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Considerations for surgical cases

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Abstract

The vast majority of pet dogs will, at some stage or another, require some form of surgical intervention. This may be a ‘routine’ elective procedure, such as neutering, or a non-routine non-elective procedure such as removal of a foreign body or tumour, or repair of a fracture or traumatic wound. This chapter looks at informed consent and client preparation, preoperative assessment, preoperative preparation, postoperative care and the postoperative check-up.

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Figures

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6.3 A skin mass 3 mm in diameter was noted during routine ovariectomy of a 3-year-old Golden Retriever. Fine-needle aspiration suggested that this was a mast cell tumour (MCT). The mass was removed using 2 cm margins; subsequent histopathology (original magnification X400) confirmed a grade II MCT with clear margins.
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6.4 This 5-year-old neutered female Dobermann was admitted for exploratory laparotomy. Coagulation tests had been performed in the week preceding surgery, in order to rule out von Willebrand’s disease.
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6.5 Haematocrit tube used to assess PCV. The PCV reading in this case was 50% and was within the normal range for a Greyhound.
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6.7 Jaundice in a 9-year-old neutered male cross-breed terrier. His ASA class was considered to be III. An oesophagostomy feeding tube had been placed 3 days prior to general anaesthesia (for liver biopsy).
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6.8 This 4-year-old male West Highland White Terrier had advanced temporomandibular osteopathy. Intubation was not possible orally and so a temporary tracheostomy was performed. This is a high-risk procedure.
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6.9 Preoxygenation can reduce the risk and respiratory stress of anaesthesia, as with this 10-year-old Labrador Retriever with laryngeal paralysis.
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6.10 Extensive wound reconstruction following removal of a mast cell tumour from a 7-year-old cross-breed dog. The owners had been counselled on the likely appearance of the wound prior to surgery and knew what to expect.
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6.11 Examples of surgical wound appearance 3–5 days following an operation. These wounds are healing uneventfully: there is minimal inflammation or discharge, and the wounds appear dry and healthy. This wound appears slightly damp, as the patient has been licking it. If left unchecked, this could lead to breakdown. An Elizabethan collar was placed to prevent further licking and the analgesic regime was adjusted. This wound is infected. The central portion of the wound has opened and purulent exudate can be seen. There is a ‘tide mark’ of inflammation surrounding the wound. Intensive wound care (flushing, debridement and consideration of the use of antibiotics) is required.
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6.14 Appearance at a 3-day postoperative check-up following cranial cruciate ligament repair. The wound looks comfortable, with no sign of infection. The owner should be fully informed about ongoing exercise and physiotherapy requirements.

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