Surgical approach for bitch caesar

RE: Surgical approach for bitch caesar

serena holmes — Sat, 03 Apr 2021 08:37:10 GMT

I’ve always gone midline with intradermal sutures with no problems so far, I’d worry with flank if any bleeding pedicles they would be harder to reach, and more muscle to go through so potentially more painful.

RE: Surgical approach for bitch caesar

serena holmes — Sat, 03 Apr 2021 08:34:36 GMT

RE: Surgical approach for bitch caesar

Julian Earl — Fri, 02 Apr 2021 19:29:09 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/5573/surgical-approach-for-bitch-caesar/229306#229306"]Next one please show us some pics of the suture lin[/quote]

Sorry, now I am retired I have no access to taking photographs. But the wound looks like the to edges are just neatly apposed to each other and barely a visiblered ;ime for the wound itself. The skin seems secure and well-healed very quickly indeed.

HTH?

RE: Surgical approach for bitch caesar

Ava Firth — Thu, 01 Apr 2021 15:37:36 GMT

Sheep are not routinely intubated for Caesareans, therefore doing a midline Caesarean would definitely impact their respiratory function

RE: Surgical approach for bitch caesar

Julian Earl — Wed, 31 Mar 2021 13:19:09 GMT

Also, I always did them midline and the use of subcuticular suture in these made he post-operative healing much better. No external sutures for the puppies to grab and try to suck from! HTH?

RE: Surgical approach for bitch caesar

Charlotte Marshall — Sat, 27 Mar 2021 00:04:03 GMT

Of course the other potential thing in short haired dogs is that with a flank incision you might get a visible scar line which clients are not keen on.

RE: Surgical approach for bitch caesar

Anthony Dennison — Fri, 19 Mar 2021 17:13:47 GMT

I spent a month at a neutering channel called 'Help in Suffering' in Jaipur. They did (used to, I presume still do) a paramedian approach at about the level of the left stifle fold. My wife had been over the previous year and they had collected loads of data, length of surgery, complication rates etc and then I did the statistical analysis and wrote the paper. Was published in Vet Record around 2012 I think...

Some of them were found to be early pregnant (or later pregnancy too if unhandleable) and the wound was just extended, minimal issues.

The reading I did for the paper basically said the main factor in whatever approach that is used is surgeon experience, but flank spays (not sure about caesarians) were comparable with post-operative pain scores to the 'standard' midline approach.

RE: Surgical approach for bitch caesar

Anthony Todd — Fri, 19 Mar 2021 16:16:21 GMT

Next one please show us some pics of the suture line. Single interrupted always seemed to give a perfect alingnment of the wound edges, like a closed book and subcut I saw never did but.... etc.

RE: Surgical approach for bitch caesar

Julian Earl — Fri, 19 Mar 2021 16:06:55 GMT

I thik that a key improvement for the ventral midline approach is the use of subcuticular suturing. This means no external sutures for the pups to latch on to to try and then try to suck them. Plus the skin-wound itself seems to heal much better as well. It takes a little longer putting the single continuous suture in place and learning how to tie it off at the end! Until you've done a few but I think that his technique should be taught as first-line practice for suturing midline abdominal wounds. So there!! Job sorted!!

RE: Surgical approach for bitch caesar

Joyce Whitehead — Thu, 18 Mar 2021 23:18:32 GMT

I see this is a very old thread but my first practice as a new graduate did loads of caesars. (Mainly because it was very cheap). And we did them all flank. Once I moved job I switched to midline, and find no issue with healing, although we always use intradermal sutures these days.

RE: Surgical approach for bitch caesar

Anthony Todd — Thu, 18 Mar 2021 12:34:16 GMT

I did all mine [chihuahua breeder usually] mid-line and the wound never seemed the problem but terminal anaesthetic apnoea in a lot of pups was! [never sorted??]

Wish there had been a site like this 'cos others would have sorted me out!

Cows, with local blocks, were really quick and easy and the practice should have done more 'cos vaginal delivery was often more traumatic and could take much longer.

RE: Surgical approach for bitch caesar

Julian Earl — Thu, 18 Mar 2021 11:47:44 GMT

Yes, I agree Iain although we tended to liftt hem onto our operating table if/when they were brought to the practice [ if not excessively heavy that is!]. A lot cleaner for them being the main advantage. On the subject of sheep-caesareans can I just add that a Paravertebral in a ewe is very easy and hihly effective wih none of the bruising that seems to occur with local infiltration of the flank. You only use perhaps 25-30mls local at the most I think. Easier then in cows as no special PV- needle is required, merely a standard needle of adequate length, 5-6cm to administer 5-10 ml per site? plus 2-3ml on top of the lateral process before doing the injections front and behind the lat. process. Recommended! ?

RE: Surgical approach for bitch caesar

Iain Richards — Wed, 17 Mar 2021 21:38:27 GMT

[quote userid="5797" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/5573/surgical-approach-for-bitch-caesar/21327#21327"]In which case why is a flank approach routine for sheep?[/quote]

As you say - regurgitation/pressure on lungs. If I can I like to do sheep standing

RE: Surgical approach for bitch caesar

Gillian Mostyn — Wed, 17 Mar 2021 21:21:36 GMT

When Ian, my husband, used to work at a practice that looked after laboratory animals, all the beagles had flank Caesars. The lab felt this resulted in fewer wound problems.

RE: Surgical approach for bitch caesar

ell — Wed, 17 Mar 2021 21:14:39 GMT

One of the reasons the vets I know who do flank bitch ceasars gave was that the pups could still feed without being too near the wound. Didn't seem to be any problems with healing etc.

Re: Surgical approach for bitch caesar

Charlotte Marshall — Fri, 30 Jul 2010 20:51:56 GMT

When I first started in my current job 10+ years ago we were doing flank caesars in bitches. We ended up moving on to midline after a couple of years. We had a few clients requesting it, mainly breeders and although there were the advantages you mentioned we did tend to see more seroma formation and I think it is likely to be more painful. I think as well the newer vets coming in all tended to caesar midline.

Re: Surgical approach for bitch caesar

Michael Woodhouse — Mon, 26 Jul 2010 14:52:21 GMT

As mainly a large animal vet I still do bitch caesers midline and it is most familiar approach for me.

I do sheep caesers flank, but did assist with a few paramedian ones as a student done by a German vet.

Re: Surgical approach for bitch caesar

Mark Holmes — Mon, 26 Jul 2010 13:39:13 GMT

Sorry Wren, I wasn't suggesting your wounds were ugly but that I'm not happy with mine and therefore go midline.

Re: Surgical approach for bitch caesar

Wren — Mon, 26 Jul 2010 13:23:01 GMT

Interesting, thank you. I definitely feel in the minority (although not within our practice as we are all 'flankists'). I don't have a problem with ugly flank wounds, mine are all quite neat and heal very well thank you very much, although I might reconsider and use a midline approach for a show dog.

In which case why is a flank approach routine for sheep? I can see why the midline approach isn't practical in cattle. Is the reason it's not used in sheep purely to do with depressing respiration (weight of rumen + gravid contents on lungs) or is there another reason?

Re: Surgical approach for bitch caesar

Mark Holmes — Mon, 26 Jul 2010 13:00:08 GMT

Having never done or considered a flank caesar in the bitch nor met anyone who has I would say its definately a minority approach. Having never done one I cannot comment but I hate doing cat spays flank if they are pregnant as a large wound through the muscle layers is unpleasant to manage and close and the resulting skin wound is ugly.

Regards

Re: Surgical approach for bitch caesar

Holly Lee — Mon, 26 Jul 2010 12:58:23 GMT

Midline, same as for a routine bitch spay. Believe linea alba incision should cause less pain than going direct through muscle layers (for those about to shoot me down - yes there was a paper, yes it was in cats not dogs, no I can't immediately reference it and yes I still spay cats flank ). Also believe you can get better access/exposure but this is probably just familiarity.