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Ovaro-Hysterectomy Of The Bitch Under Local Anæsthesia
CLINICAL ARTICLE:".
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OVARO-HYSTERECTOMY OF THE BITCH UNDER LOCAL ANJESTHESIA.
By W. H. THO:\lAS, M.R.C.V.S., Assistant Hospital Surgeon, Royal Veterinary College, London. THE subject of this case was a Samoyede bitch, four years old. She was admitted into the College Infirmary at midday on the 27th February of the present year. The owner informed us that she had been in labour all the previous day, and during that day had parted with four dead pups with a great amount of difficulty, having to be aided in the delivery of each pup. The pups appeared to be unusually large. During the morning of the day of admission the owner had administered several doses of extract of ergot, as she felt sure that there was a pup or puppies left, but no labour pains resulted from the administration of the drug. Our examination, both per vaginam and through the abdominal wall, revealed the presence of a fcetus. The rectal temperature was 104 F., and the bitch appeared to be generally in a very weak state. She had taken nothing in the way of nourishment since the onset of labour. Ineffectual efforts were made to remove the fcetus per vaginam. A breach presentation was distinguished, a(]d during the attempts at removal the tail and one hind leg were torn off, and the bitch, although very tractable and quiet during these operations, was visibly becoming more exhausted. Coming to the conclusion that, owing to the size of the fcetus, delivery per vaginam was impossible, ovarohysterectomy was decided upon, but, owing to the weak state of the patient, it was considered inadvisable to administer a general ancesthetic, and therefore local ana:!sthesia was decided upon. The usual antiseptic precautions were taken with regard to the operating table, hobbles, site of incision, instruments, suture material, operator's hands, cotton wool swabs, etc., and I! grains of cocaine hydrochloride were injected subcutaneously at the seat of incision. Five minutes from the time of injection the cutaneous and then the muscular incisions were made, extending 4 inches in a backward direction from an inch behind the umbilicus. After the cutaneous and muscular ha:!morrhage had ceased, the peritoneum was punctured and the uterus came into view. This was brought out through the abdominal opening, with some difficulty, as great care had to be taken owing to the fact that there were distinguished two areas of gangrenous uterine wall of the right horn, each area being as large as a florin and green in colour. No evidences of pain were seen when the uterus was being lifted from the abdominal cavity. The ligatures were then applied in the usual way, boiled silk suture material being 0
CLINICAL ARTICLES.
used, and the only evidence of pain during the whole of the operation was noticed during the application of the ligatures above each ovary, a slight moan being heard when each ligature was drawn tight. No pain was evinced during the application of the Staffordshire knot to the neck of the uterus. The abdominal muscle and skin were sutured with interrupted silk sutures. After drying the wound surface with an application of ether, iodoform-collodion and a cotton wool pad and bandage were applied. The wound was examined two days after the operation, and a slight oozing was noticed at the anterior end. On the following day there was also a little oozing, and on the next day it was deemed advisable to open up the wound. On this being done, we found what was at first thought to be inspissated pus, the presence of which was quite unaccountable, considering the care at the time of and subsequent to the operation. However, on further examination of this material it was found to be coagulated milk, which was present as the result of a slight deviation from the middle line when the primary incision was made, this leading to a slight incision into the neighbouring mammary gland. This coagulated material was removed, together with two or three of the muscular sutures which had separated from the abdominal muscle during the healing process. The wound was re-sutured, and the bitch made an uninterrupted recovery and left the infirmary in perfect health a fortnight from the day of admission. On incising the uterus we found in the left horn a very large fcetus in an emphysematous condition. In the right horn (the gangrenous one) a fcetus was found in a half-developed putrescent state, and it had evidently been in this condition some considerable time. The case is of interest, considering the state of the uterine wall at time of operation, and also as demonstrating the value of local anao:sthesia even in a major operation of this kind.
ROUND-CELLED CARCINOMA OF THE OVARY OF A COW. By A. M. TROTTER, M.R.CV.S., Glasgow. THE subject of this note was an aged Irish cow in fair condition. The right ovary measured 22'3 cm. in length and 17 cm. in breadth. It weighed 3'31 kilos. The surface was uneven, and it was divided into two lobes of almost equal size by a mesial constriction. It varied in consistency from a roasted apple to an orange. The ovary was encased in a delicate sac composed of transparent, fibrous tissue. This capsule imparted to the surface a smooth, tense, and glistening appearance. It was loosely attached to th~ underlying tissue by fibrous bands and it was continued between the lobules of the tumour as the interlobular septa. This capsule was supplied with bloodvessels. The surface of the ovary, as seen through the transparent capsule, was of a dirty yellowish-pink colour, interspersed at places with bright yellow spots. These were irregular in shape and were separated from the surrounding tissue by a sharply defined line of
eLI N I CAL
ART I C L E S.
--0--
OVARO-HYSTERECTOMY OF THE BITCH UNDER LOCAL ANJESTHESIA.
By W. H. THO:\lAS, M.R.C.V.S., Assistant Hospital Surgeon, Royal Veterinary College, London. THE subject of this case was a Samoyede bitch, four years old. She was admitted into the College Infirmary at midday on the 27th February of the present year. The owner informed us that she had been in labour all the previous day, and during that day had parted with four dead pups with a great amount of difficulty, having to be aided in the delivery of each pup. The pups appeared to be unusually large. During the morning of the day of admission the owner had administered several doses of extract of ergot, as she felt sure that there was a pup or puppies left, but no labour pains resulted from the administration of the drug. Our examination, both per vaginam and through the abdominal wall, revealed the presence of a fcetus. The rectal temperature was 104 F., and the bitch appeared to be generally in a very weak state. She had taken nothing in the way of nourishment since the onset of labour. Ineffectual efforts were made to remove the fcetus per vaginam. A breach presentation was distinguished, a(]d during the attempts at removal the tail and one hind leg were torn off, and the bitch, although very tractable and quiet during these operations, was visibly becoming more exhausted. Coming to the conclusion that, owing to the size of the fcetus, delivery per vaginam was impossible, ovarohysterectomy was decided upon, but, owing to the weak state of the patient, it was considered inadvisable to administer a general ancesthetic, and therefore local ana:!sthesia was decided upon. The usual antiseptic precautions were taken with regard to the operating table, hobbles, site of incision, instruments, suture material, operator's hands, cotton wool swabs, etc., and I! grains of cocaine hydrochloride were injected subcutaneously at the seat of incision. Five minutes from the time of injection the cutaneous and then the muscular incisions were made, extending 4 inches in a backward direction from an inch behind the umbilicus. After the cutaneous and muscular ha:!morrhage had ceased, the peritoneum was punctured and the uterus came into view. This was brought out through the abdominal opening, with some difficulty, as great care had to be taken owing to the fact that there were distinguished two areas of gangrenous uterine wall of the right horn, each area being as large as a florin and green in colour. No evidences of pain were seen when the uterus was being lifted from the abdominal cavity. The ligatures were then applied in the usual way, boiled silk suture material being 0
CLINICAL ARTICLES.
used, and the only evidence of pain during the whole of the operation was noticed during the application of the ligatures above each ovary, a slight moan being heard when each ligature was drawn tight. No pain was evinced during the application of the Staffordshire knot to the neck of the uterus. The abdominal muscle and skin were sutured with interrupted silk sutures. After drying the wound surface with an application of ether, iodoform-collodion and a cotton wool pad and bandage were applied. The wound was examined two days after the operation, and a slight oozing was noticed at the anterior end. On the following day there was also a little oozing, and on the next day it was deemed advisable to open up the wound. On this being done, we found what was at first thought to be inspissated pus, the presence of which was quite unaccountable, considering the care at the time of and subsequent to the operation. However, on further examination of this material it was found to be coagulated milk, which was present as the result of a slight deviation from the middle line when the primary incision was made, this leading to a slight incision into the neighbouring mammary gland. This coagulated material was removed, together with two or three of the muscular sutures which had separated from the abdominal muscle during the healing process. The wound was re-sutured, and the bitch made an uninterrupted recovery and left the infirmary in perfect health a fortnight from the day of admission. On incising the uterus we found in the left horn a very large fcetus in an emphysematous condition. In the right horn (the gangrenous one) a fcetus was found in a half-developed putrescent state, and it had evidently been in this condition some considerable time. The case is of interest, considering the state of the uterine wall at time of operation, and also as demonstrating the value of local anao:sthesia even in a major operation of this kind.
ROUND-CELLED CARCINOMA OF THE OVARY OF A COW. By A. M. TROTTER, M.R.CV.S., Glasgow. THE subject of this note was an aged Irish cow in fair condition. The right ovary measured 22'3 cm. in length and 17 cm. in breadth. It weighed 3'31 kilos. The surface was uneven, and it was divided into two lobes of almost equal size by a mesial constriction. It varied in consistency from a roasted apple to an orange. The ovary was encased in a delicate sac composed of transparent, fibrous tissue. This capsule imparted to the surface a smooth, tense, and glistening appearance. It was loosely attached to th~ underlying tissue by fibrous bands and it was continued between the lobules of the tumour as the interlobular septa. This capsule was supplied with bloodvessels. The surface of the ovary, as seen through the transparent capsule, was of a dirty yellowish-pink colour, interspersed at places with bright yellow spots. These were irregular in shape and were separated from the surrounding tissue by a sharply defined line of