Gravid horns should be carefully exteriorized from the abdomen to avoid tearing the uterine wall or vessels.
|Gently "milk" puppies toward the uterine incision by squeezing cranial to them.|
- Correct fluid and electrolyte imbalances prior to surgery.
- Uterine contraction usually begins upon fetus removal. Oxytocin or ergonovine maleate may be administered if contraction does not occur.
- Appositional or inverting suture patterns are used to close the uterine incision.
- Hemorrhage, hypovolemia, hypothermia, and hypocalcemia are common postpartum. Monitor calcium levels if eclampsia is suspected.
- Don't forget to tell the owners that an odorless discharge (or lochia) is to be expected for 4 to 6 weeks postpartum.
MOST COMMON COMPLICATIONS AND DIFFICULTY
- Failure to place incision near the body, making the removal of neonates from both uterine horns more difficult.
- Separating the placenta from the uterine wall requiring too much force (potential for severe hemorrhage).
- Leaving a fetus within the uterine body (pelvic canal).
Abdomen/surgical field contamination with amniotic fluid or uterine content
- Be careful NOT to incise over a placental attachment site.
- Make a small incision in the uterine wall and then continue with Metzenbaum scissors to prevent accidental incision into a fetus.
- Make sure sterile lint-free towels are available to isolate uterus and warm neonates.
- Have assistant(s) available to resuscitate and handle neonates after their removal from the uterus.
- If the bitch or queen is to be spayed, en-bloc resection is quick and easy. Have an assistant remove the puppies or kittens from the uterus as quickly as possible, as you are closing.
Use an inverting pattern such as a Lembert or Cushing to close the uterus. Puppies may try to nurse on the knots of sutures. Use a subcuticular or intradermal skin closure pattern to prevent oral irritation to nursing puppies.
SUTURE AND NEEDLE OPTIONS
|Brand||Needle Type||Needle Reference|
|Main Choice||Also Possible||Main Choice||Also Possible|
|Taper Point||SH-1, SH, CT-2, CT-1|
|LINEA ALBA||MONOCRYL* (young)
PDS* II (adult)
|VICRYL* PLUS||Taper Point
|SH-1, SH, CT-2, CT-1||RB-1, CT-3
FS-2, FS-1, FS, FSL, X-1, CP-2, CP-1
|Taper Point||RB-1, SH, CT-2, CT-1|
|Silk||Reverse Cut||FS-2, FS-1, FS||FSL, CP-2, CP-1, KS|
(20 lbs or less)
(20-45 lbs or less)
(50 to 75 lbs)
(75 lbs +)
|UTERUS||4-0 or 3-0||3-0 or 2-0||3-0 or 2-0||2-0 or 0|
|LINEA ALBA||3-0||3-0 or 2-0 or 0||2-0 or 0||0 or 1|
|SUBCUTANEOUS||4-0||4-0 or 3-0||3-0 or 2-0||2-0|
|SKIN CLOSURE||4-0||4-0 or 3-0 or 2-0||3-0 or 2-0||2-0|