Ovarian remnant

RE: Ovarian remnant

Robin Grimmer — Wed, 02 Dec 2015 09:36:05 GMT

I switched to vicryl for ligatures and much prefer it. I use the 4m one for ligating bigger/fatter bitch spays, doesn't break when you pull tight.

RE: Ovarian remnant

Anthony Dennison — Wed, 02 Dec 2015 09:13:02 GMT

I tend to only use cat gut on bitch spays that are a bit fatty and my PDS isn't giving as secure a ligature as I like.

I also switched to cat gut for dog castrates - I used to use a single pack of PDS until Evelyn Barbour-Hill told me on here that either my ligature material was too small or it was too big for intradermals. Switched to 4/0 monocryl for intradermals now and things close so much better.

RE: Ovarian remnant

Rob Loxley — Tue, 01 Dec 2015 23:03:14 GMT

[quote user="Gillian Mostyn"]Still like my catgut on reels for ligatures[/quote]

likewise, I like the way it knots but maybe if I used lots of vicryl for routine neuters I'd get used to that; similarly prefer vicryl to PDS for midline closure but accept others differ

RE: Ovarian remnant

Emily Rainbow — Tue, 01 Dec 2015 22:44:27 GMT

Yep a few options available for 'vicryl' on a reel.

Not a fan of catgut personally, a) as I often snap it (I'll take that as operator error), b) has very variable and unreliable absorption and c) more likely to cause tissue reaction than the synthetics.

RE: Ovarian remnant

Gillian Mostyn — Tue, 01 Dec 2015 22:31:21 GMT

...and there is also one called 'violine'.

Still like my catgut on reels for ligatures- but I never use it in rabbits.

RE: Ovarian remnant

Joyce Whitehead — Tue, 01 Dec 2015 22:24:02 GMT

There is an equivalent reel for PGA, various brands including Visorb. We use that for bitch spay ligatures.

RE: Ovarian remnant

grumpyoldman — Tue, 01 Dec 2015 21:25:00 GMT

[quote user="Stephen Courtney"]just out of interest, is there an equivalent to vicryl that comes on a reel?[/quote]

Dexon used to come on a roll ,none sterile, but that was 85-90 not seen it since. All ours a swaged on now ,have been for over 10years , mono soft 2-0 to 6-0 , polysorb 2-0 -4-0 , biosyn 2-0 -4-0 .

vicryl 4-0 6-0 and 8-0 , I have a thing about odd numbers and tinny words.

RE: Ovarian remnant

Stephen Courtney — Tue, 01 Dec 2015 21:07:18 GMT

We stopped using catgut ona reel for ligatures about 8 years ago. I wan't very happy as i'd never had a problem with it.

apparently it causes massive issues with periadrenal granulomata...however our very competent ultrasonographer only on ever found anything on a bitch spayed with catgut ligatures that miht even remotely have been blamed on catgut...rabbits being highly reactive abdominally, I probably would stick to vicryl for ligatures.

However, new doctrine swallowed, we don't use it any more, but I'm not sure I believe the theory, I suspect there is a massive Ivory Tower bias there.

just out of interest, is there an equivalent to vicryl that comes on a reel?

RE: Ovarian remnant

Sammy82 — Tue, 01 Dec 2015 17:21:54 GMT

I only get the cervix if it is possible without too much yanking. I would much prefer to do ovarectomies in cats any way, there is no need to take the uterus unless diseased in my opinion.

RE: Ovarian remnant

cathal rafferty — Tue, 01 Dec 2015 15:47:37 GMT

An old boss of mine used to make a big deal about getting the cervix in cats, it stemmed from a decades old report in vet record about the two ligated horns forming a stricture around the rectum

I have never tried to get cervix and no problems so far in 8 yrs

I did have that exact scenario in a rabbit about 4 weeks after spey, the referral centre I sent it to put it down to the use of catgut instead of synthetic material for ligatures rather than a technique issue.

The rabbit died....lesson learned

RE: Ovarian remnant

Mark Hedberg — Tue, 01 Dec 2015 14:30:51 GMT

I only ever bother getting the cervix if it's right there and yelling at me, otherwise i just take part of the horn; all that yanking and tugging must hurt!

RE: Ovarian remnant

Tom Ward — Tue, 01 Dec 2015 13:47:01 GMT

[quote user="Stephen Courtney"]

[quote user="Michael Woodhouse"]

[quote user="Tom Ward"]What about ligating horns vs cervix in cats? It can sometimes be almost impossible to exteriorise the cervix from a flank incision...[/quote]

You don't need to. I don't even try.

[/quote]

Neither do I. Totally pointless, adds to risks, and if you try too hard you end up with a bleeding cervical stump somewhere under the bladder because your suture material cheesewired! That put me off that extravagance for life

[/quote]

Excellent - I don't bother trying either, and had been told when I first qualified that it didn't matter, but do occasionally worry that perhaps I should have been!

RE: Ovarian remnant

Charlotte Marshall — Mon, 30 Nov 2015 23:40:38 GMT

I never worry about trying to get cervix in cats either. I do make sure I get all the ovary though so there should not be a problem. And generally cat ovaries usually exteriorise nicely making it easy to be certain you have got it all.

RE: Ovarian remnant

Stephen Courtney — Mon, 30 Nov 2015 21:05:31 GMT

[quote user="Michael Woodhouse"]

[quote user="Tom Ward"]What about ligating horns vs cervix in cats? It can sometimes be almost impossible to exteriorise the cervix from a flank incision...[/quote]

You don't need to. I don't even try.

[/quote]

RE: Ovarian remnant

Michael Woodhouse — Mon, 30 Nov 2015 20:59:41 GMT

[quote user="Tom Ward"]What about ligating horns vs cervix in cats? It can sometimes be almost impossible to exteriorise the cervix from a flank incision...[/quote]

You don't need to. I don't even try.

RE: Ovarian remnant

Tom Ward — Mon, 30 Nov 2015 18:18:09 GMT

What about ligating horns vs cervix in cats? It can sometimes be almost impossible to exteriorise the cervix from a flank incision...

RE: Ovarian remnant

Tim Charlesworth — Mon, 30 Nov 2015 17:58:29 GMT

Just a quick addition to what has already been said - always worth checking the cervical stump as well. We commonly see stump pyo's in dogs that have ovarian remnants (and vice versa depending on how they've presented).

Tim

RE: Ovarian remnant

Catriona MacIntyre — Tue, 24 Nov 2015 18:49:24 GMT

Thanks for the update Ell.

Just hoping I never come across one. (although I have in cats)

RE: Ovarian remnant

ell — Tue, 24 Nov 2015 14:05:22 GMT

Update on this, we opened up bitch as still in season. The right ovary was almost waving at us, so all fine after that, dog fine.

Still can't figure out how vet left so much in but I think there may have been an element of panic in the first op, hay ho, never a dull moment.

RE: Ovarian remnant

joanne mcallister — Mon, 16 Nov 2015 09:12:37 GMT

Has anyone ever seen extra ovarian tissue in the ovarian ligament in bitches? I've seen this in cats, but never bitches

RE: Ovarian remnant

Catriona MacIntyre — Sun, 15 Nov 2015 13:09:12 GMT

I always hold the ovary between thumb and forefinger while placing clamps to ensure it's definitely ALL above the clamp.

That said, I AM one of those who avoids bitch spays when possible, although I will sometimes wade into a pyometra operation. Over the years I have damaged both thumbs. The left I slashed across the muscle when I fell on a broken bottle as a child, and the right was trashed the last time I EVER trimmed a cow's foot without a proper crush available. Tendon and nerve damage has left my grip weak and unpredictable. In return, I pick up more of the ops and procedures others don't like so much.

RE: Ovarian remnant

grumpyoldman — Sun, 15 Nov 2015 11:44:33 GMT

Officially its no longer a first day competence , tales of people not doing them or avoiding them several years into practice are not uncommon.

RE: Ovarian remnant

Neil Wheadon — Sat, 14 Nov 2015 16:39:19 GMT

[quote user="Michael Woodhouse"]always check both full ovaries removed in a bitch spay before closing. Doesn't everyone else do this? [/quote]

Yes I always dissect them out (I clamp above the ovary and transfix the pedicle without clamping - works for me) It's 20 seconds well spent. Very occasionally I have taken the scissors too close and you can see this on the edge of the ovary, it's not smooth all the way round, so I take the time and go deeper, making sure it's out fully

Neil

RE: Ovarian remnant

grumpyoldman — Sat, 14 Nov 2015 14:15:38 GMT

[quote user="Robin Grimmer"]Does this come under the classification of 'cock up'? I can't imagine a client will be too chuffed about having to pay for another operation, particularly if a referral is involved.[/quote]

I think so. More recently we have had a golden retriever and labrador come back from Spain with the same problems. Can't remember who paid, owners or insurance.

RE: Ovarian remnant

Michael Woodhouse — Sat, 14 Nov 2015 14:06:53 GMT

The VDS is very clear on this - the owner paid for a properly spayed dog. If it requires further surgery it is at the initial practice's expense that carried out the botched operation. Bleeding after a properly conducted operation is within the accepted risk. Leaving behind the very thing you have been paid to remove is negligence.

I was taught as a student to always check both full ovaries removed in a bitch spay before closing. Doesn't everyone else do this? I can't see the circumstances of how this could happen and not be noticed?!

[aside - I heard about a vet leaving behind a lamb during a sheep caeser - so I guess a bit of ovary is possible....]