Small Animal > Repro surgery > Flashcards

Repro surgery Flashcards

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1
Q

What are the three types of ovarian neoplasias in dogs?

A
  • Sex cord stromal tumours(most common)
  • Epithelial cell tumours
  • Germ cell tumours
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2
Q

What are the most common sex cord stromal tumors in dogs and cats?

A

Granulosa cell tumors (most common ovarian tumor overall in dogs and cats)

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3
Q

What are granulosa cell tumors?

A

Tumors that produces estrogen and/or progesterone

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4
Q

What are the clinical signs of granulosa cell tumors (five)?

A
  • Estrus or proestrus
  • Cystic endometrial hyperplasia
  • Pyometra
  • Bone marrow aplasia
  • Pancytopenia
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5
Q

What percent of granulosa cell tumors are malignant in cats?

A

50%

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6
Q

What are the common epithelial cell tumors in dogs (three)?

A
  • Papillary adenomas and adenocarcinomas (can be bilateral)
  • Cystadenomas
  • Undifferentiated carcinomas
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7
Q

What are the common germ cell tumors in dogs (three)?

A
  • Dysgerminomas
  • Teratomas
  • Teratocarcinomas
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8
Q

What is the most common germ cell tumor in cats?

A

Dysgerminomas (slow to metastasize but do so in 33% of cases)

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9
Q

What is ovarian remnant syndrome?

A

Signs of estrus due to elevated estrogen levels after being spayed (as a result offailing to remove all ovarian tissue)

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10
Q

How can ovarian remnant syndrome be diagnosed (three)?

A
  • Anti-Mullerian hormone
  • Progesterone levels
  • Exploratory laparotomy 3 weeks after ovulation (formation of a CL makes the ovarian tissue easier to identify)For best chance of diagnosis, performbothAM and progesterone hormones testing
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11
Q

How should you close the uterus after a C-section?

A

Close the uterus intwolayers
1. Mucosa (simple continuous appositional)
2. Inverting (Cushing’s) on external surface/perimetrium (we donotwant cut surfaces on the external surfaces or we increase adhesion risk)
Do not enter the lumen/endometrium!

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12
Q

What medication should be given after a C-section andwhy?

A

Oxytocinto stimulate contractions after surgery! Even though puppies are out, you want to “wring out” the fluid left in the uterus

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13
Q

True or False: A spay can be done during the same surgery as a C-section

A

True. It is recommended to do the C-section and the spayafterwards(not taking everything out altogether). If you spay first, you only have60 secondsto get the puppies out once you ligate the uterine artery!!)

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14
Q

How is pyometra diagnosed on radiographs?

A

The presence of distended loopsbetween colon and bladder

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15
Q

Where should your ligatures be when performing an ovariohysterectomy for a pyometra?

A

The ligatures will be in the cervix (because you should remove the entire uterine body)

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16
Q

True or False: Uterus neoplasias are common in dogs

A

False, they are rare (account for 0.2-1.5% of all tumors)

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17
Q

What is the most common uterine neoplasia in a dog?

A

Uterine leiomyomas (90%)

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18
Q

What is the most common uterine neoplasia in a cat?

A

Uterine adenocarcinoma (more likely to metastasize)

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19
Q

What are the clinical manifestations of a hooded or recessed vulva (two)?

A
  • Perivulvar dermatitis
  • Recurrent UTIs
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20
Q

True or False: Early spaying is a leading cause of hooded or recessed vulvas

A

False. It may or may not have any effect at all

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21
Q

How can a hooded/recessed vulva be treated?

A

Vulvoplasty/episioplasty

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22
Q

What is vaginal edema?

A

When dogs develop a mass of edematous tissue that arises from ventral floor of the vagina

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23
Q

What causes vaginal edema?

A

The uterus has more edema when under the influence of late proestrus and estrus

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24
Q

How can vaginal edema be treated?

A

OVH and/or resection of edematous tissue

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25
True or False: Vaginal prolapses are rare in dogs and cats
TRUE
26
How can vaginal prolapses be treated?
Manual reduction and OVH or hysteropexy
27
How long should you wait before diagnosing cryptorchidism in dogs?
6 months
28
Which conditions are dogs with cryptorchidism more prone to if not addressed?
Testicular neoplasia (dogs are 13x more likely to develop these but we don't see this in cats)
29
What are the most common testicular tumors in dogs?
- Leydig (interstitial) cell tumors - Sertoli cell tumors - Seminomas
30
What are the clinical signs of sertoli cell tumors (four)?
- Feminization syndrome (gynecomastia) - Bilaterally symmetrical alopecia - Anemia - Pancytopenia These tumors produce estrogen!
31
True or False: Sertoli cell tumors are not reversible
False. They are reversible with an orchiectomy unless metastasis is present (2-10%)
32
True or False: Sertoli cell tumors commonly metastasize
FALSE
33
What are the clinical signs of interstitial cell (Leydig) tumors (three)?
- Concurrent perineal hernia - Perineal adenomas - Perineal adenocarcinomas These tumors produce testosterone!
34
How can interstitial cell (Leydig) tumors be treated?
Castration and scrotal ablation
35
What is the prognosis of interstitial cell (Leydig) tumors?
The prognosis is excellent if there is no metastasis
36
What is the most common developmental anomaly of the penis?
Hypospadia (can be either glandular, penile, scrotal, or anal)
37
What is hypospadia?
The failure of fusion of urogenital foldsleading to the incomplete formation of the penile urethra
38
Which dog breeds are more predisposed to hypospadia?
Boston terriers
39
In hypospadia, the urethra _______ to the defect is usually deficient
Cranial
40
How can you treat major strangulation or trauma to the penis?
Penile amputation and scrotal urethrostomy
41
Is penile neoplasia more common in dogs or cats?
Dogs
42
What are the most common penile neoplasias in dogs (five)?
- Transmissible venereal tumors (TVT) - Penile papillomas - Penile squamous cell carcinoma (SCC) - Mastocytomas (penile mast cell tumors) - Osteosarcoma of the os penis
43
What are the clinical signs of a penile neoplasia?
Licking and serosanguineous preputial discharge
44
How can penile neoplasias be diagnosed (three)?
- Physical exam - Cytology (alone this may be sufficient for TVT) - Biopsy
45
What is paraphimosis?
When the penis protrudes from the preputial sheath and cannot be replaced to its normal position
46
How can paraphimosis be treated (five)?
- Replace penis within prepuce - Place ice or hyperosmolar solutions (sugar) - Lubricants - Pain management - Surgery if replacement is not successful (enlarge preputial opening or phallopexy)
47
What is phimosis?
The inability to extrude the penis beyond the preputial orifice (can be congenital or acquired)
48
True or False: Phimosis is more rare than paraphimosis
TRUE
49
What are the clinical signs of congenital phimosis (three)?
- Inability to pass urine other than in drops or thin stream - Licking of penis - Dribbling urine
50
True or False: Palpation of the prostate gland should never be painful
TRUE
51
What are the clinical signs of an enlarged prostate (three)?
- Tenesmus - Hematuria (+/- urethral bleeding) - Ribbon like stools
52
How can prostate disorders be diagnosed (four)?
- Radiographs +/- cystourethrogram (to delineate bladder or show urethral backflow into prostate) - Ultrasound - Cadet Braf assay (to diagnose TCC or prostatic carcinoma) - Prostatic fluid (traumatic catheterization/prostatic wash)
53
What must you remember about radiographs as a means of diagnosing diseases of the prostate?
Radiographs can only show an enlarged prostate and cannot differentiate between neoplasia, cysts, or abscesses!
54
Prostatic abscesses or cysts on ultrasound will appear __________
Hypoechoic
55
Prostatic neoplasia or inflammatory processes on ultrasound will appear __________
Hyperechoic
56
Which two bacterial agents most commonly cause prostatitis?
- E. coli - Brucella canis
57
True or False: Prostatitis is very rare in castrated dogs
TRUE
58
What are the clinical signs of a prostatic abscess (five)?
- Unilateral prostatomegaly - Dyschezia or dysuria (pain on defecation or urination) - Purulent or sanguineous penile discharge - Pain upon rectal or abdominal palpation - Non-specific signs (anorexia, pyrexia, lethargy)
59
How can a prostatic abscess be diagnosed on a CBC and serum chemistry (five)?
- Leukocytosis (leukopenia if septic) - Elevated ALP and ALT - Elevated globulins  - Elevated BUN - Hypoglycemia
60
How can a prostatic abscess be treated (three)?
- Castration is a requirement for resolution (may also need scrotal ablation) - Antibiotics (enrofloxacin, TMS, and chloramphenicol all penetrate prostate well) - Advanced surgery (marsupialization or omentalization)
61
What can occur if a prostatic abscess is not treated?
The abscess may be walled off and can rupture into peritoneum or retroperitoneum
62
What are the clinical signs of a prostatic cyst (four)?
- Urinary incontinence - Dysuria - Hematuria - Dyschezia Clinical signs are related to mass effect of cyst in caudal abdomen
63
How can a prostatic cyst be diagnosed (five)?
- Radiographs (caudal abdominal mass that may be mineralized) +/- contrast (elongated urethra and cranial displacement of bladder) - Abdominal ultrasound (presence of second "bladder") - Rectal or abdominal palpation - Bloodwork (may show azotemia) - Urinalysis (usually unremarkable)
64
How can a prostatic cyst be treated (three)?
- Castration - Percutaneous drainage - Surgery (resection or partial resection and omentalization)
65
True or False: Prostatic neoplasias are common in small animals
FALSE
66
What are the most common prostatic neoplasias in small animals (three)?
- Prostate adenocarcinomas - SCC - TCC
67
True or False: Prostatic neoplasias are very aggressive both locally and metastatically
TRUE
68
What are the clinical signs of prostatic neoplasias (four)?
- Dysuria or hematuria - Urine retention and azotemia - Tenesmus - Pain (may have vertebral metastasis)
69
How can prostatic neoplasias be diagnosed?
- Ultrasound (heterogenous enlargement of prostate and mineralization) - Rectal exam - Bloodwork (may have azotemia if obstructed) - Aspiration and cytology
70
How can prostatic neoplasias be treated?
- Radiation - Urethral stenting (if obstructed) - NSAIDs - Prostatectomy (rare) Chemotherapy tends to be unrewarding!
71
What is the prognosis of a prostatic neoplasia?
Poor. Usually palliative (survival is 1-3 months)
72
True or False: There is an increased incidence of prostatic neoplasia in castrated male dogs
TRUE
73
What are some causes of anal gland abscesses (two)?
- Chronic impaction - Dermatologic disease
74
How can anal gland abscesses be treated (three)?
- Anal gland expression - Cannulation and infusion with antibiotics +/- steroids (for anal sacculitis) - Incision and drainage with parenteral antibiotics (for abscessation) Recurrent issues may be indication for anal sacculectomy (open vs. closed)
75
What are the complications of an open anal gland sacculectomy (four)?
- Fecal incontinence - Fistulation - Stricture formation - Infection
76
What is the most common anal gland neoplasia?
Anal sac adenocarcinoma
77
What are the clinical signs of anal sac adenocarcinoma (two)?
- Perineal swelling - PUPD
78
What is the main paraneoplastic process of anal sac adenocarcinoma?
Hypercalcemia (causes the PUPD)
79
How can anal sac adenocarcinoma be diagnosed (four)?
- Rectal exam - Bloodwork (ionized calcium) - Abdominal ultrasound of lymph nodes - Thoracic radiographs
80
How many dogs have metastasis at the time of diagnosis of an anal sac adenocarcinoma?
50%
81
How can anal sac adenocarcinoma be treated (three)?
- Surgical excision of mass +/- regional lymph nodes - Chemotherapy - Radiation therapy
82
What are rectal prolapses secondary to?
Tenesmus
83
How can a rectal prolapse be treated?
Reduction and purse string placement (just to narrow, not occlude the orifice) for 3-5 days with medical management If tissue is traumatized or devitalized, then a resection and anastomosis is necessary
84
What is the most common neoplasia of the perineum?
Perineal (circumanal) gland adenoma
85
If you see a perineal adenoma in a female or castrated male dog, which condition should you be worried about?
Cushing's disease (as this neoplasia only really occurs in male intact dogs)
86
What cells do perineal adenomas arise from?
Sebaceous glands
87
How can perineal gland adenomas be treated?
Castration and surgical excision (this tumors is not very infiltrative and does not require extensive margins)
88
What is the mechanism behind perineal hernias?
There is a weakness and separation of pelvic diaphragm components and the loss of this muscular support permits the dilation and deviation of the rectum and caudal protrusion of various organs
89
What is the most common location for a perineal hernia?
Most common location is between the levator ani, external anal sphincter, andinternal obturator
90
In which presentation of dogs are perineal hernias more common?
Older intact male dogs
91
What are the clinical signs of a perineal hernia (five)?
- Stranguria with bladder retroflexion - Perineal swelling - Tenesmus - Constipation +/- Azotemia
92
How can perineal hernias be treated (three)?
- Bladder retroflexion (urethral catheterization or perineal cystocentesis) - Perineal herniorrhaphy (internal obturator flap to pelvic diaphragm muscle) - Castration
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