Rabbit Spay- ovariohysterectomy or ovariectomy?

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Yantha Smyth — Thu, 08 Aug 2013 15:30:13 GMT

Thanks for all your thoughts.

I think the point made by Marie makes sense about the consensus being that ovarectomy acceptable in young rabbits, but to do OH in adults. This practice does routinely only ovarectomise the rabbits as well as bitches, but when I have asked other assistants there why this is done in rabbits there has been no explanation. I dont think they know for sure if this would reduce the risk of uterine cancer as effectively as an OH.

So far I have had no bitch speys to do here, but would happy to do an an ovarectomy in a bitch. I am less comfortable with the idea of doing ovarectomy in a rabbit as I have not been told of or read of any info re chances of the uterine cancer being similarly prevented by ovarectomy alone.

From what I have seen the consent forms are limited to 'spay' and do not specify OH vs O. I am going to corner the practice partner and quiz them on their rationale!

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Dagmar Steele — Thu, 08 Aug 2013 15:01:41 GMT

If someone rings and wants his tomcat castrated or his cat spayed we will happily give him an appointment. But I will always, always see the animal before surgery and talk to the owner about what we do and if there are any problems present!

Rabbits OHE always, they tend to get uterus problems so never leave it in (in contrast to cats and young dogs which I do OE's on)

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

James Laidlaw — Thu, 08 Aug 2013 14:46:02 GMT

Sell 'em cheap, stack 'em high.

I think. There's no good reason anyway.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Evelyn Barbour-Hill — Thu, 08 Aug 2013 14:44:18 GMT

[quote user="Clive Ansell"]

[quote user="Evelyn Barbour-Hill"]

But the owner will have already talked to a veterinary surgeon when making the appointment or on admission and been told that it's an ovariectomy.

[/quote]

Maybe, maybe not. Some practices, particularly the cheap jacks, will admit animals for routine neuters and dentals without a veterinary surgeon being involved. In addition I've worked in clinics where animals are anaesthetised without being seen or checked by a vet. Yes, scary, but true.

[/quote]

Bloomin' 'eck. Not only scary but bizarre. Why?? Why??

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Evelyn Barbour-Hill — Thu, 08 Aug 2013 14:41:59 GMT

[quote user="Robin Grimmer"]Completely disagree. As a locum, it's one thing to fit in with practice policy on vaccinations, flea and worm treatment etc. But surgical technique is a completely different thing. I won't do a procedure I'm not happy with because it might be 'practice policy'. For instance, last week in a locum job, I had a dog booked in for cruciate surgery and a dental! Needless to say I didn't do the dental. Hopefully such situations can be avoided as the one in the OP - it could have been discussed before the day of the op, so some arrangement could have been come to - eg the vet does the op how they want to do it, or another vet familiar with ovariectomy does the op.[/quote]

I quite agree. What I mean is, first of all: if there's a "spay" booked in, and the assistant knows that this practice does spays by ovariectomy, he or she can't just press ahead and do a hysterectomy anyway. If he tells his employer "sorry, I don't do ovariectomy, shall I re-schedule for another vet or do you mind if I do an ovariohysterectomy?" that's fine. (This is all just by way of illustration, because in fact anyone competent can do an ovariectomy of course)(And also assuming that he doesn't find something during the op that dictates a hysterectomy).

Secondly, if the client through informed consent, the information being either specific (on the form in writing, or given directly verbally by a partner) or implied (everybody knows they do ovariectomy, or there's a waiting-room notice) then it's a trespass and could just possibly even be a DC matter to do a hysterectomy unless there were some emergency reason which dictated it.

Going back to the OP, I got the impression there was no practice protocol about rabbits and the OP was sensibly thinking ahead a bit. Of course a practice policy on bitch spays doesn't dictate what you do for rabbits.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Clive Ansell — Thu, 08 Aug 2013 13:39:48 GMT

[quote user="Evelyn Barbour-Hill"]

But the owner will have already talked to a veterinary surgeon when making the appointment or on admission and been told that it's an ovariectomy.

[/quote]

If I've not admitted an animal I will always look at the clinical notes and the consent form to be sure I have signed consent for what I am doing.

[quote user="Evelyn Barbour-Hill"]

Serious point. If the practice does ovariectomies for elective spays, it's not up to an assistant or locum to come along and decide to make it an ovariohysterectomy without special reason.

[/quote]

A moot point. I wouldn't deviate as I'm happy with either procedure, but some others may feel as the MRCVS it is their call to make assuming they have consent?

One positive think to come out of the Mr C case, is that we now have a big green light to ignore practice policies and protocols - Mr C was sanctioned for doing so.

Going back to the OP, if you feel strongly that you should be doing ovariohysterectomies in rabbits, then that is what you should do. It's your call to make.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

James Laidlaw — Thu, 08 Aug 2013 13:30:25 GMT

Absolutely agree with Robin. Can be difficult as a locum to go against the grain in a clinic, but you must be responsible for your cases and if you aren't happy to do something someone else has booked in then why should you? Either book things for yourself or at least open up discussion on any cases with whomever books them in. If I book ops for my colleagues, I'll let them know. I try to get my cases, but sometimes days don't suit clients, but I don't expect anyone to do anything they don't feel confident to do or don't want to do for any reason, any more than I expect others to do that to me.

You can't look back afterwards if something goes wrong and say "the other vet booked it in for me to do" and expect that to stand up as a defense.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Robin Grimmer — Thu, 08 Aug 2013 13:21:42 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Clive Ansell"]

[quote user="Evelyn Barbour-Hill"]

[quote user="Clive Ansell"]Even if it is practice policy, you can choose to ignore it if you want. As the professional and the MRCVS it is your decision entirely.[/quote]

S'pose the client has signed a consent form - informed consent, remember - having been informed that the operation will be ovariectomy?

[/quote]

It is a point worthy of moot. How precise should the consent be?, most practices I work just get consent signed for "spey" it could mean either ovariectomy or ovariohysterectomy.

[/quote]

But the owner will have already talked to a veterinary surgeon when making the appointment or on admission and been told that it's an ovariectomy.

Serious point. If the practice does ovariectomies for elective spays, it's not up to an assistant or locum to come along and decide to make it an ovariohysterectomy without special reason.

[/quote]

Completely disagree. As a locum, it's one thing to fit in with practice policy on vaccinations, flea and worm treatment etc. But surgical technique is a completely different thing. I won't do a procedure I'm not happy with because it might be 'practice policy'. For instance, last week in a locum job, I had a dog booked in for cruciate surgery and a dental! Needless to say I didn't do the dental. Hopefully such situations can be avoided as the one in the OP - it could have been discussed before the day of the op, so some arrangement could have been come to - eg the vet does the op how they want to do it, or another vet familiar with ovariectomy does the op.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Evelyn Barbour-Hill — Thu, 08 Aug 2013 11:34:40 GMT

[quote user="Clive Ansell"]

[quote user="Evelyn Barbour-Hill"]

[quote user="Clive Ansell"]Even if it is practice policy, you can choose to ignore it if you want. As the professional and the MRCVS it is your decision entirely.[/quote]

S'pose the client has signed a consent form - informed consent, remember - having been informed that the operation will be ovariectomy?

[/quote]

It is a point worthy of moot. How precise should the consent be?, most practices I work just get consent signed for "spey" it could mean either ovariectomy or ovariohysterectomy.

[/quote]

But the owner will have already talked to a veterinary surgeon when making the appointment or on admission and been told that it's an ovariectomy.

Serious point. If the practice does ovariectomies for elective spays, it's not up to an assistant or locum to come along and decide to make it an ovariohysterectomy without special reason.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Martin Atkinson — Thu, 08 Aug 2013 09:49:52 GMT

[quote user="Clive Ansell"]It is a point worthy of moot. How precise should the consent be?, most practices I work just get consent signed for "spey" it could mean either ovariectomy or ovariohysterectomy.[/quote] I think the word spay (spey) is too woolly and we always put 'General anaesthetic ovaro-hysterectomy (spay)' on the consent form, at least that's what the nurses are told to do! - some have a problem with the spelling so there is a list of more commonly used 'big' words at reception for this purpose.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Clive Ansell — Thu, 08 Aug 2013 06:14:15 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Clive Ansell"]Even if it is practice policy, you can choose to ignore it if you want. As the professional and the MRCVS it is your decision entirely.[/quote]

S'pose the client has signed a consent form - informed consent, remember - having been informed that the operation will be ovariectomy?

[/quote]

It is a point worthy of moot. How precise should the consent be?, most practices I work just get consent signed for "spey" it could mean either ovariectomy or ovariohysterectomy.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Evelyn Barbour-Hill — Wed, 07 Aug 2013 22:25:55 GMT

[quote user="Clive Ansell"]Even if it is practice policy, you can choose to ignore it if you want. As the professional and the MRCVS it is your decision entirely.[/quote]

S'pose the client has signed a consent form - informed consent, remember - having been informed that the operation will be ovariectomy?

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Clive Ansell — Wed, 07 Aug 2013 18:20:51 GMT

What would be the advantage of an ovariectomy unless one is doing it laproscopically? surely ovariohysterectomy elimates the possibility of uterine neoplasia altogether.

[quote user="Yantha Smyth"]

I am in a locum position at the moment where it is practice policy to perform ovariectomy in bitches instead of overiohysterectomy

[/quote]

Even if it is practice policy, you can choose to ignore it if you want. As the professional and the MRCVS it is your decision entirely.

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Marie Kubiak — Wed, 07 Aug 2013 17:12:41 GMT

This was a discussion topic at AEMV last year - the general consensus was that ovariectomy in young rabbits was acceptable as the hyperplastic/neoplastic changes are a reflection of chronic hormone stimulation and should be avoided with ovarian removal alone. If rabbits present as adults then ovariohysterectomy is appropriate as there may already be changes in the uterine lining that has been exposed to repeat non-pregnant cycles.

I still tend to do ovariohysterectomy regardless as it doesn't take much longer and there doesn't seem to be morbidity associated with this compared to ovariectomy alone.

Marie

Re: Rabbit Spay- ovariohysterectomy or ovariectomy?

Stephen Courtney — Wed, 07 Aug 2013 17:08:02 GMT

In a rabbit I'd prefer to do ovariohysterectomy - ie proper spay, but i feel it likely that in the absence of ovarian activity the uterine issues are less likely - but I'd definitely check that with a bunny doc first..