6 Cervix Vagina ﬁlled of pus or blood Section Clove hitch Bladder Pubis Figure 4: Complication: Pathological cervix amputation. Finally, the skin is sutured using simple interrupted sutures or mattress sutures with non-resorbable ﬁlament such as MONOSIN N.D. Dec.3. The wound is then dis- infected with antiseptic solution and protected with a few swabs and an adhesive dressing. 3. Results 3.1. Surgical Variation. Hysterectomy in the bitch via the linea alba is not very diﬃcult. Nevertheless, it is sometimes necessary to perform the surgery via a vaginal approach rather than via the linea alba. 3.1.1. Hysterectomy via the Vaginal Approach. Per-vaginal hysterectomy is performed in the event of uterine prolapse, if the latter cannot be reduced or if has been traumatised to such an extent that it cannot be replaced safely. The elective site for amputation is between the cervix and urinary meatus, in which case there are two diﬀerent possible techniques, either with an elastic ligature, or by suturing. (a) Elastic Ligature. An elastic band is placed between the cervix and the urinary meatus, the exeresis is then performed and the stump sutured by joining the internal and external segments with a perforating simple continuous suture. (b) Suture. Firstly, an intestinal clamp is placed between the cervix and the urinary meatus to crush the pedicle, then, either a transﬁxing suture or overlapping mattress suture is placed. Once the sutures have been placed, the vagina is excised. The stump will be expelled within 15 days. 3.2. Postoperative Care. Firstly, advise perioperative oxygena- tion if the surgical shock is very great. The animal is warmed, especially if the female was in poor condition prior to the procedure, she must be rolled in a blanket and placed in a heated kennel. Obstetrics and Gynecology International Intravenous ﬂuid therapy is administered with isotonic saline along with an injection of Vitamin C and corticos- teroids. The bitch is then placed under antibiotic therapy for at least 5 days. The sutures are removed after 10 days. Any stagnant uterine secretions in the cervix and vagina will be eliminated in the days following and then cease completely. 3.3. Complications. These can be classiﬁed as general or speciﬁc. 3.3.1. General. (i) Evisceration. (ii) Abdominal herniation. (iii) Suppuration from the cutaneous wound. (iv) Peritonitis. 3.3.2. Speciﬁc. Haemorrhage: occurring during the inter- vention and continuing in the hours following. The latter represents one of the most common causes of the death of the animal. They can be situated at the level of the following. (i) Ovarian pedicle: this is why it is not advisable to operate during oestrus, where the uterine arteries and veins are hypertrophied. (ii) Broad ligament: always check that there is no signiﬁ- cant haemorrhage after rupture. (iii) Uterine cervix: treatment involves a blood transfusion and repeat surgery to ligate the bleeding vessel. (iv) Abscess: These form especially at the level of the anterior straight of the pelvis and lumbar, when the cervix is not correctly treated, resulting in pain during defecation, vomiting, and ﬁnally an occlu- sive syndrome. The diagnosis is established via an exploratory laparotomy. Treatment is surgical, and may even necessitate nephrectomy or enterectomy. (v) Abdominal adherences: these result from a localised peritonitis and cause an occlusive syndrome. (vi) Urinary incontinence: around 20% of spayed bitches are aﬀected, especially large breeds. (vii) Recurrence of metritis: occurs in the month or years following the intervention, and a serous, purulent, or haemorrhagic vulvular discharge may occur. This complication occurs in bitches who have undergone hysterectomy alone, and which did not resolve the problem given that part of the genital apparatus remains in place: vagina, cervix, and occasionally a short section of uterus in front of the cervix, and when the oestrus cycle is abnormal, the uterine mucosa is not the only organ to suﬀer the conse- quences, the cervix and to a lesser extent the vagina also react. There are two possible solutions.