TECHNIQUE

Ovariohysterectomy of Rabbits (Disease Investigation & Management - Treatment and Care)

Rabbit prepared for ovariohysterectomy (spay). Click here for full page view with caption. Rabbit draped for ovariohysterectomy (spay). Click here for full page view with caption. Rabbit draped for ovariohysterectomy (spay). Click here for full page view with caption. Ovariohysterectmy (spay) of a rabbit. Click here for full page view with caption. Ovariohysterectomy (spay) of a rabbit. Click here for full page view with caption.

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords Spaying
Description For general information on rabbit surgery see: Treatment and Care - Surgery
Preparation
  • Anaesthetise the rabbit. See: Treatment and Care - Anaesthesia and Chemical Restraint
  • Give preoperative analgesia.
  • Consider expressing the bladder.
    • Take care during manual expression; the bladder is thin-walled and easy to traumatise or rupture. (B600.15.w15)
  • Prepare the skin for surgery.
  • Place the rabbit in dorsal recumbency. (B602.22.w22)
  • Position drapes as appropriate. (B602.22.w22)
  • If removing a diseased uterus (e.g. uterine adenocarcinoma), place an intravenous catheter and give intravenous fluids during surgery. (B601.17.w17)
Incision
  • Make a 1.0 - 2.0 cm midline incision about half way between the pubic symphysis and the umbilicus. (B600.15.w15) 2.0 - 3.0 cm incision. (B602.22.w22)
  • Grasp the body wall with forceps and elevate it to incise through the linea alba into the abdominal cavity. (B600.15.w15, B602.22.w22)
    • This helps avoid cutting into the caecum or bladder, which are directly adjacent to the ventral abdominal wall. (B600.15.w15, B602.22.w22)
Ovariohysterectomy
  • The uterus may be visible cranial and dorsal to the cranial pole of the bladder. (B602.22.w22)
    • In young rabbits, the uterus is dorsal to the bladder. (B601.17.w17)
    • In older does, the cervix is just dorsal to the bladder with the uterine horns lying laterally. (B601.17.w17)
  • Lift the uterus using forceps. (B602.22.w22)
    • Note: gentle handling is important with a diseased uterus to avoid rupture. (B601.17.w17)
  • Use gentle traction to exteriorise the ovary and ovarian ligament. (B600.15.w15)
    • The ovaries are often covered in adipose tissue and may be difficult to visualise; the oviduct completely encircles the ovary. (B601.17.w17)
    • Use gentle palpation to ensure the ovaries have been identified and are removed fully. (B601.17.w17)
  • Place ligatures to tie off the ovarian blood vessels. (B600.15.w15)
    • Double-ligation with transfixing sutures, around each ovarian pedicle, using either chromic gut or synthetic absorbable suture material, is suggested. (B601.17.w17, B602.22.w22)
      • Or two metal haemostat clips can be placed on each pedicle. (B601.17.w17)
    • Tissue friability and lack of space prevent use of a three-clamp technique on the ovarian pedicles. (B601.17.w17)
    • The oviduct is long and coiled. (B602.22.w22) Make sure the whole oviduct is removed; remaining tissue can develop into a fluid-filled cyst, since the oviduct is secretory. (B601.17.w17)
    • Note: the uterine vessels are several millimetres off the uterus in the broad ligament. In mature does they may be quite large. (B602.22.w22)
    • The mesometrium is a major site of fat storage in does, therefore it can be difficult to find and ligate the uterine vessels. (B601.17.w17, B602.22.w22).
  • Place ligatures to tie off the vessels of the broad ligament. (B600.15.w15)
    • Double-ligation with transfixing sutures around the uterine vessels in the broad ligament, using either chromic gut or synthetic absorbable suture material, is suggested. (B602.22.w22)
    • Additionally, there are numerous small vessels in the broad ligament; identifying these by blunt dissection is time consuming. One or two encircling sutures, or several haemostatic clips, can be placed, then sharp dissection used to transect the ligament. (B601.17.w17)
  • Ligate the uterus:
    • Either place a ligature just cranial to the cervices to avoid the ureters and common blood supply to the bladder. (B600.15.w15)
      • Preferably use a transfixing suture. (B600.15.w15)
      • 3/0 catgut can be used. (B600.15.w15)
      • Ligation of each uterine horn is suggested. (B602.22.w22)
    • Or the ligature can be placed just on the vaginal side of the cervices. (B600.15.w15, B602.22.w22)
      • This tissue is flaccid; it is more difficult to ensure secure placement of ligatures. (B600.15.w15)
      • The rabbit doe's vagina fills with urine when the bladder is emptied, and ligation at this site produces a greater risk of leakage of urine from the stump into the abdominal cavity. (B600.15.w15)
      • If the ligature is placed too far distally there is a risk that the ureters and the blood supply to the bladder will be included in the ligature. (B600.15.w15)
      • Take care not to contaminate the abdomen with urine or vaginal contents if the caudal site is used. (B602.22.w22)
    • Check the ovarian pedicles and vaginal pedicle for haemorrhage. (B601.17.w17)
Closing the abdomen
  • Close the abdomen. (B602.22.w22)
    • Repair the abdominal fascia in a single layer using 4/0 polydioxanone (high tensile strength, degrades slowly) or 4/0 poliglecaprone (Monocryl, Ethicon) in either: (B600.15.w15)
      • A row of simple interrupted sutures. OR
      • A continuous suture, with an extra four throws at the start and six throws at the end. The first throws need to draw the edges of the fascia together without crushing the tissue. (B600.15.w15)
  • Close the skin using staples, a subcuticular suture, or tissue glue. (B602.22.w22)
    • A continuous subcuticular suture with a buried Aberdeen knot is appropriate; tissue glue can be used in addition. Or staples can be used. (B600.15.w15)
Post-operative care
  • Analgesia. (B601.17.w17)
  • Gastro-intestinal motility stimulants. (B601.17.w17)
Appropriate Use (?)
Notes --
Complications/ Limitations / Risk
  • Do not carry out this operation until the doe is sexually mature, i.e. at least five months old. (B600.15.w15)
  • Anorexia is common for 12 - 36 hours after ovariohysterectomy, even when appropriate analgesia is given. (B600.15.w15)
  • Avoid carrying out in obese rabbits:
    • They are more prone to the development of hepatic lipidosis if inappetant after the operation. (B600.15.w15)
    • Large quantities of subcutaneous and abdominal fat makes the operation more difficult. (B600.15.w15)
  • There is a risk of adenoma formation in the residual uterine tissue left behind when the cervical ligature is placed on the uterine side of the cervices, but this is a small risk because of the removal of the ovaries and therefore hormonal influences. (B600.15.w15)
  • Gentle handling is important with a diseased uterus to avoid rupture. (B601.17.w17)
  • Tissue friability and lack of space prevent use of a three-clamp technique on the ovarian pedicles. (B601.17.w17)
  • Make sure the whole oviduct is removed; remaining tissue can develop into a fluid-filled cyst, since the oviduct is secretory. (B601.17.w17)
  • The mesometrium is a major site of fat storage in does, therefore it can be difficult to find and ligate the uterine vessels. (B601.17.w17, B602.22.w22). 
  • Fat necrosis may develop in the broad ligament around where the sutures have been placed. (B600.15.w15)
  • The rabbit doe's vagina fills with urine when the bladder is emptied; ligation caudal to the cervices produces a greater risk of leakage of urine from the stump into the abdominal cavity. (B600.15.w15)
  • If the cervical ligature is placed too far distally there is a risk that the ureters and the blood supply to the bladder will be included in the ligature. (B600.15.w15)
  • If uterine ligation is carried out cranial to the cervices, there is a risk of haemorrhage from cervical aneurysms, which can be fatal. (B601.17.w17)
Equipment / Chemicals required and Suppliers
  • Standard anaesthetic equipment for rabbits.

  • Surgical instruments

  • Suture and ligature material e.g. 4/0 polydioxanone (high tensile strength, degrades slowly) or 4/0 poliglecaprone (Monocryl, Ethicon). (B600.15.w15)

  • Surgical staples if preferred for skin closure.

  • Tissue glue if wanted to reinforce skin closure following subcuticular suture.

Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience; this would usually be someone with a veterinary degree.
Cost/ Availability

The costs of a surgical operation include those associated with: (J15.30.w1)

  • Pre-operative diagnostics (e.g. radiography, ultrasonography, blood tests)
  • Anaesthesia.
  • Perioperative medication (e.g. analgesics, antibiotics, fluids).
  • Surgical preparation (of the operating theatre and the patient, including staff time).
  • Consumables and equipment.
  • Time of the surgeon and assistant(s).
  • Post-operative hospitalisation.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee Frances Harcourt-Brown BVSc FRCVS (V.w140)
References B600.15.w15, B601.17.w17, B602.18.w18, B602.22.w22, J15.30.w1

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