Can you perform an ovariectomy concomitantly with caesarian?

RE: Can you perform an ovariectomy concomitantly with caesarian?

Clive Ansell — Sun, 10 Mar 2024 09:12:40 GMT

[quote userid="3169" url="~/f/clinical-questions/30912/can-you-perform-an-ovariectomy-concomitantly-with-caesarian/243993#243993"]Literally, you there by yourself? Surely someone in house could be trained up for emergencies?[/quote]

There are simply not enough boots on the ground, trained or untrained. Untrained staff are great and help out as much as, and when they can, but one young trainee cannot man reception, monitor anaesthesia and monitor recovering animals at the same time.

Staff were cut back to the bone with redundancies about a year ago, since then 1 RNV and 2 receptionists have left and another RVN is on long term sick leave.

[quote userid="8991" url="~/f/clinical-questions/30912/can-you-perform-an-ovariectomy-concomitantly-with-caesarian/243990#243990"]If you've only one assistant then surely any ops are somewhat risky? As in recovery etc. [/quote]

Exactly, so it limits what can be done. Restricted to smaller and shorter procedures, metedtomadine/atipamazole for faster recovery, and recover animals in same room.

Larger or riskier procedures or cases have to be directed elsewhere I'm afraid.

RE: Can you perform an ovariectomy concomitantly with caesarian?

Michael Woodhouse — Sat, 09 Mar 2024 22:34:00 GMT

[quote userid="8991" url="~/f/clinical-questions/30912/can-you-perform-an-ovariectomy-concomitantly-with-caesarian/243990#243990"]

Clamp all the bits off and remove uterus en bloc. Scrub out and slice the pups out. Have rvn or yourself jab all the pups im with premixed Naloxone/atipam (1ml syringe, 0.5ml atipam, 0.5ml Naloxone mixed in same syringe) give each pup 0.1ml. resus as normal.

Scrub back in and ligate the bits, close up. About 10-15 mins start to finish.

[/quote]

You are completely correct regarding the block removal technique - fast and works very well. Have done so many times with just me and a nurse, without be scrubbing out. Nurse in prep with door open.

Years ago Ive done a couple of bitch caesers with the farmer owner being the only other person present and they did the puppy rubbing. Far from ideal but sometimes little choice (we got our first student nurse in 2016, 10 years after I graduated).

A caeser is the one OP I am very keen to get back home and out of the practice.

[quote userid="5012" url="~/f/clinical-questions/30912/can-you-perform-an-ovariectomy-concomitantly-with-caesarian/243989#243989"]can only do surgeries or investigations on 3 out of 5 days. [/quote]

Literally, you there by yourself? Surely someone in house could be trained up for emergencies?

RE: Can you perform an ovariectomy concomitantly with caesarian?

David Mills — Sat, 09 Mar 2024 19:49:20 GMT

If you've only one assistant then surely any ops are somewhat risky? As in recovery etc.

Even with a few untrained people you can recover pups or kittens.

Scrub back in and ligate the bits, close up. About 10-15 mins start to finish.

RE: Can you perform an ovariectomy concomitantly with caesarian?

Clive Ansell — Sat, 09 Mar 2024 18:25:10 GMT

[quote userid="12930" url="~/f/clinical-questions/30912/can-you-perform-an-ovariectomy-concomitantly-with-caesarian/243988#243988"]This does assume more than one assistant.[/quote]

Absolutely right.

Where I am currently working we are very short staffed; there is one RVN 3 days a week, and none on the other 2 days. can only do surgeries or investigations on 3 out of 5 days.

RE: Can you perform an ovariectomy concomitantly with caesarian?

Beats — Sat, 09 Mar 2024 15:38:23 GMT

This does assume more than one assistant.

RE: Can you perform an ovariectomy concomitantly with caesarian?

David Mills — Fri, 08 Mar 2024 23:32:29 GMT

Christ why bother?

Just do en bloc Caesar/spay. Hand the uterus to others to sort the pups. Reverse any premed in the pups (atipam/Naloxone). Pretty much 100pc survival.

Best thing is, then everyone leaves theatre and you can get on tying off everything in peace :)

Easiest way of getting staff to help? A Csection

RE: Can you perform an ovariectomy concomitantly with caesarian?

Clive Ansell — Fri, 08 Mar 2024 17:28:37 GMT

[quote userid="4872" url="~/f/clinical-questions/30912/can-you-perform-an-ovariectomy-concomitantly-with-caesarian/243973#243973"]My thinking was mainly that you would preserve the red blood cells that are present in the uterus at the time of the surgery, potentially increasing bitch welfare.[/quote]

Could give oxytocin to aid involution and some blood at least would go back into general circulation.

RE: Can you perform an ovariectomy concomitantly with caesarian?

Dinu Catilina — Fri, 08 Mar 2024 15:32:01 GMT

In theory I see no reason not to just do ovariectomy but I am not aware of any evidence. You will be brave to do it first!

As an anecdote, I did lap ovariectomies for bitches with open cervix pyo where there was little lumenal fluid on ultrasound and they did well. It might be the same in your case.

RE: Can you perform an ovariectomy concomitantly with caesarian?

Jon Bray — Fri, 08 Mar 2024 15:29:21 GMT

My thinking was mainly that you would preserve the red blood cells that are present in the uterus at the time of the surgery, potentially increasing bitch welfare.

Risk of haemorrhage is there in either case; risk of uterine wall breakdown isn't something I've come across myself, having done rather more Frenchie caesars than I'd like.

Up until very recently I'd agree with you at least that it took no longer to spay the bitch than to repair the uterus. Then I found myself caesar-spaying a (not particularly fat) Labrador and thinking "if this had been a standard caesar I'd have been finished half an hour ago". That might be because my "normal" caesar is a Frenchie and it would have taken a bit longer to caesar the labrador. I agree that properly closing the uterus AND performing an ovariectomy would probably take longer than either alternative though.

RE: Can you perform an ovariectomy concomitantly with caesarian?

Clive Ansell — Fri, 08 Mar 2024 15:14:16 GMT

Why would you?

I've spayed many bitches at the same time as c-section, and find it quicker than suturing the uterus back together. I can't think of any reason why one would prolong surgery and anaesthesia time to repair the uterus and leave it in situ, with the risk of wound breakdown or haemorrhage, while removing the ovaries. Makes no sense at all.