Prepubertal gonadectomy in dogs: A comparison between ovariohysterectomy, ovariectomy and laparoscopic ovariectomy

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Prepubertal gonadectomy in dogs:

A comparison between ovariohysterectomy, ovariectomy

and laparoscopic ovariectomy

1 Department of Obstetrics and Gynaecology, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey.

2 Department of Biochemistry, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey.

3 Department of Biostatistics, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey.

hkanca@ankara.edu.tr

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Project Partners

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The number of stray dogs in Ankara

Total estimated:

75 000 – 80 000

≥20 000 – 25 000 in Cankaya District

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Cankaya Municipality

Animal Care and Rehabilitation Center

The Number of Neutered dogs in 2015-2016

1135 1443 2578

Conventional surgical methods

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8 Patient monitor

(ETCO

₂

’li, PM5000V, UTECH, China)

Anaesthesia device

(UT-201A, UTECH, China)

Operating table

(V tip, Germany)

Veterinary USG device

(DUS 60 VET, Edan Instrument, Inc., China)

Instrument-Equipment

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9 Laparoscopy tower (170×60×60 cm)

• 30° Laparoscope (5×30 cm)

• Light source (LED 1000)

• Fiber optic cable (Xenon, 3,5 mm×1,8 m)

• CO

₂

insuflator and insuflation tube

• Monitor

• Camera (Zoom adaptor, 18-35 mm)

• Grasping forceps (5 mm×36 cm)

Instrument-Equipment

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Instrument-Equipment

10 Electrothermal bipolar vessel sealing devices

(5 mm×37 cm, LigaSure

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, Covidien, Medtronic, Turkey)

Electrosurgery generator

(LS10, Covidien, Medtronic, Turkey)

Trocars- 5 mm/11 mm/12 mm

(VersaOne

^™

Bladed Trocar, Covidien, Medtronic, Turkey)

http://www.medtronic.com/covidien/en-us/products/vessel-sealing.html

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The Advantages of Laparoscopic Surgery

11 Devitt et al., 2005; Nickel et al., 2007; Van Goethem et al., 2003

• Better visibility

• Smaller incisions

• Reducing ORS risk

• Decreasing surgical trauma

• Shortening healing time

• Atraumatic cauterization

• Less surgical pain and stress

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Prepubertal Sterilization

12 Olson et al., 2001; De Bleser et al., 2011; Schneider et al., 1969

•Population control

•Reducing maintenance and hosting costs before adoption

•Preventing risk of mammary neoplasia

•Shortening of surgical time through better visibility

•Small sizes of reproductive tissues and high tissue fragility causing harder procedures

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Prepubertal Sterilization

13 Olson et al., 2001; De Bleser et al., 2011; Schneider et al., 1969

Described techniques include removal of the ovaries through a ventral midline, flank, or minimally invasive approach.

In some countries, including the U.S., the standard procedure involves concurrent surgical removal of the uterus (ovariohysterectomy [OVH]); some common American textbooks still lack discussion of ovariectomy (OVE).

Conversely, for decades in many European countries, OVE has been the standard procedure for spaying

animals without uterine disease.

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Prepubertal Sterilization

14 Olson et al., 2001; De Bleser et al., 2011; Schneider et al., 1969

 Minimally invasive surgery is becoming increasingly common, and elective spaying is one of the most common indications for laparoscopy.

 Both OVE and OVH can be performed laparoscopically, although minimally invasive OVH is most commonly performed as a laparoscopic-assisted procedure to facilitate ligation and section of the uterine body or cervix.

 Laparoscopic OVE is technically easier and quicker than laparoscopic OVH and usually reduces the number of required

 incisions by at least one.

 Development of minimally invasive spay procedures may likely be the single best

worldwide promoter of OVE.

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Twenty-one healthy prepubertal (4-8 months old) dogs underwent;

I-Ventral midline ovariohysterectomy (OHE; n=7), II- Ventral midline ovariectomy (OVE; n=7) or

III- Two-portal laparoscopic ovariectomy (LOVE; n=7) by the same surgeon were randomly selected.

No intra- or postoperative complications were observed.

15 Materials and Methods

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16 Selection criteria for elective gonadectomy

No abnormality on physical examination and total blood count

Ultrasonographic examination

Determination of conditions that could cause obstacles for sterilization such as pregnancy, uterus or ovarian pathologies

Vaginal cytological examination

Determination of prepubertal anoestrus

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17 Materials and Methods

 Acclimatization in individual pens for 5 days.

 Restriction of water and food 6-8 hours.

 Application of single dose cefazolin (20 mg/kg, IM) on preoperative 30. min

 Medetomidine hydrochloride (0,04 mg/kg, IM, Domitor®, Zoetis, Turkey)

 Propofol (2-3 mg/kg, IV, Fresenius Kabi®, Sweden)

 %1 Isoflurane- %50 oxygen

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18 Materials and Methods

 Peripheral blood samples were collected and serum tumor necrosis factor (TNF)-α, interleukin (IL)-6,

cortisol and glucose concentrations and white blood cell (WBC) counts were measured preoperatively and 1, 6 and 24 hours postoperatively.

 Melbourne pain scores were monitored 1, 6, 24 and

48 hours after surgery as described (1).

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19 Materials and Methods

 Commercial ELISA kits (FineTest®) were used and run in accordance with the manufacturer’s instructions for, TNF-α (canine TNF-α, ECA0020), IL-6 (canine IL-6, ECA0013) and for cortisol, (cortisol, EU0391) measurements (Sunrise®

Elisa Reader, Tecan, Switzerland).

 Serum glucose was assayed by photometric method in an autoanalyzer (ERBA XL 600, Mannheim, Germany).

 WBC counts were obtained by automated reading

impedance within hematologic counter (Exigo®, Boule

Diagnostics AB, Sweden).

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20 Materials and Methods

 Descriptive statistics for each variable were calculated and presented as Mean±SEM.

 General linear model for repeated measures procedure was used to evaluate the difference between groups among

repeated measurements.

 The model included group and time point main effects and their interaction terms.

 Post hoc testing for significant interactions was performed using simple effect analysis with Bonferroni adjustment.

 A P value <0.05 was considered significant.

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In veterinary practice, surgical sterilization of cats and dogs is one of the most common surgical procedures performed. Routine spaying/castrating is often performed because of its value in preventing reproductive tract disease, including pyometra and mammary neoplasia in female cats and dogs, and benign prostatic hyperplasia and testicular neoplasia in male dogs.

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Elective gonadectomy is also routinely performed in shelter situations in animals as young as 6–8 weeks of age as a method of contraception to help with the pet-overpopulation problem in the US.

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However, recently the routine practice of sterilizing all nonbreeding animals has come under scrutiny.

21 Materials and Methods

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in bitches, because of their important physical manifestations, the onset of the first proestrus is generally considered puberty (Johnston et al. 2001).

we still have an insufficient

understanding of the various parameters involved in the sexual maturation of domestic dogs and possess a limited knowledge of breed-specific differences as well as within-breed variation

22 Laparoskopik Cerrahi Nedir?

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23 Results

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24 TNF-α

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25 IL-6

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26 Cortis

ol

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27 Gluco

se

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28 WBC

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29 UMPS

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30 Conclusion

 Surgical time for prepubertal OVH, OVE and LOVE are similar when performed by an experienced surgeon.

 Results indicate that OVE is superior to OHE in terms of pain and surgical stress in prepubertal dogs.

 In addition, LOVE causes less pain and surgical stress than both conventional OHE and OVE and may be more

appropriate for an outpatient setting in prepubertal dogs.

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