ST E2- OVE, Tracheal and Laryngeal Collapse

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Questions and Answers

During an ovariohysterectomy using spay hooks, what does it indicate if the hook comes out of the incision with omentum or intestinal loop?

  • The hook is correctly positioned, and the ovary is being tightened.
  • The hook is snagged deep against the dorsal body wall.
  • The hook is advanced at the appropriate depth.
  • The hook is too loose. (correct)

Why is it crucial to avoid over-tightening sutures on the uterus during an OHE?

  • To prevent severing the uterus, especially if it's friable or unhealthy. (correct)
  • To prevent the spay hook from getting damaged.
  • To avoid exteriorizing the ovary.
  • To minimize blood pooling.

What is the primary goal when breaking down the suspensory ligament during an ovariohysterectomy?

  • To use clamps effectively.
  • To cause blood pooling.
  • To exteriorize the ovary. (correct)
  • To insert the spay hook.

What does the presence of blood clots, rather than simple blood pooling, typically indicate post-OHE?

<p>A bigger problem, such as hemorrhage. (D)</p> Signup and view all the answers

What is the significance of locating the caudal gutter during surgery?

<p>To assess blood amount. (D)</p> Signup and view all the answers

What is the effect of neutering on the risk of certain types of cancer in dogs?

<p>It increases the risk of prostatic carcinoma, HSA, Osteosarcoma, and TCC. (C)</p> Signup and view all the answers

What is a potential complication associated with performing an OHE or OVE?

<p>There are no significant differences in post-operative pain associated with OHE compared to OVE. (B)</p> Signup and view all the answers

What is the effect of neutering Rottweilers before 1 year of age on their risk of developing OSA (obstructive sleep apnea)?

<p>Increases the risk of OSA by 2-4 times. (B)</p> Signup and view all the answers

When performing a canine castration, what is the most common and easiest surgical approach?

<p>Prescrotal. (C)</p> Signup and view all the answers

During a canine castration, when is closed castration indicated?

<p>When the spermatic cord &lt; 1cm in diameter. (C)</p> Signup and view all the answers

When performing a castration, what anatomical structure must be avoided when closing?

<p>The Urethra (D)</p> Signup and view all the answers

What clinical sign confirms a diagnosis of Ovarian Remnant Syndrome?

<p>Same clinical signs as being in heat post-opt OHE. (A)</p> Signup and view all the answers

What diagnostic test is used to confirm Ovarian Remnant Syndrome?

<p>Progesterone Concentrations. (D)</p> Signup and view all the answers

Which breed is most commonly affected by Brachycephalic Airway Syndrome and typically has the worst response to surgical correction?

<p>English bulldog. (C)</p> Signup and view all the answers

What is the consequence of stenotic nares?

<p>Partial occlusion of external nares (D)</p> Signup and view all the answers

Elongated soft palate can obstruct what?

<p>Glottis (A)</p> Signup and view all the answers

If a patient has everted laryngeal saccules, what should be done?

<p>Surgical removal is needed when they block the airway. (B)</p> Signup and view all the answers

Name a diagnostic tool that is used to examine Hypoplasic trachea

<p>Radiography using tracheal-to-thoracic inlet ratios (C)</p> Signup and view all the answers

What are the 3 major components that are normally required to treat Brachycephalic Airway Syndrome?

<p>Stenotic Nares, elongated soft palate, and laryngeal collapse (C)</p> Signup and view all the answers

Which of the following is a sign of laryngeal paralysis?

<p>High Pitched Stridor (B)</p> Signup and view all the answers

Which stage of laryngeal collapse refers to "aryepiglottic collapse"?

<p>Stage 2 (A)</p> Signup and view all the answers

What happens to the arytenoid cartilage in a patient diagnosed with laryngeal paralysis?

<p>Laryngeal cartilages are in paramedian position and DO NOT abduct during inspiration (D)</p> Signup and view all the answers

What is a special surgical procedure that is used to treat laryngeal disease?

<p>Tie-Back (B)</p> Signup and view all the answers

What can occur in 10-20% of cases post-opt after a tie-back?

<p>Aspiration Pneumonia (D)</p> Signup and view all the answers

What direction does a tracheal collapse normally occur?

<p>Dorsoventral (A)</p> Signup and view all the answers

What type of trachea collapse occurs on inspiration?

<p>Cervical (A)</p> Signup and view all the answers

1/3 of dogs that are diagnosed with trachea collapse also have___

<p>Systolic Murmur (A)</p> Signup and view all the answers

Dorsal tracheal membrane decreases luminal diameter up to 25%, what grade is this?

<p>Grade I (A)</p> Signup and view all the answers

Main stem bronchi collapse results in____

<p>Shorter survival times (B)</p> Signup and view all the answers

During an ovariohysterectomy (OHE) in a dog, according to the traditional method used in the US, where should the incision be placed?

<p>Cranial 1/3 of an imaginary line from the umbilicus to the pubis (B)</p> Signup and view all the answers

When using spay hooks during an ovariohysterectomy, if the hook feels too tight and seems snagged deep against the dorsal body wall, it is acceptable to apply more force to free it.

<p>False (B)</p> Signup and view all the answers

When performing an ovariohysterectomy, what is the goal when breaking down the suspensory ligament?

<p>To exteriorize the ovary (A)</p> Signup and view all the answers

Blood pooling during an ovariohysterectomy is always an indicator of a major problem and requires immediate intervention.

<p>False (B)</p> Signup and view all the answers

What is the primary significance of locating the caudal gutter during abdominal surgery?

<p>To assess the amount of blood and fluid accumulation (C)</p> Signup and view all the answers

What is one advantage of performing an ovariectomy (OVE) compared to an ovariohysterectomy (OHE)?

<p>There is no significant difference between OHE and OVE in time, pain scores, and wound scores. (A)</p> Signup and view all the answers

Antibiotics are always necessary for routine ovariohysterectomies.

<p>False (B)</p> Signup and view all the answers

What is the youngest age at which it is considered safe to neuter dogs and cats, according to the provided information?

<p>7 weeks (D)</p> Signup and view all the answers

Neutering reduces the risk of mammary neoplasia by what percentage if done before the first heat in dogs?

<p>95% (D)</p> Signup and view all the answers

What percentage of intact male dogs are likely to develop testicular tumors?

<p>29% (C)</p> Signup and view all the answers

By what percentage does neutering reduce prostatic size in dogs, and over what timeframe?

<p>50% in 3 weeks</p> Signup and view all the answers

Neutering decreases the risk of prostatic carcinoma.

<p>False (B)</p> Signup and view all the answers

According to the information provided, Rottweilers neutered before what age are more likely to develop osteosarcoma (OSA)?

<p>1 year (C)</p> Signup and view all the answers

When performing a canine castration, which surgical approach is described as the most common and easiest?

<p>Prescrotal (D)</p> Signup and view all the answers

In canine castration, a closed castration technique is recommended for any size dog regardless of spermatic cord diameter.

<p>False (B)</p> Signup and view all the answers

What is a critical step to avoid during closure following a canine castration?

<p>Avoiding the urethra (D)</p> Signup and view all the answers

Which canine breed is identified as most commonly affected by Brachycephalic Airway Syndrome, and generally has the worst response to surgery?

<p>English Bulldog (B)</p> Signup and view all the answers

List two major anatomical components/deformities associated with Brachycephalic Airway Syndrome

<p>Stenotic nares; Elongated soft palate</p> Signup and view all the answers

What is a critical consideration regarding extubation in animals with upper respiratory obstruction?

<p>Caution with early extubation as need to be prepared to re-intubate (C)</p> Signup and view all the answers

How would you describe the sound that a dog makes that has Stertor?

<p>Low Pitched sound (B)</p> Signup and view all the answers

Match the stage of laryngeal collapse with its description:

<p>Stage 1 = Laryngeal saccule eversion Stage 2 = Aryepiglottic collapse Stage 3 = Corniculate collapse</p> Signup and view all the answers

Which of the following is a goal for treating a dog with Laryngeal Paralysis?

<p>Weight loss (A)</p> Signup and view all the answers

What position are the laryngeal cartilages in when evaluating dogs affected by Laryngeal Paralysis?

<p>Paramedian (B)</p> Signup and view all the answers

Aspiration pneumonia cannot happen after undergoing a unilateral arytenoid lateralization (Tie-back) surgery procedure.

<p>False (B)</p> Signup and view all the answers

What is the most common direction of tracheal collapse?

<p>Dorsoventral (D)</p> Signup and view all the answers

When it comes to tracheal collapse, the _____ inlet, is most susceptible to collapse.

<p>thoracic</p> Signup and view all the answers

A dog presents with a classic "goose honk" cough. What condition does this indicate?

<p>Tracheal Collapse (B)</p> Signup and view all the answers

What is the recommended amount to transect of the soft palate during elongated soft palate surgery?

<p>1/3 to 1/2 width (A)</p> Signup and view all the answers

What type of mucosa is opposed during elongated soft palate surgery?

<p>Oropharyngeal (A), Nasopharyngeal (B)</p> Signup and view all the answers

Extraluminal ring protheses when treating tracheal collapse requires antibiotics

<p>True (A)</p> Signup and view all the answers

What are the main causes of vaginal prolapse and what happens?

<p>Prolonged labor, hormone mediated changes, and neoplasia. Vaginal prolapse may present as a 360-degree protrusion of the mucosa due to edema.</p> Signup and view all the answers

If no testicular development by ___, a dog is considered cryptorchid.

<p>2 months (A)</p> Signup and view all the answers

What are the most common tumors that dogs are predisposed to when they are cryptorchid?

<p>Seminomas (B), Sertoli cell tumors (A)</p> Signup and view all the answers

Match each surgical procedure with its correct definition regarding the female reproductive system:

<p>OHE (Ovariohysterectomy) = Surgical removal of the ovaries and uterus OVE (Ovariectomy) = Surgical removal of the ovaries Episiotomy = Incision of the vulvar orifice to expose the vulva and vagina Episioplasty/vulvoplasty = Reconstruction methods of the vulva to excise skin folds</p> Signup and view all the answers

Match the phase of brachycephalic airway syndrome with its anatomical description:

<p>Stage 1 = Laryngeal saccule eversion Stage 2 = Aryepiglottic collapse Stage 3 = Corniculate collapse Stenotic Nares = Partial occlusion of external nares</p> Signup and view all the answers

Match the term to the location of a tracheal collapse:

<p>Thoracic inlet = Most susceptible to collapse Cervical trachea = Collapse on inspiration Thoracic trachea = Collapse on expiration Dorsoventral direction = Normal collapse pattern</p> Signup and view all the answers

Match the mammary tumor characteristic to the species:

<p>Dogs = Benign or malignant Cats = 90% malignant Simple mastectomy = Removal of one gland Regional mastectomy = Removal of several glands within the same area</p> Signup and view all the answers

Match each diagnostic term with the most appropriate associated descriptor:

<p>Pyometra = Extreme leukocytosis Uterine torsion = A condition which should NOT be corrected before ligation during surgery Cryptorchid = Prone to Seminomas and Sertoli Cell tumors Vaginal Prolapse = Takes place during estrus or proestrus</p> Signup and view all the answers

Match the anatomical descriptor or action with the purpose of using spay hooks:

<p>Insert Hook Cranially = Until handle stops Rotate Handle 180 degrees = Until ovary is located Too tight = Snagged deep against dorsal body wall Too loose = Ovary comes out with omentum</p> Signup and view all the answers

Match the description of the canine castration approaches:

<p>Prescrotal = Most common approach Left hand pushes = Testes forward Right hand makes = Incision Scrotal ablation = Dogs with neoplasia</p> Signup and view all the answers

Match each laryngeal paralysis feature with the description:

<p>Complete or Partial Failure = Causes all animals to be at risk for aspiration Acquired is usually = GOLPP Affected dogs DO NOT = Abduct during inspiration</p> Signup and view all the answers

Match the description of unilateral arytenoid lateralization:

<p>Unilateral Arytenoid Lateralization = Treatment of choice Mimics directional pull of = Cricoarytenoid dorsal muscle Post-Opt = Bark will be quieter Aspiration Pneumonia = Can still happen</p> Signup and view all the answers

Match the description of a cesarean section component:

<p>Goal = Remove all fetuses as quick as possible Ventral midline incision = Cranial to umbilicus near pubis Double check = Placenta and All puppies are out En bloc surgery = Requires a good ready team</p> Signup and view all the answers

Match the condition with its risk factor or description:

<p>Neutering Rottweilers Early = More likely to develop OSA Closed castration in ANY sized dog = As long as the spermatic cord is &lt; 1cm Open castration = Spermatic cord is &gt; 1cm 1/3 dogs with tracheal collapse = Have concurrent LP</p> Signup and view all the answers

Match the antibiotic implication:

<p>If surgery is &gt; 1.5 hours = Use antibiotics Routine OHE = Antibiotics NOT necessary Pyometra = Use antibiotics for E.Coli Blood pooling = Normally post opt from SQ bleeding</p> Signup and view all the answers

Match the breed with the component of Bracycephalic Airway Syndrome:

<p>English bulldog = WORST surgical prognosis Aspiration pneumonia = Likely to develop Stenosis nares = partial occlusion of external nares</p> Signup and view all the answers

Match the description to it's correct phrase:

<p>Neutering = HIGHER risk for prostatic carcinoma</p> Signup and view all the answers

Match the procedure with its possible complication described in surgical notes:

<p>break down suspensory ligament = exteriorize the ovary Clamps or over tightened sutures on uterus = severe uterus locating caudal gutter = assessment to blood from guttter Neutering = resolve 95% perinatal adenomas (testicular tumors)</p> Signup and view all the answers

What 4 cancers are neutered dogs at higher risk for?

<p>Prostatic carcinoma, hemangiosarcoma, osteosarcoma, and transitional cell carcinoma.</p> Signup and view all the answers

Flashcards

What is an OHE?

Surgical removal of the ovaries and uterus, a traditional method in the US.

Caution during OHE

Clamping or over-tightening sutures on the uterus can cause it to sever, especially if it is unhealthy.

What is an OVE?

Surgical removal of the ovaries, more common in European countries.

OHE vs OVE

There is no significant difference between OHE and OVE regarding time, pain scores, and wound scores.

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When is neutering safe?

Safe in dogs and cats older than 7 weeks. It is associated with lower morbidity and quicker anesthetic recovery in younger dogs.

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Benefits of neutering

Neutering prevents androgen-related behaviors and can resolve perinatal adenomas.

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What is an Episiotomy?

Procedure involving surgical incision into the vulva.

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What is Episioplasty/vulvoplasty?

A surgical technique where the vulva is reconstructed by excising skin folds.

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What is Vaginal Prolapse?

A prolapse that takes place during estrus or proestrus due to edematous enlargement of the vaginal tissue.

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What is Cryptorchidism?

A condition where no testicular development occurs by 2 months old.

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What is a Cesarean Section?

surgical incisions into the vulva for extraction. This is done due to oversized, malpositioned, or maldeveloped fetuses or a small pelvic canal

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What is Pyometra?

A infection in the uterus often caused by E.coli

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What is Tracheal Collapse?

This collapse refers to the trachea

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What are you hearing when you hear a '“Goose honk” cough**'?

This is the term for 'goose honk'

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What is a Permanent tracheostomy?

Procedure completed involving cutting the trachea and sewing the skin too it.

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What is Unilateral arytenoid lateralization?

A treatment of choice for Laryngeal Paralysis

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What should always be avoided?

This is what you should always avoid when closing

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What diseases is the animal at risk of?

This results in a higher risk for prostatic carcinoma and other related oncological diseases.

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What is Surgical treatment?

Multiple procedure are require to treat which condition.

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What lab will identify?

This will be diagnosed via progesterone concentrations.

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What is exteriorization?

In OHE, the goal when breaking down the suspensory ligament to free the ovary.

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Dangers of 'Too Tight' Spay Hooks

Using spay hooks can snag against the dorsal body wall, potentially lodging on the ureter.

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OHE timing with Mastectomy.

Procedure that should be done BEFORE mastectomy to avoid seeding the abdomen with tumor cells.

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Post-operative Blood Pooling

Post-operative problem that is normal post op from SQ bleeding. Clots indicate larger issue.

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Checking the Caudal Gutter

Sweep the caudal gutter with a finger and gauze to check for blood accumulation.

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Triangular Excision Alar Fold

Technique involves incision, vertical wedge removal, and medial-to-lateral suturing.

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Elongated Soft Palate

During inspiration that pulls the soft palate causally, obstructing the glottis.

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Everted Laryngeal Saccules

Indicates need for removal of tissue when block airway.

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Brachycephalic Airway Syndrome

English bulldogs are affected breed w/ worse surgical outcomes due to collapse.

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Stenotic Nares

The worst outcome and most common component of brachycephalic animals

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Clinical signs of being in heat.

A sign that something is wrong in the animal.

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Laryngeal Paralysis

Complete or partial failure of arytenoid cartilage and vocal folds to abduct during inspiration.

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Laryngeal Cartilages in Paramedian Position

Dogs are not able to do this function during the operation.

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“Goose Honk” cough

Common for larger dogs affected due to trauma.

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Episiotomy Purpose

An incision of vulvar orifice is performed for this operation.

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Cesarean timing

This may be a necessary for removing all fetuses with speed.

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En Bloc Surgery Resection

Requires a good team, not indicated if fetuses are in distress, and necessitates quick puppy removal.

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Spaying dogs

Most important with hormone mediated issue for treatment.

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Spay Hook Danger

Avoid this function with the uterus, may tear.

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Closed Pyos

Should not be delayed, can cause dysfunction.

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Spay Hook Technique

Insert hook cranially at 45 degrees until resistance, then rotate 180 degrees to locate the ovary.

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Ovary Location

Draw imaginary line from umbilicus to pubis, divide into thirds to locate ovaries.

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OHE Antibiotics

Routine OHE does not require antibiotics unless surgery is over 1.5 hours.

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How to milk the fetus

Incision towards the fetus.

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No Skin Sutures Due To..

Condition requires blood supply

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Study Notes

Surgical Technique

  • When draping, ensure the drape extends halfway to the xiphoid.
  • The goal is to free ligaments further from the ovary to exteriorize it.
  • Employ a modified 3-clamp technique if the pedicle is short.
  • Triple clamp the pedicle; if the pedicle is short, place two clamps on the pedicle below the ovary and one above.
  • Ligate below and between the bottom two clamps, and cut above the second clamp.
  • Ligate the uterus and uterine arteries and veins with encircling and transfixing-encircling sutures.

Ovariectomy

  • Ovariectomy is surgical removal of ovaries.

Feline Neuter Techniques

  • When performing an overhand technique, ensure the point is down at first.

Canine Neuter

  • Break down the scrotal ligament, and flatten the cord between index finger to separate the vessels.
  • Ensure that "window into spermatic cord" is closer to circumferential when ligating.
  • Ligate vas deferens and vascular cord individually.

Scrotal Ablation

  • The removal of the scrotum may require external rectus resection if deep enough.
  • The "excision" should be slightly not perfectly straight.

Ovarian Remnant Syndrome

  • Human Chorionic Gonadotropin (HCG) maintains pregnancy during the procedure.

Brachycephalic Airway Syndrome

  • Laryngeal collapse is different than laryngeal paralysis.
  • It is an aspect of brachycephalic syndrome, and can be severe.

Laryngeal paralysis

  • Laryngeal paralysis prevents complete or partial failure of arytenoid cartilage and vocal folds to Abduct during inspiration.
  • Affected dogs have laryngeal cartilages in the paramedian position, and they do not abduct during inspiration.
  • The cricoid is sutured to the arytenoid cartilage together and suturing around the ET Tube during correction

Pyometra

  • Pyometra may sometimes require resecting external rectus sheath if deep enough.

Prostatic Biopsy

  • A laparoscopic technique can be employed to perform a prostatic biopsy.

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