Surgical Report For Subtotal Colectomy Procedure in Feline
Prior to surgery, a normal perineal reflex and anal tone was observed. In dorsal recumbency the ventral abdomen was clipped, prepped and draped in routine fashion. A caudal ventral midline was made through the skin, subcutaneous tissue and linea alba using sharp technique - #10 or 15 blade from the umbilicus to the pubis. Placement of baby balfour retractors was used to aide in exposure. The urinary bladder was emptied by expression or cystocentesis. Ileocececalcolostomy: The caudal mesenteric, left and middle colic, and ileocecocolic vessels were ligated. The mesentery associated was transected close to the colonic border. Feces was milked away from the sites of proposed resection and doyen forceps were applied to decrease contamination. Two stay sutures were placed in the distal colon and one in the ileum. Ileocolostomy: The caudal mesenteric and left and middle colic vessels were ligated. The mesentery associated was transected close to the colonic border. Feces was milked away from the sites of proposed resection and doyen forceps were applied to decrease contamination. Two stay sutures were placed in the distal and proximal colon. A one-layer approximating suture pattern using 4-0 on a tapered needle with polydioxanone was used for the anastomosis procedure. A leak test was used to evaluate the anastomosis site. The abdomen was lavaged with warm saline and the abdomen closed routinely. The linea alba and subcutaneous tissues were closed in simple continuous fashion using (0, 2-0, 3-0) (polydioxanone, polyglyconate) suture. The skin was closed in simple interrupted pattern using (0, 2-0, 3-0) (polydioxanone, polyglyconate, polypropylene, flourafil, staples, tissue adhesive). Postoperative recommendations: 1. Continue IV/oral antibiotics for 24- 48 hours. Elect whether or not to continue oral antibiotics (Cephalexin or Clavamox) for 7-10 days. 2. Continue IV fluids for 2-3 days. 3. Water may be offered 12 hours after surgery. 4. Food may be offered 24 hours after surgery. 5. Cyproheptadine (2 mg/cat PO, bid) may be used to stimulate eating. Postoperative care and expectations: Monitor postoperatively for fever and successful passage of stool. Expect multiple bowel movements (4-6) initially. Some cats loose weight for the first 2-4 weeks postoperatively, but usually regain afterwards. Consistency of stool usually is watery to mucoid for the first 3-6 weeks and it gradually becomes more solid over weeks and the number of bowel movements decrease over weeks to months. Surgical Risks Include: 1. Infection (peritonitis) which may require additional testing and medication at an additional cost. 2. Incision leakage of intestinal contents necessitating further surgery. 3. Short term diarrhea and frequent bowel movements that improve over time. 4. Some patients continue to have some straining during bowel movements for 7-10 days after surgery. 5. There is a possibility the condition could reoccur at some point in the future due to nature of the primary disease process affecting the gastrointestinal tract. Strict adherence to post-surgical care and medicating of your pet will minimize these potential complications and serious problems are very uncommon in most cases. Your pet may need to be on a special low volume, high calorie diet for a period of time (10-14 days in most cases). Most patients need to remain on intravenous fluid support for 2-3 days after surgery.
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