Ovariohysterectomy

From Dog
Laparocopic ovariohysterectomy[1]

Ovariohysterectomy is a surgical neutering technique which removes both ovaries and uterus.

In dogs, this is the most frequently performed surgical procedure and is used primarily to prevent estrus cycling, vaginal prolapse, pyometra[2], female reproductive tumors, mammary tumors[3] and risk of pregnancy.

Ovariectomy is not normally recommended due to the inherent risk of the bitch developing pyometra.

Ovariohysterectomy also minimizes symptoms associated with diabetes mellitus[4].

An alternative to ovariohysterectomy is use of depot GnRH agonists such as deslorelin.

This surgical procedure requires general anesthesia, using a variety of agents such as thiopentone, alfaxolone[5] or propofol[6] and maintenance on isoflurane or halothane.

There are various surgical techniques which are used, and this surgical procedure is usually performed by either an ventral midline approach, flank approach or via laparotomy[7].

Post-operative analgesia is usually employed to minimize post-operative pain, with commonly used drugs including buprenorphine, tramadol[8], tolfedine, meloxicam or robenacoxib.

Complications of ovariohysterectomy in dogs include immediate post-operative hypotension and hypothermia, sepsis, hemorrhage associated with uterine ligature slippage[9], swab retention (gossypiboma)[10], wound dehiscence with consequent risk of peritonitis, seroma formation, ovarian remnant syndrome, ureteral stenosis (due to ureteral trauma) and long-term development of incontinence[11].

At best, complications associated with elective procedures can harm the doctor-client relationship. At worst, these can present legal and financial problems[12].

Surgical experience with this procedure is a determining factor with duration of procedure and post-operative complications[13].

References

  1. ACVS.org
  2. Nakamura K et al (2012) Bilateral segmental aplasia with unilateral uterine horn torsion in a Pomeranian bitch. J Am Anim Hosp Assoc 48(5):327-330
  3. Murai A et al (2012) GH-producing mammary tumors in two dogs with acromegaly. J Vet Med Sci 74(6):771-774
  4. Pöppl AG et al (2012) Diabetes mellitus remission after resolution of inflammatory and progesterone-related conditions in bitches. Res Vet Sci Nov 16
  5. Herbert GL et al (2013) Alfaxalone for total intravenous anaesthesia in dogs undergoing ovariohysterectomy: a comparison of premedication with acepromazine or dexmedetomidine. Vet Anaesth Analg 40(2):124-133
  6. Suarez MA et al (2012) Comparison of alfaxalone and propofol administered as total intravenous anaesthesia for ovariohysterectomy in dogs. Vet Anaesth Analg 39(3):236-244
  7. Reece JF et al (2012) Description and evaluation of a right flank, mini-laparotomy approach to canine ovariohysterectomy. Vet Rec 171(10):248
  8. Mastrocinque S et al (2012) Comparison of epidural and systemic tramadol for analgesia following ovariohysterectomy. J Am Anim Hosp Assoc 48(5):310-319
  9. Leitch BJ et al (2012) Pedicle ligation in ovariohysterectomy: an in vitro study of ligation techniques. J Small Anim Pract 53(10):592-598
  10. Forster K et al (2011) Retained surgical swabs in 13 dogs. Vet Rec 169(13):337
  11. Beauvais W et al (2012) The effect of neutering on the risk of urinary incontinence in bitches - a systematic review. J Small Anim Pract 53(4):198-204
  12. Adin CA (2011) Complications of ovariohysterectomy and orchiectomy in companion animals. Vet Clin North Am Small Anim Pract 41(5):1023-1039
  13. Kennedy KC et al (2011) Peri-operative morbidity associated with ovariohysterectomy performed as part of a third-year veterinary surgical-training program. J Vet Med Educ 38(4):408-413