAL PREOPERATIVE CONSIDERATIONS Same as for tail dockings Same as for tail dockings TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS Aeseptically prepare surgery site Aeseptically prepare surgery site Cradle puppy on its side and extend one leg at a time toward the surgeon Cradle puppy on its side and extend one leg at a time toward the surgeon Dewclaw is excised Dewclaw is excised Hemorrhage is controlled (pressure, electrocautery) Hemorrhage is controlled (pressure, electrocautery) Can either heal by second intention or sutured closed (silver nitrate, surgical glue) Can either heal by second intention or sutured closed (silver nitrate, surgical glue)

DEWCLAW REMOVAL POSTOPERATIVE CONSIDERATIONS Return to mother quickly Return 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 sutures/redness/drainage/open surgery site Observe for hemorrhage/early removal of sutures/redness/drainage/open surgery site Area can get infected Area can get infected

Tail Docking & Dewclaw removal video

TAIL AMPUTATION AND DEWCLAW REMOVING - adults INDICATIONS Aesthetics, trauma, infection, neoplasia Aesthetics, trauma, infection, neoplasia PREOPERATIVE CONSIDERATIONS What is reason for surgery? What is reason for surgery? Neoplasia – Obtain clean margins, submit tissue for histopathology Neoplasia – Obtain clean margins, submit tissue for histopathology Trauma – Stabilize patient before procedure Trauma – Stabilize patient before procedure Infection – Culturing of area may be warranted Infection – Culturing of area may be warranted

DEWCLAW REMOVAL - adults TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS – dewclaw removal GENERAL ANESTHESIA required GENERAL ANESTHESIA required Clip, aeseptically prepare site Clip, aeseptically prepare site Dewclaw is excised at the base (excision extends through joint, not bone) Dewclaw is excised at the base (excision extends through joint, not bone) Hemorrhage is controlled, skin edges are apposed with suture Hemorrhage is controlled, skin edges are apposed with suture Paw is bandaged to prevent swelling, self trauma Paw is bandaged to prevent swelling, self trauma

DEW CLAW AMPUTATION

TAIL AMPUTATION - adults TECHNIQUE AND INTRAOPERATIVE CONSIDERATIONS – tail amputation May also be performed in other animals May also be performed in other animals Clipped, aseptically prepared Clipped, aseptically prepared Some surgeons prefer for tail to positioned in air (vertically) Some surgeons prefer for tail to positioned in air (vertically) Tourniquet at base of tail is useful for hemorrhage 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) 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 Ligation of blood vessels Skin is sutured to cover caudal vertebrae that is now exposed Skin is sutured to cover caudal vertebrae that is now exposed

TAIL AMPUTATION TeKAojeDb4I

TAIL AMPUTATION AND DEWCLAW REMOVAL - adults POST-OPERATIVE CONSIDERATIONS Tail bandaging is difficult Tail bandaging is difficult Monitor site for hemorrhage/swelling/drainage/redness/self- trauma/dehiscence Monitor site for hemorrhage/swelling/drainage/redness/self- trauma/dehiscence Consider placing an Elizabethan Collar Consider placing an Elizabethan Collar Skin sutures generally removed in days Skin sutures generally removed in days Pain meds are important Pain meds are important