课件文稿说明讲稿spay neuter training en ch wwl

1Guidelinesforspay/neuterofdogs&cats

犬猫绝育指南Dr.KatiLoefflerIFAW国际爱护动物基金会Overview概述Animalhandling照料动物Pre-surgicalcare术前护理Generalclinicalconsiderations

临床注意事项Surgery手术Post-surgicalcare术后护理2AnimalHandling照料动物Keepanimalscalm

保持动物平静Animalsareusuallystressedandfrightened

通常动物易紧张害怕Noshouting,smoking,excessivenoiseoractivity

不要大声叫嚷、抽烟、制造过多噪音或动作Speakquietly,behavewithcompassionandempathy

小声说话，行为举止充满关爱3AnimalHandling照顾动物Keepanimalscalm

保持动物平静Ifananimalisupsetandresisting,leaveitaloneinaquiet,darkenedplaceforafewminutesuntilithascalmeddown.Thenapproachgentlyandquietly.如果动物焦虑抵触，将其独自安置于僻静昏暗处，直到它平静下来。然后温柔、安静地接近。4AnimalHandling

把持动物Physicalrestraintfollowshumaneprinciples

对动物进行身体约束时遵循人道原则Ensuresafetyofanimalsandpeople.

确保人与动物的安全Handleanimalsgentlyevenwhenonemustbefirmwiththem

尽管把持动物须确保稳固、有力，但一定要温和。Minimizestressanddonoharm.

施加最小压力，拒绝伤害Neverhit,chokeorotherwiseinjureananimal

决不能击打、掐或以其它方式伤害动物5AnimalHandling

把持动物Preventionofzoonoticdisease

预防人畜共患病Anyonewhoworkswithdogsandcatsshouldbevaccinatedagainstrabies凡为犬猫工作的人一定注射疫苗预防狂犬病WashhandsbetweenhandlingeachanimaI.Ifwearinggloves,useafreshpairforeachanimal接触下一个动物前要重新洗手；若使用手套，要为每个动物更换新的Washhandsbeforeeatingandafterusingtoilet

饭前便后要洗手6Pre-surgicalcare术前护理Fastingpriortosurgery:

术前禁食Adults:8hours成年：8小时Youngerthan9months:4hours

小于9月龄：4小时Donotrestrictaccesstowater

勿限制喂水7Pre-surgicalcare术前护理Informownersaboutsurgery&post-operativecare;signconsentform

告知动物主人手术及术后护理；签字同意Completephysicalexaminationwithin24hrsofsurgery–seeworksheet

手术24小时内全面体检—见表单8Pre-surgicalcare术前护理5.Preparerecordsforeachanimal

每个动物的记录准备Consentformtobesignedbyowner

动物主人签字同意书Animalidentification,biographicaldata,History&physicalexamination

动物身份鉴别，传记资料，病历及体检报告Anaesthesiarecordform麻醉记录表Clinicalrecordform 临床记录表9Generalclinicalconsiderations

临床注意事项Puppies&kittensmustbeatleast5monthsold幼犬、猫一定至少5月龄Aclinicalrecordwillbecompletedforeachanimal(previousslide)

完成每个动物的临床记录表（见前页）10Generalclinicalconsiderations

临床注意事项

Estrousorpregnantanimalsmaybespayedatthediscretionofthesurgeon,butownersmustbeinformedoftheadditionalrisk.

医生可根据判断，为发情或怀孕的动物绝育，但务必通知动物主人额外的风险11Generalclinicalconsiderations

临床注意事项

Surgeryshouldbedelayedorrefusedifphysicalexaminationindicatesthatsurgeryconstitutesunreasonablerisktotheanimal.

如果体检表明手术将对动物构成不合理危险，应该推迟或拒绝手术。12Generalclinicalconsiderations

临床注意事项

Alldrugsmustbelabeledwithdateopened

所有药物需标明开瓶使用日期Allsyringescontainingdrugsmustbelabeledwithname&concentrationofdrug

须在所有含药物的注射器上标明药物的名称及浓度Usenew,sterileneedle&syringeforeachinjection

每次注射后更换新的，无菌针头和注射器13Generalclinicalconsiderations

临床注意事项

Ifananimalisfoundtobeillwithaconditionthatiscausingunduesufferingandhasapoorprognosisforrecovery,itwillbeeuthanisedhumanely.

若发现动物伤病已导致其遭受过多痛苦且恢复的可能性不佳，人道地实施安乐死。14Generalclinicalconsiderations

临床注意事项

Duringsurgery,animalsmaybepermanentlymarkedassterilized:

手术期间，给动物做持久的已绝育标记Cats–cliptipoftheleftear.

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

母犬—左耳尖端去除一小块；若长毛，在左耳内侧纹标记15Anaesthesia:priortoinduction

麻醉：引入前Calculatedrugdoses

计算药品剂量Anaestheticdrugs麻醉药品Emergencydrugs(adrenaline,atropine,doxapram,diazepam)

急救药（肾上腺素，阿托品，吗啉比咯碱/多沙普仑，地西泮）Analgesics解热镇痛药Antibiotics抗生素16Anaesthesia:priortoinduction

麻醉：引入前Knowwhattoexpectofthedrugs.

全面了解药物Zoletil–vomiting,respiratorydepression,transienttachycardia(dogs),salivation,musclerigidity,roughrecoveries

舒泰—呕吐，呼吸抑制，短暂的心跳加速（犬），流涎，肌肉僵硬，恢复时不稳定Xylazine–vomiting,respiratorydepression,bradycardia

塞拉嗪—呕吐，呼吸抑制，心搏缓慢17Anaesthesia:priortoinduction

麻醉：引入前Minimizestress!

减少压力！Keepanimalquiet,dark

保持安静，昏暗的环境Noloudvoices,noise,commotion;minimizepeople

不要大声讲话，噪音，骚乱；闲人免进18Anaesthesia:priortoinduction

麻醉：引入前Endotrachealtubes:soakin4%chlorhexidineandrinsedthoroughlybetweenpatients.

气管插管：浸泡于4%洗必泰，在每个病号使用前彻底刷洗干净Preparewarmsurfaceonsurgerytable

在手术台上准备暖和的铺盖Ifpossible,placeIVcatheter条件允许，准备静脉留置针19Anaesthesia:priortoinduction

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

怀孕的动物、面临潜在危险的动物，若手术预计超过30分钟，期间一定静脉补液（0.9NaCl或LRS；10ml/kg/小时）20Anaesthesia:induction

麻醉：引入前Minimizestress(dark,quiet)

减少压力至最小（黑暗、安静）Ifpossible,placeIVcatheter

条件允许的话，准备静脉留置针Monitorclosely:breathing,position,CNSsigns

密切监控：呼吸、姿势、中枢神经系统症状21Anaesthesia:post-induction

麻醉：引入后Checkvitalsigns

检查生命指征Intubateimmediately

立即插管PlaceIVcatheter

准备静脉留置针22Anaesthesia:post-induction

麻醉：引入后Lubricateeyes

给眼睛抹润滑油Administermeloxicam/carprofenandantibioticinjection

给药：美洛昔康/卡洛芬和抗生素注射

23Anaesthesia麻醉Anaestheticmonitoring&recordsevery5minutes,beginningwithinduction–seeform

每五分钟进行监控并记录，麻醉注射时开始—见表Theanimalmustbeinasurgicalplaneofanaesthesiathroughouttheprocedure

在手术期间，保持动物的麻醉状态24Stagesofanaesthesia麻醉阶段25Stage阶段Characteristics特征Laryngealreflexes

喉头反射Respiration呼吸Jaw&tongue

下颚及舌Eyes眼睛1:Sedation镇静期Sedation,possibledisorientation镇静，定向力可能消失Swallowingreflexintact,canmaintainownairway吞咽反应存在，气管可自控Strongjaw&tonguetone下颚及舌紧张度强Drowsybutallreflexesintact昏昏欲睡但所有反应存在2:Unconscious,Delirium无意识，昏迷LossofconsciousnessHyperresponsetostimulationIrregularrespirationVocalizationUncontrolledmovementRetching,vomiting意识丧失，对刺激反映强烈，呼吸无规则，发声，不自主运动，恶心，呕吐Swallowingreflexintact,canmaintainownairway吞咽反应存在，气管可自控Irregularbutusingintercostalmuscles+Diaphragm不规则，使用肋间肌和膈控制呼吸StrongjawtoneTonguevoluntarilyretractedwhenpulled下颚紧张度强，将舌体拉出自主缩回PalpebralreflexpresentPupilsdilated尚有眼睑反应，瞳孔扩大3:Surgical手术期NovocalizationorvoluntarymovementMusclerelaxationAnalgesia,butpainfulstimulimaycause↑HR,RR,BP无发声或自主运动，肌肉松弛，镇痛，疼痛刺激导致心跳、呼吸、血压升高Lossofswallowingreflex,mustprotectairway吞咽反应消失，必须保护气管Regularwithstrongchestmovement&diaphragmfunction呼吸规则，依靠胸廓强烈运动及膈功能LossofjawtoneTonguerelaxed,doesnotretractwhenpulled下颚紧张度消失，舌体松弛，将舌体拉出不能自主缩回LossofpalpebralreflexPupilsfixedEyeballusuallyrotatesdownReducedlacrimation眼睑反应消失，瞳孔大小固定，通常眼球转向下方流泪减少4:Medullarydepression延髓麻痹期Anaestheticcrisis:deathimminentPulseweak(BPtoolow)AdministerIVfluids&ventilationAdministerpharmacologicalstimulationofrespiratory&cardiovascularsystems麻醉危险期：死亡临近，脉弱（血压过低）静脉补液及通风，药物急救：呼吸及心血管系统Noswallowingreflex,shouldbeintubated!无吞咽反应，插管！Respiratoryarrest呼吸停止NojawtoneTonguerelaxed下颚无紧张感，舌体松弛NopalpebralreflexPupilsdilateCorneadry无眼睑反应，瞳孔扩大，角膜干燥Monitoringsurgicalplaneofanaesthesia

监控麻醉手术期Palpebralreflexabsentorslight(retainedwithZoletil)

无眼睑反应或轻微反应（舒泰维持）Jawtone&tonguerelaxed

下颚及舌体松弛Noswallowing吞咽反应消失Novocalization不发声26Monitoringsurgicalplaneofanaesthesia

监控麻醉手术期Heartrate&rhythm心率及心律Cat:100-200猫：100-200Dog:70-100狗：70-100Regularrhythm;ifsinusarrhythmia,checkpulse

节律固定；若心律不齐，检查脉搏Peripheralpulsestrength&rate–strong&consistentwithheartbeat

周围血管搏动强度及速率—强，与心搏一致27Monitoringsurgicalplaneofanaesthesia

监控麻醉手术期Capillaryrefilltime<2seconds

毛细血管再充盈时间<2秒Mucousmembranecolor–pink

可视粘膜颜色—粉色Respiratoryrate&depth

呼吸频率及深度Bodytemperature(q.15min)

体温（每15分钟）28Surgery手术Surgicalareaascleanaspossible–washwalls,floors,tables&othersurfaceswithdisinfectant

手术区域一定整洁—用消毒剂彻底清洁墙壁、地板及其它地方的表面Ventilationshouldnotbeblowingdust,fungalspores,etc.(airconditioner,fan)

保证通风设备的清洁，不得吹出灰尘、真菌孢子等（空调，电扇）29Surgery手术Clip&asepticallypreparesurgicalarea

剃毛及无菌手术部位Useclippersonly(norazorbladeorchemicals).

只能用电推剪（误用剃须刀或化学用品）Clipcarefullytoavoidskinrash

剃毛须小心避免皮肤受损患皮疹Prepwithchlorhexidineorbetadine/alcohol

准备洗必泰或碘酒/酒精Avoiduseofalcoholonscrotum

切勿在阴囊表面涂抹酒精30Surgery手术Clip&asepticallypreparesurgicalarea

剃毛及无菌手术部位Females:from4cmcranialofumbilicusumbilicustopubis;laterally1-2cmbeyondteats

雌性：肚脐顶端以上4cm，脐部至耻骨前缘；乳头旁边1-2cmMalecats:pluckfuronscrotum(don’tuseclippers)

公猫：拔掉阴囊上的毛（误用电推剪）Maledogs:caudalabdomen&medialthighs

公犬：腹下方及股内侧31Surgery手术Surgeons&assistantswearcleanscrubtop,cap&mask

医生及助手须穿戴干净的手术服，手术帽及口罩Practicesteriletechnique

进行无菌操作32Surgery手术Surgeonsandanyonetouchingsterileareasmustscrubhandsanddistalforearmsatleast5minuteswith4%chlorhexidinepriortoglovingwithsterilegloves

医生及其他人员必须用4%洗必泰刷洗手部及前臂至少5分钟，配带好无菌手套再接触这些无菌区域33Surgery手术Useafresh,sterilesurgerypack,drapes,scalpelblade,suturematerialandglovesforeachanimal.

为每只动物配置新的无菌手术包、被单、手术刀片、缝合材料及手套34Surgery手术Coldsterilizedinstruments:

冷消毒的器具Acceptableforcastrations

去势适用Washtoremoveallorganicmatter

清洗去除所有有机物Soakin3partschlorhexidine(4%)toonepartisopropylalcohol(70%)foratleast15minutes.

浸泡在4%洗必泰：70%异丙醇比例为3：1的溶液中至少15分钟35Surgery手术Instrumentsthatentertheperitonealcavitymustbesterilizedbyautoclave

高压消毒那些进入腹腔操作的器具36Surgery手术Suturematerialmustbeabsorbablepolyfilamentormonofilament(e.g.,VicrylorPDS),withafreshsterilepackforeachpatient.

一定为每个病号准备可吸收复丝或单丝（如可吸收的Vicryl或PDS纤维）及新的无菌手术包Cottonfibersuturematerialisnotacceptable

不能使用棉质纤维的缝合材料37Surgery手术Removebothovaries,bothuterinehornsandasmuchaspossibleoftheuterinebody.

摘除双卵巢，双侧子宫角，尽可能多的子宫体。BesurethatALLovariantissueisremoved.

确定摘除了所有卵巢组织。38Surgery手术Removebothtesticles.

摘除双侧睾丸Retainedtesticlesmustberemoved.

务必摘除残留的睾丸组织Allstumpsandpedicleswillbedouble-ligated.

双重结扎手术切除后的剩余部位及卵巢蒂39Surgery手术Pregnantanimalsmaybespayedbyasurgeonwithsufficientskill.

由资深医师为怀孕动物绝育。Pregnantanimalsmustundergoacompleteovariohysterectomy(pernormalspay).

对怀孕动物必须进行完整的卵巢子宫摘除术（每次常规绝育）Fetusesolderthan4weeksmustbeeuthanizedwithanoverdoseofanaesthetic.

对四周龄以上的胎儿注射过量麻醉药实施安乐死

40Surgery:incisionclosure

手术：切口闭合Bitches:3or4layers:peritoneum/muscle,subcutaneous,subcuticular,(skin)

母犬：3或4层：腹膜/肌肉层，皮下组织层，表皮层，（皮肤）Queens:2or3layers:peritoneum/muscle,(subcutaneous),subcuticular

母猫：2或3层：腹膜/肌肉层，（皮下组织层），表皮层Maledogs:3or4layers:scrotum,fascia,(subcutaneous),subcuticular

公犬：3或4层：阴囊，筋膜，（皮下组织层），表皮层

41Surgery:incisionclosure

手术：切口闭合Malecats:donotsuture

公猫：不须缝合Muscle&skin:simpleinterruptedsutures

肌肉和皮肤：简单的间断缝合Subcutaneous&subcuticular:continuoussuturepattern

表皮及皮下：连续缝合42Post-operativecare:anestheticrecovery

术后护理：麻醉恢复期Criticaltime:beprepared

关键时刻：做好准备RemoveETtubewhenswallowingorcoughing

当动物吞咽或咳嗽时取出气管插管Keepquiet,warm&dimlight

保持环境安静，温暖和昏暗43Post-operativecare:anestheticrecovery

术后护理：麻醉恢复期Monitoratleastevery5minutesuntilabletostand&walk

至少每5分钟监测一次，直到可以站立行走Giveanalgesicdrug3dayspost-operatively

术后给3天止痛药Giveantibiotic7daysifpotentialforinfection

若感染潜在发生给7天抗生素44Post-operativecare:woundcare

术后护理：伤口护理Ownershouldcheckwoundtwicedailyforsignsofswelling,redness,dischargeordehiscence

动物主人应该每天两次检查伤口，是否红、肿、出现分泌物或裂开Ownershouldnottouchorwashincisionunlessinstructedtodoso

动物主人不要触碰或清洗切口，除非