March 11, 1998

Surgical Report For
Subtotal Colectomy Procedure in Feline

Prior to surgery, a normal perineal reflex and anal tone was observed.
In dorsal recumbency the ventral abdomen was clipped, prepped and draped in routine
fashion. A caudal ventral midline was made through the skin, subcutaneous tissue and
linea alba using sharp technique - #10 or 15 blade from the umbilicus to the pubis.
Placement of baby balfour retractors was used to aide in exposure. The urinary bladder
was emptied by expression or cystocentesis.
Ileocececalcolostomy:
The caudal mesenteric, left and middle colic, and ileocecocolic vessels were ligated. The
mesentery associated was transected close to the colonic border. Feces was milked away
from the sites of proposed resection and doyen forceps were applied to decrease
contamination. Two stay sutures were placed in the distal colon and one in the ileum.
Ileocolostomy:
The caudal mesenteric and left and middle colic vessels were ligated. The mesentery
associated was transected close to the colonic border. Feces was milked away from the
sites of proposed resection and doyen forceps were applied to decrease contamination.
Two stay sutures were placed in the distal and proximal colon.
A one-layer approximating suture pattern using 4-0 on a tapered needle with
polydioxanone was used for the anastomosis procedure. A leak test was used to evaluate
the anastomosis site. The abdomen was lavaged with warm saline and the abdomen
closed routinely. The linea alba and subcutaneous tissues were closed in simple
continuous fashion using (0, 2-0, 3-0) (polydioxanone, polyglyconate) suture. The skin
was closed in simple interrupted pattern using (0, 2-0, 3-0) (polydioxanone,
polyglyconate, polypropylene, flourafil, staples, tissue adhesive).

Postoperative recommendations:
1. Continue IV/oral antibiotics for 24- 48 hours. Elect whether or not to continue
oral antibiotics (Cephalexin or Clavamox) for 7-10 days.
2. Continue IV fluids for 2-3 days.
3. Water may be offered 12 hours after surgery.
4. Food may be offered 24 hours after surgery.
5. Cyproheptadine (2 mg/cat PO, bid) may be used to stimulate eating.

Postoperative care and expectations:
Monitor postoperatively for fever and successful passage of stool.
Expect multiple bowel movements (4-6) initially.
Some cats loose weight for the first 2-4 weeks postoperatively, but usually regain
afterwards.
Consistency of stool usually is watery to mucoid for the first 3-6 weeks and it
gradually becomes more solid over weeks and the number of bowel movements
decrease over weeks to months.
Surgical Risks Include:
1. Infection (peritonitis) which may require additional testing and medication at an
additional cost.
2. Incision leakage of intestinal contents necessitating further surgery.
3. Short term diarrhea and frequent bowel movements that improve over time.
4. Some patients continue to have some straining during bowel movements for 7-10
days after surgery.
5. There is a possibility the condition could reoccur at some point in the future due to
nature of the primary disease process affecting the gastrointestinal tract.
Strict adherence to post-surgical care and medicating of your pet will minimize these
potential complications and serious problems are very uncommon in most cases.
Your pet may need to be on a special low volume, high calorie diet for a period of
time (10-14 days in most cases). Most patients need to remain on intravenous fluid
support for 2-3 days after surgery.


Thank you.
Justin Harper, DVM, Dipl. ACVS, LA

Source: http://www.tsvs.net/webforms/SM-SurgeryReport/Subtotal%20colectomy%20surgery%20report.pdf