2017 marks the Surgery Suite s 26 th year at the Minnesota State Fair!!

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1 Minnesta Veterinary Medical Assciatin MVMA ffice Shelley Harpster, CVT: cell Dr. Krista Walkwiak: cell State Fair Surgical Suite Mderatr s Infrmatin / Script This script is a guide fr yu t fllw. Please read carefully, as there are new changes this year. Yu can alter r add t the scrip as yu feel necessary, r highlight key phrases t use as a guide. Yu shuld strive t crdinate yur infrmatin with what the surgen is ding and/r what is n the vide. In additin, strive t engage the audience; a discussin is mre enjyable than a lecture. Plan t arrive at the Surgery Suite early t discuss with the surgen things such as: the planned pace f the surgery, what suture is t be used, what the clsure technique will be, and any unique techniques the surgen uses t perfrm the surgery. Als discuss crdinating hw the surgen might shw tissues (e.g. vary, linea alba) n camera s the audience can better rient itself t what the surgen is ding. We nw have a small speaker in the surgery suite s that the surgen can hear the mderatr t aid in this cmmunicatin. This will als help the audience better understand the surgery itself. During the fair, Shelley Harpster is the technician in charge f the surgery suite. Please cnsult with her if yu have any questins. Dr. Krista Walkwiak, surgery suite cmmittee c-chair is als available fr questins r cncerns. We have a hands free micrphne that will enable yu t mve arund the audience mre freely and t make better use f the Interactive Bx (see next page). We have received audience feedback indicating that they enjy the additinal demnstratins frm the bx and questins frm the mderatr. Sme f the questins are listed in the bx, but if yu think f ther questins that the audience wuld enjy, feel free t use them and let us knw s we can include them t ur repertire. Shelley will set the vlume f the micrphne. Please test it befre yu start yur speech, s that it can be adjusted if needed. It is essential that the audience be cmfrtable with the vlume marks the Surgery Suite s 26 th year at the Minnesta State Fair!! 1

2 Please familiarize yurself with the Interactive Bx befre yu start mderating. INTERACTIVE BOX!! We have prvided a bx f interactive material. The bx is lcated either in the suite r n the flr just utside the surgical suite at the Nrthwest crner. Explain and demnstrate materials used t anesthetize patients (e.g. endtracheal tubes, sedatin, gas anesthesia). Explain and demnstrate materials used t perfrm surgery (e.g. instruments, spay hk, tissue glue, suture material). Explain and demnstrate materials used t identify lst pets (e.g. Hme Again ID micrchips, micrchip reader, stuffed dg with inserted micrchip.) Audience questins and prizes. List f cmpanies that cntribute prducts/equipment. Infrmatin abut Bair Hugger blankets. Set aside a few minutes prir t the demnstratin t determine hw yu wuld like t share these interactive prps with the audience. Strive t keep the bx lcked between demnstratins and place it in the trailer at the end f the day. The micrphne will als be stred in this bx. 2

3 INTRODUCTION: Start yur intrductin a few minutes befre the inductin f the animal. Depending n the speed f the prep and the surgen, yu may fit sme f the general pints in during the surgery instead f all at the beginning. If yu are asked questins while yu are mderating, please be sure t repeat the questin fr the rest f the audience t hear befre yu answer it. Try t mentin the fllwing pints (these are included in the script belw, starting n page 4): Give yur name, the surgen's name, the technician s name, and the student s name. Repeat, at several intervals, the instructins fr thse wh may be feeling faint. Emphasize the gals f this demnstratin: educatin abut pet verppulatin, educatin abut veterinary medicine, and that these dgs and cats may have a better chance f adptin if sterilized. Emphasize the breadth f the veterinary prfessin and the valuable cntributin f technicians & supprt staff. Pint ut the high standards f care (sterility, safety f anesthetic drugs, patient mnitring, etc.) in mdern veterinary surgical prcedures. INTERACT WITH THE AUDIENCE: Ask wh wns animals? What are their animals names? Are their animals neutered/spayed? Why is neutering/spaying imprtant? Discuss the advantages t the individual animal f spay surgery, such as decreased risk f cancers, pymetra, and undesirable behavirs. If asked abut surgery cst, avid an exact figure (if necessary give a gd range) and emphasize that all veterinarians perfrm spay and neuter surgeries fr less than the true cst f any cmparable surgery, as a cntributin tward pet ppulatin cntrl. If the animal being spayed is pregnant, never use the wrd abrtin. Use an alternative phrase that wuld be mre palatable t the general public, terminatin f pregnancy, fr example. All dgs/cats will have a presurgical screen: bld cunts, clt time & mini-prfile. Mentin the advantages f having patient baseline data even fr rutine surgery. Dgs/cats will be mnitred while in the prep rm with a Pulse Oximeter and during surgery with a Surgivet patient mnitr. We are ding this because we have n past health histry n these dgs/cats and t demnstrate sme f the technlgy available. Mentin the value f advanced mnitring ptins in difficult r emergency cases. The gas anesthetic we are using at the Fair is isflurane. This inhalant anesthetic allws fr safe, cmplete anesthesia fr dgs and cats. We are using Bair Hugger and Ht Dg frced-air warming blankets at the Surgery Suite t help maintain the animal s bdy temperature during and after surgery. This same warming blanket is used in human hspitals. Animals and peple tend tlerate anesthesia much better and recver better pstperatively if their bdy temperature is maintained as clse t nrmal as pssible. If the dgs/cats have nt already received micrchips at the animal shelter, they will each receive a Hme Again ID micrchip. These are tiny, inert micrchips, shaped like a grain f rice, that are 3

4 placed under the skin between the shulder blades t permanently identify a pet. These micrchips are read with a scanner that mst veterinary clinic and animal shelters nw have. We have many ptins fr pain cntrl in small animal medicine and are nw treating animals fr pain befre it ccurs (befre surgery), during surgery and after surgery. As we learn mre abut pain cntrl in pets, we knw that they perceive pain as we d, but they display signs f pain differently, ften masking signs f pain as a prtective mechanism. Buprenrphine is a liquid ral pain medicatin that will be sent with the cat patients fr pstperative pain cntrl and ral Rimadyl, a nn-steridal anti-inflammatry drug, will be sent with dgs patients. They will be given these medicatins fr 2-3 days. All dgs/cats will receive ne dse f injectable antibitic pre-peratively. And please remember t acknwledge ur spnsrs. In additin t the sign n the frnt f the Surgery Suite, there is anther list in the Interactive Bx that describes what each cmpany has cntributed t the Surgery Suite and, in general, what their missin is. Surgery Script Outline Intrductin (t be used when the animal is being prepped) The Minnesta Veterinary Medical Assciatin is pleased t welcme yu t ur State Fair Surgery Suite. We are excited t claim it ur 25 th year here at the State Fair. Tday we will be perfrming an varihysterectmy, mre cmmnly knwn as a spay, n a female dg/cat (r a canine castratin). Did yu knw?????? The wrd SPAY is frm ld French meaning t cut with a swrd. Tday its meaning has evlved t depict the remval f varies frm a living animal. My name is and I will be yur mderatr fr this surgery. I will describe the surgical prcedure step-by-step and explain what yu are seeing n the televisin mnitrs. There is a camera abve the surgery table which will allw yu t see the surgery that is taking place. The entire prcedure, including the preparatin, will take 40 t 60 minutes. Fr safety reasns, please keep the aisles clear during the demnstratin. Nt everyne is cmfrtable with the idea f watching a surgery. There is n reasn t feel embarrassed if yu prefer nt t watch, r if yu feel uncmfrtable during the prcedure. But, if at any time during the demnstratin yu start t feel very warm, dizzy, r faint, d nt try t get up and leave suddenly. Ask fr assistance. If yu are feeling faint, put yur head dwn between yur knees and ask yur neighbr fr help. Let me knw right away. The stands are steep and we dn't want anyne t fall. The animals receiving the spay surgery tday are frm (humane rganizatin). These dgs/cats will g back t the humane rganizatin and will be available fr adptin. Phts f the dgs/cats and infrmatin abut (humane rg) can be seen n bth ends f the surgery suite. Humane rganizatins take the respnsibility f managing pet verppulatin, and we jin with them in this prject t increase public awareness f the prblem and educatin abut the slutins. We hpe the surgery n these dgs/cats will help them find adptive hmes, and prvide an educatinal experience fr 4

5 yu. Many veterinary and pet prduct cmpanies have dnated generusly t allw this demnstratin t take place. Their names are listed n the frnt f the suite, and we want t thank them fr their supprt and their cncern fr animal health. Pet verppulatin is a serius prblem. Despite all their effrts t find hmes fr unwanted animals, humane scieties and veterinarians acrss the cuntry euthanize thusands f animals each year. If a single pair f healthy cats and their ffspring are allwed t breed withut restrictin, mre than 80,000 ffspring can be prduced in 10 years. Spaying and neutering are the best ways t keep ur pet ppulatin under cntrl. The prcedure, as it is dne in mdern veterinary clinics tday, is safe, effective, and makes the animal a healthier and better-behaved pet fr its wners. The surgery area yu see here in the suite is similar t what yu wuld find in a veterinary hspital and the prcedure is the same. Of curse, a spay surgery is nly ne example f the wide variety f prcedures that veterinarians perfrm daily. Veterinary medicine is an interesting and diverse prfessin, ranging frm dairy herd-health specialists t rthpedic surgery, frm wildlife and z medicine t bimedical research and industry. There are ver 1,500 veterinarians in Minnesta, and even mre veterinary technicians and assistants. Technicians are a valuable part f veterinary practice. Their respnsibilities include animal care and nursing, client educatin, labratry wrk and mre. If yu have questins abut veterinary medicine feel free t ask me, r cntact a veterinarian in yur hmetwn. We are very prud f ur prfessin and will be pleased t answer yur questins. Tday's surgen will be. He/She will be assisted by veterinary technician Shelley Harpster and veterinary student frm the University f Minnesta - Cllege f Veterinary Medicine. WHAT ARE SOME BENEFITS OF SPAYING/NEUTERING? Decrease pet verppulatin Decrease reprductive tract infectins Minimize reprductive tract cancers Minimize urine marking Minimize raming behavir I want t emphasize again that it is pssible that seeing the surgery may make yu feel uncmfrtable. If yu feel warm, dizzy r faint, d nt try t stand up and leave. Put yur head dwn n yur knees and ask yur neighbr fr help. With yur head dwn, the feeling may pass, but if yu try t stand, yu may faint. We dn't want anyne t fall r get hurt. 5

6 Pre-Surgical Prep: This dg/cat has had: A negative heartwrm test - if ver 6 mnths f age (dgs nly). A negative feline leukemia test (cats nly). A fecal test fr parasites r a dewrmer. Distemper/hepatitis/parainfluenza/parv cmbinatin vaccinatin if a dg, r a distemper/rhintracheitis/calicivirus vaccinatin if a cat. A physical exam this mrning. A test fr nrmal bld cltting and a bld cunt which checks fr anemia and infectin. Bld chemistry screen fr diseases like diabetes, liver r kidney disease. A cmbinatin f medicatins t help prevent pain and t sedate the dg/cat given 15 minutes ag. Inductin: The anesthetic inductin and surgical preparatin f dg/cat will be shwn n a pre-recrded videtape. This is nt the dg/cat yu will see in surgery, but she is having the same prcedures perfrmed in the prep rm while we watch the tape. IV catheter placed t administer medicatins int the vein. IV inductin with Ketamine/Diazepam, a cmmn and safe cmbinatin. Intubatin fr xygen and Isflurane delivery. Isflurane is a safe inhalant anesthetic; it puts minimal stress n the bdy and allws the animal t wake up quickly after surgery. IV fluids administered. Fluids are ften nt used fr yung, healthy animals in rutine prcedures but we are taking precautins because f unknwn health histry n these dgs/cats. Placement f a Pulse Oximeter in the Prep rm t aid in the mnitring the patient s vital signs befre surgery. Surgical Prep: Surgical shave f abdminal r scrtal area; urinary bladder emptied. Surgical scrub f whle area with Betadine and alchl 3 times. Transfer int surgery, placement n table and tied securely s she cannt slip. Bair Hugger frced-air warming blanket placed arund the pet t help maintain her bdy temperature as clse t nrmal as pssible. Psitin camera, surgery lights and scrub ne mre time. Place Surgivet leads. This surgical site preparatin is ne f the imprtant respnsibilities f the technician, wh will then cntinue t make sure that dg/cat is ding well under anesthesia thrughut the prcedure. 6

7 Surgen's Prep: Put n clean scrubs, cver hair with cap, wear mask. Scrub hands with disinfectant sap and sterile brush fr 5 minutes. This has been shwn t reduce bacteria n the skin, just in case a glve is punctured r cut. Dry with sterile twels. Glve and gwn. All surfaces that might tuch the incisin, drapes, hands, instruments, and suture are nw sterile. Surgery script (spay): Ask the surgen in advance abut his/her prcedure - multiple ligatures, ligatin f vessels in the brad ligament r separate fixatin f uterine vessels, type f clsure. 1. Technician pens the pack, tuching nly the utside. All cntents sterilized in an autclave using pressurized steam. 2. Surgen drapes t cver all f dg/cat except surgical site. 3. Incisin thrugh skin and subcutaneus tissue (mstly fat). 4. Incisin thrugh linea alba (means white line ), which is the fibrus line where left and right abdminal muscles meet. 5. By cutting thrugh the linea alba there is less bleeding and less pain fr the dg/cat n recvery. 6. Uterus is shaped like a Y with 2 lng hrns, each leading t an vary just behind the kidneys. Size f the uterus depends n age and reprductive histry. 7. Ovary accessed, varian pedicle clamped and ligated. Cut. Pedicle bserved fr bleeding and then gently released back int place. Repeat ther side. 8. Clamp ff bdy f uterus abve cervix, ligate (+/- fixate vessels), cut and remve uterus (discarded separately as bilgical waste in bihazard bag). 9. Clsure in separate and distinct layers. Surgery Script (clsed castratin): 1. Surgen verifies that there are 2 testicles in the scrtum. 2. Applies pressure t scrtum t advance ne testicle int pre-scrtal area. 3. Incisin thrugh skin and subcutaneus tissues n midline. 4. Discuss difference between "pen" and "clsed" castratin. 5. Discuss cryptrchidism. 6. Exteririzes testicle and tears fibrus attachment between spermatic crd tunic and scrtum. 7. Places ligatures arund entire spermatic crd. 8. Excises testicle. 9. Repeats n ther side. 10. Clsure in distinct layers, depending upn surgen. 7

8 Suggestins f subjects t discuss during the spay prcedure: Hw d can we clse the skin? Three cmmn techniques are used t clse the skin: Sutures Surgical Glue Staples During surgery try t name and explain the instruments as they are used. Discuss the advantages f spay r castratin t this dg/cat (n heats r unwanted pregnancies, reduced incidence f breast cancer, n varian cancer r pymetra, surgery has less mrbidity and mrtality than pregnancy). The benefits f neutering male dgs are: prevents enlargement and inflammatin f the prstate gland, eliminates any chance f testicular cancer, prevents the desire t ram due t females in heat and therefre prevents unwanted litters, decreases the incidence f aggressin between male dgs, and decreases the urge t urine mark. Please explain terminlgy that the public might nt understand. Discuss rle f technician in mnitring anesthesia (checks heart, reflexes, CRT, etc.) and the advantage f adjusting the cncentratin f the inhalant anesthesia t keep dg/cat at the apprpriate depth. Surgical Cmplicatins: Pst-Op: Adverse reactin t anesthesia: apnea, hyp- and hyper-tensin, bradycardia, tachycardia, Bleeding: Pedicle, venus r arterial Drapes remved and site cleaned. Dg/cat mved back t prep area fr mnitring, using Pulse Oximeter as an aid, and placed n anther Bair Hugger warming blanket there. Endtracheal tube will be remved when dg/cat can swallw. Watched carefully as she recvers. Technician will cntinue t mnitr vital signs, such as heart rate and mucus membrane clr. Patient may wake up disriented r nauseus, just like a human. Patient will be kept quiet and mnitred the rest f the day. Mst dgs/cats are sitting up and aware f their surrundings in a few hurs. The dgs and cats will receive ral pain medicatin fr 2-3 days. Any skin stitches r staples will be remved in 2 weeks by the new wner's vet. Ptential cmplicatins i.e. dehiscence, licking at the wund, bleeding, infectin. This cncludes the demnstratin. Thank yu fr yur attentin. We hpe this surgical demnstratin was interesting and that it emphasized the imprtance f safe, healthy slutins t the prblem f pet verppulatin. If yu have questins I will be happy t try t answer them. The Minnesta Veterinary Medical Assciatin is here t help with yur animal's needs and yur cncerns. MODERATOR: If yu cannt participate at the last minute fr any reasn Please find a replacement and ntify the MVMA ffice immediately. AND mst f all have fun!! If yu are having a gd time, s will the audience. We really appreciate yur help!! 8