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1Guidelinesforspay/neuterofdogs&cats

犬貓絕育指南Dr.KatiLoefflerIFAW國際愛護動物基金會Overview概述Animalhandling照料動物Pre-surgicalcare術前護理Generalclinicalconsiderations

臨床注意事項Surgery手術Post-surgicalcare術后護理2AnimalHandling照料動物Keepanimalscalm

保持動物平靜Animalsareusuallystressedandfrightened

通常動物易緊張害怕Noshouting,smoking,excessivenoiseoractivity

不要大聲叫嚷、抽煙、制造過多噪音或動作Speakquietly,behavewithcompassionandempathy

小聲說話,行為舉止充滿關愛3AnimalHandling照顧動物Keepanimalscalm

保持動物平靜Ifananimalisupsetandresisting,leaveitaloneinaquiet,darkenedplaceforafewminutesuntilithascalmeddown.Thenapproachgentlyandquietly.如果動物焦慮抵觸,將其獨自安置于僻靜昏暗處,直到它平靜下來。然后溫柔、安靜地接近。4AnimalHandling

把持動物Physicalrestraintfollowshumaneprinciples

對動物進行身體約束時遵循人道原則Ensuresafetyofanimalsandpeople.

確保人與動物的安全Handleanimalsgentlyevenwhenonemustbefirmwiththem

盡管把持動物須確保穩固、有力,但一定要溫和。Minimizestressanddonoharm.

施加最小壓力,拒絕傷害Neverhit,chokeorotherwiseinjureananimal

決不能擊打、掐或以其它方式傷害動物5AnimalHandling

把持動物Preventionofzoonoticdisease

預防人畜共患病Anyonewhoworkswithdogsandcatsshouldbevaccinatedagainstrabies凡為犬貓工作的人一定注射疫苗預防狂犬病WashhandsbetweenhandlingeachanimaI.Ifwearinggloves,useafreshpairforeachanimal接觸下一個動物前要重新洗手;若使用手套,要為每個動物更換新的Washhandsbeforeeatingandafterusingtoilet

飯前便后要洗手6Pre-surgicalcare術前護理Fastingpriortosurgery:

術前禁食Adults:8hours成年:8小時Youngerthan9months:4hours

小于9月齡:4小時Donotrestrictaccesstowater

勿限制喂水7Pre-surgicalcare術前護理Informownersaboutsurgery&post-operativecare;signconsentform

告知動物主人手術及術后護理;簽字同意Completephysicalexaminationwithin24hrsofsurgery–seeworksheet

手術24小時內全面體檢—見表單8Pre-surgicalcare術前護理5.Preparerecordsforeachanimal

每個動物的記錄準備Consentformtobesignedbyowner

動物主人簽字同意書Animalidentification,biographicaldata,History&physicalexamination

動物身份鑒別,傳記資料,病歷及體檢報告Anaesthesiarecordform麻醉記錄表Clinicalrecordform 臨床記錄表9Generalclinicalconsiderations

臨床注意事項Puppies&kittensmustbeatleast5monthsold幼犬、貓一定至少5月齡Aclinicalrecordwillbecompletedforeachanimal(previousslide)

完成每個動物的臨床記錄表(見前頁)10Generalclinicalconsiderations

臨床注意事項

Estrousorpregnantanimalsmaybespayedatthediscretionofthesurgeon,butownersmustbeinformedoftheadditionalrisk.

醫生可根據判斷,為發情或懷孕的動物絕育,但務必通知動物主人額外的風險11Generalclinicalconsiderations

臨床注意事項

Surgeryshouldbedelayedorrefusedifphysicalexaminationindicatesthatsurgeryconstitutesunreasonablerisktotheanimal.

如果體檢表明手術將對動物構成不合理危險,應該推遲或拒絕手術。12Generalclinicalconsiderations

臨床注意事項

Alldrugsmustbelabeledwithdateopened

所有藥物需標明開瓶使用日期Allsyringescontainingdrugsmustbelabeledwithname&concentrationofdrug

須在所有含藥物的注射器上標明藥物的名稱及濃度Usenew,sterileneedle&syringeforeachinjection

每次注射后更換新的,無菌針頭和注射器13Generalclinicalconsiderations

臨床注意事項

Ifananimalisfoundtobeillwithaconditionthatiscausingunduesufferingandhasapoorprognosisforrecovery,itwillbeeuthanisedhumanely.

若發現動物傷病已導致其遭受過多痛苦且恢復的可能性不佳,人道地實施安樂死。14Generalclinicalconsiderations

臨床注意事項

Duringsurgery,animalsmaybepermanentlymarkedassterilized:

手術期間,給動物做持久的已絕育標記Cats–cliptipoftheleftear.

貓咪—左耳尖端去除一小塊Bitch–notchleftear;iflong-haired,tattooinsideofleftear

母犬—左耳尖端去除一小塊;若長毛,在左耳內側紋標記15Anaesthesia:priortoinduction

麻醉:引入前Calculatedrugdoses

計算藥品劑量Anaestheticdrugs麻醉藥品Emergencydrugs(adrenaline,atropine,doxapram,diazepam)

急救藥(腎上腺素,阿托品,嗎啉比咯堿/多沙普侖,地西泮)Analgesics解熱鎮痛藥Antibiotics抗生素16Anaesthesia:priortoinduction

麻醉:引入前Knowwhattoexpectofthedrugs.

全面了解藥物Zoletil–vomiting,respiratorydepression,transienttachycardia(dogs),salivation,musclerigidity,roughrecoveries

舒泰—嘔吐,呼吸抑制,短暫的心跳加速(犬),流涎,肌肉僵硬,恢復時不穩定Xylazine–vomiting,respiratorydepression,bradycardia

塞拉嗪—嘔吐,呼吸抑制,心搏緩慢17Anaesthesia:priortoinduction

麻醉:引入前Minimizestress!

減少壓力!Keepanimalquiet,dark

保持安靜,昏暗的環境Noloudvoices,noise,commotion;minimizepeople

不要大聲講話,噪音,騷亂;閑人免進18Anaesthesia:priortoinduction

麻醉:引入前Endotrachealtubes:soakin4%chlorhexidineandrinsedthoroughlybetweenpatients.

氣管插管:浸泡于4%洗必泰,在每個病號使用前徹底刷洗干凈Preparewarmsurfaceonsurgerytable

在手術臺上準備暖和的鋪蓋Ifpossible,placeIVcatheter條件允許,準備靜脈留置針19Anaesthesia:priortoinduction

麻醉:引入前Pregnantanimals,animalspotentiallyatriskorsurgeriesexpectingtolastlongerthan30minutesmustreceiveIVfluidsduringsurgery(0.9%NaClorLRS;10ml/kg/hour)

懷孕的動物、面臨潛在危險的動物,若手術預計超過30分鐘,期間一定靜脈補液(0.9NaCl或LRS;10ml/kg/小時)20Anaesthesia:induction

麻醉:引入前Minimizestress(dark,quiet)

減少壓力至最小(黑暗、安靜)Ifpossible,placeIVcatheter

條件允許的話,準備靜脈留置針Monitorclosely:breathing,position,CNSsigns

密切監控:呼吸、姿勢、中樞神經系統癥狀21Anaesthesia:post-induction

麻醉:引入后Checkvitalsigns

檢查生命指征Intubateimmediately

立即插管PlaceIVcatheter

準備靜脈留置針22Anaesthesia:post-induction

麻醉:引入后Lubricateeyes

給眼睛抹潤滑油Administermeloxicam/carprofenandantibioticinjection

給藥:美洛昔康/卡洛芬和抗生素注射

23Anaesthesia麻醉Anaestheticmonitoring&recordsevery5minutes,beginningwithinduction–seeform

每五分鐘進行監控并記錄,麻醉注射時開始—見表Theanimalmustbeinasurgicalplaneofanaesthesiathroughouttheprocedure

在手術期間,保持動物的麻醉狀態24Stagesofanaesthesia麻醉階段25Stage階段Characteristics特征Laryngealreflexes

喉頭反射Respiration呼吸Jaw&tongue

下顎及舌Eyes眼睛1:Sedation鎮靜期Sedation,possibledisorientation鎮靜,定向力可能消失Swallowingreflexintact,canmaintainownairway吞咽反應存在,氣管可自控Strongjaw&tonguetone下顎及舌緊張度強Drowsybutallreflexesintact昏昏欲睡但所有反應存在2:Unconscious,Delirium無意識,昏迷LossofconsciousnessHyperresponsetostimulationIrregularrespirationVocalizationUncontrolledmovementRetching,vomiting意識喪失,對刺激反映強烈,呼吸無規則,發聲,不自主運動,惡心,嘔吐Swallowingreflexintact,canmaintainownairway吞咽反應存在,氣管可自控Irregularbutusingintercostalmuscles+Diaphragm不規則,使用肋間肌和膈控制呼吸StrongjawtoneTonguevoluntarilyretractedwhenpulled下顎緊張度強,將舌體拉出自主縮回PalpebralreflexpresentPupilsdilated尚有眼瞼反應,瞳孔擴大3:Surgical手術期NovocalizationorvoluntarymovementMusclerelaxationAnalgesia,butpainfulstimulimaycause↑HR,RR,BP無發聲或自主運動,肌肉松弛,鎮痛,疼痛刺激導致心跳、呼吸、血壓升高Lossofswallowingreflex,mustprotectairway吞咽反應消失,必須保護氣管Regularwithstrongchestmovement&diaphragmfunction呼吸規則,依靠胸廓強烈運動及膈功能LossofjawtoneTonguerelaxed,doesnotretractwhenpulled下顎緊張度消失,舌體松弛,將舌體拉出不能自主縮回LossofpalpebralreflexPupilsfixedEyeballusuallyrotatesdownReducedlacrimation眼瞼反應消失,瞳孔大小固定,通常眼球轉向下方流淚減少4:Medullarydepression延髓麻痹期Anaestheticcrisis:deathimminentPulseweak(BPtoolow)AdministerIVfluids&ventilationAdministerpharmacologicalstimulationofrespiratory&cardiovascularsystems麻醉危險期:死亡臨近,脈弱(血壓過低)靜脈補液及通風,藥物急救:呼吸及心血管系統Noswallowingreflex,shouldbeintubated!無吞咽反應,插管!Respiratoryarrest呼吸停止NojawtoneTonguerelaxed下顎無緊張感,舌體松弛NopalpebralreflexPupilsdilateCorneadry無眼瞼反應,瞳孔擴大,角膜干燥Monitoringsurgicalplaneofanaesthesia

監控麻醉手術期Palpebralreflexabsentorslight(retainedwithZoletil)

無眼瞼反應或輕微反應(舒泰維持)Jawtone&tonguerelaxed

下顎及舌體松弛Noswallowing吞咽反應消失Novocalization不發聲26Monitoringsurgicalplaneofanaesthesia

監控麻醉手術期Heartrate&rhythm心率及心律Cat:100-200貓:100-200Dog:70-100狗:70-100Regularrhythm;ifsinusarrhythmia,checkpulse

節律固定;若心律不齊,檢查脈搏Peripheralpulsestrength&rate–strong&consistentwithheartbeat

周圍血管搏動強度及速率—強,與心搏一致27Monitoringsurgicalplaneofanaesthesia

監控麻醉手術期Capillaryrefilltime<2seconds

毛細血管再充盈時間<2秒Mucousmembranecolor–pink

可視粘膜顏色—粉色Respiratoryrate&depth

呼吸頻率及深度Bodytemperature(q.15min)

體溫(每15分鐘)28Surgery手術Surgicalareaascleanaspossible–washwalls,floors,tables&othersurfaceswithdisinfectant

手術區域一定整潔—用消毒劑徹底清潔墻壁、地板及其它地方的表面Ventilationshouldnotbeblowingdust,fungalspores,etc.(airconditioner,fan)

保證通風設備的清潔,不得吹出灰塵、真菌孢子等(空調,電扇)29Surgery手術Clip&asepticallypreparesurgicalarea

剃毛及無菌手術部位Useclippersonly(norazorbladeorchemicals).

只能用電推剪(誤用剃須刀或化學用品)Clipcarefullytoavoidskinrash

剃毛須小心避免皮膚受損患皮疹Prepwithchlorhexidineorbetadine/alcohol

準備洗必泰或碘酒/酒精Avoiduseofalcoholonscrotum

切勿在陰囊表面涂抹酒精30Surgery手術Clip&asepticallypreparesurgicalarea

剃毛及無菌手術部位Females:from4cmcranialofumbilicusumbilicustopubis;laterally1-2cmbeyondteats

雌性:肚臍頂端以上4cm,臍部至恥骨前緣;乳頭旁邊1-2cmMalecats:pluckfuronscrotum(don’tuseclippers)

公貓:拔掉陰囊上的毛(誤用電推剪)Maledogs:caudalabdomen&medialthighs

公犬:腹下方及股內側31Surgery手術Surgeons&assistantswearcleanscrubtop,cap&mask

醫生及助手須穿戴干凈的手術服,手術帽及口罩Practicesteriletechnique

進行無菌操作32Surgery手術Surgeonsandanyonetouchingsterileareasmustscrubhandsanddistalforearmsatleast5minuteswith4%chlorhexidinepriortoglovingwithsterilegloves

醫生及其他人員必須用4%洗必泰刷洗手部及前臂至少5分鐘,配帶好無菌手套再接觸這些無菌區域33Surgery手術Useafresh,sterilesurgerypack,drapes,scalpelblade,suturematerialandglovesforeachanimal.

為每只動物配置新的無菌手術包、被單、手術刀片、縫合材料及手套34Surgery手術Coldsterilizedinstruments:

冷消毒的器具Acceptableforcastrations

去勢適用Washtoremoveallorganicmatter

清洗去除所有有機物Soakin3partschlorhexidine(4%)toonepartisopropylalcohol(70%)foratleast15minutes.

浸泡在4%洗必泰:70%異丙醇比例為3:1的溶液中至少15分鐘35Surgery手術Instrumentsthatentertheperitonealcavitymustbesterilizedbyautoclave

高壓消毒那些進入腹腔操作的器具36Surgery手術Suturematerialmustbeabsorbablepolyfilamentormonofilament(e.g.,VicrylorPDS),withafreshsterilepackforeachpatient.

一定為每個病號準備可吸收復絲或單絲(如可吸收的Vicryl或PDS纖維)及新的無菌手術包Cottonfibersuturematerialisnotacceptable

不能使用棉質纖維的縫合材料37Surgery手術Removebothovaries,bothuterinehornsandasmuchaspossibleoftheuterinebody.

摘除雙卵巢,雙側子宮角,盡可能多的子宮體。BesurethatALLovariantissueisremoved.

確定摘除了所有卵巢組織。38Surgery手術Removebothtesticles.

摘除雙側睪丸Retainedtesticlesmustberemoved.

務必摘除殘留的睪丸組織Allstumpsandpedicleswillbedouble-ligated.

雙重結扎手術切除后的剩余部位及卵巢蒂39Surgery手術Pregnantanimalsmaybespayedbyasurgeonwithsufficientskill.

由資深醫師為懷孕動物絕育。Pregnantanimalsmustundergoacompleteovariohysterectomy(pernormalspay).

對懷孕動物必須進行完整的卵巢子宮摘除術(每次常規絕育)Fetusesolderthan4weeksmustbeeuthanizedwithanoverdoseofanaesthetic.

對四周齡以上的胎兒注射過量麻醉藥實施安樂死

40Surgery:incisionclosure

手術:切口閉合Bitches:3or4layers:peritoneum/muscle,subcutaneous,subcuticular,(skin)

母犬:3或4層:腹膜/肌肉層,皮下組織層,表皮層,(皮膚)Queens:2or3layers:peritoneum/muscle,(subcutaneous),subcuticular

母貓:2或3層:腹膜/肌肉層,(皮下組織層),表皮層Maledogs:3or4layers:scrotum,fascia,(subcutaneous),subcuticular

公犬:3或4層:陰囊,筋膜,(皮下組織層),表皮層

41Surgery:incisionclosure

手術:切口閉合Malecats:donotsuture

公貓:不須縫合Muscle&skin:simpleinterruptedsutures

肌肉和皮膚:簡單的間斷縫合Subcutaneous&subcuticular:continuoussuturepattern

表皮及皮下:連續縫合42Post-operativecare:anestheticrecovery

術后護理:麻醉恢復期Criticaltime:beprepared

關鍵時刻:做好準備RemoveETtubewhenswallowingorcoughing

當動物吞咽或咳嗽時取出氣管插管Keepquiet,warm&dimlight

保持環境安靜,溫暖和昏暗43Post-operativecare:anestheticrecovery

術后護理:麻醉恢復期Monitoratleastevery5minutesuntilabletostand&walk

至少每5分鐘監測一次,直到可以站立行走Giveanalgesicdrug3dayspost-operatively

術后給3天止痛藥Giveantibiotic7daysifpotentialforinfection

若感染潛在發生給7天抗生素44Post-operativecare:woundcare

術后護理:傷口護理Ownershouldcheckwoundtwicedailyforsignsofswelling,redness,dischargeordehiscence

動物主人應該每天兩次檢查傷口,是否紅、腫、出現分泌物或裂開Ownershouldnottouchorwashincisionunlessinstructedtodoso

動物主人不要觸碰或清洗切口,除非

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