Postoperative care. Caring for the animal after surgery. General anesthesia for animals. Myths and reality First, the epizootological state of the farm is studied. Then animals intended for castration are examined clinically in order to exclude any

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Indications and contraindications for surgery

General preparation of the animal for surgery

Private preparation of an animal for surgery

Preparation of the surgeon's hands, instruments, sutures, dressings and surgical linen

Fixation of the animal during surgery

Anatomical and topographic data of the operated area

Anesthesia

Online access

Operative procedure

The final stage of the operation

Postoperative treatment

Feeding, care and maintenance of the animal

Bibliography

1. Indicationsme and contraindications for surgery

Castration (Latin castration - castration, sterility) is the artificial infertility of males and females by surgical removal of the gonads or by stopping their function using biological, physical and chemical methods.

Removal of male buttock glands is called orchidectomy (from Greek, orchis - testis and ectome - excision), and removal of female ones - oophorectomy (from Latin ovaium - ovary).

The gonads of males and females perform two main functions. 1) produce germ cells; 2) release hormones. Sex hormones, entering the blood, have a great influence on the state of the body through the nervous system. Only the presence of testes and ovaries can explain in animals the uniqueness of their exterior forms, individual parts of the body, behavior and other features characteristic of male or female individuals.

Castration causes fundamental changes in metabolism, due to which a new physiological state of the body is created, which causes new qualitative and quantitative changes in its organs and tissues. The behavior of animals also changes. They become calmer.

Castrated males develop traits characteristic of females, and, conversely, castrated females develop traits characteristic of male animals. Castration has a particularly strong effect on animals operated on at a young age, when the growth and development of tissues and organs has not yet finished. Males castrated at a young age become lethargic and voracious; They are submissive, therefore easy to use, as they do not show pugnacity and anger. In addition, timely culling and castration of males makes it easier to keep animals on pastures and prevents inbreeding.

Castration of animals is performed for economic, therapeutic and preventive purposes. Castration can also be considered as an act of surgical (non-surgical) intervention aimed at improving the qualitative and quantitative indicators of productivity, operation, and maintenance.

Meat products obtained after uncastrated slaughter have a specific, unpleasant odor. It is especially felt during cooking. To get rid of it, as well as to improve the taste of meat and lard, bulls must be castrated. More often, non-breeding males, meat and working animals are castrated in order to obtain high-quality products, as well as for therapeutic purposes (purulent-necrotic processes, hernias, neoplasms in the scrotum and testes).

Castration of bulls is not only a cost-effective operation, but also necessary for the prevention of a number of diseases (sexual trauma, collagenosis, D-hypovitaminosis, etc.), as well as for therapeutic purposes (orchitis, dropsy of the common vaginal membrane, etc.). The effectiveness of castration depends on the age of the castrated animals, breed and housing system. Thus, bulls of the Simmental breed must be castrated at 5-7 months of age with a body weight of 150-160 kg, kept loose and slaughtered at 12 months.

Contraindications to castration of males are exhaustion, illness, early age, and orchidectomy cannot be performed two weeks before and after the end of preventive vaccinations against infectious diseases (anthrax, emkar, erysipelas, and others)

2. Generalpreparing the animal for surgery

First, the epizootological state of the farm is studied. Animals intended for castration are then examined clinically to rule out any diseases. During mass castrations, selective thermometry is carried out, pulse and respiration are measured.

They study the surgical area, that is, the size of the testes,

damage to the testes, dropsy of the common vaginal membrane, hermaphroditism, cryptorchidism, the presence of inguinal scrotal hernias. Before surgery, animals are kept on a 12-24 hour fast and given only water. Before castration, animals should not be given water, and immediately before castration they are released for a walk to empty the intestines and bladder. Castration can be done throughout the year, but the operation is conveniently performed in spring and autumn, when there are no flies, and moderately cool temperatures and the absence of dust and dirt favor better healing of the surgical wound.

Preparation before surgery also includes cleaning and general or partial washing of the animal, places of constant contamination (perineum, thighs, distal limbs). It is advisable to carry out the operation in the morning in order to monitor the animal throughout the day.

3. Private preparation of the animal for surgery

castration infertility postoperative pain relief

Treatment of the surgical field includes four main points: removal of hair, mechanical cleaning with degreasing, disinfection (asepticization) of the tanned surface and isolation from surrounding areas of the body.

The hair is cut or shaved. The latter has the great advantage that aseptic skin can be done with greater care. It is most convenient to use a regular safety razor with a broken blade. This treatment is easier to carry out on a fixed animal.

In young bulls, hair removal may not be necessary, since it is rare on the scrotum.

During mechanical cleaning and degreasing, the surgical field is wiped with a swab or napkin moistened with a 0.5% solution of ammonia or ether alcohol (equal parts), or with pure gasoline, only after dry shaving. There are many ways to asepticize and tan the surgical field. Thus, according to Filonchikov’s method, tanning is carried out by treating the surgical field twice with a 5% alcohol solution of iodine, and the interval between treatments should be at least 3 minutes.

According to the Borchers method - double treatment with a 5% alcohol solution of formaldehyde. This method is best used on skin with increased sweating. According to Lepsha, the surgical field is treated three times with a 5% aqueous solution of potassium permanganate (for dermatitis), and according to the Boccala method - with a 1% alcohol solution of brilliant green. Aseptic and tanning of the skin can be performed with a solution of altin, a 1% solution of degmin or 3 % degmicide.

An effective remedy for these purposes is a 1-3 solution of surfactant antiseptics Patanol and Atony.

Treatment of the surgical field with the solution consists of the following: mechanical cleaning and degreasing of the skin is carried out with an aqueous solution of furatsilin in a dilution of 1:5000, aseptic and tanning - with an alcohol solution of furatsilin in a concentration of 1:5000 - 500.0

Recipe: Solutions Furacilini 1:5000 - 500.0

Misce. Yes. Signa. For mechanical cleaning and degreasing of the surgical field.

When processing the surgical field, the surface of the skin is wiped and lubricated in a certain order - from the central part to the periphery. The exception is the presence of an open purulent focus. In this case, process from the periphery to the center

Modern antiseptics for preparing the surgical field: Septotsid k-1 (colored, used for pigmented areas of the skin); septotsid k-2 (not stained); assipur (contains iodine); altin (1% alcohol solution. Disadvantage - slippery field after treatment); aseptol (2% solution. The field is treated for 3 minutes); Iodonate (1% solution. Treat the field twice).

4. Preparation of the surgeon’s hands, instruments, sutures, dressings and surgeonssexy underwear

Preparing the surgeon's hands.

It is one of the aseptic measures that ensures the prevention of contact infection of the surgical wound. Modern methods of preparing the surgeon's hands are based on the use of the tanning properties of antiseptics, which compact the upper layers of the skin and thereby close the skin openings of the gland ducts, blocking the exit of microorganisms from them during the operation. The preparation of the surgeon's hands includes three main components:

1. Mechanical cleaning- cut the overgrown parts of the nails short, remove hangnails, remove rings, watches, expose the hand to the desired length, wash with warm water and soap or in a 0.5% solution of ammonia in two baths, so that in the second bath the hands are washed with clean water . Dry your hands with a clean, sterile towel.

2. Disinfection- destruction of microorganisms on the surface, as well as in the initial part of the excretory ducts of the sweat and sebaceous glands.

3.Tanning- thickening of the upper part of the skin, as well as closing of the excretory ducts of the sweat and sebaceous glands. This is done with alcohol. Hand treatment is carried out from fingertips to elbows. The most common methods in practice are the following:

- Spasokukotsky-Kochergin method: First, wash your hands in a 0.5% solution of ammonia in two basins for 2.5 minutes. Then the hands are wiped with a rough sterile towel and treated with 70% alcohol. Nail beds and tips - with a 5% alcohol solution of iodine.

Olivevo method: hands are washed in a 0.5% solution of ammonia, and then wiped twice with a swab soaked in an alcohol solution of iodine at a dilution of 1:3000 -1:1000.

-Kiyashov method: Hands are washed for five minutes in a 0.5% solution of ammonia in two baths, and then for three minutes under running water with a 3% solution of zinc sulfate. The fingertips are lubricated with a 5% iodine solution.

Hand treatment with furatsilin: in a 0.5% solution of ammonia in two baths, then treated with a solution of furatsilin 1:5000, and then with an alcohol solution of furatsilin 1:5000. Nail beds and fingertips - 5% iodine solution. Currently, modern antiseptics are used - dehyecid, novosept, septotsid, degmetsid, degmin, diotsid, rakkol, plivasept. In our case, hand preparation was carried out in the following way: hands were washed with a 0.5% solution of ammonia.

Then we treat our hands with an aqueous solution of furatsilin 1:5000, and then with an alcohol solution of furatsilin 1:1500.

Preparation tool

During castration bulls using the open method use the following tools: a sharp abdominal scalpel and scissors. You also need cotton-gauze swabs and ligatures made of artificial silk or cotton and linen threads. Deschano needles, injection, surgical needles, syringes, hemostatic tweezers, needle holder.

All metal instruments are sterilized in water with the addition of alkalis: 1% sodium carbonate, 3% sodium tetracarbonate (borax), 0.1% sodium hydroxide. Alkalis increase the sterilization effect, precipitate salts present in ordinary water, and prevent corrosion and darkening of instruments. Before boiling, the tools are cleaned of the lubricant covering them, large and complex tools are disassembled.

The liquid is boiled in special metal vessels - simple and electronic sterilizers. Sterilizers have a volumetric grille. The grid is removed with special hooks and instruments are placed on it, which are then lowered into the sterilizer after boiling the liquid for 3 minutes. During this period, the water is freed from oxygen dissolved in it and neutralized with alkali.

After boiling, the grid with instruments is removed from the sterilizer and the instruments are transferred to the instrument table. If instruments need to be prepared in advance, then after sterilization they are wiped with sterile swabs, wrapped in 2-3 layers of a sterile sheet or towel, and then in film; store and transport instruments in a sterilizer.

Other sterilization methods are used depending on the circumstances and type of instruments. In emergency cases, flambéing of metal instruments is allowed; they are placed in a basin, doused with alcohol and burned. However, cutting and stabbing instruments become dull and lose their shine when burned.

If there are no conditions for sterilization by boiling, instruments are sterilized chemically by immersing them for a certain time in an antiseptic solution: in an alcohol solution of furatsilin in a concentration of 1:500 for 30 minutes. You can lower the tools for 15 minutes. in Karepnikov's liquid: 20 g of formalin, 3 g of carboxylic acid, 15 g of sodium carbonate and 1000 ml of distilled water or in a 5% alcohol solution of formalin, 1% alcohol solution of brilliant green.

Preparation of suture material

The suture material must have a smooth, even surface, be elastic, sufficiently extensible and biologically compatible with living tissues, while having minimal reactogenicity and having an allergenic effect on the body.

When castrating boars, ligatures made of artificial silk or other synthetic threads are used. Before sterilization, they are loosely wound on glass rods or glass with polished edges, and then boiled for up to 30 minutes with the lid ajar so that the water temperature does not exceed 100 0 C, otherwise the threads will tear. You can also use cotton and linen threads. They are sterilized according to Sadovsky’s method: the threads in skeins are washed in hot water and soap, then rinsed thoroughly, wound on glass slides and dipped in 1.5% ammonia for 15 minutes, then in a 2% solution for 15 minutes. formalin prepared in 65 0 alcohol.

Can be immersed for 24 hours in a 4% formaldehyde solution.

Re-sterilize in an alcohol solution of furatsilin 1:1500, septocide.

Sterilization of cotton gauze swabs is carried out by autoclaving. Before autoclaving, swabs are placed (loosely) in containers. The holes on the side wall are opened before loading the autoclave and closed after sterilization. Several containers are placed in the autoclave at the same time. The duration of sterilization depends on the pressure gauge readings: at 1.5 atm. (126.8 0) - 30 min., at 2 atm. (132.9 0) - 20 min. Control of sterilization in an autoclave - look at the test tubes with sulfur, how it melted, then the sterilization was carried out reliably.

After the required time has passed, the heating is stopped, the release valve is carefully opened, steam is released and the pressure is brought to atmospheric (to zero), only after this the autoclave lid is carefully opened and the material is removed. Tampons can also be sterilized with flowing steam, either in a special Koch flowing steam sterilizer, or using a pan or bucket with a lid.

Sterilization begins from the moment when steam begins to flow out from under the lid in a continuous stream for some time. The steam temperature reaches 100 0; The duration of sterilization is at least 30 minutes.

5. Fixation of the animal duringI have surgery

The main thing when restraining animals is to use the necessary technique to calm them down and create conditions for safe examination and surgery.

Fixation in a standing position. During a group examination, closely spaced animals are tied to a hitching post or to a rope stretched tightly near a fence. In this position they fix each other. This makes it possible to examine the area of the head, neck, pelvis, external genitalia, give vaccinations, perform rectal examinations for pregnancy, castrate bulls in a standing position, etc.

Fixation of cattle.

When practicing the Russian (Mikhailov) method of felling cattle, they take a long, strong rope and tighten it with a movable loop at the base of the horns (in polled animals - on the neck). On the side opposite the fall, the rope is directed back and at the level of the posterior corner of the shoulder blade, a tightening loop is placed around the body. After this, the rope is moved back again, a second such loop is tied in front of the maklaks and the end of the rope is pulled back under the limb. In this case, one of the clamps holds the bull's head, tilting it in the direction opposite to the fall, the other two pull the free end of the rope horizontally back. The animal, crushed by the rope, bends its limbs and lies down. The tension of the rope is not weakened until the bull is finally strengthened and the limb is fixed, and the head is pressed to the floor.

6. Anatomical and topographic data

The inguinal canal is formed by the oblique abdominal muscles. It has two openings - external (subcutaneous) and internal (abdominal), which are called inguinal rings. Within the scrotum, the vaginal canal expands and passes into the cavity of the common vaginal membrane. The inguinal canal contains the external levator testis, external pudendal arteries and veins, branches of the external spermatic nerve and lymphatic vessels.

The seminal sac or scrotum in ruminants and single-hoofed animals is placed between the thighs, and in the rest - in the perineum. It consists of a paired cavity, a paired external levator testis and a paired common tunica vaginalis. The wall of the scrotum consists of the following layers of skin, a muscular-elastic membrane and the fascia of the scrotum.

The muscular-elastic membrane is firmly connected to the skin and forms the scrotal septum.

The fascia of the scrotum is closely connected to the muscular-elastic membrane and loosely to the general vaginal membrane

The common tunica vaginalis is formed by the parietal layer of the peritoneum and the transverse fascia and lines each half of the scrotum, forming a cavity with the common tunica vaginalis. The latter communicates with the abdominal cavity through the vaginal canal.

A special vaginal membrane of the testicle covers the testis with the epididymis and the spermatic cord. Its lower section, connecting the tail of the appendage with the common vaginal membrane, is thickened. It is called the testicular inguinal ligament or transitional ligament.

The epididymis of the testis in stallions is on its dorsal surface. It has a head, body and tail.

The spermatic cord is covered on the outside by a fold of visceral peritoneum. It consists of two folds of the massive vascular serosa in front and a fold of the vas deferens behind.

The vascular fold contains the internal spermatic artery, the internal spermatic vein with their pampiniform plexus, the internal levator testis, the spermatic plexus and lymphatic vessels.

The fold of the vas deferens includes the vas deferens, the artery and the nerve of the vas deferens.

Innervation and blood supply of the scrotum. The scrotum and external levator testis are supplied with blood from the branches of the external spermatic and pudendal arteries.

The innervation of the scrotum and common tunica vaginalis is carried out by the branches of the external spermatic nerve, the ilioinguinal and iliohypogastric nerves, and in the posterior part of the scrotum it is supplied by the branches of the perineal nerve. Lymphatic vessels pass through the lateral walls of the scrotum and empty into the superficial inguinal lymph nodes. The testis is a paired reproductive organ in which germ cells (sperm) are formed and develop. It is an endocrine gland that produces and releases male sex hormones (androsterone and testosterone) into the blood. On the testis there is a head and a tail, two edges: free and accessory; two surfaces: lateral and medial.

7. Pain relief

The animal is fixed in a standing position and a mixed alcohol-chloral hydrate solution is injected intravenously at the rate of 50 ml of 33% ethyl alcohol and 7 g of chloral hydrate per 100 kg of animal weight. Chloral hydrate is administered in a 10% concentration prepared in a 40% glucose solution. After administration of the solution, the animal is monitored. At the same time, the onset of loss of sensitivity is noted (when tingling with a needle in various parts of the animal’s body), muscle relaxation (the animal lies down), pulse and respiration rates, duration of anesthesia, etc. are determined.

It is emphasized that the animal can be administered intravenously with chloral hydrate in an 8...10% solution at a dose of 10 g per 100 kg of weight, or 96° ethyl alcohol at a dose of 0.35...0.45 ml/kg of weight , and inject in a 33% solution.

Bull for anesthesia

Rp.: Chlorali hydrati 40 ml

Sol. Sodium chloride steril. 0.85% ad 400.0

M.D.S. Intravenous

8. Online access

In order to make an incision in the scrotum, the surgeon grabs it along with the testes with his left hand and pulls it back. It is most rational to dissect the scrotum on the cranial surface (along the greater curvature of the testis, because wounds in the front are more protected from contamination), retreating from the scrotal suture of 1-1.5 cm. The length of the incision should correspond to the size of the testis. A prerequisite is dissection scrotum for blood and exudate after operations did not accumulate in the scrotal cavity.

9. Surgical procedure

The freed testis is pulled out of the scrotal cavity, the transitional ligament is dissected, the mesentery is torn, and a ligature from the cleft is applied to the thinnest part of the spermatic cord. The ends of the ligature are tied with a nautical or surgical knot.

The first loop of the knot is carefully and gradually tightened in 2-3 steps with an interval of 2-3 seconds so that the threads are deeply immersed in the tissue, from which the liquid elements of their composition have been sufficiently squeezed out. The second loop of the knot is obtained with the ends of the ligature stretched, thereby preventing relaxation of the tightened first loop.

After this, the spermatic cord is crossed with scissors, retreating 1 cm below the ligature. At this moment, its ends are held in the hand and the quality of the ligation is checked, after which the ends of the ligature are cut off, retreating the knot by 1 cm. Performing these two techniques in reverse order is unacceptable. There is no need to place a castration loop on the spermatic cord. It is necessary to avoid additional tissue irritation with a double thick ligature. It is also unreasonable to leave a long stump (2-2.5 cm) of the spermatic cord, because this contributes to the development of infection.

Then blood clots are removed from the scrotal cavity with a sterile swab and the wound is powdered with tricillin or a mixture of streptocide and iodoform.

10 . The final stage of the operation

Blood clots are removed from the wound cavity and powdered with antibiotic powder.

Recipe: Benzylpenicilini-natrii 100000 ED

Streptocidi 20.0

Misce, fiat pulvis.

Yes. Signa. Powder on the wound.

The wound is not closed or sutures are applied so that ecussate does not accumulate in the wound cavity.

11. Postoperative treatment

After castration, the animals are monitored. If suppurative processes occur, the wound is cleaned and treated with an antiseptic solution.

Post-castration complications:

Bleeding from the vessels of the scrotum, bleeding from the artery of the vas deferens, bleeding from the stump of the spermatic cord, prolapse of the common tunica vaginalis, prolapse of the stump of the spermatic cord.

12. Feeding, care andanimal possession

After castration, the animals are placed in a clean pen. Sawdust is not advisable as bedding, as it can contaminate cassation wounds; straw (not barley) is desirable.

Bibliography

Veremey E.I., Korolev M.I., Masyukova V.N. Workshop on operative surgery with the basics of topographic anatomy of animals: Textbook. - Mn.: Urajai, 2000. - 153 pp.

Eltsov S. G., Itkin B. Z., Sorokova I. F. et al. Operative surgery with the basics of topographic anatomy of domestic animals Ed. S. G. Eltsova. - M.: State Publishing House of Agricultural Literature, 1958.

Magda I. I. Operative surgery with the basics of topographic anatomy of domestic animals. - M.: Selkhozizdat, 1963.

Olivekov V. M. Complications during castration, their prevention and treatment. - Kazan: Tatizdat, 1932. - 97 p.

Operative surgery / I. I. Magda, B. Z. Itkin, I. I. Voronin, etc.; Ed. I. I. Magda. - M.: Agpromizdat, 1990. - 333 p.

Plakhotin M.V. Handbook of veterinary surgery. - M.: Kolos, 1977. - 256 p.

Lecture notes on operative surgery given by Associate Professor I.V. Rakhmanov for 3rd year students of the Faculty of Medical Sciences in 2001.

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2. Tell us that it is not always possible to take your pet home right away; sometimes you need to leave it at the clinic. In what cases and for how long?

A long time ago, when veterinary clinics were not yet equipped with medical equipment that helps monitor the patient’s condition, and anesthesia was administered to animals right in the corridor, animals were returned asleep after surgery. The owners were told that it was necessary to monitor breathing and ensure that the tongue did not fall into the trachea. In such a situation, the owner created an imaginary feeling of involvement in what was happening and control over the situation, and the doctor sighed with relief and believed that if something happened to the animal, then in any case it was due to the owner’s oversight. In such a situation, everyone was happy with everything, both the owner and the doctor. In modern clinics the situation has changed radically. In order to minimize anesthetic risks, the animal must be left in the clinic for several hours and sometimes days. In order for the anesthesiologist to have the opportunity to qualitatively examine the patient before surgery, in some cases, conduct a number of additional studies, develop a protocol for anesthesiological support that is most suitable for this particular patient. At this time, surgery and instrumentation are also prepared. The surgical intervention itself is the shortest period of time the patient is in the clinic.

Sanitation of the dog's oral cavity. The procedure takes 15-45 minutes. During anesthesia, the animal's condition is monitored using a heart monitor.

After surgery, the animal must be stabilized. If we are talking about simple surgical interventions, ear cropping, castration, opening an abscess, sanitation of the oral cavity, etc., then this period is quite short from 15 minutes to 1-2 hours.

The dog at the time of completion of rehabilitation. The animal is given oxygen therapy.

Once the animal is fully awake, it can be sent home. But if the animal has undergone surgery, for example on the chest cavity or brain, then such animals should remain in hospital until their condition stabilizes. This period can sometimes take from several days to several weeks. This is due to the fact that the severity of the condition of such patients can change very quickly and only timely adoption of adequate measures will lead to the patient’s recovery. Intensive therapists, not owners, should be with such animals.

3. How to prepare the house for the arrival of an animal after surgery? Should there be a toilet next to his place? Do I need to buy a “collar” or a special bandage?

If the animal has undergone surgery, the owner certainly needs to prepare the house for the post-operative period of his pet. Features of preparation depend on the specifics of the operation. For example: if an operation was performed on the oral cavity (jaw fracture, bite correction, neoplasms in the oral cavity), then it is necessary to remove all toys and objects that the dog can chew. It is also necessary to isolate other animals. If the animal has stitches, then it is advisable to have spare post-operative blankets and collars at home, since animals can tear or break them. If orthopedic surgery has been performed, then it is necessary to prepare the floor so that the animal does not slip while moving. Your doctor should tell you about all these features.

4. How does your pet usually behave after surgery? What behavior can be considered normal, and when is it better to immediately contact a veterinarian?

Normally, the animal’s behavior after surgery should not differ much from the preoperative period. Of course, for the first day or two, dogs and cats may be calmer and react less to external stimuli. But they must maintain their appetite, they must walk, recognize their owners, and go to the toilet. After metal osteosynthesis for limb fractures, animals should immediately rest on the operated paws. There should be no bleeding from the suture, only minor spotting on the first day. In any case, the animal’s behavior is determined not only by its general health, but also by its individual reaction to the damaging factor and stress associated with the injury. Some easily excitable animals may whine and cry out even with very minor pain reactions, or very balanced patients with a lower pain threshold may step on and use a limb that must be protected after surgery. In any case, if the owner seems that the dog or cat is behaving inappropriately, or any symptoms appear that are alarming, it is better to show it again, or call your doctor.

5. Is it possible to walk the dog immediately after the operation or should it spend several days at home?

In most cases, you can walk your dog immediately after surgery. In some cases, movement is even indicated during the postoperative period of orthopedic operations or recovery from paresis or paralysis. You just need to take into account unfavorable weather conditions. If it snows or rains, you need to consider additional protection for the seams.

6. How and with what to treat the wound yourself? Can I cope on my own or is it better to go to a clinic? In what cases should you go to the clinic?

In most cases, owners process the seams themselves; this procedure is quite simple and does not require special skills. There are a lot of preparations for treating sutures, some of them have a prolonged effect (act for several days), some have the effect of a liquid dressing (form a film that prevents the penetration of infection), some have a pronounced antibacterial effect. Therefore, postoperative prescriptions must indicate which drug and with what frequency it is necessary to treat the sutures. If discharge appears from the stitches, the stitches turn red, or signs of swelling appear, this is a reason to immediately go to the clinic and not self-medicate.

7. How to feed your pet after surgery? Are there any dietary considerations if your pet is taking medications/injections?

As a rule, the patient can be fed within a few hours after surgery. The exception is operations on the gastrointestinal tract. Then the fasting diet can last for up to several days. Sometimes animals may refuse food, which may be associated with post-traumatic pain or the patient’s severe general condition. A special feature for cats is that in such cases they must be force-fed, since with a starvation diet, even a healthy animal can develop fatty hepatosis. Starving a dog even for a few days is not a problem. There are also a number of medications that must be used before, after or during meals. Features of taking such drugs should be indicated in postoperative prescriptions.

8. Is it necessary to give your pet more attention and affection, or is it better to leave him alone during this time?

How much and what kind of attention can and should be given to each pet in different circumstances is best known only by the owner who lives with his pet side by side. There are animals that are looking for affection and support at a time when I am experiencing physical and mental discomfort, there are animals that are better not to touch, to leave alone until they come up and demand your attention. These are all nuances that owners know better than their attending physician.

9. After what time can I start playing with my pet? Why should this absolutely not be done immediately after surgery?

After surgery, it is better to postpone playing with your pet for a while. Because during games, animals can get so excited that they practically stop paying attention to pain. In this case, a jump in blood pressure may occur, which will lead to bleeding, or premature excessive support after orthopedic operations can lead to damage to metal structures and displacement of bone fragments. There are a number of surgical interventions in which movement must be minimized as much as possible. For example, skin grafting with free flap transfer requires complete immobilization of the operated area. Such patients should be placed in small isolated boxes, so there is simply no talk of any games.

10. Are any additional measures needed during this period if the pet is old?

Old age, as you know, is not a diagnosis. Therefore, there are no special measures in the postoperative period for older patients. The period of tissue regeneration and suture fusion may slightly lengthen, which is associated with a decrease in the regenerative abilities of the body.

11. Are there any other features of caring for an animal during the postoperative period?

In order for the postoperative period to pass as quickly and painlessly as possible, you must strictly follow the instructions of your attending physician. Under no circumstances should you self-medicate or use miracle ointments created by your neighbor’s grandmother or miracle drugs that you read about on the Internet. Find a doctor you completely trust and strictly follow all of his recommendations.

Ksenia Andreevna Lavrova, plastic surgeon
Nesterova Svetlana Valerievna anesthesiologist

“I was told that the operation could not be performed because my dog (cat) would not tolerate anesthesia” - veterinarians often hear this phrase from pet owners. We talked about where this myth came from, why it continues to live and what modern veterinary anesthesiology actually is, with the chief physician of the Biocontrol veterinary clinic, head of the department of anesthesiology, resuscitation and intensive care, president of the veterinary anesthesiological society VITAR, candidate of biological sciences Evgeniy Aleksandrovich Kornyushenkov.

— Please tell us, first, what types of anesthesia for animals exist?

— There are the same types of anesthesia for animals as for people. This is an intravenous injection of the drug. In some cases, for aggressive or restless animals, an intramuscular option is used to calm them down and then insert a catheter. Next, intravenous medications are administered, then intubation occurs (a tube is inserted into the airway) and then gas anesthesia is performed.

Regional anesthesia, that is, local, is also possible and encouraged.

— Does it happen that several types of anesthesia are used at once?

— Yes, such anesthesia is called combined.

— What procedures are performed on animals under general anesthesia and why?

— For animals, unlike people, general anesthesia is a very common procedure. The reason is that a veterinarian does not always have the opportunity to conduct a high-quality examination of patients. After all, our patients cannot lie for a long time with their mouths open if it is necessary to conduct an examination of the oral cavity, or lie motionless under an X-ray machine or in. Sometimes animals do not allow the surgeon to fully examine the joints, and then the animal has to be sedated so that the animal calms down and relaxes. Sedation is light anesthesia, and anesthesia is deeper.

Also, of course, all surgical interventions are performed under anesthesia. Well, inspection of aggressive animals.

— What methods of anesthesia are used at Biocontrol?

— Our clinic uses all modern techniques, including the most advanced ones, such as the use of a neurostimulator to carry out blockades. That is, we connect a special device to find the nerve, and apply anesthesia near this nerve. This allows you to reduce the amount of general anesthesia and perform the operation only due to this anesthesia technique. That is, there will be less general anesthesia, there will be fewer consequences, and the animal’s recovery from anesthesia will be better and of higher quality.

— What is special about gas anesthesia?

— The fact is that the gas enters the lungs and also exits back through the lungs. It is not metabolized in the liver and kidneys, so for patients with concomitant diseases of these organs, such anesthesia is safe.

— Do animals have any contraindications to general anesthesia? Weight, for example, or age?

— Of course, animals have contraindications to general anesthesia. As for age, this is a controversial issue. Age may or may not be a limitation for anesthesia if anesthesia is necessary for health reasons. The question is not age, but what condition the animal is in. For this purpose, the anesthesiologist examines the animal before surgery.

— What does the anesthesiologist pay attention to when examining an animal before surgery?

— In animals with a complex clinical situation, it is necessary to resort to additional studies, such as ultrasound of the heart, taking blood tests, including a coagulogram and gas-electrolyte composition. These diagnostic tests allow the anesthesiologist to determine the degree of risk. There is a scale of anesthetic risk with five degrees. Due to the specifics of our clinic, we most often deal with animals from risk levels 2 to 4.

- What kind of degrees are these?

- For example,

5 is already a terminal animal. In such cases, we need to understand that even if we perform the operation required on the patient, the probability of his death is high;
4 are patients of moderate severity,
3 - these are older animals with some concomitant diseases,
2 - this is actually a healthy animal, but which will undergo a major operation,
and 1 are clinically healthy animals undergoing minor surgery.

Therefore, based on this scale, we have no desire to give an animal with grade 5 anesthetic risk anesthesia. It is given only if there is at least a minimal chance that the operation will provide an opportunity for survival. It is necessary to discuss with the owners that the animal can die at the stage of induction of anesthesia, during the operation, and immediately after the operation. That is, the risk is maximum, and is associated not only with anesthesia, but with the entire procedure in general. But operations cannot be performed without anesthesia. Anesthesia exists precisely so that the animal undergoes surgery.

— Why then is age a contraindication to general anesthesia in other clinics?

- It is not right. These are clinics that, apparently, do not have normal anesthesiology equipment and staff. Not every clinic has the opportunity to have specialized anesthesiologists on its team. Yes, this direction is developing, but not in every clinic. Since 1992, Biocontrol has operated an entire anesthesiology service, that is, doctors who deal only with anesthesiology and understand this issue much more than doctors who are simultaneously surgeons, anesthesiologists, therapists, and dermatologists all rolled into one. A doctor who provides a wide range of services cannot be a professional in all areas. Our people are engaged specifically in this specialty, and they, as opinion leaders, are responsible for the adequacy of decision-making, the adequacy of such a concept as “correct anesthesia.”

— Describe the process of putting an animal into a state of anesthesia.

— First, the animal is examined by an anesthesiologist. If there are no contraindications, the patient is allowed to undergo a particular procedure. If the procedure is not complicated, then, as a rule, premedication is not done. An intravenous catheter is placed in the presence of the animal, then an intravenous drug is administered, and it falls asleep. Afterwards, an examination or procedure is carried out and our patient wakes up quite quickly.

If we are talking about surgery, then 10-15 minutes before the procedure itself, premedication is performed intramuscularly or subcutaneously, that is, preparing the animal for anesthesia. Premedication includes various drugs, including sedatives, and drugs that prevent cardiac arrest. Premedication is not mandatory; only a specialist decides whether it is necessary. After premedication, an intravenous catheter is placed and anesthesia is administered. In 99% of cases, this drug is Propofol, which has long proven its effectiveness and safety and is one of the most common among induction drugs (drugs for immersion in anesthesia). Next comes tracheal intubation - this is an almost mandatory rule. A tube is inserted so that the animal can breathe calmly during the operation and nothing interferes with it. Oxygen is supplied through it, and after intubation the animal can be transferred to gas anesthesia so as not to administer intravenous drugs. Various pain management options are also needed. If this is a systemic drug, then it is also administered intravenously, and if the technique of regional anesthesia is also used, then either epidural anesthesia or, as we have already said, a neurostimulator is taken.

— What if you don’t use painkillers? Will the animal feel anything? It's sleeping, isn't it?

— During operations, various psychophysiological parameters of the patient, heart rate and respiratory movements are necessarily measured. That is, if the animal is in pain, all these parameters will increase. And although the animal is not conscious, these indicators will increase, including, possibly, a motor reaction. This is unacceptable.

— Still, do animals feel anything during surgery?

— There is a concept of “anesthesia.” This is a reversible loss of consciousness. This has nothing to do with pain relief. And there is the concept of “analgesics”. These are the drugs that eliminate pain sensitivity. Accordingly, the analgesic does not put the patient into deep sleep. He may be sleepy, that is, sleepy, but he will not be completely asleep, but he will not feel pain. An anesthetic is needed to ensure that the animal sleeps and does not move. If you administer only analgesics, the animal will not allow you to work normally. Therefore, two components are always introduced: both anesthesia and analgesia. And, of course, muscle relaxation is required - muscle relaxation. These are the three mandatory components of a complete anesthesia care.

— How is the animal’s condition monitored during surgery?

— The patient is connected to special sensors to assess the parameters of his condition. To monitor the functioning of the cardiovascular system, an ECG is done, and blood pressure is monitored using various methods. We also evaluate oxygenation, which is the level of oxygen supplied to the animal. We evaluate ventilation - how the animal releases CO2, whether it accumulates in the body. We evaluate diuresis, for this we place urinary catheters in patients - this is very important during long-term operations. We use an easy-to-use instrument called an esophageal stethoscope, which is inserted directly into the esophagus.

Biocontrol has high-tech equipment - anesthesia-respiratory machines. In them, all indicators are included in a single block. The patient is connected to the equipment, and the anesthesiologist's job is to monitor how the device works. These devices are so “smart” that they themselves adapt to the patients. That is, even if the animal does not breathe, the device itself will do it for him. Today, the greatest responsibility lies with the anesthesiologist during the introduction of the patient into a state of anesthesia and connection to the anesthesia-respiratory machine, and then during his awakening. But even though the anesthesiologist has special equipment, he must look at the animal clinically.

— How is recovery from anesthesia carried out?

— Approximately 10 minutes before the end of the operation, when the surgeons are already suturing the surgical wound, the anesthesiologist reduces the amount of drugs supplied to the animal. The gas and the flow of analgesics decrease, and by the last suture the animal should already be breathing on its own. If the operation was not very complicated, planned, then the patient is transferred to spontaneous breathing, and he is placed in our anesthesiology and intensive care unit, where he wakes up smoothly and carefully. He is immediately prescribed painkillers of various groups. Some people require stronger painkillers that last for several days. In such cases, the animal has to spend some time here in the clinic.

— Why should operations and other procedures under general anesthesia be carried out exclusively in specialized clinics, and not at home?

— Under modern conditions, which can be provided exclusively in the clinic, death on the operating table is becoming very rare, with the exception of operations on the chest cavity or neurosurgical operations, in which the risk of surgical error is high. However, if any difficulties arise, the clinic has the opportunity to attract an additional team of doctors who can help. In specialized clinics, like ours, there are defibrillators that can start the heart. There is one that can be used immediately in case of sudden bleeding and save the animal. All this is impossible at home.

For the same reasons, the animal should be monitored in the clinic and after surgery. One of the common complications after surgery, especially for small animals, is cooling. Anesthetics affect certain centers of the brain, including the thermoregulation center. Inhibition of this center causes the body to cool down. A small dog, when its abdominal cavity is open, can lose up to 2.5-3 degrees in half an hour of surgery. The modern heating system based on infrared radiation, which we have installed, helps to avoid such problems.

Another important fact is pain relief. You cannot use the same painkillers at home as in the clinic. This is prohibited by law. That is, if the owner wants his animal to be anesthetized, then he must understand that at home he will not be able to provide such an opportunity. Even such seemingly simple operations as sterilization and castration are very painful.

— What are the side effects of anesthesia?

“We must understand that there are no bad drugs, there are no simple manipulations. There are bad anesthesiologists. It should not be surprising that one of the drugs can cause side effects from the heart, from breathing, from temperature, or cause vomiting - for the reason that all anesthesia affects the centers of the brain. One of the centers is the brain stem; when exposed to it, drugs turn off consciousness, putting the patient to sleep. And the other center is located in the medulla oblongata - this is the cardiovascular, respiratory, thermoregulation, and vomiting center. Absolutely all drugs affect these centers, thereby reducing the heart rate, respiratory rate, causing vomiting, and lowering the temperature. They just work to a greater or lesser extent.

All these effects are regulated by the anesthesiologist himself. If the patient is stable and connected to the monitoring system (that is, the operation is performed in a clinic and not at home), then all these drugs, even if there are side effects, are a benefit. But performing an operation without anesthesia means certain death. Anesthesia was invented to help patients endure operations.

But we should not forget that there are various phenomena that cannot be predicted. For example, such a thing as malignant hyperthermia is very rare. This is a genetic defect of the gene, and some anesthetics cause a reaction that will most likely lead to death. Such a factor as an allergy to anesthesia has long ceased to exist in modern anesthesiology. This is a kind of myth that was invented by people who are not exactly anesthesiologists and are trying to justify their failures in this way.

— Does general anesthesia, as well as the number of procedures performed under anesthesia, subsequently affect the patient’s health and life expectancy?

— In our practice, there are many examples when anesthesia is prescribed to a patient almost every day, for example, when a tumor is irradiated for five days in a row in small fractions, which is carried out under anesthesia. There are patients who received 15-18 anesthesia per year during treatment. This had no effect on life expectancy, given their illnesses.

In our clinic, each manipulation point is equipped with oxygen, and there are stands with inhalation anesthesia, which is a safe method, as we have already said. That is, we can provide anesthesia for X-rays, radiation therapy, CT, and sanitation of the oral cavity. We have 9 anesthesia-respiratory machines - a fleet that is inaccessible to many clinics.

Moreover, we have patients who undergo operations such as bone transplantation. During such an operation, the patient is under anesthesia for 10-12 hours. Afterwards, he undergoes intensive therapy, spends 2-3 days in intensive care on various means of control, but even in the presence of concomitant diseases, the animals successfully undergo this operation. But to ensure that your pet can return home in a timely manner, a whole team of specialists works. And the anesthesiologist is one of the most important links in it. It is he who initially makes the decision on the possibility and advisability of the operation and is responsible for the patient’s condition. The owner themselves will never be able to adequately decide whether the pet will undergo the procedure under general anesthesia or not. This is the deepest misconception that is imposed on owners by non-professionals.

Postoperative care is a fairly broad topic, because there are almost as many nuances of postoperative management of a patient as there are different types of operations. Let’s consider some general and specific aspects of postoperative management of a patient.

The postoperative period can be divided into “acute” and “chronic”.

The acute postoperative period begins immediately after the patient leaves the operating room.

Although technically the operation of ovariohysterectomy is comparable to that of sterilization, the general condition of the patient is immeasurably more severe due to intoxication. With such interventions, the animal may spend several days in the hospital. (In uncomplicated cases, infusion therapy (drips) on an outpatient basis is possible, but owners should be prepared for a significant investment of time (4-9 hours).

If the condition is clinically satisfactory, a long (7-14 days) course of antibiotic therapy (injections or tablets) is prescribed. Processing and removal of seams, blanket - as indicated above.

Surgeries to remove tumors (eg breast tumors). As a rule, in this case, a unilateral mastectomy is performed (removal of the entire ridge with capture of the lymph nodes). This is a major operation accompanied by significant tissue damage.

Patients often belong to the older age group and have a number of concomitant pathologies. Infusion therapy may be required for 1-3 days, the animal must be anesthetized (injections of opiate analgesics or NSAIDs) for the first 2-5 days, a course of antibiotics for 5-7 days.

The sutures are treated with levomekol ointment and are usually removed on the 14th day.

Quite often, with such interventions, a seroma (liquid) forms under the skin along the suture on days 4-5, which in some cases must be aspirated (“sucked out” with a needle) or even the cavity drained. If you experience symptoms of “ichor” discharge along the suture or a “water ball” “rolling” under the skin, it is better to see a surgeon.

Urethrostomy.

The most common indication for surgery is the resulting blockage of the urethra. The essence of the surgical intervention is to dilate the urethra and form a new, shorter urethra; In cats, the scrotum and penis are removed. During the operation, a urinary catheter is installed and sutured, which should remain in place for 3-5 days until the stoma is formed. The bladder is sanitized (washed) through a urinary catheter 2-3 times a day. Patients after urethrostomy usually require a long course of antibiotics, antispasmodics, hemostatic drugs and a strict special diet. If acute renal failure occurs, intensive infusion therapy (drips) is required for several days and observation in a hospital.

The formed stoma must be carefully protected from licking at least until the sutures are removed (the sutures are removed on days 12-14) (put an Elizabethan collar or diaper on the animal). After the operation, a specialized diet is prescribed.

(removal of non-viable teeth, opening of oral abscesses, osteosynthesis of jaw fractures, etc.) in the postoperative period require feeding with soft, mushy food for 7-20 days and thorough treatment of the oral cavity after each meal with an antiseptic (for example, copious rinsing with chamomile decoction or Stomadex tablets). An antibiotic is usually needed.

Operations on the stomach and intestines.

After most surgical interventions performed on the organs of the digestive system (removal of foreign bodies and neoplasms from the stomach, intestines or esophagus, surgical interventions for volvulus/acute dilation of the stomach), the patient needs a strict fasting diet for 2-4 days - no water, no food should not enter the gastrointestinal tract.

Fluids and nutrients must be given parenterally (intravenously). Since in such cases we are almost always talking about high volumes of infusion therapy and the need for strictly calculated administration of parenteral nutrition drugs, such animals are indicated for observation in a hospital before the start of feeding.

After discharge, you will need a course of antibiotic therapy, special dietary nutrition, and in the first weeks a fractional feeding regimen (5-6 times a day in small portions)

Osteosynthesis and other orthopedic operations.

Osteosynthesis- surgical intervention for fractures of varying complexity. It may involve installing an external fixation apparatus (Ilizarov apparatus in large dogs or a wire fixation apparatus in small animals), introducing a plate, screw, wire, wire cerclage, etc.

In simple cases, the owner will need to treat the sutures daily (chlorhexidine + levomekol) and limit the pet's exercise. The external fixation apparatus requires careful care (treatment of sutures and places where pins are inserted), protection with a gauze bandage until its removal (depending on the complexity of the fracture, up to 30-45 days, sometimes longer). It is mandatory to take a systemic antibiotic; in the early period, injections of analgesics may be required.

For a number of orthopedic interventions, the patient is given a special soft Robert-Johnson fixation bandage for up to a month, which needs to be changed from time to time in the clinic.

Spine operations.

Patients with spinal injuries (fractures) or disc herniations usually require inpatient observation for the first 2-3 days. The rehabilitation period until full restoration of supporting ability can last from several days to several weeks. The owner must monitor regular urination and, if necessary, express urine or catheterize the bladder. The animal must be limited in mobility (cage, carrier). The sutures are treated with levomekol ointment; a protective bandage is usually not required. Spinal patients require a course of antibiotics and steroids for 3-5 days.

To speed up rehabilitation, massage, swimming, and physiotherapy are indicated.