Prospective comparison of perioperative wound and pain score parameters in cats undergoing flank vs midline ovariectomy

Abstract

Objectives The aim of this study was to prospectively compare perioperative pain score and wound parameters, inclusive of postoperative swelling and erythema, between flank and midline ovariectomy (OVE) in cats, performed by final-year veterinary students. Methods Healthy cats presented for routine OVE were randomly assigned to either the midline or flank group after owner consent to participate in the study. Perioperative protocols were standardised for both groups. Clinical data were collected prior to surgery, intraoperatively, at 1 h postoperatively, at the time of discharge, and at 3 and 10 day postoperative re-examination appointments. Data recorded included duration of surgery and anaesthesia, intraoperative complications, Feline Acute Pain Scale (FAPS) scores, a simple descriptive scale of reaction to wound palpation (SDSwound), a dynamic and interactive visual analogue scale assessment of pain (DIVAS), and both a simple descriptive scale (SDSswelling) and a visual analogue scale (VASswelling) of surgical wound swelling. Results Thirty-eight cats received a flank OVE and 37 received a midline OVE. Duration of surgery, duration of anaesthesia and intraoperative complications did not vary significantly between the two groups. Cats in both groups had significantly higher FAPS scores after surgery ( P = 0.0002), with cats receiving a flank OVE having significantly higher pain scores compared with a midline OVE at 1 h postoperatively ( P = 0.0004) and at discharge ( P = 0.002). Swelling of the surgical wound (SDSswelling) was significantly higher in cats receiving a midline OVE at the time of discharge ( P = 0.048), as well as at the 3 day ( P <0.0001) and 10 day ( P = 0.001) postoperative re-examinations. FAPS scores were significantly higher in cats receiving a midline OVE at the 3 day ( P = 0.016) and 10 day re-examinations ( P = 0.045). No cats in either group suffered a wound breakdown or infection. Conclusions and relevance Our study does not support advocating a preferred surgical approach for feline OVE within a teaching environment.

Midline versus flank approach for spaying cats – is one less painful than the other?

“…In the second study, 6 this effect was reversed at three and 10 days after surgery, with the midline group demonstrating significantly higher pain scores. This was the only study to score pain for more than 24 hours after surgery.…”

“…Paper 5: Prospective comparison of perioperative wound and pain score parameters in cats undergoing flank vs midline ovariectomy 6 …”

Comparing wound complications associated with midline and flank approaches for spaying cats

“…Paper 1: Prospective comparison of perioperative wound and pain score parameters in cats undergoing flank vs midline ovariectomy 1 …”

“…There are a number of constraints to be considered when comparing these three papers. First, one paper described ovariectomy, 1 while the other two 2,3 described ovariohysterectomy. Second, two studies used shelter animals, 2,3 while one used client‐owned animals 1 …”

“…Third, surgery was performed by veterinary students in two studies, 1,3 while qualified veterinary surgeons performed the procedures in the third 2 . Finally, postoperative assessment was carried out by veterinary surgeons in two of the studies, 1,2 while owner‐reported outcomes were recorded in the third 3 …”