European Union OLRDA

Health of Ethiopian Animal

For Rural Development(HEARD)

Oromia Regional State

Livestock Resource Development Agency

Standard Operating Procedures for Veterinary Surgery

(First Edition)
Organizers and Editors
Prepared by:
• Jiregna Dugassa (DVM, MVSc, Assist. Professor of Veterinary
Surgery, AAU)
• Dessalegn Jarso (DVM, MVSc, Senior Veterinarian, OLRDA)
Edited by:
• Dr. Abdi Feyisa (DVM, Assistant Professor of Veterinary
Clinical Medicine, AAU)
• Dr. Aga Edema (DVM, MVSc, Senior Veterinarian, AAU)
• Shubisa Abera (DVM, MSC, Associate Researcher, NAHDIC)

• Mohammed Aliyi (DVM, Senior Veterinarian, OLRDA)

• Sadiya Haji (DVM, MVS, Senior Veterinarian, OLRDA)
• Kifle Nigusu (DVM, Senior researcher, HRVL)
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Presentation Outline
1. Introduction
2. Objectives
3. Standard Operative Procedures In Vet Surgery
4. SOP In Regional Veterinary Surgery
5. Annexes

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1. Introduction
• SOP is written guidelines that specifically describe how to
complete various tasks in particular activity.
• SOP guides and serves as reference for professional
training, creates consistency and uniformity to
accomplish particular activity and assures procedures
through mitigation of risk of job failures
• It will provide bridge of information and serves to make
sure that all tasks are carried out consistently.
• Currently in Ethiopia there is high demand of vet
services for companion and food animals.

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1. Introduction cont…..
• But, there are no well described, elaborated,
documented SOPs particularly on veterinary
surgical procedures
• Therefore, this SOPs is prepared with more
emphasis on common surgical conditions
expected to be performed so as to serve as base
line information for veterinary practitioners found
at different Veterinary service centers of districts
of Oromia Region.

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2. OBJECTIVES

2.1. General Objective

• To standardize the veterinary surgical approaches in
different levels of veterinary clinics across the Oromia
region, thereby optimizing veterinary services delivery
and quality.
2.2. Specific Objectives
• To clearly describe, document and commercialize
standard operative surgical procedures in selected
domestic animals.
• To outline pre-, peri- and post-operative procedures in
companion and food animal species.
• To highlight standard operative procedures on surgical
asepsis.
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3. Standard Operative Procedures In Vet Surgery
3.1. Pre-operative Considerations and
Intra operative Care of the Surgical
Patient
• Complete physical examination,
laboratory work-up and recording &
give prognosis,
• Restrict the patient from food and
water
Ruminants placed in lateral or dorsal
recumbence should have restriction of:
 Roughage for 48 hours
 Concentrate for 24 hours
 Water for 12 hours
 No food or water restriction for neonates
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or animals fed exclusively milk diet
3.1. Pre-operative Considerations…..
Mono-gastric patients should have restricted intake from:
 Feed for 24 hours
 Water for 12 hours
• Communicate with the client & inform all necessary
options:
 potential complications,
 postoperative care,
 Cost
 Fill and sign a consent form
• Patients should be stabilized thoroughly
• Fluid therapy should be initiated if hemorrhage or shock
is suspected
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3.1. Pre-operative Considerations…..
• Anesthetize the animal in
an area designated for
surgical preparation and
anesthesia,
• Shave an area twice the size
of the expected surgical
field & coarsely clean with a
disinfectant

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3.2. General Surgical Principles
• Good surgical techniques are performed if veterinarians
practiced
 Asepsis,
 Gentle tissue handling,
 Minimal dissection of tissues,
 Appropriate use of instruments and its sterilization,
 Effective hemostasis,
 Proper use of suture materials and patterns
 Proper post operative care of the surgical patients.
• A minimum of three individuals should be present during procedures.
 The surgeon performing the procedure and assistant surgeon assists the
major surgeon.
 The anesthetist inducing, monitoring, maintaining, and adjusting
anesthesia.
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3.3. Principles of Surgical Asepsis
• During the disruption of dermal integrity of the patient,
microorganisms have access to inner tissues.
• The bacteria that contaminate surgical wounds mainly
can originate from:
the patient's endogenous flora,
operating room personnel,
the environment.
• Thus, rules of aseptic technique must be followed to
prevent wound contamination.

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3.3.1. Preparation of the patient
• Examine the patient for evidence of any infection while
surgery can be postponed

• Skin should be cleaned preoperatively to reduce surgical

site contamination
Wash → Shave → Wash → Disinfect

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3.3.2. Preparation of the surgical instruments
• Clean, disinfect and sterilize instruments to avoid
gross contamination.
Instruments can be cleaned manually or with
ultrasonic cleaning equipment
Instruments should sterilized in self-sealing
sterilizer

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3.3.3. Preparation of the surgical team
• Careful preparation of the
surgical team

• Scrub suits, caps, masks, sweat

bands, shoe covers, gowns and
gloves have to be worn.

• Fingernails have to be kept

short, clean and jeweler should
be removed.

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3.3.4. Preparation of operation room
• There should be separate induction, preparation and
recovery rooms.
• The room should be free from bacterial contamination.
• Floors and walls should be suitable for efficiently cleaning
and drain
• Carefully disinfect all the surfaces in the operating room,
and the tables are disinfected in between operations.
• Operating room doors should remain closed during the
surgery,

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3.4. Surgical Restraint
• The physical restraint of ruminant alone is not adequate for
surgical procedure
• Hence, the combination of different forms chemical restraining
method is used
3.4.1. Ruminant Anesthesia
Purpose
• Used for restraint of fractious animals and to prevent unnecessary
pain as well as suffering.
Responsibility
• Veterinarian, Para veterinarian and Animal health assistants
Materials
• Analgesics, anesthetics, sterile ophthalmic ointment, Stethoscope,
Thermometer, Pulse oximeter, Blood pressure monitor, warm-
water circulating pad, emergency airway equipment, Xylocaine
spray, Endotracheal tubes and syringes. 3
3.4. Surgical Restraint cont…..
 Local Anesthesia
• Direct infiltration on topical skin or mucus membrane or
directly injecting into the tissues of anesthetic solution,
• A Line Block: injecting a local anesthetic solution into the
skin, subcutaneous tissues, and muscles along the
incision line,
• A Reverse 7 Block: is used for left flank laparotomy or
any procedure on the left side of the animal.
 Regional Anesthesia
• Anesthetizing the nerves innervating the tissues to be
manipulated by using local anesthetics

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3.4. Surgical Restraint cont…..
• A Paravertebral Block (PV): injecting anesthetic at each
nerve arising from last thoracic and lumbar processes.
It can be conducted in proximal and distal PV ways
General Anesthesia
• Injectable general anesthetics as sole agents
Chloral hydrate, Ketamine
• Inhalant anesthetics (halothane, isoflurane) are
the safest choice for general anesthesia

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Common Injectable and Few Combinations Used For Induction
Drug Dose Route Duration of effect

Ketamine-Diazepam 3mg/kg 0.3m/kg IV 20 minutes

Dexmedetomidine 0.01 to 0.08mg/kg IV, IM Dose dependent

Pentobarbital 20 to 30 mg/kg IV 30-45 minutes

Propofol 2 to 8mg/kg (dose to effect) IV, slowly Until discontinued

0.2 to 0.4mg/kg/min for IV
infusion

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3.4. Surgical Restraint cont…..
Endotracheal intubation
• Placement of an endotracheal tube to deliver of
isoflurane anesthesia.
• Cuffed endotracheal tubes are preferred as they
reduce the possibility of aspiration of saliva or
stomach contents.

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3.5. Surgical Procedures, Monitoring and Supportive Care
• Use efficient surgical planning to
monitor surgical time, tissue
contamination, and tissue damage.
• Continuously monitor heart rate and
rhythm, blood pressure, respiratory rate
and depth, and temperature and record
on intraoperative patient monitoring
format
• Monitor hemodynamic parameters to
assure adequate gas exchange:
 Mucous membranes: pink and moist
 Capillary refill time: less than 2s
 Oxygen saturation (SpO2)

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3.6. Postoperative Care
• Postoperative care begins with recovery from anesthesia,
and may extend from days to weeks depending on outcomes.

• Continuously observe the animal and monitor

temperature, heart rate and respiratory rate until the
animal recover.
• Examine the wound daily until completely healed.

• Remove skin sutures or staples (if any) after 10-14 days.

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3.7. Post-Operative Complications and Their Management
Management
3.7.1. Shock
• Shock is a result of a collapsed circulatory system and
can occur due to stress, blood loss, fluid loss, low blood
pressure and a damaged heart.
• Measure to be taken: first aim at reducing stress,
stopping bleeding, administer IV fluids like epinephrine.
3.7.2. Hypothermia
• Is caused by a lowering of the body temperatures.
• Measure to be taken : the animal needs to be gradually
warmed with a body contact in a handling bag, heat
lamp or a hot water bottle.

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3.7. Post-Operative Complications cont…
Management
3.7.3. Dehydration
• Dehydration is the excessive loss of fluid from the body.
• Check for signs of dehydration by pinching the skin of the
animal
• Administering of fluid therapy
3.7.4. Hyperthermia
• Is caused by a increasing of the body temperatures.
• It can cause renal failure, hypotensive shock, coma and
death.

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3.8. Wound Management
•Management
Wound is an injury to living tissue caused by a cut, blow,
or other impact causing disruption of the normal body
• It can be closed with closure materials or managed as
open wound management principle
Purpose
• to highlight the wound management to be performed as
first aid in some veterinary clinical practice.
Responsibility
• Veterinarians and animal health care professionals

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3.9. Euthanasia
• To minimizes an animal’s pain and stress.
Management
3.9.1. Small and large animal euthanasia
Responsibility
• Veterinarians and animal health professionals
• Cat and Dog: Barbiturate overdose, Overdose of inhalant
anesthetic and Exsanguination under general anesthesia
• Sheep, goat, pig, cattle: Barbiturate overdose,
Exsanguinations under general anesthesia and Physical
methods

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3.10. Record Keeping
• Document the Patient history on case record and
management format (annex 1)
•Management
Record the preoperative assessment and intraoperative
activities on the format as in (Annex 2)
• Document surgical procedure in the animal’s medical
record forms as found in annexes.
• Record and document the overall follow up as in format
(Annex 4).

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4. SOP In Regional Veterinary Surgery
4.1. Surgery of Head and Neck
4.1.1. Amputation of horn in cattle
Management
Purpose
• For treatment purpose, to reduce horn scratch on other
animals etc
Responsibility
• Veterinarians and Animal Health Care Professionals.

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4. SOP In Regional Veterinary Surgery cont….
4.1.2. Extirpation of Eyeball in Cattle
Purpose
•Management
Due to various ailments that cannot respond to medical
treatment and may causing continuous irritation as well
as lacrimation.
Responsibility
• All veterinarians and Animal Health Care Professionals.

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4. SOP In Regional Veterinary Surgery cont….
4.2. Surgery of Thorax
4.2.1. Cervical esophagotomy in cattle
Management
Purpose
• Due to various ailments that cannot respond to medical
treatment and cause the animal life threatening.
Site of Operation
• At the level of obstruction or lesion
• At upper or lower border of irregular furrow

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4. SOP In Regional Veterinary Surgery cont….
4.3. Surgery of the Abdomen
4.3.1. Ruminotomy in cattle
Management
Purpose
• Due to rumino-reticular foreign body that cannot respond
to medical treatment and cause the animal life
threatening or removal of ruminal contents prior to
surgical repair of diaphragmatic hernia and exploratory
purposes.
Site of Operation:
• Left mid paralumber fossa
• Left cranial paralumber fossa near to last rib

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4. SOP In Regional Veterinary Surgery cont….
4.3.2. Amputation of rectum in cow
Purpose
•Management
For resection of rectum in cattle due to irreparable rectal
tear, prolapsed rectum, rectovaginal fistula, and necrosis
that cause the animal life threatening.
Site of Operation
• Proximal to the affected part of rectum depending on the
degree of affected part of rectum on the circumference
of the bowel.

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4. SOP In Regional Veterinary Surgery cont….
4.3.3. Surgical correction of rectal prolapse and its
management
Management
Purpose
• Used for repositioning of prolapsed rectum in cattle due
to irreparable rectal tear, prolapsed rectum and necrosis
that cause the animal life threatening.

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4. SOP In Regional Veterinary Surgery cont….
4.3.4. Surgical management of atresia ani and atresia ani
et recti
Management
Purpose
• For surgical correction and management of atresia ani
and atresia ani et recti in cattle due to congenital in
nature causing life threatening to the animal.
Site of Operation: below the base of tail where the anus
should have been present or over the bulge.

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4. SOP In Regional Veterinary Surgery cont….
4.3.5. Repair of Ventrolateral Hernia in Cow
Purpose
Management
• Designed for surgical correction and management of
ventrolateral hernia in cattle due to traumatic in origin
causing life threatening to the animal.

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4. SOP In Regional Veterinary Surgery cont….
4.4. Surgery of Locomotor Organs and Musculoskeletal
System
Management
4.4.1. Amputation of tail
Purpose
• To remove irreparable injuries of the tail like, fracture,
necrosis, tumor, gangrene and complete paralysis.
• Tail docking in sheep to reduce the incidence of blowfly
strike that may result from urine and faecal staining of
the perineum.
5.4.2. Application of plaster cast on limbs of large animal

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4. SOP In Regional Veterinary Surgery cont….
4.5. Surgery on Urogenital Organs of Male and Female Animals
4.5.1. Urethrotomy in bull
Management
Purpose
• Is designed for surgical correction and management of
urethra due to obstruction or urethral calculi at different
location.
4.5.2. Ovariohystrectomy in Bitch
• The operation involves the surgical removal of the ovaries,
uterus and proximal parts of uterus
Purpose
• Used for various ailments on uterus or ovary or for surgical
sterilization of bitch.

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4. SOP In Regional Veterinary Surgery cont….
4.5.3. Castration- Open Castration in
stallion
Management
Indication
• Consumer preference, for economic
considerations and to improve the
temperament of animals.
4.5.4. Caesarean section in cow
Purpose
• For emergency surgical managemnt
of dystocia due to various factors
leading to difficulty through normal
reproductive birth canal
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4. SOP In Regional Veterinary Surgery cont….
4.5.5. Repair of uterine prolapsed
Purpose
Management
• Prolapse of the uterus may occur in any species; however,
it is most common in dairy cows and ewes
• The purpose is for emergency surgical managemnt of
Prolapsed uterus due to various factors leading to
threatening of the life of femal animal.

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5. Annexes
Annex 1: Case recording and management format
• Date.____________
Management
• Case No._________
Name of the Hospital: -------------------------------------------------------
Animal Detail
Species: Bovine Ovine Caprine Feline Canine Swine Avian
Equine
Breed _____________ Sex Male Female Age _______________
Animal identification _______________ Name /if any/
_______________
OWNER DETAIL
• Owners’ Name _________________Address Town ________Peasant
association _____ House No___
• Occupation _______________ Phone No __________________
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5. Annexes
CASE HISTORY
_______________________________________________________________
_________________________________________
Management
CLINICAL FINDING
Body Temp ______oC Respiration rate ______Breaths/min Heart rate
________ Beat/min
Ruminal Motility ­____/min Gut sound _____ VMM: Normal pale Congested
Joundice Cyanotic CRT: _____ Body Condition:_____Superficial Ln:
____________
Description of Case
_______________________________________________________________
_________________________________________
Organ or system affected: Nerous Muskulo skeletal Respiratory Cerculatory
Digestive Urogenital Intigument Other (specify)
SAMPLE TAKEN
Faeces Blood skin scraping Nassal swab vaginal swab Ruminal content
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5. Annexes
Differential Diagnosis List:____________________________________________________

Laboratory Result:__________________________________________________________
Management
Tentative Diagnosis: _________________________________________________________

Definitive Diagnosis:________________________________________________________

PATIENT CARD

Prognosis:
_____________________________________________________________________________________________
_________________________________________________________

OBSERVATION AND TREATMENT

CLINICAL WORK TO BE PERFORMED: Surgical_________________________________

Medical________________ Gynaecology/Obstetric Follow up /Quarantine

MEDICAL TREATMENT ADMINISTERED

Date: _____________________________________________________________________

Name of Staff in Charge: _______________________________Signature______________

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Student in Charge: ____________________________________Signature______________
5. Annexes
Annex 2: Pre-Anesthetic Evaluation Form
Time: _______
Date: _______
•
•
Management
Patient Name: __________________________________________________________________________
Requested By: ___________________________________________________________________________
• History:_________________________________________________________________________________
_______________________________________________________________
• Physical exam
data:___________________________________________________________________________________
_______________________________________________________________________________________
• Findings/case/ and Diagnosis___________________________________________________
• Labs/Rads/ Other:______________________________________________________________________
• Procedure/Reason For Anesthesia:_______________________________________________
• Plan/Recommendations:________________________________________________________
• Further Diagnostics:
___________________________________________________________________________
• Pre-Anesthetic Therapy: _______________________________________________________
• Premedication: ______________________________________________________________
• Induction: __________________________________________________________________
• Maintenance: _______________________________________________________________
• Analgesia: __________________________________________________________________
• Fluids:______________________________________________________________________
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Monitoring:
5. Annexes
Annex 3: Anesthetic and Intra operative Observations
format
Management
Group Date Procedure
Surgeon As.surgeon
Anaesthetist Patient
monitor
Animal Sex Wei Physical status
ght

Good Medium Poor

Pre anesthetic drugs Anesthetic drugs

Drug Dose Route Time Drug Dose Route Time

Total dose

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