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Veterinary surgery

Veterinary surgery is surgery performed on animals by veterinarians. Most veterinarians perform surgery, but it is also possible to specialize in surgery by becoming board certified.

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1 Specialization in surgery
2 Veterinary anesthesia
3 Common veterinary surgeries
4 References
5 See also

Specialization in surgery

In the United States, veterinary surgery is one of 20 veterinary specialties recognized by the American Veterinary Medical Association.^[1] Those wishing to become board-certified must perform a large number of large animal or small animal procedures in such categories as abdominal surgery, surgical treatment of angular limb deformities, arthroscopic surgery, surgery of the foot, fracture fixation, ophthalmic surgery, urogenital surgery, and upper respiratory surgery.^[2]

Veterinary anesthesia

Main article: Veterinary anesthesia

Anesthesia in animals has many similarities to human anesthesia, but some differences as well. Local anesthesia is primarily used for wound closure and removal of small tumors. Lidocaine, mepivacaine, and bupivacaine are the most commonly used local anesthetics used in veterinary medicine.^[3] Sedation without general anesthesia is used for more involved procedures. Sedatives commonly used include acepromazine, diazepam, xylazine, and medetomidine. α2 agonists like xylazine and medetomidine are especially useful because they can be reversed, xylazine by yohimbine and medetomidine by atipamizole. Xylazine is approved for use in dogs, cats, horses, deer, and elk in the United States, while medetomidine is only approved for dogs.^[4] Most surgeries in ruminants can be performed with regional anesthesia.

General anesthesia is commonly used in animals for major surgery. Animals are often premedicated with a sedative, analgesic, and anticholinergic agent (dogs frequently receive buprenorphine, acepromazine, and glycopyrrolate). The next step is induction, usually with an intravenous drug. Dogs and cats commonly receive thiopental, ketamine with diazepam, tiletamine with zolazepam (usually just in cats), or propofol.^[5] Horses commonly receive thiopental and guaifenesin.^[3] Following induction, the animal is intubated with an endotracheal tube and maintained on a gas anesthetic. The most common gas anesthetics in use in veterinary medicine are isoflurane, enflurane, and halothane, although desflurane and sevoflurane are becoming more popular due to rapid induction and recovery.^[6]

Common veterinary surgeries

Elective procedures

One of the most common elective surgical procedures in animals is neutering. Neutering in animals describes spaying or castration (also please see castration). To spay (medical term: ovariohysterectomy) is to completely remove the ovaries and uterus of a female animal. In a dog or cat this is accomplished through a ventral midline incision into the abdomen. The ligaments of the uterus and ovaries are broken down and the blood vessels are ligated and the organs are removed. The body wall, subcutis, and skin are sutured. To castrate (medical term: orchectomy) is to remove the testicles of a male animal. Different techniques are used depending on the type of animal, including ligation of the spermatic cord with suture material, placing a band around the cord, or crushing the cord with a Burdizzo. Neutering is usually performed to prevent breeding or prevent unwanted behavior or future medical problems. Please see spaying and neutering for more information on the advantages and disadvantages of this procedure. Neutering is also performed as an emergency procedure to treat pyometra and testicular torsion, and it is used to treat ovarian, uterine, and testicular cancer. It is also recommended in cases of cryptorchidism to prevent torsion and malignant transformation of the testicles.

Other common elective surgical procedures include declawing in cats (onychectomy) and ear and tail docking in dogs and horses. These procedures are illegal in some countries and face ethical challenges in others. Declawing consists of removal of the distal phalanges using either a scalpel, scissors, or laser.

Dental surgery

Common dental surgical procedures:

Horses - Floating (grinding down) of uneven teeth edges and removal of wolf teeth.^[7]
Dogs - Dental prophylaxis is commonly performed to remove tartar and treat periodontal disease. This procedure is usually performed under anesthesia. Other common procedures include extraction of abscessed or broken teeth, extraction of deciduous teeth, root canals, and removal of gingival hyperplasia and epulides.
Cats - Dental prophylaxis as described above for the dog and treatment and extraction of teeth with feline odontoclastic resorptive lesions (FORLs).^[8]

Surgical oncology

In older dogs and cats tumors are a common occurrence. Common skin tumors include lipomas, mast cell tumors, melanomas, squamous cell carcinomas, basal cell carcinomas, fibrosarcomas, and histiocytomas. Skin tumors are removed through either simple incisions or through plastic surgery. Common oral tumors include melanomas, fibrosarcomas, squamous cell carcinomas, which are removed with as much surrounding tissue as possible, including parts of the mandible and maxilla. Other types of cancer requiring surgery include osteosarcoma, stomach and intestinal tumors, splenic masses, and urinary bladder tumors.

Ophthalmic surgery

Common ophthalmic surgeries in animals include:

Enucleation to treat glaucoma or eye proptosis.
Cataract surgery
Entropion surgery
Ectropion surgery
Eyelid tumor removal
Cherry eye surgery
Exenteration (complete removal) of the orbit, especially for squamous cell carcinoma in the cat and cow.

Orthopedic surgery

Common orthopedic surgeries in animals include:

Ruptured anterior cruciate ligament repair
For hip dysplasia:
- Femoral head ostectomy
- Triple pelvic osteotomy
- Hip replacement
Leg amputation
Bone fracture repair
Arthroscopy

Other common procedures

Caesarean section

Caesarean sections are commonly performed in dogs, cats, horses, sheep, and cattle. Usually it is done as an emergency surgery due to difficulties in the birthing process. Certain dog breeds such as Bulldogs often need to have this surgery because of the size of the puppy's head relative to the width of the bitch's birth canal.

Bloat surgery

In dogs bloat or gastric dilatation volvulus (GDV) is a common condition where the stomach fills with gas and twists, requiring immediate surgical intervention to prevent necrosis of the stomach wall. The stomach is put back into its normal position and tacked (gastropexy) to the body wall. Sometimes a splenectomy or partial gastrectomy is also required.

Cystotomy

A cystotomy is a surgical opening of the urinary bladder. It is commonly performed in dogs and cats to remove bladder stones or tumors.

Wound repair

Bite wounds from other animals (and rarely humans) are a common occurrence. Wounds from objects that the animal may step on or run into are also common. Usually these wounds are simple lacerations that can be easily cleaned and sutured, sometimes using a local anesthetic. Bite wounds, however, involve compressive and tensile forces in addition to shearing forces, and can cause separation of the skin from the underlying tissue and avulsion of underlying muscles. Deep puncture wounds are especially prone to infection. Deeper wounds are assessed under anesthesia and explored, lavaged, and debrided. Primary wound closure is used if all remaining tissue is healthy and free of contamination. Small puncture wounds may be left open, bandaged, and allowed to heal without surgery. A third alternative is delayed primary closure, which involves bandaging and reevaluation and surgery in three to five days.^[9]

Foreign body removal

A variety of objects are commonly swallowed by dogs, cats, and cattle. Foreign bodies can cause obstruction of the gastrointestinal tract causing severe vomiting and resulting electrolyte imbalances. The stomach (gastrotomy) or intestine (enterotomy) can be surgically opened to remove the foreign body. Necrotic intestine can be removed (enterectomy) and repaired with intestinal anastomosis. Foreign bodies can also be removed by endoscopy. The condition in cattle is known as hardware disease.

References

^ Veterinary Specialty Organizations. Retrieved on 2006-04-06.
^ ACVS Residency Program
^ ^a ^b Muir, William W.; Hubbell, John A. E. (1995). Handbook of Veterinary Anesthesia (2nd ed.). Mosby. ISBN 0-8016-7656-8.
^ Paddleford, Robert R.; Harvey, Ralph C. (1999). "Alpha₂ Agonists and Antagonists". The Veterinary Clinics of North America 29: 737-744.
^ Paddleford, Robert R. (1999). Manual of Small Animal Anesthesia (2nd ed.). W.B. Saunders Company. ISBN 0-7216-4060-5.
^ Clarke, Cathy W. (1999). "Desflurane and Sevoflurane". The Veterinary Clinics of North America 29: 793-809.
^ Woolridge, Anne A.; Seahorn, Thomas L. (1999). Proper Dental Care Is Vital For Horses. Louisiana State University Equine Veternary Research Program Newsletter. Retrieved on 2006-07-29.
^ Feline Odontoclastic Resorptive Lesions. Small Animal Dental Service. Texas A&M University Veterinary Medical Teaching Hospital. Retrieved on 2006-07-29.
^ Holt, David E.; Griffin, Greg (2000). "Bite Wounds in Dogs and Cats". The Veterinary Clinics of North America 30: 669-678.