Comparison of laparoscopic ovariohysterectomy and ovariohysterectomy in dogs

OBJECTIVES: To evaluate technique, complication rates, postoperative pain scores, and clinical outcomes in dogs after laparoscopic ovariohysterectomy (LOVH) or traditional ovariohysterectomy (OVH). STUDY DESIGN: Prospective clinical trial. ANIMALS OR SAMPLE POPULATION: Thirty-four intact female dogs, weighing 2.4-31 kg. METHODS: LOVH (16 dogs) was performed by ligation of the uterus and ovaries with surgical wire, and then removal by an assisted laparoscopic technique. OVH was performed in 18 dogs. Subjective and objective pain scores were assigned at 0, 2, 8, and 24 hours. Surgical time, complications, and pain and incision scores were evaluated. Dogs were followed for up to 6 months. RESULTS: The mean surgical time for LOVH (120 minutes; range, 47-175 minutes) was significantly longer than for OVH (69 minutes; range, 25-140 minutes). Significantly lower pain scores (subjective, in 2 of 10 categories; objective, in 8 of 10 categories) were identified with LOVH at 1 or more time periods. Surgical complications with LOVH were postoperative fever and anorexia (1 dog), minor splenic (3) or pedicle hemorrhage (4), intermittent vaginal hemorrhagic discharge (1), and suture reaction (3). Surgical complications with OVH were hemorrhage from an ovarian pedicle requiring reoperation (1 dog), dehiscence of the abdominal wall (1), and seroma (1). Anesthetic complications included hypotension in 8 OVH dogs and 1 LOVH dog, and hypothermia in 4 OVH and 9 LOVH dogs. The mean incision scores were lower for LOVH at all time periods. CONCLUSION: LOVH was performed successfully in young nonparous dogs >10 kg. Surgical time and complication rates were greater; however, LOVH postoperative pain scores were < or =OVH scores. CLINICAL RELEVANCE: LOVH is a potentially safe surgical alternative to traditional OVH in dogs. Equipment cost and necessity for more than 1 surgeon may limit its usefulness in small animal practice.     

Laparoscopic ovariectomy and ovariohysterectomy in llamas and alpacas.

The minimally invasive nature of laparoscopic techniques and shorter convalescent periods have made these techniques increasingly popular for use in New World camelids (llamas and alpacas). This article outlines the instruments and steps needed to perform laparoscopic surgery on the female reproductive tract in llamas and alpacas.     

Pyothorax in nine dogs

Summary

The results of treatment of pyothorax using systemic antibiotics, drainage, and lavage of the pleural space, are reported for 9 dogs. All 9 dogs recovered completely. In 8 of the 9 dogs the follow‐up period was at least 6 months and in none was there a relapse. The results obtained with this treatment are excellent in comparison with the results that have been reported for treatment with systemic antibiotics and drainage of the pleural space but without lavage. Apart from the addition of pleural lavage to the treatment protocol, the better result might be because migrating plant related foreign bodies did not seem to play an important role in the pathogenesis of pyothorax in this group of dogs.     

Pyothorax in nine dogs

The results of treatment of pyothorax using systemic antibiotics, drainage, and lavage of the pleural space, are reported for 9 dogs. All 9 dogs recovered completely. In 8 of the 9 dogs the follow-up period was at least 6 months and in none was there a relapse. The results obtained with this treatment are excellent in comparison with the results that have been reported for treatment with systemic antibiotics and drainage of the pleural space but without lavage. Apart from the addition of pleural lavage to the treatment protocol, the better result might be because migrating plant related foreign bodies did not seem to play an important role in the pathogenesis of pyothorax in this group of dogs.     

Intraoperative fluid therapy for video-assisted ovariohysterectomy in dogs

BackgroundIntraoperative fluids are still poorly studied in veterinary medicine. In humans the dosage is associated with significant differences in postoperative outcomes.ObjectivesThe aim of this study is to verify the influence of three different fluid therapy rates in dogs undergoing video-assisted ovariohysterectomy.MethodsTwenty-four female dogs were distributed into three groups: G5, G10, and G20. Each group was given 5, 10, and 20 mL·kg⁻¹·h⁻¹ of Lactate Ringer, respectively. This study evaluated the following parameters: central venous pressure, arterial blood pressure, heart rate, respiratory rate, temperature, acid-base balance, and serum lactate levels. Additionally, this study evaluated the following urinary variables: urea, creatinine, protein to creatinine ratio, urine output, and urine specific gravity. The dogs were evaluated up to 26 h after the procedure.ResultsAll animals presented respiratory acidosis during the intraoperative period. The G5 group evidenced intraoperative oliguria (0.80 ± 0.38 mL·kg⁻¹·h⁻¹), differing from the G20 group (2.17 ± 0.52 mL·kg⁻¹·h⁻¹) (p = 0.001). Serum lactate was different between groups during extubation (p = 0.036), with higher values being recorded in the G5 group (2.19 ± 1.65 mmol/L). Animals from the G20 group presented more severe hypothermia at the end of the procedure (35.93 ± 0.61°C) (p = 0.032). Only the members of the G20 group presented mean potassium values below the reference for the species. Anion gap values were lower in the G20 group when compared to the G5 and G10 groups (p = 0.017).ConclusionsThe use of lactated Ringer''s solution at the rate of 10 mL·kg⁻¹·h⁻¹ seems to be beneficial in the elective laparoscopic procedures over the 5 or 20 mL·kg⁻¹·h⁻¹ rates of infusion.     

Effects of ovariohysterectomy on reactivity in German Shepherd dogs

This study investigated the effects of ovariohysterectomy on reactivity of German Shepherd dogs. Fourteen healthy dogs ranging in age from 5 to 10 months were assigned to an ovariohysterectomy or a sexually intact group. Their behaviours were digitally video recorded 4-5 months after treatment and analysed for treatment effects on reactivity. Responses to the approach of an unfamiliar human leading an unknown dog were assigned the following reactivity scores: severe reactivity, 3; moderate reactivity, 2; defensive or mild reactivity, 1; attentive or no reactivity, 0. Median reactivity scores in response to the approach of an unfamiliar human walking with an unknown dog were calculated for each observation period. Dogs in the ovariohysterectomized group showed more reactivity, and median reactivity scores were higher in the ovariohysterectomy group compared with those of the sexually intact group. Ovariohysterectomy of 5-10 month old German Shepherd bitches specifically, and perhaps bitches of any breed generally, may induce an increase in reactivity. Practitioners may benefit from recognizing that a range of behavioural changes may occur post-ovariohysterectomy.     

Changes in the blood coagulation profile after ovariohysterectomy in female dogs

This study investigated changes in the coagulation profile of 10 healthy female dogs subjected to ovariohysterectomy. Blood samples were collected three times--before, directly after and 24 h after surgery. Plasma samples were analyzed to determine thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen content, D-dimer content and antithrombin (AT) III activity. The results revealed post-operative haemostatic system disorders related to prolonged APTT, higher fibrinogen and D-dimer concentrations and lower levels of AT III activity.     

Hemostatic response to surgical neutering via ovariectomy and ovariohysterectomy in dogs

Objective-To investigate the hemostatic response to surgery and compare the response for ovariohysterectomy with that for ovariectomy and to evaluate the usefulness of thromboelastography on plasma samples. Animals-42 female dogs. Procedures-Dogs were assigned to undergo ovariohysterectomy or ovariectomy. Blood samples were collected immediately before and 1, 6, and 24 hours after surgery and stored at -80°C for subsequent analysis. Plasma samples were subjected to thromboelastography after thawing. In addition, coagulation variables were measured, including concentrations of von Willebrand factor antigen, fibrinogen, antithrombin, and protein C; activity of factor VIII; activated partial thromboplastin time; prothrombin time; and thrombin time. The fibrinolytic response was assessed via concentrations of D-dimer, plasminogen, and α-2-antiplasmin (plasmin inhibitor). Results-Substantial hemostatic and fibrinolytic activation was evident after surgery in both groups, as characterized by significantly increased global clot strength and an overall hypercoagulable state at 4 hours after surgery in addition to decreases in von Willebrand factor antigen and factor VIII concentrations and shortened prothrombin and thrombin times. The dogs also typically had activation of the fibrinolytic system, as evidenced by increased postoperative concentrations of D-dimer, plasminogen, and plasmin inhibitor. Differences between the 2 groups could not be detected for any variables. Conclusions and Clinical Relevance-Elective surgery with limited tissue trauma induced hemostatic activation in dogs, which led to hypercoagulability after surgery. A difference between the ovariohysterectomy and ovariectomy groups was not detected. Thromboelastography can be used on plasma samples and may be useful for evaluating patterns over time.     

Preoperative and postoperative hemostatic profiles of dogs undergoing ovariohysterectomy.

Hemostatic profiles were evaluated in 15 healthy dogs immediately before and 24 hours after celiotomy for routine ovariohysterectomy. Prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin degradation products, antithrombin III activity, platelet count, and hemogram were measured. There were no significant changes in prothrombin time, activated partial thromboplastin time, fibrin degradation products, antithrombin III activity, or platelet count. Fibrinogen concentration was significantly higher following surgery. Postoperative leukocyte differential counts were typical of stress leukograms, and were characterized by leukocytosis, neutrophilia, lymphopenia and eosinopenia. Mild decreases in packed cell volume, red blood cell count and hemoglobin concentration were consistent with minor blood loss during surgery or fluid retention and hemodilution postoperatively. It was concluded that celiotomy and routine ovariohysterectomy in healthy dogs did not alter hemostatic profiles 24 hours after surgery. Abnormal postoperative hemostatic profiles should not be attributed to surgery alone; other causes of abnormal hemostatic profiles should be investigated.     

Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs

OBJECTIVE: To describe a simple method of laparoscopic-assisted ovariohysterectomy (LAOHE) and compare duration of surgery, complications, measures of surgical stress, and postoperative pain with open ovariohysterectomy (OHE) in dogs. DESIGN: Randomized, prospective clinical trial. ANIMALS: 20 healthy sexually intact female dogs weighing >10 kg (22 lb). PROCEDURES: Dogs were randomly allocated to receive conventional OHE or LAOHE. Intraoperative complications, anesthetic complications, total anesthesia time, and total surgery time were recorded. Serum cortisol and glucose concentrations, temperature, heart rate, and respiratory rate were measured preoperatively and 1, 2, 4, 6, 12, and 24 hours postoperatively. Pain scores were assigned by a nonblinded observer at 1, 2, 4, 6, 12, and 24 hours postoperatively. Duration of surgery, pain scores, objective measures of surgical stress, anesthetic complications, and surgical complications were compared between OHE and LAOHE. RESULTS: Age, weight, PCV, and duration of surgery did not differ between treatment groups. Nine of 10 dogs in the OHE group required additional pain medication on the basis of pain scores, whereas none of the dogs in the LAOHE group did. Blood glucose concentrations were significantly increased from preoperative concentrations in the OHE group at 1, 2, 4, and 6 hours postoperatively and at 1 hour postoperatively in the LAOHE group. Cortisol concentrations were significantly increased at 1 and 2 hours postoperatively in the OHE group. CONCLUSIONS AND CLINICAL RELEVANCE: LAOHE caused less pain and surgical stress than OHE and may be more appropriate for an outpatient setting.     

Cranial mediastinal carcinomas in nine dogs*

Nine dogs were diagnosed with cranial mediastinal carcinomas. Based on histological and immunohistochemical analysis, four dogs were diagnosed with ectopic follicular cell thyroid carcinomas, one dog with ectopic medullary cell thyroid carcinoma, two dogs with neuroendocrine carcinomas and two dogs with anaplastic carcinomas. Clinical signs and physical examination findings were associated with a space‐occupying mass, although one dog was diagnosed with functional hyperthyroidism. Surgical resection was attempted in eight dogs. The cranial mediastinal mass was invasive either into the heart or into the cranial vena cava in three dogs. Resection was complete in six dogs and unresectable in two dogs. All dogs survived surgery, but four dogs developed pulmonary thromboembolism and two dogs died of respiratory complications postoperatively. Adjunctive therapies included pre‐operative radiation therapy (n = 1) and postoperative chemotherapy (n = 3). Three dogs had metastasis at the time of diagnosis, but none developed metastasis following surgery. The overall median survival time was 243 days. Local invasion, pleural effusion and metastasis did not have a negative impact on survival time in this small case series.     

Extradural spinal synovial cysts in nine dogs

Nine dogs presenting for investigation of cervical or thoracolumbar myelopathies were diagnosed with extradural spinal synovial cysts. Degenerative disease affecting the articular facets or intervertebral discs was present on plain spinal radiographs in all cases. Myelography was consistent with dorsolateral, extradural spinal cord compression. Two groups of dogs were identified: (1) young, giant breed dogs with multiple cysts involving one or more levels of the cervical spinal cord; and (2) older, large breed dogs with solitary cysts involving the thoracolumbar spinal cord. The synovial cysts constituted the major compressive lesions in four of the dogs. Analysis of lumbar cerebrospinal fluid demonstrated albuminocytological dissociation, consistent with chronic compressive myelopathy, in six dogs. All dogs underwent decompressive surgery and the diagnosis of synovial cysts was confirmed histologically. The mean follow-up period was 17 months (range four to 36 months). At the time of follow-up, all dogs were fully ambulatory with improved neurological function compared with that at initial presentation.     

Analgesic effect of pre-operative etodolac and butorphanol administration in dogs undergoing ovariohysterectomy

The analgesic, bleeding, and renal effects of dogs pre‐medicated with etodolac with and without butorphanol were evaluated. Twenty‐four 1‐year‐old healthy dogs, weighing 19 ± 3 kg (mean ± SD) were randomly assigned to four treatment groups (n = 6): control (C), etodolac (E), butorphanol (B), and etodolac with butorphanol (EB). Etodolac (12–14 mg kg^?1 PO) was given 1 hour before propofol induction and isoflurane maintenance anesthesia. Butorphanol (0.4 mg kg^?1 IV) was given immediately following endotracheal intubation. Control dogs received only propofol (8 mg kg^?1 to effect) and isoflurane anesthesia. All dogs were mechanically ventilated to maintain Pe ′CO₂ between 35 and 45 mm Hg (4.7–6.0 kPa). Lactated Ringer's solution was given at 10 mL kg^?1 hour^?1 during anesthesia. Plasma cortisol concentrations were assessed 1 day prior to surgery (baseline), immediately prior to anesthesia induction, and every 30 minutes until 5 hours following extubation, and 1 day after surgery. Total duration of anesthesia was 50 minutes and total surgery duration was 30 minutes. Isoflurane concentration area under the curve (AUC) over time during the anesthesia was compared among treatment groups. Buccal mucosal bleeding time (BMBT) was assessed 1 day before E administration and during surgery. Urine GGT to urine creatinine ratio, BUN, and plasma creatinine were taken daily from 1 day before to 3 days after surgery. Behavioral pain scores (numerical rating scale) were assessed by two observers blinded to the treatment during the 5‐hour recovery period at 30 minute intervals until 3 hours, and again at 5 hours after extubation. All data were analyzed using anova . Multiple comparisons were performed if the anova was significant. Alpha value was set at 0.05. Plasma cortisol concentrations significantly increased from time of extubation in all the treatment groups. They did not return to the baseline until 5, 2.5, 1.5, and 1.5 hours after extubation in the C, B, E, and EB groups, respectively. Isoflurane AUC was not significantly different among treatment groups. Dogs treated with EB had significantly less behavioral pain than all other groups throughout the 5‐hour recovery period. No significant difference was found between treatment groups or within treatment groups over time in BMBT, or any renal variables. This study demonstrated that (i) pre‐operative administration of E provides profound analgesia during the post‐operative period without renal or bleeding side‐effects in dogs undergoing OHE; and (ii) a combination of butorphanol–etodolac provides the best analgesic effect during the post‐operative period based on the behavioral pain score.     

Clinical use of a low-dose medetomidine infusion in healthy dogs undergoing ovariohysterectomy

Eight healthy dogs undergoing elective ovariohysterectomy were anesthetized with a standard protocol and received a low-dose medetomidine constant rate infusion during surgery. Cardiorespiratory parameters, including non-invasive cardiac output, were measured at various times. This protocol resulted in acceptable and stable cardiovascular performance, allowed low isoflurane concentrations, and provided smooth recoveries.     

Comparison of carprofen and meloxicam for 72 hours following ovariohysterectomy in dogs

OBJECTIVE: To compare the peri- and post-operative (72 hours) analgesic effects of injectable and orally administered carprofen and meloxicam for ovariohysterectomy in dogs. STUDY DESIGN: Prospective, randomized clinical study. ANIMALS: Forty-three dogs undergoing elective ovariohysterectomy. MATERIALS AND METHODS: Dogs were randomly assigned to receive pre-operative carprofen, meloxicam or sterile saline by subcutaneous injection. Pre-anaesthetic medication was intramuscular acepromazine (0.02 mg kg(-1)) and methadone (0.2 mg kg(-1)). Anaesthesia was induced with either thiopentone or propofol injected to effect, and maintained with isoflurane in oxygen. Visual analogue scores (VAS) for pain and sedation were recorded at 1, 2, 3, 4 and 6 hours following tracheal extubation. Oral medication with the same treatment was continued post-operatively for 3 days, with VAS scores for pain being recorded before, and 2 hours after treatment on each day. Differences between group age, body mass, duration of general anaesthesia, time from treatment injection to tracheal extubation and time from treatment injection to first oral treatment were analysed using one-way analysis of variance and Kruskal-Wallis test. Visual analogue scores for pain and sedation were analysed using a re-randomization method. The significance level was set at p < 0.05. RESULTS: Meloxicam-treated subjects had lower mean VAS than the control group at 2 and 6 hours following tracheal extubation. Control group VAS were more varied than meloxicam scores (at 6 hours) and carprofen scores (at 3 and 6 hours). On the first post-operative day, pre- to post-treatment VAS scores decreased significantly after meloxicam. On day 3, scores in the meloxicam-treated group were significantly lower than control values after treatment. Changes in pre- to post-treatment VAS were greater in animals receiving either meloxicam or carprofen compared with those given saline. CONCLUSIONS AND CLINICAL RELEVANCE: Both carprofen and meloxicam provided satisfactory analgesia for 72 hours following ovariohysterectomy in dogs.     

Comparison of intraperitoneal ropivacaine and bupivacaine for postoperative analgesia in dogs undergoing ovariohysterectomy

Objective

To compare postoperative analgesia following either intraperitoneal (IP) ropivacaine or bupivacaine in dogs undergoing ovariohysterectomy (OVH) in the scope of multimodal analgesia.

Efficacy and safety of preoperative etodolac and butorphanol administration in dogs undergoing ovariohysterectomy

Eighteen dogs undergoing ovariohysterectomy were premedicated with etodolac, butorphanol, or their combination. Various parameters, such as blood pressure, isoflurane requirements, behavioral pain scores, plasma cortisol concentration, plasma glucose concentration, and mucosal bleeding time, were assessed. The integrated plasma cortisol values were significantly lower in the etodolac and etodolac with butorphanol groups. Dogs receiving etodolac and butorphanol had the lowest behavioral pain scores from extubation until the end of monitoring. Isoflurane concentration over time (area under the curve), buccal mucosal bleeding time, and indices of renal function were not significantly different among the treatment groups.