Such complications are common when trying to restore the descent or torsion of the ovarian pedicle. The action of grasping the ovarian pedicle puts the risk of damage to the urethra. As with all other complications, the best way to solve this proble...
Such complications are common when trying to restore the descent or torsion of the ovarian pedicle. The action of grasping the ovarian pedicle puts the risk of damage to the urethra. As with all other complications, the best way to solve this problem is early detection and prevention. Every surgeon's intraoperative procedure should include steps to protect the ovarian pedicle and reduce the risk of tearing. Although the exact procedure will vary from operator to operator and from case to case, this step is easily integrated into an inherent component of ovariectomy.
Even for experienced sterilizers, the ovarian pedicle may occasionally prolapse or torsion. In such cases, efforts should be made to expand the field of view. The use of suction devices and self-fixing retractors can greatly improve the field of view and help reduce the risk of ureteral trauma. Every sterilizer should be proficient in the basic technique of observing the ovarian pedicle by traction on the mesoduodenum on the right side of the abdomen and the mesocolon on the left side.
According to the description of some experienced sterilization doctors, during routine sterilization, the ureter can be found using a sterilization hook, or one side of the ureter can be elevated along one uterine horn, either when finding the uterine horn or when crossing the first uterine horn to the other uterine horn through the bifurcation point. This procedure may present specific risks in some puppies because their ureters are less tight and more tortuous than in adult dogs, and there may be less retroperitoneal fat covering and protecting the ureters. According to surgeons who have performed this procedure, the tension, appearance, size, and location of extraction of the ureters are very similar to those of the uterine horns. Failure to find an ovary at the distal end of the ureter indicates an error in the procedure, but in some cases the ureter can rupture due to the force exerted by the surgeon. After such an error occurs, removal of the affected kidney (nephrectomy) is usually the most feasible treatment and can be performed directly within the hospital; in turn, ureteral repair or reimplantation usually requires referral to a specialist.
Postoperative Complications
Fortunately, most postoperative complications are mild and easy to manage. Most of these problems are incision problems, such as loose incision edges, minor contusions, local infection, and exposed suture knots. These issues are not discussed in this article.
Early postoperative bleeding and hemorrhagic peritoneum
In some cases, intra-abdominal bleeding is more likely to occur during the postoperative recovery period than during the operation. Most of them occurred within 12 hours after surgery, after recovery, in the cage, or on the first night after surgery. Some cases even showed obvious symptoms after a longer period of time. Once the patient is found to be bleeding continuously, surgery should be performed again to find the bleeding point and stop the bleeding. During the second surgery, the steps to find bleeding points and determine whether autologous blood transfusion is needed are the same as those during the first surgery. (See the previous article. On the details page of this medical news on the Pet Doctor APP, you can slide to the bottom of the screen to find the article titled "Dog and cat sterilization surgery: What to do about intraoperative bleeding? Detailed analysis of causes and solutions." Click to view directly)
The symptoms of postoperative abdominal bleeding are not always visible at a glance, especially in the early stages of abdominal bleeding, which usually does not cause incisional bleeding. The following conditions should increase the suspicion of intra-abdominal hemorrhage: abnormally slow recovery (longer lying time than expected), moderate hypothermia with poor insulation, elevated heart rate without obvious signs of pain or excitement, and pale mucous membranes. When there are conditions for monitoring blood pressure, if the blood pressure is found to be too low, especially when the blood pressure shows a downward trend and tachycardia occurs, the possibility of blood loss should be highly suspected. Hematocrit (PCV) is not sensitive enough as a bleeding indicator. Therefore, this should not be used as an indicator of the severity of the hemorrhagic peritoneum in the first few hours. Blood entering the abdominal cavity causes a decrease in blood volume, not hemodilution. Therefore, unless aggressive intravenous fluid infusion and blood volume resuscitation have been initiated, the PCV will only show a slight decrease, even though a large amount of blood has entered the abdominal cavity.
Abdominal puncture can determine the degree of hemorrhagic peritoneal cavity. The puncture can be performed using a 22G needle connected to a 3ml syringe. The puncture site should be disinfected and skin prepared. The puncture site should be located near the midline behind the navel or a few centimeters to the right of the midline to avoid puncture entering the spleen. Slowly pull the plunger to create a negative pressure state in the syringe. If the blood can be easily withdrawn, the presence of hemorrhagic peritoneum can be confirmed; however, if no blood is found during abdominal puncture, the possibility of hemorrhagic peritoneum cannot be ruled out. At this time, the reasonable approach is to continue to observe the condition of the affected pet, infuse fluids as needed, and take measures to keep warm. If the affected pet still does not improve, consider repeating abdominal puncture.
