Mety, life of a big bad dog

This is a long post. Today was not a normal day. It started as a normal day, we got up and went out for a walk. We went to the park and we went to the fields and we went to school. But then stuff became suspicious when I was put on the table to be the center of attention. I know I am interesting, but I am not sure the color of my gums is, or the size of my lymphnodes...

Clinical examination

Then I was cannulated. They came to me with a machine that is scary and goes BZZZZZZ and takes fur off. That sound was the hard part. The easy part is when they put a tube into my arteries and blood came out.

They put a bandage to hide the cannula, maybe they were ashamed?

Well, they should be!

First they put some antibiotics in the cannula (ampicillin).. Then they put two more liquids, medetomidine and butorphanol. These are very boring liquids. So boring, that I fell asleep almost immediately. I barely had the time to hear Jen say "good night" as I let my head go to the floor. To be sure I stayed asleep, a little bit of propofol was given, but not too much, because I wasn't breathing very much and the other liquids worked very well on me.

I was intubated, shaved more and brought to the surgery room.

There I was put in dorsal recumbency and attached (just in case I decided to leave in the middle of the surgery?). My tube was hooked up to a gas-breathing system with inhalant gas (isoflurane) and to a series of monitors (ECG, capnograph...).

Dorsal recumbency

Cleaning my belly

Left: Me
Middle back: TV for laparoscope
Middle front: Inhalation anesthetic device
Right: Monitors

The red, yellow and green are the ECG probes.
The tube in my mouth is to keep me asleep.

Then Dr. Crha prepared the instruments. It's not as easy as it looks, you must prepare for all possibilities that will occur during the surgery. Also, everything must be sterile. But Dr. Crha is a very good doctor, he knew what he was doing.

The goal of the surgery was a spay (ovariectomy = removal of the ovaries) to prevent pregnancy and reproductive tract diseases, and a gastropexy (suturing the stomach to the wall to prevent a condition called Gastro-dilatation-volvulus).

Procedure:

make 2 holes to install camera and grabbing tool
find and catch ovary
fix the ovary into position
cut off ovary
repeat steps 2-4 with the other ovary
find and catch stomach
suture it to the wall
check everything is fine and close up

Oariectomy

Then the surgery started. I don't remember anything. First they made a hole in my abdomen. There are a lot of layers. Outside there is the skin (and subcutis), under that there are several muscles (but they cut in the middle of my belly, so it was only tendon tissue) and under that there is peritoneum, which is the inside wall of the abdomen.

Except that the poor surgeon was not lucky, and probably went to the exact same place that my stick injury happened (remember, it happened like this). So it was a little harder than usual to get to the peritoneum. Usually, you use a trocar and pierce through, and feel two "POC" sounds: the first is the subcutis and tendon sheets, and the second is the peritoneum.

If the tube is not properly in the peritoneum, there will not be space to insuflate CO2. There is a little test you can do: put drops at the edge of the hole, and move the belly around a bit. It should make a bit more space inside the abdomen and suck in the droplets. If not, it means you only went down one "POC" and you are still in the out layers (subcutis).

So here are the 3 steps again:

Very small incision in the skin

Pierce through with trocar POC-POC

Put in CO2

They got in to the right place! The abdomen got bigger and bigger with air - I mean CO2!

The hand is taping on the abdomen and it makes an empty sound like a drum :)

Time to put in the camera! (and light!).

And... hurray! We can see!

Even if it's only intestine

No time to doddle around, having a camera in there is not enough, let's look for a good place on the wall to add our tools (by making a second and last small hole in the abdomen). We aim the camera to a cranio-lateral direction so it's facing the abdominal wall behind the diaphragm (diaphragm is the respiratory muscle attached on the last ribs, and it separates the body into two: abdomen and thorax)

View from the inside

View from the ouside (three fingers behind the last rib)

Back inside, you see where the doctor is pressing on the wall

Now that we have a spot, we will put in our tool. Same procedure as last time? Same procedure as every time miss Sophie! (semi-obscure reference, sorry)

1...

2...

There! We are all set now to get working properly. We have camera and tools in place :)

This is the spleen

Ugh intestine is everywhere, we use the forceps to move it away

Kidney and in the back, an ovary

Now that we found the ovary, we would like to take it out together with its pouch (bursa) and the fat conected around it. The problem is that we only made one hole for one tool... so it would be hard to have a tool to hold the ovary properly, and another to cut it at it's base. So we use a clever technique: maintain the ovary in place by having a suture from the outside go through the wall, and hold it in place, just for the time of cutting out the ovary! :)

First grab the ovary, and put it against the wall

Feel the location and control it on camera

Put a stitch to grab the ovary through the wall

See on camera that the ovary

Now that the ovary is maintained in place, we can take out the grabbing tool (forceps) and use burner/cutter tool!

Grab, burn, cut

Grab again, burn again, cut again

Smoke is coming out,
but it doesn't burn too much, just enough to cut safely

One tiny tiny bit left!

After the last snip, the ovary was free, we caught it with the forceps, undid the temporary stitch that was holding the ovary, and pulled it out through the small hole.