5 hacks to the Pyometra

It is not often that a veterinary surgeon is performing spay and neuters on patients. It happens, but probably not as much as general practitioners, leaving a majority of the responsibility to them. However, when issues that could be life-threatening, such as pyometra, occur in patients, general practitioners may be looking for tips and tricks to help avoid pyometra.

On this episode of The Vet Blast Podcast, Shadi Ireifej, DVM, DACVS, shares 5 tips that general practitioners can implement at their practice to help clinics possibly see fewer pyometra cases with our host Adam Christman, DVM, MBA.

Shadi Ireifej, DVM, DACVS: One of the pearls I like to stress when I give pyometra talks is surgical exposure. It's all too often that very experienced, well-intentioned general practitioners will try to create as small an incision as possible for their spay. And it looks impressive, it's quicker surgery because less closing time, the pet owner loves the tiny incision which means [their pet] is not going to be in that much pain postoperatively, [and] less chance of complications. However, if you are trying to operate on a large breed dog or a deep-chested dog, and you're working in those caverns, you need to not be shy about making a larger incision in order to get access to the ovarian tissue and that uterus. You don't need to overdo it, you should be adequate. You can always make your incision longer if you need to start small and go longer, but that's point No. 1.

Point No. 2 is retraction. So I'm fortunate as a boarded surgeon, that usually I have all the bells and whistles. I got all the toys, I can have 3 assistants in there if I want to right to retract stuff and hold things. That's me. Most spays are done by general practitioners. They're not going to have the staffing for that, nor the toys. So you need to have not only a big incision, as seems realistic for that dog that size a dog but also need to retract either have somebody, or something, push those organs aside, you can actually visualize the ovaries in that gutter or self-retracting Balfour retractors. Great solution.