What you need to know about the cryptorchid patient
👋 Welcome to the Mentorship Program! We’re so glad you’re here!
This program is designed to help you grow your surgical skills and confidence, one step at a time.
Each month covers a new topic with a suggested schedule to guide you. This month’s topic is The Neuter Surgery and Current Trends with Spays/Neuters. There is a lot of discussion occurring these days on when a pet should be spayed or neutered, or if at all and what diseases may be prevented or potentially created with the surgery.
This month, we will take a deep dive into the literature on these trending topics so your information is based on evidence, not hearsay. We will also take an in-depth look at the orchiectomy procedure itself.
This surgery tends to be less stressful than the spay, but it is still important to have a good understanding of the regional anatomy, the procedure, and its variations.
We have created a viewing order and timeline for you, but feel free to move at your own pace. The first video in the menu is the longest one and is packed with valuable information, it’s an excellent starting point.
As you work through the material, please post any comments or questions below. We’re monitoring this space and will do our best to respond quickly.
This is a great opportunity to ask questions, review cases, and gain further clarification on the topics covered this month.
In the downloadable resources section at the top of the page, you’ll find a surgery log template. We strongly encourage you to use it, especially to track your spay surgeries. It’s a valuable teaching tool that helps reinforce learning and monitor progress.
Let’s get started!
Watch video: Introduction (4)
Hi All,
I apologize that I have not monitored this page as much as I usually do. I have had some medical issues but I am getting back into healthy mode now. Thank you for your patience.
Emerald, I will alert Dr Brock that you have another question. I believe she is back from her ski vacation this week.
Nicole, thank you for making that comment. So yes 2mm in between ligatures can be enough and, in my opinion, it is better to have 2 ligatures a bit close together than just one, most of the time. Regarding the "flashing". We 'flash' when a clamp is on the pedicle because the nature of the clamp will tend to 'spread' the tissues out, so by flashing (releasing the clamp) we allow the ligature to fully strangulate the tissues without the tissues being held 'spread out'. The flashing is needed because of the hemostat. One ligature close to another will not cause the tissues to be held spread out because the ligature circumferentially encloses the pedicle. I hope this explanation makes sense and that I understood your comment correctly. I know you are in a different time zone but hopefully you can join us for the webinar next week in case I did not adequately clarify this question.
Have an amazing day!
Thankyou Dr Sylvestre
Yes I wil continue to pursue a cat gut alternative , thanku for the monocryl tip.
As I was religating the ovarian pedicles post bitch spey bleed I only managed to get 1 ligature on he ovarian pedicles due to there not being much tissue , if I was to put 2 on this particular case there would have only been a couple of mm between the 2 ligatures , is that still better than 1, I always allow more space between ligatures due to the need for " flashing ' u talk about ?
Thanks 😊
Hi Emerald
I saw your question for Dr Brock. I know she was heading to BC today for a ski holiday. I will alert her to your question but she may not get back to you for a few days. I do not know what her computer/work availability is like while away. Just an FYI.
Thanks and have an amazing day!
Hi Nicole
Great questions, difficult case. I do believe that the spaniel had some sort of bleeding disorder, or an adverse reaction to something that might have caused the odd clotting issue. Going back in the second time certainly could have caused you to go through muscle which would lead to bruising at the incision line. I am very cautious with ligating pedicles, especially in bigger patients. I had one patient, a large mixed breed dog on which we did a hindlimb disarticulation amputation. 2 weeks post op his entire incision fell open and he was bleeding from his femoral artery. Thank goodness the owner was the veterinarian also! But it made me realize that large vessels do take a long time to clot securely closed. So I would not be using catgut on such pedicles (I used it for many years but with everything I have learnt in the past 40 years, I would not touch it anymore). PDS is a good choice but that extra strength and duration is not necessary within the abdomen so I would simply use monocryl or biosyn, or something equivalent. I do certainly embrace the Modified Miller's knot (new to me for the past few years!) as those knots do stay on securely; others, if using the surgeon's knot or slip knot (as I used to) then I would transfixed when ligating an organ/pedicle like the body of the uterus in a larger patient as these knots can slip and I would always place 2 ligatures (large patient again). I hope this helps a bit. Welcome to the program.
Questions & Answers (1)
Hi Dr. Brock,
I was wondering if I could ask a question about a reply you had given last month to a colleague's question about a feline neuter anesthetic protocol for a cat with a heart murmur. You had mentioned at the end: "Listen carefully for upper respiratory noises such as gurgling both before and also in the half hour or so after extubation and treat with IM glycopyrrolate at 0.01mg/kg." I do sometimes hear this in feline patients after extubation during neuter procedures, (does not occur in patients we do IM sedation for other procedures and are not intubated). I was told or assumed it may be due to the lidocaine spray upon intubation and we tell clients this should resolve within 24-48h. Should I be treating this with glycopyrrolate and is the lidocaine spray the actual reason for this??
A question for Dr. Sylvestre also: I was just looking for the spay and neuter workshop to see if I could watch the cryptorchid videos, do we still have access to this?
Thank you very much,
Tina
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