Barrow Hill Vets – 20th February 2013

Although today I saw less animals because I did not observe any consultations, what I did see was brilliant. When I arrived this morning, after taking out the rubbish and mopping the kennels, I was told to put on some scrubs to go into theatre. As well as having all my clothes covered, I had to wear a face mask, hair net and cover my shoes. The hygiene required for even entering the operating theatre seemed extreme but I realised that it was necessary when considering the surgery that would be taking place and the dangers associated with the infections which could be passed to an animal. Standing in the preparation room, I watched the nurse scrubbing down the dog ready for surgery. A patch of fur on her abdomen was shaved and cleaned meticulously with hibiscrub disinfectant, starting with a dilute solution and then finishing with concentrated disinfectant. After the animal has been cleaned, it is very important that this shaved area touches nothing. The vet then scrubbed up, washing their arms with disinfectant and rigorously scrubbing their hands. They could then put on a sterile gown and gloves, similarly, they could not touch anything except the disinfected area on the animal. These leaves it up to the nurse to manoeuvre everything else into place and carefully assist the vet where possible. The first operation I saw was a bitch spay which I had seen previously when I did work experience at Kingsnorth Vets. It was a good opportunity to refresh my memory and mentally test myself to see what I remembered. The procedure took about an hour and all went smoothly. As the dog was under anaesthetic, the owners had asked for another procedure to take place. This was the removal of her dew claws. Before the operation, these had also been clipped ready and the vet proceeded to simply remove them. Dew claws have no purpose but can be damaged, especially in a dog like this who lived on a farm. Therefore, they would be easily removed, causing no harm and preventing any future harm from occurring.

After this operation, there was the opportunity to see another bitch spay, but this was going to be done laparoscopically. This is key hole surgery. As the first veterinary surgery in Kent to get a laparoscope, Barrow Hill were very excited with their investment. They give owners the option as to whether they want their dog to undergo keyhole surgery but currently, about 50% do and 50% don’t. Although laparoscopic surgery is more expensive, it is beneficial because a smaller incision is made, the surgery is quicker, the recovery is quicker and the bitch undergoes less pain. Only two vets at the surgery have had training to do keyhole surgery as it is expensive and a procedure needing a lot of skill. I watched from outside the theatre, but this gave me a fantastic view of the monitor on which the camera was feeding to, as well as the dog’s body. In a lap spay, a large patch of fur across the abdomen is clipped. To begin with, a small incision is made and carbon dioxide gas is used to inflate the abdomen of the so that there is more room in which the surgery can take place. Carbon dioxide is used because it will not diffuse into the cells as oxygen would, disrupting the biological function. After this, a camera is placed into the hole and the entire abdomen can be seen. This was fascinating because when you see the inside of a body in a text book, although it is accurate, it is nowhere near as incredible as the real thing. Every organ has its position in the body and all the different tissues are different colours, indicating the differences in blood supply. The most obvious organs were the large liver and the purple spleen whilst if the camera was pointed up the body, I could see the diaphragm contracting, separating the abdomen from the thorax. This gives an opportunity for the vet to check that everything is clean and in order, highlighting any health concerns and ensuring that the operation could continue safely. Next, a similar incision was made further up the dogs body and a trocar and cannula (hollow cylinder with a sharply pointed end) was inserted through which other instruments could be passed. The dog was then tipped into its side, meaning that the other, more mobile, organs would fall out of the way, giving a clearer view of where the uterus would be. Carefully using the camera and instruments, the vet could quickly locate the uterus and, using a grasping instrument, he could grab hold one of the ovaries and pull it up, against the abdomen wall. At this site, a sharp hook could be pushed through the skin and used to hold the ovary against the wall. Cauterising forceps were then introduced through the incision, securing around the base of the ovary and causing it to break away quickly and cleanly. The forceps continued to hold the ovary so the hook could be removed. The dog was then pushed back onto its back and the abdomen was deflated, reducing the pressure. The ovary could then be carefully pulled out from the second incision. Because the dog was now on its back, if the ovary was dropped it could be more easily found, although luckily, all went well. This whole procedure was repeated on the other side until finally the abdomen could be quickly examined for any bleeding, and the camera could be removed before stitching the incisions.

Also in the surgery today was a rough collie who had damaged its leg by having a log dropped on it. This was very similar to the accident which happened to the fox terrier on Monday, but this collie was a lot luckier. The position in which the log had landed meant that little serious damage was done and after a radiograph of the carpal to the elbow, this was confirmed and the leg was bandaged to allow the bruising to heal with no further risks. Whilst under anaesthetic, the dog also had a dental in which all the teeth were cleaned and several were removed.

Although many procedures are very different in dogs and cats, on of the most similar operations which takes place is a dental. Although the mouths of a cat and a dog are different in terms of the size of their teeth, they both have jaws of a carnivore and both encounter the same dental problems. I could observe these similarities when, shortly after the dog dental, a cat also had a dental. Similarly, all the teeth were cleaned and several teeth were removed. However, the cat’s mouth was in a worse condition than that of the dog because the cat already had some teeth missing and had slight gingivitis in its gums.

Although very little happened today, my experience in the theatre and dressing in scrubs was both fun and fascinating.

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