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President's Message
July/August 2025 Newsletter Volume 4
Dear Members, As we move into the heat of summer, I hope this message finds you well and energized. The year has brought both challenges and opportunities, and I would like to take a moment to reflect on our progress and share some critical updates from the Veterinary Association. With all the recent changes in government policy affecting veterinary practice, particularly in areas such as animal welfare legislation, staffing, and corporate takeover, we as an association have initiated dialogue with key policymakers to ensure our profession’s voice is heard. Your feedback continues to guide our approach and is vital as we navigate these developments. If you have any concerns or would like us to discuss specific matters, please do not hesitate to contact us. As we approach the mid-year mark, it is a great time to evaluate your goals and expectations for 2025. It is a great time to put in place the necessary strategies that will help you achieve those goals. It's a great time to meet with your team, accountant, and lawyers to make sure everything is in place for a successful 2025. We, as an association, are taking the same steps to ensure we continue to provide you with the best service possible. We continue to have a strong presence in our CE meetings. We are already starting to plan out the Holiday Party. We are continually seeking new ways to support our members and the broader community. Please feel free to contact us with any opportunities or ideas you may have to achieve those goals.
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Currently, we are also seeking new association members and board members to help us continue our success. The association is a great way to support your colleagues and get to meet a lot of them in a very special way. We aim to attract new graduates and younger members to our association. If you have any new staff members, please invite them to our next meeting so they can see what we have to offer. As we noted in our last questionnaire, most of our current members have been with us for over ten years. We need a new influx of members as they will be the future of our association. Looking ahead, I encourage all members to stay involved, whether by attending our meetings, serving as a board member, engaging in local outreach, or simply sharing your insights. Together, we continue to shape the future of veterinary medicine in our region. Wishing you a safe, restful, and productive summer. Warm regards, Dr Armando Villamil DVM, ACVIM (oncology) BCVMA President Pet Cancer Group Chief Oncologist
Contact: info@petshelptheheartheal.org
President Armando Villamil, DVM drv@petcancergroup.com Immediate Past President Stephanie Jones, DVM drstefni@gmail.com Secretary Stefeny Pollack, DVM szpollack@gmail.com Treasurer Claudia Valderrama, DVM claudia67v@aol.com Education Chair Simon Kornberg, DVM drkornberg@sevneurology.com Social Chair Jason Horgan, DVM jason081977@aol.com Newsletter Chair Yolanda Ochoa, DVM dr.yolanda@vet2yourpet.com
BCVMA Executive Board 2025
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JOIN OR RENEW TODAY! Enjoy the camaraderie and top-notch continuing education offered by the BCVMA! We offer 10 great CE meetings per year, including Florida Pharmacy and Rules, a newsletter, and the best Holiday Party in South Florida! Membership is Only $130 yearly. Join or Renew online by visiting BCVMA 2025 Membership OR Scan QR Code Are you a new graduate? Click here to find out about our one year complimentary membership.
Dr. James Anderson II` 954-347-3557 doctor_anderson98@gmail.com Dr. Peggy Carlow 954-341-9552 pmcarlow@att.net Dr. Doris Caraballo 786-410-9462 doriska32@yahoo.com Dr. Diana Drogan 954-854-9426 dr.diana.dvm@gmail.com Dr. Ursula Dell 965-696-0642 drdell03@gmail.com Dr. Fumiko Miyamoto 352-339-2207 www.theasiandoctorllc.com Dr. Dan Selvin 954-604-0084 dcselv4@gmail.com Dr. Mark Steele 954-942-7193 mdsteele@bellsouth.net Dr. Ana M. Tassino 305-335-3111 tassino@bellsouth.net
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FVMA District VI Leadership Update We extend our sincere gratitude to Dr. Robert Swinger for his dedicated service as the FVMA District VI representative. His commitment and leadership have been greatly appreciated.You will be missed! Please join us in welcoming Dr. Susan Zobler as the new District VI representative. We look forward to her contributions and leadership in this important role. Thank you, Dr. Swinger — and welcome, Dr. Zobler
Medical Article Maria Serrano, DVM Chief Veterinarian Miami Dade Animal Services
A Comparative Analysis of Scrotal and Pre-Scrotal Neuter Procedures in Dogs.
I. Introduction Canine neutering is a common surgical procedure performed for various reasons, including population control and behavioral modification. The two primary surgical approaches are the scrotal and pre-scrotal methods. While the pre-scrotal technique has been traditionally emphasized , the scrotal technique has gained popularity, particularly in high-volume clinics, suggesting it's a safe and efficient alternative. This report provides a comprehensive comparison of these two procedures for veterinary professionals, covering surgical techniques, potential complications, recovery, pain levels, and postoperative care. II. Surgical Technique: Scrotal Neuter Approach The scrotal neuter involves a direct incision on the scrotum to access the testicles. Patient preparation includes anesthesia and aseptic preparation of the scrotal area. The dog is positioned in dorsal recumbency, and a sterile drape is applied. A sterile swab over the prepuce minimizes contamination. A single incision is made on the ventral scrotum, lateral to the median raphe, approximately one-third the length of the testicle. Some surgeons prefer the median raphe. The incision length is typically approx. 1-2 cm. The testicle is exteriorized. In a closed technique, the parietal vaginal tunic remains intact. The spermatic cord fascia is stripped. Two hemostats are placed across the ductus deferens and vascular cord proximal to the testicle. The cord is ligated with absorbable suture (e.g., polyglactin) using secure knots. Single or double ligation may be used. The cord is transected distal to the hemostats , and the cut end is checked for bleeding. The process is repeated for the other testicle through the same incision. In an open technique, after incision and exteriorization, the parietal vaginal tunic is incised. The epididymis ligament is separated. The ductus deferens and vascular cord are ligated separately or together. The vaginal tunic may be closed with absorbable suture. Scrotal incision closure varies. It can be left open to heal by second intention, or a single subcutaneous suture may be placed. Skin glue is another option. The choice depends on factors like the dog's size and the surgeon's preference.
Medical Article Continued
III. Surgical Technique: Pre-Scrotal Neuter Approach The pre-scrotal neuter involves an incision cranial to the scrotum. Patient preparation includes anesthesia and aseptic preparation from the prepuce to the scrotum and medial thighs. The dog is in dorsal recumbency, and a sterile drape is positioned between the prepuce and scrotum. One testicle is pushed cranially into the pre-scrotal area and stabilized. A single midline incision (1-2 cm) is made in the pre-scrotal skin. For a closed pre-scrotal castration, the first testicle is exteriorized with the parietal vaginal tunic intact. The spermatic cord fascia is stripped. Two hemostats crush the spermatic cord proximal to the testicle. The cord is ligated with absorbable suture (e.g., 2-0 polyglactin) using secure knots. The cord is transected distal to the second hemostat , and the cut end is checked for bleeding. The process is repeated for the second testicle. In an open pre-scrotal castration, after exteriorization, the parietal vaginal tunic is incised. The ductus deferens and vascular cord are ligated individually or together. The vaginal tunic is typically closed with absorbable suture. The pre-scrotal incision typically involves a three-layer closure. The fascial layer is closed with interrupted or continuous absorbable sutures. The subcutaneous tissue is closed with a continuous absorbable suture. The skin is closed with buried subcuticular or intradermal absorbable sutures, or non-absorbable cutaneous sutures. IV. Comparative Analysis of Surgical Techniques The main difference is the incision location: scrotal on the scrotum, pre-scrotal cranial to it. This affects the surgical access to the spermatic cord. Scrotal allows direct access, while pre-scrotal requires cranial manipulation. Closure methods also differ. Scrotal closure is variable (open, single suture, glue), while pre-scrotal typically uses a three-layer closure. Studies show that surgical time is generally shorter for the scrotal approach, with reductions of around 30% reported. 6 This can reduce anesthetic risk, increase efficiency and reduce costs. The scrotal approach eliminates the risk of accidental urethral ligation or laceration during closure, a potential complication in pre-scrotal neuter, especially in young dogs.
V. Potential Complications: Scrotal Neuter vs. Pre-Scrotal Neuter Overall minor complication rates are similar for both techniques, including dehiscence, swelling, hemorrhage, bruising, hematoma, and self-trauma. Pre-scrotal complication rates range from 0% to 32%, often lower in younger dogs. Infection rates are similar despite the open incision possibility in scrotal neuter suggesting a lower risk of infection due to drainage. Meticulous preparation and postoperative care are crucial regardless of the technique used. Hemorrhage risk is similar, but the scrotal approach may allow for earlier detection and intervention. Hematoma formation in the scrotum may be less likely with the scrotal approach. Severe scrotal hematomas formed with the pre-scrotal approach may necessitate further surgical intervention, potentially including scrotal ablation in some cases. 7 Incision dehiscence can occur with both, often due to self-trauma. 6 Some studies report less self-trauma with the scrotal technique. 8 Also, if left open, dehiscence is not likely due to wound closure by second intention. Scrotal swelling is common and usually resolves spontaneously. 6 Peri-incisional dermatitis is less common 16 , and seroma formation may be less likely with the scrotal approach. VI. Recovery Time and Pain Levels The recommended recovery period for both is 7-14 days of restricted activity. 4 Some suggest a slightly faster recovery with the scrotal approach. Postoperative pain is expected and managed with analgesics like NSAIDs. Studies show no significant difference in pain levels between the two techniques with appropriate analgesia. VII. Postoperative Care Recommendations: Scrotal Neuter Postoperative care includes pain management with prescribed medications 1 and educating owners on recognizing pain signs. Wound care involves keeping the area clean and dry and monitoring for infection. 1 Owners should be informed about potential serosanguineous drainage if the incision is open or partially closed. Topical ointments should be avoided unless instructed.
Activity restrictions are crucial for 7-14 days, avoiding strenuous activities. Leash walks for elimination only are recommended , and confinement when unsupervised. Preventing licking or chewing with an Elizabethan collar is important. Other recommendations include informing owners about the possibility of fertility for up to 30 days post-neuter. A recheck is needed if any concerns arise. VIII. Postoperative Care Recommendations: Pre-Scrotal Neuter Postoperative care includes pain management with prescribed medications 1 and owner education on pain signs. Wound care involves keeping the incision clean and dry and monitoring for infection. Bruising may occur initially. Topical ointments should be avoided unless instructed. Activity restrictions are essential for 7-14 days, avoiding strenuous activities. Leash walks for elimination only are recommended, and confinement when unsupervised. Preventing licking or chewing with an Elizabethan collar is crucial. 1 Self-trauma is more likely with pre-scrotal approach due presence of sutures and potential tension caused by scrotal edema or hematoma. Other recommendations include informing owners about potential scrotal swelling 1 and the possibility of fertility for up to 30 days post-neuter. 2 A recheck is needed for suture removal if non-absorbable sutures were used or if any complications arise. 2 IX. Conclusion Both scrotal and pre-scrotal neuter are effective techniques. Scrotal neuter offers potential benefits like shorter surgical time and possibly less self-trauma 6 , and eliminates urethral trauma risk. 7 Pre-scrotal is well-established with a consistent closure. Minor complication rates are similar; however, scrotal neuters may have a lower risk of major complications such as scrotal hematomas and abscess formations because it allows easier hemorrhage detection and drainage. 8 These complications may require more extensive and invasive surgical interventions, including drainage placements, or scrotal ablations. 8 The choice depends on surgeon preference, patient factors, and practice environment. The scrotal approach appears to be a safe and efficient alternative, especially in high- volume settings. Meticulous postoperative care is crucial for both techniques, including pain management, incision care, activity restriction, and preventing self-trauma. Clear communication with owners is essential for a smooth recovery.
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