Stephanie Bos, Anna Hoeve,

Christine Smith, Megan O’Kelly

Surgery #1-- Abdominal Exploratory● Exploratory Laparotomy

● View the tissues and organs of the

abdominal cavity

● Very common○ Ingested foreign objects

○ Twisted intestines

○ Bloat

○ Biopsies

● Radiographs, ultrasounds, or contrast radiographs don’t give definitive

answers

IndicationsWhen all other tests are inconclusive surgery is the next best option

● Chronic vomiting

● Abdominal pain

● Abdominal fluid accumulation

● Abdominal masses

Instruments Needed● Olsen-Hegar Needle Holder● Straight Mayo Scissors● Curved Metzenbaum Scissors● Adson Brown Forcep● #3 Handle● Backhaus Towel Clamp● Curved Halstead Mosquito

Forceps● Straight Kelly Forceps● Curved Rochester-Carmalt

Forceps

Special Instruments● Balfour Retractor

○ Holds abdominal walls open during surgery

● Laparotomy Sponges○ Special sponge used inside body○ Soaks up blood and other fluids

● Heated Lavage Fluid○ To wash away foreign debris, purulent

fluid, and microorganisms

● Suction ○ Remove blood and fluids from surgical area

Postoperative Care● Crucial to the recovery of your pet

● Kept calm for at least 3 weeks○ Leash walking only

○ No rough housing

○ No jumping from high surfaces like human bed or the car

● Monitor incision site daily

● Make sure pet has started eating normal meals within a few days

Abdominal Exploratory Anatomy

● Abdominal exploratory surgery is performed for surgical exploration of the abdominal cavity, which can be due to multiple different reasons

● This procedure should be performed with the animal in dorsal recumbency, if a ventral midline approach is wanted

○ With all four legs secured

● It is also important for the bladder to be expressed before the surgery

Exploratory Anatomy● Abdominal exploratory surgery takes place in the abdominal cavity, which

contains the following organs:○ Stomach○ Small intestine○ Large intestine○ Spleen○ Liver○ Gall bladder○ Pancreas○ Kidneys○ Adrenal glands

43½ socks found inside a Great Dane

Surgery #2 -- Pyometra ● “A condition of the uterus in which

endometrial hyperplasia has resulted in increased uterine secretions and accumulation of fluid in the uterus with secondary infection”

● Typically occurs in middle aged - older dogs 4-8 weeks after estrus

● Can be referred to as open or closed based on the position of the cervix

Indications● Symptoms include:

○ Decreased appetite○ Lethargy○ PU/PD○ Sometimes foul smelling vaginal discharge

● Pyometra can be seen on abdominal radiographs

Treatment ● Ovariohysterectomy is the

recommended treatment○ Open pyometra means the pus can

be drained through the open cervix○ Valuable breeding dog owners may

opt to simple manage the symptoms■ This is strongly discouraged!

○ The uterine can rupture at any point

○ Up to 77% rate of recurrence if symptoms are just managed

Instruments

● Special Instruments:○ Routine surgical instrument pack○ Sterile laparotomy sponges○ Heated lavage fluid○ Suction○ Synthetic absorbable suture material as well

as non-absorbable suture material

Pre Op and Surgery Considerations● Pre-Op & Surgery:

○ Broad-spectrum IV antibiotics should be used pre-op

○ Special care should be taken during surgery because the uterus is so heavy

○ An assistant may need to scrub in just to lift the uterus

○ An abdominal exploratory surgery may be completed before removing the uterus in order to confirm that pyometra is the only infection present

Post Op Considerations● Post-Op:

○ Normal monitoring that occurs during an OHE is recommended

○ IV antibiotics are given until the animal is stabile, eating, and drinking

○ Oral antibiotics should be given for 7-10 days post-op

Pyometra Surgery Anatomy● Routine ovariohysterectomy, but with a few special circumstances● Animal should be placed in dorsal recumbency● Due to enlarged uterus, the incision will generally be extended from the

xiphoid to the pubis● This procedure includes:

○ Uterus○ Blood vessels ○ Ovaries

Pyometra in a cat

Surgery #3 Entropion

● Normally a hereditary disorder● The eyelids roll inward and can

cause the hair on the eyelid to rub on the outside of the eyeball (cornea)

● Can happen in both eyes but most commonly only affects one eye

Lower lid is rolled inward

● Excessive tear production ● Squinting ● Holding their eye shut ● Inverted eyelid● Sensitivity to light● Corneal ulcers, erosions or scarring● Inflammation of the conjunctiva

Indications

**Performed only if the canine is 6-12 months of age**

● Holtz- Celsus Procedure

A portion of the skin and muscle on the eyelid is removed to reverse the rolling inward towards the cornea

Surgery Procedure Option #1

Surgery Procedure Option #2● Eyelid tacking

○ Temporarily roll the eyelid outward in young animals

○ A second corrective surgery may be needed to help reduce an over correction of the eyelid

○ Permanent correction is done when the animal is mature■ Overcorrection will cause ectropion

Instruments Needed

● Special eye drape ● Towel clamps● Tissue forceps● Needle holders● Suture or staples

Special Instruments● Half curved tissue forceps

○ Handling eyelid and conjunctival tissue without causing trauma

● Chalazion forceps○ Help stabilize tissue and hemostasis

● Jaeger lid plate ○ Flat, curved ends to place under

eyelid and make a firm surface during the incision

● Tenotomy scissors○ Special tips help divide and dissect

the muscles and tendons

Postoperative Considerations● E-collar prevents pawing at the area of surgery ● Warm compresses can reduce swelling● Wounds should be cleaned with moist cotton

balls daily● Topical antibiotic ointments and (+/- oral

medications) may be needed● Non-dissolvable sutures should be removed

10-14 days after surgery

Entropion Surgery Anatomy● Most common ocular disease found in neonatal lambs● The congenital/primary form involves just the lower lid, but it tends to

occur bilaterally● The position for this procedure is sternal or lateral recumbency

depending on the veterinarian performing the procedure○ Towels and sandbags are used to aid in stabilization

● Anatomy involved:○ One or both eyelids○ Cornea and conjunctiva (numbing)

ReferencesAbdominal Exploratory Laparotomy. (n.d.). Retrieved July 27, 2016, from

http://www.michigananimalhospital.com/abdominal-exploratory

Abdominal Surgery: Post-Operative and Incisional Care. (n.d.). Retrieved July 26, 2016, from

http://metro-vet.com/references/abdominal-surgery/

Canine Entropion: Page 2 of 2. (2013, November 19). Retrieved June 29, 2016, from

http://www.expertvet.com/articles/canine-entropion?page=0,1

Denger, D. A. (n.d.). Abdominal Exploratory Surgery. Retrieved July 26, 2016, from

http://www.vetsurgerycentral.com/Ab_exploratory.htm

Eyelid Entropion in Dogs. (n.d.). Retrieved June 29, 2016, from

http://www.vcahospitals.com/main/pet-health-information/article/animal-health/eyelid-entropion-in-dogs/1009

McCurnin, D. M., Bassert, J. M., & Thomas, J. A. (2014). Small animal surgical nursing. In Clinical textbook for veterinary technicians

(8th ed., pp. 1235-1236). St. Louis, MO: Elsevier Saunders.

ReferencesSurgeon's Corner: Pyometra. (n.d.). Retrieved July 26, 2016, from

http://www.cliniciansbrief.com/article/surgeons-corner-pyometra

Tear, M. (2012). Surgical procedures. In Small animal surgical nursing (2nd ed., pp. 133-135, 155-156, 168-170). St. Louis,

MO: Mosby Inc.

University of Prince Edward Island. (n.d.). Entropion. Retrieved from http://discoveryspace.upei.ca/cidd/disorder/entropion