Small Animal Ovariohysterectomy and Avoidance of Associated Complications in Pet Practices Across Pakistan: A Current Perspective

Abstract

Ovariohysterectomy (OVH) is a routine surgical procedure in small animal practices for sterilization and management of several uterine diseases, namely pyometra, cystic endometrial hyperplasia, uterine tumors, rupture, and torsion. Ovariohysterectomy (OVH) offers numerous clinical advantages, but post-operative complications could pose financial challenges for veterinarians due to the inherent risk of malpractice suits and clients owing to the extended recovery period for their pets. The authors reviewed about two dozen peer-reviewed English language articles from PubMed, Scopus, Web of Science, and Google Scholar databases to identify risks and avoidance strategies following OVH. These may include the ones arising from celiotomy (infection, incisional hernias, wound dehiscence, inadvertent injury to organs and adhesions) or affections, such as intraoperative hemorrhage, stump pyometra, ovarian remnant syndrome, ureteral ligation, urinary incontinence, granulomas, fistulous tracts, post-surgery weight gain, and eunuchoid syndrome. This review emphasizes prevention and management methods for each of these complications. Effective surgical techniques play a vital role in preventing hemorrhage, while meticulous resection, ligation, and omentalization of uterine stump reduce the risk of stump pyometra. Complete removal of ovarian tissue and systematic exploration prevent ovarian remnant syndrome. The use of advanced imaging methods, such as ultrasound, fluoroscopy, or CT scans, can greatly aid in identifying and preserving ureters during surgical procedures, thus minimizing the risk of ureteral complications. Strategies to address urinary incontinence, granulomas, and post-surgery weight gain might encompass the use of hormonal therapy involving estradiol analogs or the application of precise surgical techniques involving ureteral reimplantation. Innovative strategies such as auto-transplantation of ovaries are suggested for managing eunuchoid syndrome, while inadvertent prostatectomy and bowel obstruction may simply be avoided by better tissue handling and dissection. In summary, optimizing surgical protocols, incorporating CT scans, using appropriate drug therapies, and continuous education within the veterinary community are crucial for reducing complications associated with OVH.