Spays

Re: Spays

Evelyn Barbour-Hill — Thu, 25 Mar 2010 03:35:20 GMT

[quote user="Jon Bray"]If spaying a cat that I know is in season or pregnant I do sometimes do them midline, just so if there is a problem the cat doesn't go home with two holes.[/quote]

I'd agree with that, mostly for a simpler reason: If I am going to need more than a little hole to get the thing out, I might just as well do it midline which is suited to big holes.

Re: Spays

Jon Bray — Sat, 20 Mar 2010 21:15:29 GMT

Back in university Professor Holt was supervising my first cat spay. As I was about to close (midline) we noticed rather a lot of blood coming up from somewhere. The Prof's response upon taking over was to temporarially tack the lateral wound together and to go in midline, on the basis that trying to find stumps through a lateral incision was extremely difficult.

If spaying a cat that I know is in season or pregnant I do sometimes do them midline, just so if there is a problem the cat doesn't go home with two holes.

Re: Spays

salome2001 — Tue, 06 Oct 2009 16:29:56 GMT

Gillian, it IS bloody painful. Absolute crashing-right-now emergency c-sections in women may be midline but for the majority of c-sections the "bikini-line" approach is used for, as you guessed, cosmetic reasons.

Absolutely destroys your abdominal muscle strength though.

Re: Spays

salome2001 — Tue, 06 Oct 2009 16:26:22 GMT

all midline cats and dogs. never done a flank spay in 17 years of practice. Prof Chris Bellenger would have had my guts for garters for even thinking it.

Re: Spays

Clive Ansell — Wed, 30 Sep 2009 12:33:25 GMT

Midline for bitches always, tried flank in the past but I couldn't get on with and cannot see an advantage. Never had a problem with caesarians with lots of milk as long as incision is exactly midline.

Cats usually flank, but if pregnant, requested, or likely to be complicated such as possibly speyed already then happier to go midline for better access and visibility. No problem with suture reactions using PDS.

Re: Spays

scarlet — Wed, 30 Sep 2009 10:40:26 GMT

flank for cats (except preg) midline dogs, tho i also was taught flank caesars by my first practice (dark ages) for above reasons. much prefer midline everytime!!

Re: Spays

Charlotte Marshall — Tue, 29 Sep 2009 19:42:35 GMT

When I started in my current practice (12yrs ago) the boss liked to do bitch caesars flank and I did a couple. It does avoid milk in your wound in a bitch with plenty of milk but there was more stitching up to do and we did see seroma formation in quite a few of them. Now I do them all midline.

Re: Spays

Gillian Mostyn — Tue, 14 Jul 2009 08:41:56 GMT

ouch!

Re: Spays

Stephen Ashman — Mon, 13 Jul 2009 22:24:36 GMT

[quote user="Laurence Webb"]

That's the first time I've come across such a major wound failure. Presumably a flank incision would have a lower probabilty of such a complication, but it still remains such an unusual complication that I'd still prefer to stick to midlines myself

[/quote]

Interesting signature to have under this statement!

Re: Spays

Laurence Webb — Mon, 13 Jul 2009 22:19:14 GMT

We share OOH with a nearby practice. Last week my boss saw a disasterous wound breakdown from a midline caesar done by the other practice (no concerns about their ability, just a 'bad luck' case). As the cat came into the surgery it lept from the towel it was carried in and eventrated in the reception, tearing the mesentary to most of its small intestine. Needless to say, it didn't have a good outcome.

Re: Spays

Hanna Bennett — Mon, 13 Jul 2009 20:55:46 GMT

can see that point, which is why i always use intradermal sutures - tho you still get 'sweaty' appearance to the wound due to the usually very saggy mammary glands. however i'm sticking to my midlines!

Re: Spays

Ian Mostyn — Mon, 13 Jul 2009 13:04:28 GMT

Because they had problems previously (before I started) with pups chewing mid-line stitches and they didn't want any problems. They were a big breeder so even 1 litter in 10 chewing stitches would be a problem. Partly paranoia and partly very high requirements.

Ian

Re: Spays

Hannah Wynne Richards — Mon, 13 Jul 2009 12:31:18 GMT

Why would these be any different to normal Ceasars? I'm curious !

Wynne

Re: Spays

Ian Mostyn — Mon, 13 Jul 2009 12:03:25 GMT

These were Specific Pathogen Free dogs from a commercial dog breeder so strict biosecurity on site and no excuses for wound infections as if they needed to go off site for vet care there was a long quarantine period. Hygiene was spotless but this was a policy decision made with the named vet. Not sure I would do them again as a routine, only in special circumstances.

Ian

Re: Spays

Hannah Wynne Richards — Mon, 13 Jul 2009 10:10:15 GMT

I've always done cow and sheep Ceasars flank for 2 reasons. 1) can do with paravertebral block, plus sedative in sucklers else your patient will be "over the hills and far away " mid-op-avoid risk of GA in ruminant. 2) weight of rumen would predispose to wound breakdown. if done mid-line I've never done a mare Ceasar but know they like to do flank to keep weight of gravid uterus off aorta-but colics done mid-line for better exteriorisation.

If you Ian did that many Ceasars, obviously a very big breeder. I would query kennel conditions and whether one of the reasons the breeder liked flank was that in dirty kennels there was a greater likelihood of wound infections.if done mid-line I'm a suspicious so-and so and that makes more sense than keeping wound away from mammary glands which would apply to all Ceasars

Wynne

Re: Spays

Don Rutherford — Mon, 13 Jul 2009 08:49:59 GMT

As is so often the case with surgical technique - horses for courses.

Re: Spays

sophia guymer — Sun, 12 Jul 2009 22:30:40 GMT

[quote user="Gillian Mostyn"]I believe it is pretty painful [/quote]

Hi Gillian,

I have had one done, had my first boy 'the normal' way, hours and hours (19) of agony, and the second one (breech) 'the easy way'!!! I really think that was true. Ok yes it was painfull and I do not understand that bitches just up and go afterwards, but there was no agony like with the first one and it healed lovely. (he is 3yr now and scar hardly visible)

Still, do bitch spays and cs (and suspect pregn cat spays) midline and cats flank.

Sophia

Re: Spays

Ian Mostyn — Sun, 12 Jul 2009 21:44:22 GMT

Maybe it is just Beagles, never tried it on any other breed!!

Ian

Re: Spays

Gillian Mostyn — Sun, 12 Jul 2009 20:17:59 GMT

I was thinking the same!

Re: Spays

Hanna Bennett — Sun, 12 Jul 2009 19:35:44 GMT

how on earth do you exteriorize a gravid uterus thru a 2" hole! well done you.

Re: Spays

Ian Mostyn — Sun, 12 Jul 2009 17:50:40 GMT

No more than a 2" hole in a Beagle. If you follow the line of muscle you can divide between muscle fibres getting minimal bleeding.

Re: Spays

Gillian Mostyn — Sun, 12 Jul 2009 17:05:05 GMT

Don't forget that women (and livestock) have caesars done via a muscle incision/tear!! I believe it is pretty painful (not had one myself thank goodness) but is obviously not a bad technique..... I assume it isn't all about cosmetic results? Or is it?????

Re: Spays

vio doran — Sun, 12 Jul 2009 13:05:58 GMT

i do it mid-line, all of them

no problems so far....

Re: Spays

Hanna Bennett — Sun, 12 Jul 2009 12:54:20 GMT

having had to spay pregnant cats thru a flank wound when i failed to realise they were pregnant before starting surgery (always check now!) i found it necessary to make what i considered to be a very large hole to enable me to get the (not full term) uterus out of my flank incision so kudos to you for managing it in caesars!

Re: Spays

Ian Mostyn — Sat, 11 Jul 2009 22:17:13 GMT

Muscle stretches quite a lot so you can get away with a small hole and exteriorise the uterus. I never had a problem in my 10 or so caesars done this way but since the uterus is external, you can easily tie off the vessel. We used metacam and opiates during the surgery and post-op metacam. The dogs seemed to come round very quickly and showed no obvious signs of pain - they just got on with things the same as the normal deliveries.The pain would surely be equivalent to a flank cat spay and we accept that.

Now I do all my caesars mid-line, partly because that is the expected way to do things but at least I have gained the technical skills to do the op either way if I want.

Ian