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Senin, 02 Mei 2011

Dog Castration


Castration is the surgical removal of the testicles. Reasons for castration include the following:
Eliminate the reproduction potential
Reduce sexual activity
Reduce tendency to roam and fight
Reduce general level of agression
Eliminate testicular cancer
Resolve disease of the prostate gland
The best age for castration is between six and twelve months of age. At this age the procedure is very low risk and easy to perform. It is also at this age that diseases of the prostate and testicles are virtually non-existant; bad habbits such as marking have not started, and unwanted pregnancies have not added to the overpopulation of the pet world. If your dog is not to be used as a valued breeder, early castration is the responsible thing to do. It could save your dogs life and make him a much more desirable housemate.
After a careful examination, the pet is put under general anesthesia. The best method is inhalent anesthesia since it is much more controlable than injectible anesthesia. The patients also recover without the prolonged "hangover" of injectible drugs. We like Isoflurane gas the best. It is totally metabolized by the lungs and is kind to the liver and kidneys. Even though it is a little more expensive than other anesthetics we think the fast recovery time and increased safety are worth it.

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Induction of anesthesia by mask technique.
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After induction, an endotracheal tube is positioned within the trachea (windpipe) to deliver the anesthetic gas and oxygen; to keep the pet from aspirating saliva and to provide direct control of respiration if needed.
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Shaving the surgical site to remove hair which might contaminate the area and cause infection.
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The area is now clipped and ready for sterile preparation. We are looking at the dog positioned upside down with the rear legs towards the camera.
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The surgical site is scrubbed with disinfectant soap solutions to remove dirt and debris and kill surface bacteria on the skin.
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In keeping with sterile procedure, all instruments are autoclaved to kill off bacteria and spores. The instruments remain wrapped within a surgical "pack" until needed by the surgeon.
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This is what we see when the instrument pack is opened.
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Sterile drapes have been applied and clamped in position. These further minimize any chance of contamination of the surgical site from surrounding bacteria and dirt. The only area left open is that which is required to do the procedure. Notice the surgeon now has sterile gloves on to prevent contamination of the site from his skin bacteria. Before putting on the sterile gloves the surgeon scrubs his hands with a disinfectant soap to minimize skin bacteria, just in case a glove is pricked.
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We are now making the skin incision to expose the testicle. This is about a 1" incission just in front of the scrotum over the shaft of the penis. The scrotum is on the left under the hand.
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Notice the testicle beginning to pop out of the skin incision (Just to the left of the scalpel).
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Further exposure of the testicle from the skin incision.
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The testicle is above the thumb and the cord leading into the body contains the following structures: vas deferens ( tube that carries sperm to the penis), pampiniform plexus (a network of blood vessels that surround the vas deferens and keep the sperm at constant temperature), and internal cremaster muscle which regulates the proximity of the testicle to the body to regulate sperm temperature).  In a "closed procedure" a ligation or tie is placed around this entire structure, it is then cut and released freeing the testicle. We do not use this inferior method. We use what is referred to as an "open technique".
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In the "open technique" the testicle is elevated from the surface of the skin and is opened to expose the vas deferens, cremaster muscle and pampiniform plexus. Although the "open technique" takes a little more time, this is the best way to perform a castration. Each structure is tied or ligated separately. This is opposed to the "closed technique" where a single ligation (tie) is put around all the above mentioned structures. With a "closed technique" drainage complications can occur post surgery and you can never be as sure that all the internal structures are tied off securely as with the "open technique". We like the "open technique" best.
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Making the first ligation or tie.  This is done with an absorbable suture material that is securely tied around the vas deferens and pampiniform plexus. In the weeks following surgery the material will be completely absorbed by the body after it has performed its' task of preventing any internal blood leakage.
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Once the ligations have been made, the structure is cut and the remaining stump is checked for bleeding before being released into the body.
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The stump is held with forceps until we are sure the ligature is tight and no bleeding will occur.
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In this view we are ligating the internal cremaster muscle and pampiniform plexus. The cremaster muscle can have a significant artery within it that if left untied can allow severe blood loss. This is the final ligation that will free the testicle for removal.
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In this view the testicles have been removed and we are beginning to close the skin incision. We use what is called a buried subcuticular suture pattern. This pattern allows all suture material to be inside the incision. This leaves no outside sutures for the animal to lick, get infected and cause soreness. It takes a little more time than external sutures or merely gluing the incision shut, but we like to do it in the best manner for the pet.
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Tying the suture.
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The incision is now closed, but some tiny gaps are seen between sutures.
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Any gaps are cemented shut using an instant curing medical glue. Many "cheap" facilities use no sutures and only glue. This is inferior in strength to suturing and gluing.
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The incision is closed. Notice that there are no external sutures to irritate the pet. In 4 to 6 weeks the suture material will be absorbed by the body and scarring is almost non-existant. At this point we awaken the animal and keep them caged for the remainder of the day for observation. If all is well, we send the pet home at the end of the day.
Things to watch for at home:
The number one complication is licking and chewing at the incision site. Normally this does not occur due to the suture pattern we use in closure, but occasionally we have to apply an Elizabethan Collar to prevent he dog from reaching the site.
We suggest "leash only" exercise for 24 to 36 hours after surgery.  This ensures that the pet will not break open the incision while running.
We ask owners to look underneath their dog once a day for the first 4 or 5 days after surgery. If signs of chewing are seen or any seepage or swelling occur, we want to know immediately.
Normally our patients leave in good spirits, wide awake and ready to enjoy the family.  They may sleep lots the first night home. By the second day you will never know they had anything done.
What to look for when considering surgery for your pet.
I would want to make sure that my pet was the only one operated on with the sterile instrument pack. I have actually worked for practices that operated on more than one animal with an instrument pack.
Look for quality. Ask the right questions. What type of anesthetic do they use? Gas is best, but more expensive than injectible anesthesia. How is the procedure performed?  Are they there for hi quality or hi production?  I would want the very best for my pet.
Don't go for the lowest bidder. We have people price shopping every day. All they want to know is the bottom line and rarely ask how the procedure is accomplished. Generally, in surgery, like anything else you get exactly what you pay for. I don't think it's beyond reason to have your questions answered before a surgery is undertaken.

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