Please don't be offended... but I did. And I liked it! Although she is my second spay, this one will be very memorable for years to come. First of all, she is a super adorable spaniel mix that was very scared and submissive initially - but definitely warmed up to us by the end :) I was sad to see her go without being adopted.
She had no other issues, other than being an intact female. She didn't defecate before surgery, so when we palpated the abdomen, we thought we were feeling feces. She also didn't urinate before surgery and we were unable to empty her bladder before inducing her(because, hey, we still don't really know if we are feeling bladder or not). I made my initial incision and immediately saw the linea alba because she had no subcutaneous fat.
I went through body wall and was immediately introduced to her bladder.
I learned how to express the bladder intraabdominally, which was cool. And good to know (you squeeze it... it empties... pretty basic). I then attempted to locate the uterus. I tried manually and with the spay hook... no dice.
(Damn it again.)
I continued looking. Still nothing. I located the broad ligament over and over - and could feel it attached, but there was no uterus.
(Damn it, Damn it, Damn it).
I searched visually and with my hands... I thought I felt the kidney, I thought I felt dilated colon filled with feces, but for the life of me, the uterus continued to evade me. Because that is the nature of women - we are difficult, but intriguing creatures. I even saw a huge, pulsating artery that looked really neat, but wasn't helpful in my uterine quest. A surgical resident was walking around, so I asked him to see if he could see anything - he told me I most likely was holding broad ligament, so the uterus should be "right there". It most definitely was not. Another surgical resident stopped by, and she offered to glove in and assist. I really dislike not being able to do things on my own and I knew the anatomy and what I was looking for... the uterus was just hiding! Silly, silly uterus. She starts looking and moving things around and says, "well, you may not have a uterus."
She says that she's looking for the stumps to confirm that she was spayed previously. My group had initially looked for a spay scar and not seen one... but again, what do we really know at this point? Then she stops and just says, "Oooooooooh, you do have a uterus."
(Hurray! I get to do surgery!)
She pulls it out and IT. IS. HUGE. She is obviously pregnant with 7 fetuses. My "colon" that I had been feeling? Uterus. The "kidney" I though I palpated cranially? Uterus. My group was shocked.
Hopefully I'm not coming off as too much of an idiot right now, but when you have only done one other spay, you don't have a lot of experience to base your second one on. I removed the uterus, and we were told to inject Fatal Plus into each of the sacs that the fetuses were in (excuse my lack of vet terminology, my brain is filled with radiology knowledge for my upcoming exam this morning). I did the spay as you'd normally do it - I just took extra care because of the increased vasculature. Oh, and that cool, pulsating artery? Uterine artery. Right up against the uterus that I ran away from me earlier.
After we had recovered our patient and she was warm and safely back in her run, we gloved up and tried to see how big the fetuses were. They ended up being only about the size of my pinky fingernail and a gooey mess of gelatinous tissue. Not really "puppy-like" at that early of pregnancy. But it was fun when one of my groupmates incised the uterus and a stream of fluid shot into the air... and we screamed in surprise. Just another reason to wear face masks in junior surgery! Apparently the screaming didn't go over well - a doctor came flying by to see why we were screaming in the middle of surgery...
21 hours ago