GA related death

RE: GA related death

Andreas Ege — Fri, 22 Dec 2017 18:44:25 GMT

I don't know how evidence based ovariectomy (OE) vs OHE is, but even though I learned OHE at vetschool about 15, 16 years ago, I've been told at the same time that there were some american scientific studies saying OE in bitches not a problem.

Never thought the risk of stump pyo likely, anyway. After all, when do we normally get a pyo? Right, after season. No ovaries, no season, very unlikely to get a pyo.

Can't remember when I did my last OHE in a bitch for routine neutering, and for cat's Germany and as far as I know most other countries only do OE as well. I'd love to say never seen any problems but obviously am not likely to know what's happened 5, 10 years down the line.

As far as I'm aware, endoscopic spaying is normally just OE.

RE: GA related death

John Wessels — Tue, 19 Dec 2017 19:36:29 GMT

[quote user="Michael Woodhouse"]

[quote user="Nicola M"]Then should we scrap full OVH and just do the ovaries?[/quote]

I did some ovariectomies and there is a need to ligate the pedicle then the cranial end of the uterine horn, so 4 ligatures to tie. I therefore find simple to ligate right pedicle, left pedicle and then uterus beyond bifurcation. 3 ligatures. A little faster and familiar.

[/quote]

Also I would need the bifurcation to get to the left horn.

RE: GA related death

Michael Woodhouse — Tue, 19 Dec 2017 19:32:57 GMT

[quote user="Nicola M"]Then should we scrap full OVH and just do the ovaries?[/quote]

RE: GA related death

Nicola Cole — Tue, 19 Dec 2017 19:27:37 GMT

I was going to mention a similar point-if the consensus is that you don’t need to get down to the cervix in a bitch (presumably young without any uterine changes) then why bother with the uterus at all?

Is that the consensus? Then should we scrap full OVH and just do the ovaries?

RE: GA related death

Anthony Todd — Tue, 19 Dec 2017 17:32:14 GMT

[quote user="Andreas Ege"]Well, actually, as long as there are no gross pathological changes, you don't have to bother with the uterus at all.[/quote]

If that is cast iron proven then ovariectomy [?term?] is an obvious major simplification of a B/S which, for the first time ever, may not get me one star!

RE: GA related death

Andreas Ege — Tue, 19 Dec 2017 16:21:42 GMT

[quote user="John Wessels"]exactly! you don t have to go down to the cervix, down to bifurcation is sufficient, just make damn sure you got those ovaries![/quote]

Well, actually, as long as there are no gross pathological changes, you don't have to bother with the uterus at all.

RE: GA related death

Joyce Whitehead — Tue, 19 Dec 2017 14:02:25 GMT

I would agree with John on the small bitch spay incisions. I also normally incise about 3cm and find it easy enough to find everything. I don’t stress about cervices as already stated if you get the ovaries then you won’t get a stump Pyo. The other advantage (other than less time to suture) is that you get the ovarian fat out of your incision and it tends to stay there, allowing easier ligature placement. I’ve taught quite a few younger vets now and most of them continue to use my adapted method.

RE: GA related death

John Wessels — Tue, 19 Dec 2017 12:58:39 GMT

[quote user="Edward Jones"]

[quote user="Nicola M"]I can’t visualise how you can get sufficient access to the ovaries and down to cervix[/quote]

You can't (and Dick White says that too so I'm with him). Though I can't remember the last time I saw a cervix during a routine spay.

[/quote]

exactly! you don t have to go down to the cervix, down to bifurcation is sufficient, just make damn sure you got those ovaries!

RE: GA related death

John Wessels — Tue, 19 Dec 2017 12:49:08 GMT

[quote user="Nicola M"]

[quote user="John Wessels"]

Doing part time now, but I promise to record the very next one I spay.

Did you know you can spay almost any bitch( YT to G Dane) through a 10 - 15 mm incision? With conventional tools that is.

[/quote]

Another that would love to see this to see what tips I can pick up-especially for large bitch spays-I can’t visualise how you can get sufficient access to the ovaries and down to cervix through that small a hole in a dog of that size (completely believe you, I just can’t picture it!)

[/quote]

Position of incision is crucial. small incision makes an OvH easier than with a large incision.

And you can make a small incision larger but not vice versa.

When I started of in 1984 the vet I worked for spayed bitches with a 3 inch incision and both our hands ended up somewhere deep down in the animals abdomen. When I told a friend of mine about this he told me his senior vet spayed a bitch on his own and needed only 1 and half inch. I refused to believe that, thinking how on earth does he do that?? So I went to see it for myself and saw how it was easily done and adopted his approach. Watch and learn. Still learning to this day, never stop learning.

RE: GA related death

Martin Atkinson — Tue, 19 Dec 2017 10:30:53 GMT

[quote user="Andreas Ege"]

I've even met a very posh looking lady vet on a CPD about laboratory animals that credibly told how she had mouth-to-snouted(?) a pig. :-))

I have to admit, I've always struggled with the idea and don't think I'd be able to do it. Maybe, just maybe, with my own animals. Call me squeamish, but... yuck...

[/quote]I snog one of my cats every day, he loves it, I wouldn't try it with the other one though she would rip my face open.

RE: GA related death

Edward Jones — Tue, 19 Dec 2017 10:15:46 GMT

[quote user="Anthony Todd"]

[quote user="Nicola M"]to cervix through that small a hole[/quote]

Dinosaureal doctrine was that, if you left the horns or body of the uterus, you might get a subsequent pyo....

Probably nonsense??

[/quote]

Only if there's an ovarian remnant, I believe. Ovariectomy is routine for lap spays.

RE: GA related death

Anthony Todd — Tue, 19 Dec 2017 09:43:11 GMT

[quote user="Nicola M"]to cervix through that small a hole[/quote]

Dinosaureal doctrine was that, if you left the horns or body of the uterus, you might get a subsequent pyo....

Probably nonsense??

RE: GA related death

Edward Jones — Tue, 19 Dec 2017 09:27:18 GMT

[quote user="Nicola M"]I can’t visualise how you can get sufficient access to the ovaries and down to cervix[/quote]

You can't (and Dick White says that too so I'm with him). Though I can't remember the last time I saw a cervix during a routine spay.

RE: GA related death

Nicola Cole — Tue, 19 Dec 2017 09:22:24 GMT

[quote user="John Wessels"]

Doing part time now, but I promise to record the very next one I spay.

Did you know you can spay almost any bitch( YT to G Dane) through a 10 - 15 mm incision? With conventional tools that is.

[/quote]

RE: GA related death

Edward Jones — Tue, 19 Dec 2017 08:53:24 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Andreas Ege"]Call me squeamish, but... yuck...[/quote]

You're squeamish.

[/quote]

I use a semi-closed fist over the nose and mouth and blow into that, first did it with resuscitating lambs (definitely not putting my mouth on a lamb and I doubt the safety of deliberately putting my mouth on my hand in that environment, and it's probably unnecessary anyway!).

RE: GA related death

Dinu Catilina — Tue, 19 Dec 2017 08:39:11 GMT

[quote user="Andreas Ege"]I've even met a very posh looking lady vet on a CPD about laboratory animals that credibly told how she had mouth-to-snouted(?) a pig. :-))[/quote]

I did mouth to mouth to a hamster :) and he survived lol. The most disgusting thing I ever done in practice, those yellow teeth are still haunting me

RE: GA related death

Linda Filshie — Mon, 18 Dec 2017 21:11:36 GMT

[quote user="Andreas Ege"]

I've even met a very posh looking lady vet on a CPD about laboratory animals that credibly told how she had mouth-to-snouted(?) a pig. :-))

I have to admit, I've always struggled with the idea and don't think I'd be able to do it. Maybe, just maybe, with my own animals. Call me squeamish, but... yuck...

[/quote]

I've done mouth to nose on newborns that are apnoeic - lambs, calves, pups. I'm not especially posh however so I don't think it correlates

RE: GA related death

Clive Ansell — Mon, 18 Dec 2017 18:15:33 GMT

[quote user="Andreas Ege"]'ve even met a very posh looking lady vet on a CPD about laboratory animals that credibly told how she had mouth-to-snouted(?) a pig. :-))[/quote]

Would prefer that to most human beings

RE: GA related death

Evelyn Barbour-Hill — Mon, 18 Dec 2017 17:49:22 GMT

[quote user="Andreas Ege"]Call me squeamish, but... yuck...[/quote]

You're squeamish.

RE: GA related death

Andreas Ege — Mon, 18 Dec 2017 16:31:33 GMT

[quote user="Anthony Todd"]I only mentioned it, because in the incident I well remember, 1 vet and 2 competent nurses couldn't believe you could mouth-to-mouth a cat.[/quote]

I've even met a very posh looking lady vet on a CPD about laboratory animals that credibly told how she had mouth-to-snouted(?) a pig. :-))

I have to admit, I've always struggled with the idea and don't think I'd be able to do it. Maybe, just maybe, with my own animals. Call me squeamish, but... yuck...

Another advantage of having a tube in, at least if you don't have iv access (and with im narcotics I've not seen many practices routinely placing iv catheters) is: you can give emergency meds. And being able to increase oxygen saturation might not be a bad thing either. Just a thought...

RE: GA related death

Richard Carter — Mon, 18 Dec 2017 16:27:20 GMT

in countries where gas anaesthetics are rare (i.e. most of the rest) a vet or nurse doing resp by mouth through an et tube is how you treat diaphragmatic hernias, traumatic open wounds to the chest as well as anaesthetic complications such as atelectasis, apnoea etc.

ever seen a midwife clear the mucous from a newborn where suction by mechanical means is not available?

reality vs nice to have

RE: GA related death

Evelyn Barbour-Hill — Mon, 18 Dec 2017 16:06:35 GMT

[quote user="Anthony Todd"]Jeepers, you have all been quoting Brodbelt, when it suited,[/quote]

No I haven't. No sidestep.

[quote user="Anthony Todd"]

[quote user="Evelyn Barbour-Hill"] I've done mouth to mouth on the rare emergency occasion but it was much more effective once the tube was in.[/quote]

So why did you give mouth to mouth then??

[/quote]

What part of "rare emergency occasion" do you not understand?

As I recall, once on a home visit. Once or twice (in 45 years) in the consulting room in the middle of the night.

[quote user="Anthony Todd"]Again. when you've got something always available that works well, and immediately, why wait or "reach into the drawer "etc etc.[/quote]

No waiting involved. I've just timed reaching into the drawer and it took 4 seconds.

Get the tube in, start blowing down that.

[quote user="Anthony Todd"]May save a life in future so don't knock it too much,[/quote]

Nobody's knocking it. This is getting silly.

RE: GA related death

Anthony Todd — Mon, 18 Dec 2017 15:31:49 GMT

[quote user="Evelyn Barbour-Hill"]"Associated with" does not imply a causal relationship in either direction.[/quote]

Jeepers, you have all been quoting Brodbelt, when it suited, so why side-step his serious association with endotubes?

[quote user="Evelyn Barbour-Hill"] I've done mouth to mouth on the rare emergency occasion but it was much more effective once the tube was in.[/quote]

So why did you give mouth to mouth then??

Again. when you've got something always available that works well, and immediately, why wait or "reach into the drawer "etc etc.

And, in an emergency, in my observations, tubing a bluish cat hasn't been an easy procedure.....

I only mentioned it, because in the incident I well remember, 1 vet and 2 competent nurses couldn't believe you could mouth-to-mouth a cat.

May save a life in future so don't knock it too much, just do it when the time comes.

RE: GA related death

Bob Russell — Mon, 18 Dec 2017 15:25:20 GMT

Not for years.

RE: GA related death

Martin Atkinson — Mon, 18 Dec 2017 15:21:30 GMT

[quote user="Bob Russell"]Rephrase, the early days of us not giving 'routine' antibiotics post surgery.[/quote]Well I kind of figured that really but it actually worries me more: do you really give routine post-op antibiotics?