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Questions and Answers
Which term does NOT refer to the surgical removal of the ovaries and uterus?
Which term does NOT refer to the surgical removal of the ovaries and uterus?
Besides preventing unwanted pregnancies, what is a significant reason to perform an ovariohysterectomy?
Besides preventing unwanted pregnancies, what is a significant reason to perform an ovariohysterectomy?
Uterine torsion is a specific condition that can be addressed by performing an ovariohysterectomy, true or false?
Uterine torsion is a specific condition that can be addressed by performing an ovariohysterectomy, true or false?
Which of the following is a potential benefit of ovariohysterectomy related to systemic disease?
Which of the following is a potential benefit of ovariohysterectomy related to systemic disease?
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Which of these is a primary effect of performing an ovariohysterectomy in female animals?
Which of these is a primary effect of performing an ovariohysterectomy in female animals?
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A client asks what 'altered' means in reference to their female pet. What is the most accurate explanation?
A client asks what 'altered' means in reference to their female pet. What is the most accurate explanation?
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What is the approximate percentage of canine mammary tumors that are malignant?
What is the approximate percentage of canine mammary tumors that are malignant?
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In canine ovariohysterectomy, the risk of mammary tumors increases to what percentage after the first estrus cycle?
In canine ovariohysterectomy, the risk of mammary tumors increases to what percentage after the first estrus cycle?
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What could be a direct effect of performing an ovariohysterectomy in relation to reproductive organs?
What could be a direct effect of performing an ovariohysterectomy in relation to reproductive organs?
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When performing an ovariohysterectomy in a dog, where is the initial incision made relative to the umbilicus?
When performing an ovariohysterectomy in a dog, where is the initial incision made relative to the umbilicus?
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If an animal presents with an emergent reproductive tract injury, what surgical procedure may be indicated as both a treatment and preventative measure?
If an animal presents with an emergent reproductive tract injury, what surgical procedure may be indicated as both a treatment and preventative measure?
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How can ovariohysterectomy impact the long-term health of an animal with congenital abnormalities?
How can ovariohysterectomy impact the long-term health of an animal with congenital abnormalities?
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During an ovariohysterectomy, which of the following is used to facilitate exteriorization of the ovary by breaking down its attachment to the body wall?
During an ovariohysterectomy, which of the following is used to facilitate exteriorization of the ovary by breaking down its attachment to the body wall?
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What is the MOST accurate term to describe the procedure of removing the uterus and ovaries in animals?
What is the MOST accurate term to describe the procedure of removing the uterus and ovaries in animals?
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When ligating the ovarian pedicle, where are the two circumferential ligatures placed?
When ligating the ovarian pedicle, where are the two circumferential ligatures placed?
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After removing the ovaries, which structure is traced to locate the uterine body?
After removing the ovaries, which structure is traced to locate the uterine body?
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Which of the following is used to clamp across the uterine body to facilitate exposure?
Which of the following is used to clamp across the uterine body to facilitate exposure?
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What is the recommended number of layers for abdominal wall closure during an ovariohysterectomy?
What is the recommended number of layers for abdominal wall closure during an ovariohysterectomy?
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A higher risk of hemorrhage during an ovariohysterectomy is most likely to be found with patients of which condition?
A higher risk of hemorrhage during an ovariohysterectomy is most likely to be found with patients of which condition?
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If unsure whether a pet has been spayed, what is the recommended method to verify this before surgery?
If unsure whether a pet has been spayed, what is the recommended method to verify this before surgery?
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Study Notes
Ovariohysterectomy (OHE)
- OHE is the surgical removal of the ovaries and uterus.
- Synonyms for OHE include spayed, fixed, altered, and neutered.
- Reasons for performing OHE in animals include preventing unwanted pregnancy, addressing neoplasia (tumors), trauma, infection or injury of the reproductive tract, preventing/treating neoplasia influenced by reproductive hormones (such as mammary tumors), and managing dystocia (difficult birth).
- The canine reproductive tract is Y-shaped, with uterine horns where puppies develop during pregnancy.
Surgical Anatomy
- Right ovary is more cranial than the left.
- Uterine horns are long.
- Uterine body is short.
- Suspensory ligaments attach ovaries to fascia.
- Ovarian arteries and veins are within the suspensory ligament.
- Ovaries are suspended by the broad ligament.
- Dogs have more fat than cats in the ovarian pedicle
Differences Between Dogs and Cats
- Dogs have more fat in the ovarian pedicle and tightly attached ovaries.
- Cats have less fat in the ovarian pedicle and a uterus with a base attaching tightly.
Instruments
- General Surgery Pack
- Spay Hook (Snook-Hook)
When to Spay
- Animals less than three months of age have a higher risk of urinary incontinence after surgery.
- Spaying before the first estrus cycle (5-6 months) is preferable.
- Spaying two months after the first heat cycle or 6-8 weeks after giving birth is also a good time
Mammary Tumors
- Canine mammary tumors occur in 35-50% of cases, and 90% of feline cases.
- Many mammary tumors are hormone-dependent and can be prevented if the animal is spayed before one year of age.
- Risk of mammary tumors in dogs is 0.05% before first estrus and increases to 8% after the first cycle, and 26% after the second.
- Cats that are spayed before one year of age have a 0.6% risk of mammary carcinoma.
Preparing the Patient
- Animals are clipped from the xiphoid to the pubis.
- Ventral midline incision is made 3-6cm caudal to the umbilicus, in dogs.
- Ventral midline incision is made 3-4cm caudal to the umbilicus, in cats.
- The incision is aseptically prepared.
Entering the Abdomen
- An incision is made through the skin and subcutaneous tissue to expose the linea alba.
- The linea alba is tented outward.
- A stab incision is made into the abdominal cavity.
- The linea incision is extended cranially and caudally using Mayo scissors.
Finding the Ovary
- A spay hook is inserted into the abdomen and then rotated medially to exteriorize the uterine horn.
- Caudomedial traction on the uterine horn facilitates exteriorization of the ovary from the abdomen.
- A hole is made in the broad ligament caudal to the ovarian pedicle, enabling access to the ovary.
Pedicle Ligation
- A Carmalt is placed on the suspensory ligament distal to the ovary.
- Two circumferential ligatures are placed and the distal Carmalts are flashed.
- A mosquito hemostat is placed on the ligament just distal to the ligatures; the ovarian pedicle is transected between the hemostat and the ovary.
- The pedicle is observed for bleeding and replaced in the abdomen.
- The left uterine horn is traced, followed by tracing the opposite uterine horn to locate the right ovary.
- The right ovary is removed during the same procedure
Uterine Body
- A window is bilaterally made in the broad ligament adjacent to the uterine body.
- Uterine artery and vein are identified.
- Two carmalts are placed on each side of the uterine body, and transected in between.
- Gentle traction is placed on the uterine body.
- Two transfixion ligatures are placed caudal to the clamp, through the uterine body, just cranial to the cervix.
Closure
- Abdominal wall closure is achieved in 3 layers: linea alba, subcutaneous tissue, and skin.
Intra-Op Concerns
- Hemorrhage is a higher risk in older, obese animals, or animals in estrus.
- A "dropped pedicle" may occur.
- Friable uterus.
- All of the ovary must be removed.
- Ureter/urethral ligation is performed.
Post-Op Care
- Keep patient warm in a quiet area.
- E-collar is used to prevent self-trauma.
- Monitor for hemorrhage or pain.
- Prescribed analgesia (opioids or NSAIDs) is given.
- Small amounts of food and water are given once recovered.
- No off-leash activity for 10-14 days; short leash walks for dogs only; cats should stay indoors for 10-14 days.
Complications
- Hemorrhage
- Ureter/urethral ligation
- Recurring estrus (ovarian remnant)
- Cervical pyometra (stump pyo)
- Urinary incontinence
- Incision problems
Videos
- Various links to videos about surgical procedures related to ovariohysterectomy are provided.
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Description
This quiz covers the surgical procedure of ovariohysterectomy (OHE) in dogs and cats, including its anatomy, reasons for the operation, and key differences between the two species. Test your knowledge on this essential surgical practice and its significance in veterinary medicine.
