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Date:   28 February, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
KPI to spay a young Maltese  
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   28 February, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

1398. Domitor + Ketamine Anaesthesia for spay duration + KPI

 
Feb 27, 2013  I spayed a 7-month-old Maltese X., 4.3 kg. The happy couple took leave and made an appointment with me. Usually spays are done by Dr Daniel as they are routine surgeries. This dog had been vigorously licking her vulval lips such that the area above the vulva became black. "Much less licking after antibiotics last month," the lady in her late 20s said to me. I had advised spaying as there could be pyometra which leaked out vaginal discharge causing the need to lick. It could be a urinary tract infection too. The dog was on heat with uterine horns and ovaries very red and congested when I spayed her. 

ANAESTHESIA
Based on formula of 10 kg, young healthy dog Dom=0.4 and Ket=0.5, I gave this 4.3 kg dog IV Dom=0.2 + Ket = 0.17 totalling 0.37 ml IV one syringe with 0.13 ml Hartmann.

A: Injection of D+K IV  10.22 am
B: Isoflurane first given  10.43 am
C: Isoflurane stopped    10.53 am
D: First skin incision: 10.34 am
E: Completion of skin stitching: 11.01 am.

E-A = 39 minutes. This is because the dog started moving at 10.43 am (21 minutes after injecton) and the surgery was paused to give gas by mask to stabilise. This shows that duration of D + K is 21 minutes for this dog. Spay should be completed in 21 minutes but there was some delay as there was training of the new veterinary staff on gas anaesthesia.  Without traiining, spay should be completed in 30 minutes for this small breed.   

E-D= 27 minutes. Dog was on heat. More time was spent ensuring no bleeding and on speed on hooking out the ovaries.
Hooking left ovary took 3 trials and it was hooked out at 10.38 am. 4 minutes after incision. Right ovary was hooked out at 10.42 am, 8 minutes after skin incision. 

Conclusion: Usually the above formula gives at least 20 minutes of surgical anaesthesia. If spay takes longer, isoflurane top up is needed. Efficiency and timing are important in productivity of a vet surgeon. Taking too long to spay a dog is not good.

Conclusion:
Much time was wasted between first skin incision and injection (D-A=12 minutes) as I was teaching a new assistant since Mr Min was poached. He had worked 2 years for me and I wished him well as he ought to move on for a better future and more income. Surgery should commence around 7 minutes around injection as IV effects would occur in 5 minutes usually. Check reflexes for surgical anaesthesia like eyelid blinking. 5 minutes extra off the E-D process would mean that I would take 22 minutes and would not need isoflurane top up. The planning and proper prompt process is essential in veterinary surgery procedures and process and in less wastage of resources.
More info at: Dogs or Cats
To make an appointment:
e-mail judy@toapayohvets.com
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