Webinar by John Chitty B.Vet.Med Cert ZooMed FRCVS
John has contributed massively to veterinary education with WebinarVet with 47 webinars to his name. Since qualification from the RVC in 1990 he has been equally busy as seen in his WebinarVet CV. He has been President of the European Association of Avian Medicine (2015-2017) and the British Small Animal Veterinary Association (2017-2018). He is currently a trustee and honorary secretary of Vetlife. His veterinary webinar is billed as ‘Guinea pig surgery. It’s not so scary really….’ but changes to the title above in the presentation, which as you can see, gives equal footage to anaesthetic considerations.
He tackles the alarming statistic that according to a CEPSAF (Confidential enquiry into perioperative small animal fatalities) report, guinea pigs fare less well than other species when anesthetised, with more than 3% deaths. Most of these are post-operative and the flowing reasons are suggested:
- Choice of anaesthetic
- Maintenance and peri-operative support
These headings are discussed in the next fifteen slides of the webinar. Some of the problems encountered include the differing size and surface area, heat loss, underlying disease (common), gut stasis and the need for pain control.
Patient preparation is important and involves antibiotic treatment where necessary, analgesia, anti-inflammatories, fluids, and correctly timed feeding.
Throughout the presentation, which has primary care colleagues very much in mind, there are many practical asides. For example, pre-anaesthetic bloods are not described as very useful, particularly as you would probably have to anaesthetise to obtain a sample. Important peri-anaesthetic considerations are fluids, warmth, gut motility and analgesia. There is a good summary of analgesia incorporating the use of NSAIDS, with advice on the use of meloxicam and carprofen. Similarly, opiates, ketamine and alpha-2 agonists are covered.
We are advised to be aware of maximum doses of local anaesthesia (and use them!), followed by various techniques of local anaesthesia -specific blocks, regional, infiltrative, incisional and splash for example.
Various anaesthetic recipes are briefly mentioned and what works for you is probably best. John uses Isofluorane, with a mask in most cases, and he rarely intubates. We are advised, if intubation is considered, to beware of material at the back of the mouth and the subsequent risk of post-operative pneumonia. For an emergency situation, doxapram, adrenaline, fluids, a tracheotomy kit and a ventilator are all of possible use.
Although subcutaneous, intra-peritoneal, intra-osseous, and intravenous routes are all possible for fluid therapy, in practice only the first two are regularly used.
Post-operatively there is a need for warmth, security, companion(s) and food (own food is best). Various food sources are recommended. Monitoring is advisable whilst in hospital, and there are some suggestions for this.
A summary bullet point states ‘Successful anaesthesia =stress relief.’ (Not stated, but true I am sure, that the figure of 3% mortality rate would ve very much diminished by attention to the preceding.)
The second part of the webinar is an account of the surgical cases that john sees, with practical tips for each. Basic surgical principles, common for all surgeons are listed before moving on to the surgical procedures.
The first of these is guinea pig orthopaedics, or more specifically fracture cases, which are rare. Some reasons why this should be are suggested. Many fractures heal with rest and analgesia. External coaption and fixation with an intra-medullary pin are briefly described. In some cases amputation is the best option and is generally well tolerated.
Dental diseases are important and we are advised image first in order to get the best assessment of the extent of the problem. Dental abscesses can form, and although they are far less common compared to rabbits, they are much more difficult to treat. In the presentation there is more emphasis on palliative care.
The remainder of the webinar deals with selected soft tissue surgeries. It is a very pictorial account with many illustrations of specific operations, demonstrating the extensive experience that John has accumulated in his career. Each operation is briefly described, with practical tips to help ensure a successful outcome. The following is a list of what you can expect:
- Castration (pre-scrotal). Associated problems and how to avoid them/deal with them if they occur
- Lots of detail and illustrations
- Tips for guinea pig caesarian.
- Spay-ovariectomy or ovariohysterectomy? Is elective spey indicated?
- Analgesia post-operatively
- Mass removals
- Mammary removals
- Cystotomy-uroliths. Risk of relapse is very high
- Interestingly masking of kidney disease, as seem in cats has not to date been a problem
- Gastric torsion ad other causes of abdominal distension
- Eye enucleation-similar to rabbits, but much easier.
The summary bullet points are:
- Guinea pigs can be operated on
- Take care with patient preparation and peri-operative care (analgesia and fluids)
- Surgical technique -taking care with hemostasis, tissue handling with emphasis on speed and precision
It’s difficult to believe that john covered all the above in an hour. But as mentioned, a lot consists of clinical pictures to which he adds comments, invariably of a practical nature. The webinar is a very useful account of just about every guinea pig problem you are likely to see in first opinion practice, and how to maximise success in dealing with them.