flank cat spay

RE: flank cat spay

Seadna — Fri, 21 Oct 2016 12:18:08 GMT

[quote user="Martin Atkinson"]The bad practice was the rest of the procedure as described. Without the hook he would have had to make a proper incision and follow good sterile procedure.[/quote]

Yeah I see what you were trying to say now. Poor little spay hook, getting the blame for bad surgical technique. In the case of your example you could probably argue that if the only thing entering the abdomen is the spay hook that there is less chance for contamination from his skin incision than if he were to stick in two fingers to fish around for the uterus though.

RE: flank cat spay

David Mills — Fri, 21 Oct 2016 11:58:03 GMT

[quote user="Seadna "]

If I was interviewing for a job and had someone tell me what instruments I should and should not require I wouldn't be long scarpering! A spay hook is very inexpensive, what's your objection with using it David?

[/quote]

Nothing really, I was just throwing out some bait

RE: flank cat spay

Martin Atkinson — Fri, 21 Oct 2016 11:12:07 GMT

[quote user="Seadna "]Not sure how it encourages bad practice though? I defo don't want to start a fight so hopefully not coming across as aggressive here, just curious in case I ever have to come working for you[/quote]The bad practice was the rest of the procedure as described. Without the hook he would have had to make a proper incision and follow good sterile procedure.

As for working for me I love people who challenge me and question the way I work, even my nurses let alone vets, so bring it on!

RE: flank cat spay

Seadna — Fri, 21 Oct 2016 09:39:45 GMT

[quote user="Martin Atkinson"]Which way would you vote?[/quote]

Err, that sounds a bit dodge to me :)

As I've said, I don't belong in this thread because I've never done a flank spay and I know from listening to others that if you incise in the correct area of the flank the uterus is right there in view and can be picked up with forceps. For my ventral midlines I do a stab incision in the linea so the hook is pretty necessary because I can't fit a finger in. But the conversation has now turned into "if I had a potential employee asking to use x,y or z inexpensive instrument, I would see that as a deficiency of technique and not employ them". Not sure how it encourages bad practice though? I defo don't want to start a fight so hopefully not coming across as aggressive here, just curious in case I ever have to come working for you :D

RE: flank cat spay

Martin Atkinson — Fri, 21 Oct 2016 09:17:31 GMT

[quote user="Seadna "]If I was interviewing for a job and had someone tell me what instruments I should and should not require I wouldn't be long scarpering! A spay hook is very inexpensive, what's your objection with using it David?[/quote]Not answering for Mr Mills but I've never seen any advantage to using one but I can see it could encourage bad practice. I know one vet who used to just dampen the cats fur with spirit, make a stab incision with a blade. hook the uterus out, do a kind of part hysterectomy/ovarectomy, release the uterus back in and job done - no suturing just left to heal. The clients loved it because there was no shaved patch and he got surprisingly few post op complications. Maybe he was a poor or lazy vet or maybe he was just years ahead of his time with minimally invasive surgery. Which way would you vote?

RE: flank cat spay

Seadna — Thu, 20 Oct 2016 23:48:22 GMT

RE: flank cat spay

Jill Butterworth — Thu, 20 Oct 2016 23:25:51 GMT

Ha ha, that's a bit harsh!

RE: flank cat spay

David Mills — Thu, 20 Oct 2016 23:16:45 GMT

If I was an employer (I'm not) and a potential employee NEEDED a spay hook I wouldn't employ them.

I am utterly perplexed by any requirement in a cat spay. Bitch spay perhaps.

RE: flank cat spay

Seadna — Thu, 20 Oct 2016 22:17:37 GMT

[quote user="Anthony Todd"]

Anyone still use spay hooks [I never could; hooked everything but...]

[/quote]

I use one all the time. Apart from a scalpel blade, it's the only instrument I couldn't start a spay without (I can do without artery forceps if I have a nurse scrubbed). But I do ventral midline so I don't belong in this thread :)

RE: flank cat spay

Anthony Todd — Thu, 20 Oct 2016 11:05:19 GMT

[quote user="Martin Atkinson"]find the sub renal fat (with minimal experience [/quote]

+1, not sure about the "minimal" though.

The "gap" between the two "pillows" of fat is the key, so look for that directly under the incision before you start poking around.

The key is the position of the incision though!

RE: flank cat spay

Martin Atkinson — Thu, 20 Oct 2016 10:24:04 GMT

Some people seem to be making this over-complicated. The only tricks you really need are:

1) The landmark: with legs tied back, palpate the ilieal crest, incision site is then vertically below 2/3 of the way down the flank. Choose left or right side depending on if you are left or right handed make an incision sloping at roughly 45 degrees parallel to the drawn back leg the length of which to match your level of confidence and if there's too much fat in the way chop a bit out - I've never found this complicated recovery.

2) Pass your fine dressing forceps dorsally to find the sub renal fat (with minimal experience its easy to tell the difference from the omentum), elevate that and the nearest horn of the uterus is invariably under that and hoves into view, perform hysterectomy same as any other approach. Follow the first horn down to the bifurcation to find the second one and don't be scared to extend your incision if you need to. Close routinely.

RE: flank cat spay

Jill Butterworth — Wed, 19 Oct 2016 22:06:18 GMT

Ha ha, yes, if ever I'm sweating that I can't find the uterus, I send a nurse out to find something, and the uterus appears!

RE: flank cat spay

Wren — Wed, 19 Oct 2016 10:02:41 GMT

Does anyone use palpation to make their incision/find the left horn? When I used to do them I would make sure the legs were pulled right back, then run my finger lightly down the clipped area (from spine to ventrum) and I could feel the left horn as a tight horizontal structure. Then made my incision over it.

RE: flank cat spay

Evelyn Barbour-Hill — Tue, 18 Oct 2016 23:56:04 GMT

[quote user="Anthony Todd"]Anyone still use spay hooks[/quote]

Yep. They still work.

RE: flank cat spay

Lindsey Edwards — Tue, 18 Oct 2016 19:59:45 GMT

Do occasionally use a spay hook - mostly to retrieve R horn once visualised first though, when first started did use to locate L horn also (used to push away fat to visualise horn, more successfully than blind fishing!).

Always teach nurses to prep carefully - avoid ribs, spinal column/musculature and hind leg - incisions approx centre of area then - fingers width down from spinal musculature and back from ribs.

RE: flank cat spay

Busybee — Tue, 18 Oct 2016 18:34:22 GMT

I think it was on here that I read how useful spay hooks can be....search around unsuccessfully for a good 10 mins to find the uterus, ask nurse to get spay hook, nurse starts to open sterile packet containing spay hook, uterus magically becomes visible.....

RE: flank cat spay

Anthony Todd — Tue, 18 Oct 2016 15:04:33 GMT

Anyone still use spay hooks [I never could; hooked everything but...]

RE: flank cat spay

Rach — Tue, 18 Oct 2016 14:12:50 GMT

Not a lot to add, but I tend to make my incision slightly on the diagonal, from craniodorsal to caudoventral, the theory being it gives better access to the ovaries and the bifurcation, not sure it makes much difference on such a small incision, and I can't remember ever doing them straight to compare, but might make identifying the bifurcation easier to trace the other horn?

RE: flank cat spay

Neil Wheadon — Mon, 17 Oct 2016 22:08:58 GMT

[quote user="Anthony Todd"]Trouble is, I found, if the incision is too far forward you can't get down to the bifurcation.[/quote]

Does it matter?

In dogs ovariectomies are the norm for laparoscopic spays

Has anyone ever seen a pyometra in a spayed cat?

Neil

Edit - as my wife points out , this isn't quite in context of the discussion.

RE: flank cat spay

Sarah Wheadon — Mon, 17 Oct 2016 21:34:05 GMT

If the right horn doesn't come up easily, I ask my nurse to release the leg tie and allow the hind legs to relax. The reduced tension in the abdomen means the bifurcation usually comes into view when you elevate the left horn. Works for me, anyway.

RE: flank cat spay

Anthony Todd — Mon, 17 Oct 2016 17:08:59 GMT

[quote user="Noweia"]If you've got one side I just follow down to the bifurcation and back up again?[/quote]

Trouble is, I found, if the incision is too far forward you can't get down to the bifurcation.

RE: flank cat spay

Noweia — Mon, 17 Oct 2016 16:32:36 GMT

[quote user="Stephen Pointing"]Are there any tips for finding the other horn easily? Am I doing something wrong? I always feel it should come up if tension is kept on the left horn but that doesn't always seem to do the trick. It is always easier to find in younger, slimmer cats.

[/quote]

If you've got one side I just follow down to the bifurcation and back up again?

RE: flank cat spay

Anthony Todd — Mon, 17 Oct 2016 16:30:50 GMT

[quote user="Stephen Pointing"]the right horn[/quote]

Possibly, [and in my cases], because the incision is too far forward??

Unless you "stretch" the cat by both feet tied together horizontally it's easy to make your incision too far forward or too high.

Compounded drastically by the clipping area being in the wrong place to start with.

A bit low is better than a bit high.....

Others will confirm or dispute

RE: flank cat spay

Stephen Pointing — Mon, 17 Oct 2016 15:59:58 GMT

I use the left flank approach as described by most people here and don't usually have any problem with finding the left uterine horn and ovary. But no one has mentioned the difficulty in sometimes finding the right horn especially in older, fatter cats. Are there any tips for finding the other horn easily? Am I doing something wrong? I always feel it should come up if tension is kept on the left horn but that doesn't always seem to do the trick. It is always easier to find in younger, slimmer cats.

RE: flank cat spay

Anthony Todd — Mon, 17 Oct 2016 14:59:44 GMT

[quote user="Anthony Dennison"]I use a scalpel to incise into the abdomen rather than scissors. [/quote]

I hope you empty the bladder first or you will sooner or later.....

Don't think many would agree with cutting a chunk of muscle out either.

Gave one star only to highlight their ineffectiveness and irrelevance