Chapter 6: Table of Contents
Use a finger or a spay hook to identify the left horn (it’s easiest to find). To use the hook, retract the left abdominal wall (not the skin) with thumb forceps and insert the hook a few centimeters caudal to the kidney (mid to caudal aspect of incision) with the hook sliding against the abdominal wall. Be aware that the spleen might be enlarged due to anesthetic drugs and could be in your way. If this is the case, gently move the spleen cranially with your fingers prior to inserting the spay hook. Once the hook is inserted deep into the abdominal cavity, turn it 180 degrees (hook facing the abdominal organs) to engage the uterine horn or broad ligament and gently retract to identify the structure(s) hooked. If you insert the hook too far cranially, you might pick-up the ovary which will be tight and could traumatize the vascular pedicle. Observe the tissues carefully. If the tissue is not the uterine horn, it is most likely to be the broad ligament. Follow it with digital palpation to find the uterine horn. Confirm that you indeed have the correct structures by visualizing an ovary, a horn and the uterine bifurcation. If the hook picked up intestine or omentum, replace these structures within the abdominal cavity and begin again or use an alternative method. Another option is to use your fingers to identify the kidney and then the ovary just caudal to it. That will allow you to follow the horn and exteriorize it. Alternatively, you can elevate or retroflex the urinary bladder (you might need to extend your incision for this to be possible) to identify the cervix of the uterus and to follow the horns up towards the ovary.