Keyhole Surgery

What is key-hole surgery?

Cinque Ports Vets are pleased to be able to offer our clients the option of key-hole (laparoscopic) surgery for routine bitch spays and other procedures where appropriate.

Key-hole spay involves the introduction of a camera and specialised instruments into the abdomen through two or three small incisions. Many of the traditional surgical procedures such as spaying can be now performed laparoscopically. Traditional surgery involves the removal of the ovaries and uterus (ovariohysterectomy) but laparoscopically generally only the ovaries are removed (ovariectomy).

The tissues are visualised under high magnification and blood vessels are cut and sealed using specialist equipment.

It is well established in human surgery that laparoscopic procedures provides quicker healing time and less post-operative complications than other methods. This is proven also in modern veterinary medicine.

The benefits of laparoscopy for our pets are similar and aim for a faster and more comfortable return to normal activity. One typical example is the young, very active bitch that is not likely to accept easily periods of complete rest from exercise post neutering.

After Key-hole surgery dogs will still need to be kept on the lead but the risk of damaging the surgical wounds (because of the small size) is greatly decreased.

Other procedures such as cryptorchid castration (retained testicle), gastropexy, cystoscopy (bladder examination) and organ biopsies can be performed in this way with increased level of safety for unwell patients and reduced discomfort.

Please contact our Rye branch if you would like more information or to discuss further.

What is Brachycephalic Obstructive Airway Syndrome (BOAS)?

Brachycephalic obstructive airway syndrome is the term given to the effects of a significantly shortened nose. These signs mainly affect the passage of air through the upper airways with severity of signs varying from mild snoring or snorting noises to severe breathing problems.

Animals suffering from BOAS can often struggle to breathe during periods of exercise and can even suffer collapse. Dogs can only mainly cool themselves down by panting and sweating through their paws – excessive panting can be problematic for BOAS patients making them very high risk for overheating.

What breeds are affected?

Brachycephalic breeds of dog are those that have a marked short or squashed nose appearance, and any breed of dog with such a conformation can be affected e.g.

  • English or French Bulldog
  • Pug
  • Boxer
  • Lhasa Apso
  • ShihTzu
  • Pekingese
  • Dogue de Bordeaux
  • Cavalier King Charles Spaniel
  • And many more

Why do these animals have problems?

Unfortunately, due to the extra effort required for inspiration (breathing in), secondary problems develop. These secondary effects include:

  • Tonsillar eversion and hypertrophy. The tonsils sit in the back of the mouth – increased negative pressures can cause them to enlarge and they can bulge into the back of the mouth, further obstructing the airway.
  • Pharyngeal muscle hypertrophy. The pharynx is the chamber at the back of the mouth before the entrance to the oesophagus (food pipe) and larynx (voice-box). The muscles in this chamber can become hypertrophied (enlarged) due to negative pressure in the upper airway.
  • Acid reflux from the stomach into the oesophagus (food pipe). This can then damage the oesophagus lining and stomach wall, causing ulceration. Some severe cases can suffer from a hiatal hernia where part of the stomach can become displaced into the chest cavity during breathing.
  • Heart failure – this is less common than the other secondary effects of BOAS.

How is BOAS diagnosed?

Our vets will carry out a physical examination and assess your pet’s anatomy – some dogs of the same breed can be affected more than others. They will also gain a history and assess how well your dog copes and the degree of clinical signs attributed to BOAS – particularly in warm conditions and during exercise. The majority of brachycephalic will at the very least experience snorting or snoring as a degree of upper airway obstruction.

The nares (nostrils) can be assessed as part of the physical examination, but further evaluation would need to be carried out under general anaesthetic. Our advice on whether to proceed with further diagnostics will be evaluated based on the above – essentially if your pet is experiencing a significant level of signs or showing an anatomical conformation that may predispose him/her to problems.

How is BOAS investigated by the veterinary surgeon?

Further investigations are dependent on the initial consultation and physical examination but often include imaging of the chest, evaluation of the oral cavity under general anaesthetic and sometimes blood tests. General anaesthetic risks are higher in brachycephalic dogs, so we have a specific anaesthetic protocol for these cases to ensure as much safety as possible. We

What treatment options are available?

Surgical treatment is available for:
Stenotic nares
Widening the nares by surgically removing a section of cartilage can improve the airflow.
Elongated Soft Palate
Surgically shortening the length of the soft palate to improve air flow into the larynx. 
Laryngeal Collapse
This is dependent on the severity, mild cases can have some tissue that is slowing the airflow, in severe cases a more complex procedure is required.
Everted tonsils
Surgical removal of the tonsils may improve the condition in some cases.
Medical treatment is available for:
Acid reflux and/or hiatal hernia
Treatment for gastric reflux usually involves regular medication, rather like one might take for heartburn. We often use conservative management for cases with a hiatal hernia, but some severe cases require surgery.  

Weight management
It is difficult to lose weight from a severe BOAS patient who is also obese as often there is a reduced ability to exercise safely. Therefore the lifestyle of these patients from an early onset is an extremely important factor. Maintenance at an optimum weight to ensure minimal extra tissue (due to fat) around the face and neck is essential.

Treatment plans are selected on a case-by-case basis, and one of our vets will be able to discuss options during a consultation and/or following diagnostics.

Ultrasound

Ultrasound scanners use high frequency sound waves to look at tissues within the body. A hand-held probe emits a burst of high frequency sound waves (inaudible to the human ear) which are echoed back to the probe. These echoes are then converted into a picture which represents a slice through the tissue being examined. This is displayed in a TV screen as a ‘real time’ moving image. More complex functions of the ultrasound machine include Doppler and colour flow mapping which are used to look at blood flow through the heart of other organs.

Most people are familiar with the use of ultrasound for monitoring human pregnancies, and we use it to check for pregnancies too. We also use ultrasound for examining other structures inside the abdomen such as the liver, spleen, kidneys, stomach, intestines, lymph nodes, bladder, prostate and blood vessels.

Ultrasound is very useful for examining the heart (echocardiography). Because ultrasound gives a real-time moving image it can show us the structure of a constantly moving organ such as the heart and tells us about its function. 

If your pet needs an ultrasound scan some hair will be clipped and gel applied. Ultrasound is not painful and most animals tolerate it well. Sedation or anaesthesia will sometimes be recommended if your pet is very scared, wriggly or if we are taking biopsy samples.

Depending on the reason for an ultrasound scan, other procedures such as blood samples may be needed as well. Ultrasound is often used in conjunction with radiography (X-rays) as they are both good at showing different things, and together give us a more complete picture. Sometimes we will use ultrasound to help take biopsy samples from abdominal organs. In this case it is used to guide a needle to the area which we want to sample. This is a much less invasive and relatively painless way of taking biopsy samples than surgery.

Dog And Cat Pre Operative Castration Advice

Once you have made an appointment for your pet to be castrated, please offer a small meal at 10pm the night before the anaesthetic and then withhold any further food. Access to water should be allowed until they are ready to come into the surgery. 

Once admitted they will be examined by your vet and given a health check.  If your pet is fit and healthy a premedication injection will be given.  This helps calm the body and prepare him for the general anaesthetic.  The premedication can take 20 – 45 minutes to take effect and they will be slightly sleepy and relaxed.

Once your pet is ready, he will then be taken through to the Prep room.  A small area of hair is clipped from his leg, an intravenous catheter is placed and a general anaesthetic is injected into the vein.

An endotracheal tube is then placed into his trachea to maintain a clear airway for us to administer an oxygen/gaseous anaesthetic mix to keep him under anaesthetic.

Once asleep under anaesthetic he will be prepared for theatre.  His veterinary nurse monitors the anaesthetic while shaving an area of hair from his testicles.  Once the hair has been shaved the area is then cleaned using an antiseptic soap.  When all the dirt and hair has been removed a surgical spirit/antiseptic preparation is then applied to the operation site. This procedure is carried out to reduce any bacteria on the skin and provide a sterile operation site. All the hair will grow back in time. They are then transferred to theatre.

The nurse will carefully monitor the anaesthetic during the surgery.  Your vet will perform the castration by firstly making an incision in front of the scrotum. Each testicle is then clamped, tied off with suture material and then removed. The skin is then sutured with dissolvable stitches. This is a permanent and irreversible procedure.  Once your vet has completed the surgery the gaseous anaesthetic is switched off and your pet will be maintained on pure oxygen for a short period of time.

Once the veterinary nurse is happy, we will then disconnect the anaesthetic circuit and transport your pet to the Hospital Ward where the endotracheal tube is removed when ready.  He is placed into a warm kennel and his recovery carefully monitored by the Hospital nurse (a qualified veterinary nurse).  Once he is sitting up and alert, his intravenous catheter is removed and the Hospital nurse will contact you to update you on their progress and arrange a collection time. On discharge a veterinary nurse will explain all necessary post- operative care.

We will only discharge a patient when we feel they are fully awake and able to walk. Some pets take longer to fully recover than others and are treated on a case by case situation, so don’t panic if a late time is requested for collection.

The benefits of having your pet castrated:

  • May improve unwanted behaviour (if castrated early)
  • Decreases risk of prostatic disease
  • Testicular tumours are prevented
  • Reduced incidence of perianal tumours
  • Reduced incidence of perianal hernia
  • Stops dogs from running away after bitches in season

Dog And Cat Pre Operative Spay Advice

Once you have made an appointment for your pet to be spayed, please offer a small meal at 10pm the night before the procedure and then withhold any further food. Access to the drinking water should be allowed until they are ready to come into the surgery.

Once admitted they will be examined by your vet and given a health check.  If your pet is fit and healthy a premedication injection will be given.  This helps calm the body and prepare her for the general anaesthetic.  The premedication can take 20 – 45 minutes to take effect and they will be slightly sleepy and relaxed.

Once your pet is ready she will then be taken through to the Prep room.  A small area of hair is clipped from her leg, an intravenous catheter is placed and a general anaesthetic is injected into the vein.

An endotracheal tube is then placed into her trachea to maintain a clear airway for us to administer an oxygen/gaseous anaesthetic mix to maintain the correct level of anaesthesia.

Once asleep under anaesthetic she will be prepared for theatre.  Her veterinary nurse monitors her anaesthetic while shaving an area of hair from her abdomen (dogs are shaved on their tummy).  Once the hair has been shaved the area is then cleaned using an antiseptic soap.  Once all the dirt and hair has been removed a surgical spirit/antiseptic preparation is then applied to the operation site. This procedure is carried out to reduce any bacteria on the skin and provide a sterile operation site. All the hair will grow back in time. They are then transferred to theatre.

The nurse will carefully monitor the anaesthetic during the surgery.  Your vet will perform an ovariohysterectomy where the uterus and ovaries are removed.  This is a permanent and irreversible procedure.  Once your vet has completed the surgery the gaseous anaesthetic is switched off and your pet will be maintained on oxygen for a short period of time.

Once the veterinary nurse is happy, we will then disconnect the anaesthetic circuit and transport your pet to the Hospital Ward where the endotracheal tube is removed when ready.  She is placed into a warm kennel and her recovery is carefully monitored by the Hospital nurse (a qualified veterinary nurse). Once she is sitting up and alert, her intravenous catheter is removed and the Hospital nurse will contact you to update you on their progress and arrange a collection time. On discharge a veterinary nurse will explain all the necessary post- operative care.

We will only discharge a patient when we feel they are fully awake and are able to walk. Some pets take longer to fully recover than others and are treated on a case by case situation, so don’t panic if a late time is requested for collection.

The benefits of having your pet spayed:

  • No more seasons – therefore no unwanted male visitors
  • No more smelly / bloody discharge
  • No unwanted puppies/kittens
  • Reduced incidence of mammary tumours
  • No ovarian tumours
  • Will not suffer from a pyometra (infection in the uterus where it fills with pus and can be life threatening)

Dog And Cat Neutering Post Operative Care

These instructions have been prepared to help you with your pet’s recovery.

They will have had a general anaesthetic and hair may have been clipped from one or more of their legs. If a pre- anaesthetic blood test was performed, hair may have also been clipped in their neck region. The operation site will also have been clipped to enable us to prepare the site with maximum sterility.

Modern anaesthetics normally wear off within a few hours of a procedure, however you may notice that their eyes appear red or that they shun the light. This effect can last for up to 48 hours and is due to the pre-medication injections. They may also seem a little unsteady or drowsy and have a slight cough. This is because a tube is passed into their throat to maintain their anaesthetic and airway.

We recommend keeping them warm and quiet overnight and allow them to toilet in the garden on a lead. Following an anaesthetic they will require a light meal in the evening with water offered as normal.

During the procedure your pet will have received a pain killer injection and/or an antibiotic injection where required.  Further medication may have been prescribed to give at home and it is extremely important that you follow the instructions on the medication label. If you believe they are uncomfortable or have any questions regarding the medication, please contact us to discuss the situation.

It is extremely important that your pet does not lick or interfere with the surgical wound. This can cause an infection or their wound to break down and a Buster Collar may be required to prevent this. A period of lead exercise or confinement indoors will be required for up to 10 days following the procedure.

Following a neutering procedure, weight gain can be a common side effect. Your veterinary nurse will be able to advise on your pet’s diet and the best way to prevent this.

Please feel free to ask if you have any questions at your post operative appointment.

If you are at all concerned about your pet please contact us as soon as possible.

Neutering Your Female Cat -Spay

What is spaying?

This operation involves removal of the entire uterus (womb) and ovaries via an incision usually made on your cat’s left flank or midline into their abdomen. Your cat will be admitted as a ‘day patient’ and following a pre-operative check by your veterinary surgeon, she will be given a pre-medication and analgesic (pain killing) injection prior to her general anaesthetic. After surgery and following her recovery from the anaesthetic she will be ready to go home later the same day. You will be given full discharge instructions on how best to care for your cat after surgery and she will be checked by your veterinary nurse 3 days later to ensure the wound is healing. If there are any sutures present these will be removed 10 days later. While the operation is more complicated than castration, it is still a routine procedure and their recovery is usually fairly quick.

What are the advantages of spaying?

Spaying has a number of advantages especially if performed between 4-6 months of age.

Unwanted kittens-Most obviously spaying prevents unwanted litters. There are thousands of unwanted kittens and cats that need homes due to irresponsible owners who do not neuter their cats.

Behavioural-Cats are ‘spontaneous ovulators’ which means your cat will only ovulate (release her eggs) if she is mated. If she comes into season and is not mated she will come back into season every couple of weeks until she is. Due to physiological and behavioural patterns she will try to seek out male cats and may attempt to escape from the house in an attempt to do this. She will also attract male cats into the area. During her season she will be ‘calling’ and displaying unsociable behaviour which is often loud, persistent crying and rolling around on the floor.

Prevent spread of diseases- Mating and fighting can also spread diseases like FIV (Feline Immunodeficiency Virus) and FeLV (Feline Leukaemia Virus) which can be fatal.                                                                                                     

Medical-Spaying prevents the chance of infection of their uterus (pyometra) and greatly reduces the incidence of mammary (breast) cancer.

Are there any disadvantages?

The operation carries a small risk associated with general anaesthesia. Your cat will be assessed prior to surgery to ensure she is fit and well for the procedure, and full instructions will be given when she goes home to minimise the chances of a problem occurring with the wound.

It is a common fallacy that a neutered cat will become fat and lazy. They may have a decreased activity level following neutering, which in turn causes weight gain IF your cat continues to be fed the same amount of food as before they were neutered. Neutered pets can require up to a 30% reduction in their feeding requirements. This is due to no longer utilising energy in to reproduction.This extra energy may then be stored as excess body fat instead.
After your cat is neutered, we recommend moving her onto a neutered cat food. Royal Canin have developed a competitively priced, veterinary exclusive pet food which is high in protein and low in fat to help combat against any weight gain. Your veterinary nurse will be able to advise you on the best feeding regime for your cat.

Royal Canin also have an S/O Index with their food which is an abbreviation for struvite and calcium oxalate crystals. The S/O Index indicates that the food helps provide a urinary environment unfavourable to the development of struvite and calcium oxalate crystals.

These crystals can cause blockages in male cats due to their narrow, long urethra. In females blockages are less of a problem but can still occur.

Click on the video below to find out more about why you should neuter your cat.

Useful links:
www.royalcanin.co.uk

Neutering Your Male Cat – Castration

What is castration?

The operation involves surgical removal of both testicles via two small incisions in your cat’s scrotal sacs. It is a straightforward operation performed under general anaesthesia. Your cat will be admitted as a ‘day patient’ and following a pre-operative check by your veterinary surgeon, he will be given a pre-medication and analgesic (pain killing) injection prior to his general anaesthetic. After surgery and following his recovery from the anaesthetic he will be ready to go home later the same day. You will be given full discharge instructions on how best to care for your cat after surgery. We usually don’t need to recheck your cat after castration unless you have any concerns. There aren’t any sutures to worry about and the wounds heal over very quickly as long as there is no interference with the area!

What are the advantages of castration?

Castration has a number of advantages especially if performed between 4-6 months of age.

Unwanted kittens– Most obviously castration prevents unwanted litters. There are thousands of unwanted kittens and cats that need homes due to irresponsible owners who do not neuter their cats.   

Behavioural problems– Unneutered male cats or ‘tom cats’ can also develop a number of unwanted characteristics. For example they may become territorial and start spraying urine to mark areas, often in the house.  By puberty their urine has often developed a very strong smell and is extremely difficult to remove.  If they are allowed to venture outside they will start to stray further from home and come into contact with other cats. This is likely to lead to cat fights which result in wounds which can become infected and abscessed. Unneutered males also tend to be prone to being involved in road traffic accidents especially at night as they are out and about marking their territory and looking for females.

Prevent spread of diseases– Mating and fighting can also spread diseases like FIV (Feline Immunodeficiency Virus) and FeLV (Feline Leukaemia Virus) which can be fatal.                                                                                                      

Medical-Normally cats have two testicles present in their scrotal sac by the time they are neutered but it is not uncommon to have retained testicles (cryptorchidism). This is a condition where by one or both of the testicles have failed to move into the scrotum and are still in your cat’s groin or abdomen. When the testicles are retained they are at a higher temperature than in the scrotum. This leads to infertility and an increased likelihood of the testicle becoming cancerous. Removal of the testicle(s) is therefore still recommended but the operation may be a bit more complicated as the abdomen may need to be entered.

Are there any disadvantages?

The operation carries a small risk associated with general anaesthesia. Your cat will be assessed prior to surgery to ensure he is fit and well for the procedure, and full instructions will be given when he goes home to minimise the chances of a problem occurring with the wound.

It is a common fallacy that a neutered cat will become fat and lazy. They may have a decreased activity level following neutering, which in turn causes weight gain IF your cat continues to be fed the same amount of food as before they were neutered. Neutered pets can require up to a 30% reduction in their feeding requirements. This is due to no longer utilising energy in to reproduction.This extra energy may then be stored as excess body fat instead.

After your cat is neutered, we recommend moving him onto a neutered cat food. Royal Canin have developed a competitively priced, veterinary exclusive pet food which is high in protein and low in fat to help combat against any weight gain. Your veterinary nurse will be able to advise you on the best feeding regime for your cat.

Royal Canin also have an S/O Index with their food which is an abbreviation for struvite and calcium oxalate crystals. The S/O Index indicates that the food helps provide a urinary environment unfavourable to the development of struvite and calcium oxalate crystals.

These are crystals which can form in your cat’s urine creating urinary problems. The crystals can eventually cause a ‘plug’ or blockage in your male cat’s urethra. It only takes a few crystals to block as the urethra is very narrow and only has a small opening. This is a potentially fatal condition and will result in death if your cat is not treated due to the urinary toxins building up in the system. This will cause kidney failure in a matter of days or their bladder will eventually burst.

Click on the video below to find out more about why you should neuter your cat.

Useful website:
www.royalcanin.co.uk

Microchipping

Why microchip?

This is an extremely important way of identifying your pet should they ever go missing.  We regularly have pets brought in to the surgery who have either strayed or been injured in a road traffic accident with no way of being able to find out who their owner might be.  If these pets had been microchipped we would have been able to reunite them with their owner immediately.

Every year more than 300,000 pets are reported missing.  They may go missing for a variety of reasons especially if they are particularly inquisitive!  During the firework season, if pets are not kept inside they often become scared and disorientated due to the noise and easily become lost.  Other pets may run off during thunderstorms or if they have recently moved areas they may wander too far from their new home.  Some pets may even be stolen. Unfortunately in recent years there has been an increase in the number of pets especially dogs which are stolen, usually to breed from or to sell on in an attempt to make money.  Because the microchip is a permanent form of identification it enables your pet to be returned to their rightful owner much more easily even after a long period of time.

It is a legal requirement to have your dog microchipped by 8 weeks of age and keep their contact details up to date with the database.

Implanting a microchip is quick, simple and very cost effective.  It will give you the peace of mind that if your pet does become lost they have a form of identification which means you will be reunited much faster and may avoid the possibility of your pet being kept in a shelter or even rehomed.

How does it work?
A microchip is a small electronic device which is the size of a grain of rice.  The chip is inserted in the loose skin of your pet’s neck generally in between their shoulder blades.  Depending on the species of your pet the area may be different.  For example tortoises are microchipped in their hindlimb.

The chip contains a unique number which is read using a scanner.  This number is registered to the national database.  Once the chip has been inserted we will log all of your details via a registration form.  This means that the number will be linked to your home address and contact numbers were your pet ever to go missing.

It is extremely important that you keep your contact details up to date with the database.  If you move house or change your telephone number you must let them know in case they ever need to contact you if your pet goes missing.

Should your pet ever go missing and is found away from home all veterinary practices, animal charities and local authorities will have a scanner and be able to check your pet for a microchip.  Once the number has been read, the database would be contacted to retrieve your details and you would then receive a call informing you of the whereabouts of your pet.  Without this form of identification your pet may never be reunited with you.

Another benefit of having a microchip is that there are now cat flaps which read your pet’s own unique number only allowing your pet to enter and leave the house.  This is especially useful in preventing unwanted visitors!

If you would like any more information on the benefits of microchipping or to book an appointment please contact your local branch of Cinque Ports Vets.

Useful links:
www.tracer-microchips.co.uk
www.petlog.org.uk
www.petlog.org.uk/pet-owners/compulsory-microchipping-faqs-for-pet-owners/