SAOP2- Complications of Spay

  1. What are considerations for complications with any abdominal surgery? (6)
    • pain
    • anesthetic complications (the risks really end at extubation)
    • infection
    • shock- hypovolemic, hemorrhagic, septic
    • andominal hemorrhage
    • unrelated issures- GDV, GI obstruction, intussusception, peritonitis, pancreatitis
  2. What should you do first when you find you patient with high HR, high RR, prolonged CRT, lethargic, etc?
    • establish IV access
    • fluid therapy- crystalloids (LRS, plasmalyte), shock doses if signs of hypovolemia; maybe colloidsjQuery1101020353799895383418_1485875171651
    • then assess patient
  3. Describe patient assessment for complications. (4)
    • abdominal palpation- don't squeeze! feel for distention, fluid wave
    • ascult heart and lungs- aspiration
    • character and quality of pulse
    • temperature
  4. What is the first hint that a patient has aspirated under anesthesia?
    develop a fever, usually within 10 hours after surgery (cough doesn't develop until later)
  5. What diagnostics do you go to first immediately when you suspect complications? (4)
    • PCV/ TS- serial samples
    • indirect doppler BP
    • warm patient- heating pad, bair hugger
    • maybe EKG
  6. What information does radiographing patients after abdominal surgery give you?
    nothing- there will be air in the abdomen for up to 2 weeks and it will be impossible to interpret them (unless you're looking for a surgical instrument or sponge left in the abdomen)
  7. What are indications of active bleeding? (4)
    • abdominal fluid PCV similar to peripheral PCV
    • presence of platelets or clumps on a smear of the abdominal fluid
    • serial evaluation of peripheral PCV continuing to decrease
    • failure to respond to appropriate fluid and/or colloid therapy
  8. How do you manage a patients with a bleeding ovarian pedicle? (4)
    • increase abdominal pressure by putting a compression bandage on
    • give colloid therapy
    • monitor vitals
    • if very severe, give blood products (packed RBCs, plasma)
    • [an ovarian pedicle will not cause a dog to bleed out!]
  9. What are the most common complications of OVH? (6)
    • urogenital injury- ligation/ sever ureter, bladder perforation, bladder torsion
    • ovarian remnant
    • excessive bleeding
    • braided suture- draining tract
    • abdominal dehiscence
    • urinary incontinence
  10. What is the typical presentation with inadvertent ligation of the ureter?
    hydronephrosis--> weeks, months, years later with a giant kidney
  11. What are causes of incisional dehiscence? (5)
    • failure to close correct layer (missed external rectus fascia)
    • suture failure
    • poor choice of suture material- premature loss of tensile strength, inappropriate suture size
    • failure to restrict exercise
    • iatrogenic patient trauma
  12. Describe treatment of incisional dehiscence. (5)
    • bandage exposed tissues
    • reduce anything that has herniated out (as long as viable)
    • surgical repair
    • clean and prep open wounds or exposed tissues
    • primary closure of open tissues
  13. What are rule-outs for incisional swelling? (4)
    • incisional dehiscence
    • seroma
    • incisional abscess
    • cellulitis
  14. How do you manage a seroma?
    • wait....advise owners that it's going to take take but it will reabsorb
    • maybe warm compresses
    • maybe belly wrap
  15. What are some potential hemorrhagic situations? (5)
    • VWD- deficiency of factor VIIIA- prolonged BMBT- have FFP or cryoprecipitate ready to transfuse
    • coagulopathy
    • platelet deficiency or dysfunction
    • rodenticide toxicity
    • liver dysfunction
Card Set
SAOP2- Complications of Spay
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