Veterinary Internship: Day 5: Description of a Spay and Different Lump Removals

Today was much busier than yesterday. Early morning was spent mostly cleaning and doing some chores (feedings, cage cleanings, etc.), in addition to some regular checkup appointments. Late morning was when it started to pick up, and we had a few surgeries scheduled throughout the day: two spays, and two unidentifiable lump removals. I watched the first spay, which was on a Spanish bulldog mix. Dr. Mark performed the surgery, and he explained how the incision is made right below the ribs, in between the kidneys (the incision is vertical, parallel to the spine). After the incision is made, look for the Linea Alba (‘white line’ in Latin) where all the abdominal muscles come together. He said you want to make an incision directly down that line, otherwise all sorts of muscle problems could come up if you don’t make the incision down that line. Once he finished that incision, he cut the ligament of fat which separates the uterus from the body and pulled out the ovaries, uterus, uterine horns, and fallopian tubes (everything was of course attached together so he just pulled the whole bundle out). He tied off the fallopian tubes, and then tore the broad ligament (the huge glob of fatty tissue around the uterus) and we were able to see the uterine horn, which he also tied off. He tied off the uterus, cut off the uterus, uterine horns, and ovaries, and then placed the uterine stump back into the body. He made sure there was no internal bleeding after replacing the stump, and then stitched the abdominal muscles, tissues, and skin back together with individual stitching again (I found out that they do individual stitches because that way, if one pops or something happens to one of them, all of the other stitches are still in place and will be unaffected. I had never thought about/considered that before.). Pat and I then turned off the machines and began to wake the dog up after we moved her to the recovery room. When she finally woke up she seemed to be doing well throughout the day and was able to go home later.

The Spanish bulldog mix. Her front legs are crossed across her body because it's harder for bigger dogs to balance on the surgery table when their legs are spread open, so they balance much better ehen their front legs are crossed.

The uterus and surrounding fat.

Another view of the uterus. An ovary can also be seen by the clamp.

An ovary, fallopian tube, and uterine horn.

Dr. Mark pulling the uterine horns apart from the uterus.

The uterus, uterine horns, fallopian tubes, and ovaries which were removed from the dog.

The tied-off uterine stump, which he is replacing into the body.

The dog all stitched back up.

The second surgery I watched was a lump removal from a dog that was a mix. Dr. Mark performed this surgery as well, and the lump was going to be sent out for tests to see if it was cancerous or not. The lump was on the right thigh of the dog, and Dr. Mark made a large diamond shaped cut around the lump, to make sure that any stray cells were taken out as well. He cut off the diamond-shaped area of skin (since the lump was on the surface of the skin and not any deeper), placed that area in a jar to be sent out for testing, and then began to stitch the area closed. He cut the area a bit wide so pulling the skin together to stitch it up was a bit of a tight fit, but he was able to stitch it up and then stabled over the stitches as well to make sure it would hold. Pat and I again moved him to the recovery room and woke him up, and he seemed to be doing well as the day went on too.

Dr. Mark removing the diamond-shape area of skin. The pink spot is the lump being removed.

The underside of the skin area. Skin cells can be seen, and the area of skin is just about fully removed.

Dr. Mark lazering off a couple of cells that were excessively bleeding.

Stitching the thigh back up. The clamps on the far side of the cut are helping hold the two pieces of skin together while he stitches up the other side. After making a few stitches, he would then staple the area he sewed to make sure the cut wouldn't accidently split open at any point.

The dog's thigh all stitched and stapled up.

The third surgery I was able to see was another lump removal, only this one was a little different. It was on the right side of a dog, and it was huge; it was about the size, if not bigger than, a golf ball. Dr. Roberta performed this surgery, and since the lump was so big she decided to cut into the lump after removing it to see if she could tell what composed the lump. She did the same thing Dr. Mark did, meaning she made a diamond-shaped cut in the skin, only hers wasn’t as large of a cut. She had to dig a little bit to get the whole lump out, because it was under the skin; she didn’t have to dig too far though. She then took the area of skin and lump out, placed them on a nearby table, and then sewed the two sides of skin together. Nancy, one of the technicians, cut into the lump, and a bunch of brown goop was just pouring out of it. Even though it was strange to my eyes, Nancy and Dr. Roberta said it was nothing to worry about; the brown goop was simply pus and other toxins which had gotten trapped under the skin and just kept growing. So, luckily for the dog, the giant lump was harmless.