What should be considered before any surgery in a rabbit?
-exam and body weight
-anesthetic plan
-surgical plan
-prey physiology
-surgical instruments
-suture
-magnification
-patient preparation
What are the characteristics of prey species risks in rabbit surgery?
-prey species/target of many predators
-demonstrate flight behavior in stress
-catecholamine-driven; stimulates sympathetic NS in stress
-reduced gut motility and stasis
-greater risk of mortality vs dogs or cats
-recovery period poses highest risk
-hypothermia can prolong recovery periods and inappetence
How does anesthetic mortality differ between rabbits and dogs/cats?
healthy: 0.73% risk compared to 0.05% in dogs and 0.11% in cats
sick: 7.37% risk compared to 1.33% in dogs and 1.40% in cats
How can anesthetic time best be minimized for rabbits?
have everything needed for surgery prepared in advance
What are the characteristics of blood loss in rabbits?
-safe to lose 10-15% in a healthy animal
-pre-op blood work contributes to amount lost
-cotton-tipped applicators each hold 0.3 mL of blood
-radiosurgery, hemostatic clips, and hemostatic agents can help minimize blood loss
How can stress be minimized for rabbit patients prior to surgery?
-keep separate from sight, sound, and smell of predators
-use anxiolytic drugs
Which surgical instruments are used for small mammal surgery?
-small animal pack
-microsurgery or ophtho pack
-lonestar retractor
-number 15 or 11 scalpel blade
-radiosurgery
-LigaSure
What are the characteristics of the lonestar retractor?
-stretches incision
-lightweight; does not impede respiration
What are the characteristics of suture materials in small mammal surgery?
-3-0 or 4-0 in most species
-5-0 or 6-0 in very small species
-non-inflammatory absorbable suture; PDS most commonly
-taper needles for tissue other than skin
-subcuticular sutures for skin
-can use skin glue or staples if indicated
Which tools are used to achieve magnification for small mammal surgery?
-surgical loupes
-endoscope
What are the characteristics of castration in rabbits?
-surgery done between 3 and 6 months
-done in males for behavior
-done in females as preventative
-testicles descend at 12 weeks; difficult to sex a rabbit beforehand
What are the characteristics of castration in the male rabbit?
-open inguinal rings allow for testes to move into abdomen
-clip and prep
-can use open or close technique
-incise over center of testicle to head of epididymis
-grasp ligament and strip fascia with gauze; stronger than in dogs
-large fat pad in inguinal tunic; may be removed with open technique
-clamp and double ligate each testicle
-close inguinal rings if doing an open technique
-no skin closure necessary; can use glue
What is the benefit of the pre-scrotal technique?
can be done fully sterile
-with scrotal technique, not all of the hair can be removed (glands, etc.)
What are the characteristics of castration in rodents?
-grab ligament of epididymis as in the rabbit
-ligate distal to fat pad
-incision glued or sutured
-post-op anti-inflammatories +/- antibiotics
-no true scrotum; have post-anal sacs
-open inguinal rings
-fat around testicle
-do not mistake penis for testicle
-make incision over testicle
How is the approach to the abdomen incision done?
-incision made on ventral midline
-incision length and cranial/caudal position can be adjusted
-xiphoid to umbilicus allows access to liver and stomach
-umbilicus to pelvis allows access to bladder and repro. tract
-skin incised routinely
-cutaneous blood vessels cauterized as necessary
-linea alba is identified; beware of false lineas in rabbits
How is the approach to the abdomen done once the linea is identified?
-abdominal muscles are tented up away from viscera
-abdominal cavity opened through linea alba with #15 scalpel blade with curvature facing upwards
-incision is extended cranially and/or caudally
-beware of adhesion formation; remove powder from gloves and minimize viscera handling
What are the characteristics of ovariohysterectomy in rabbits?
-repro. tract easily visible
-more fragile than other species
-difficult to exteriorize ovaries initially
What are the characteristics of female rabbit anatomy that are important to ovariohysterectomy?
-bicornuate uterus with 2 cervices
-no uterine body
-long vaginal vestibule
-mesometrium is primary fat storage
-bladder can get in the way if not emptied pre-surgery
How is OVH performed in rabbits?
-follow uterus to the ovaries
-make a window in the fat
-use 4-0 suture, hemoclips, or ligasure to ligate ovaries
-ligate uterine vessels separately or with body using 3-0 or 4-0
-ligate distal vagina to remove cervices; ligate proximal to each cervix to retain them
-routine closure
What are the characteristics of flank ovariectomy?
-performed in rats
-2 incisions caudal to last rib on either side and 1 cm ventral to DSP of L3
-ligate proximal to ovary
-ligate ovaries with suture or hemoclips
-close body wall with one or two sutures
-close skin with sutures, staples, or glue
-NOT performed if there is uterine pathology
What are the characteristics of linea closure?
-4-0 or 3-0 monofilament absorbable suture on a tapered needle
-no catgut or braided suture; high risk of reaction or adhesion
-holding layer of abdominal wall is ventral fascia
What are the characteristics of subcutaneous tissue closure?
-continuous or interrupted sutures
-3-0 or 4-0 absorbable suture
What are the characteristics of skin closure?
-closed with continuous intradermal sutures
-cutting needles aid in closure
-not recommended to place external skin sutures
-intradermal sutures and tissue glue achieves adequate closure
-may need an e-collar in patients prone to chewing
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