What is ‘ex-lap’?
So your vet tells you, “your pet needs an ex-lap”. Many thoughts go through your mind. What is an ex-lap? What does this mean for my pet exactly?
‘Ex-lap’ is short for exploratory laparotomy. It simply means an operation, where a vet opens your pet’s abdomen (belly) to explore its contents. Organs such as the stomach, kidneys, intestines, liver and bladder are found in the abdomen. An ex-lap might be needed for many reasons, including: to repair a damaged organ; remove stones from the bladder; or to take samples of a tumour to aid diagnosis.
Most often surgeries are performed for a specific reason, for example, to spay (remove ovaries and uterus) your pet. Or to remove a foreign object that they shouldn’t have eaten. However, exploratory laparotomies are often performed when a diagnosis is not certain. To investigate the cause of your pet’s illness, an exploratory laparotomy is performed to methodically examine each organ. This will help gather information about your pet’s illness (as well as hopefully treating it).
Why does my pet need this operation?
Symptoms such as vomiting, diarrhoea, abdominal pain or swelling may mean that there is a problem within your pet’s abdomen. However, these symptoms are not specific, so your vet may need to investigate the possible causes further.
Lots of questions
Firstly your vet will gather a full history and they may ask you questions such as;
- When did your pet last eat or drink?
- How often is your pet vomiting and what does it contain?
- Does your pet chew toys?
Your vet will then perform a thorough examination of your pet. They will pay close attention to your pet’s abdomen, to see whether any abnormalities can be felt.
If your vet is concerned about your pet’s condition then they may recommend further investigations. Such as blood tests or imaging (x-rays or ultrasound) of your pet’s abdomen. If your vet is still concerned that an underlying problem is present, then they may recommend an exploratory laparotomy be performed.
Exploratory laparotomies are helpful because they allow all of the abdominal contents to be examined at once and through one incision. X-rays and ultrasound are not always conclusive. Exploratory laparotomies allow the vet to make or confirm the diagnosis, collect tissue samples (if the diagnosis is not visibly clear) and assess the severity of your pet’s condition. Exploratory laparotomies in certain situations can also be life-saving. For example, in the case of a pet ingesting a foreign body, if this is not removed quickly and continues to go undetected it could prove fatal.
What happens in an ex-lap?
Your pet will be given a general anaesthetic then placed on their back upon a surgical table. A large section of hair will be clipped from the bottom of the rib cage to the pelvis. This is to ensure no hair falls into the wound during the operation, as this may cause an infection. Their skin is scrubbed thoroughly with surgical soap to ensure it is sterile before the surgeon makes an incision along the length of the abdomen. A large incision is necessary to explore the whole abdomen. There’s no need to worry about this, the length of the wound will have no effect on the time it takes to heal, as the wound heals across and not along its length.
The vet will examine every organ in turn and if an abnormality is detected they may decide to take a tissue sample or perform another surgery to treat the condition (e.g. remove a bleeding spleen). Occasionally no abnormality is found however not all diseases are visible to the naked eye and your vet may still want to take tissue samples to achieve a diagnosis. At the end of the procedure, the incision will be closed with stitches, in three layers: the inner (muscle) layer first, then the middle (fat) layer and finally the outer (skin) layer.
What are the risks of this operation?
There is always an element of risk associated with any procedure. The degree of risk depends on the underlying condition and what procedures are performed. General anaesthesia is generally very safe. Risks that can be associated with ex-laps include bleeding, infection and wound breakdown (opening of the wound).
Pets that have undergone an ex-lap have had a large incision in their abdominal muscles. It is vital to rest your pet to allow these muscles to heal. Lack of rest may lead to wound breakdown and the life-threatening leakage of the abdominal organs to outside your pet’s body. If you are struggling to keep your pet calm and rested, you should contact your vet for advice.
Pets should also be fitted with an anti-licking device, such as an Elizabethan collar (the dreaded ‘cone of shame’) or a bodysuit. It is detrimental to allow your pet to lick its wound as its saliva will contain lots of bacteria and this, in turn, may infect the wound.
The overall complication rate of this procedure is low. However, serious complications can occur and may be life-threatening. Most complications can be prevented if you follow your vet’s advice. It is important to discuss the pros and cons of any procedure with your vet before going ahead.
Will my pet need to stay overnight?
Your pet will likely need to be hospitalised for one to three days depending on what procedures have been performed and their overall condition.
If an incision has been made into an intestine to remove a foreign body for example, then the vet will want to monitor your pet closely for a few days, to ensure their guts have healed before going home. Surgical wounds in the intestines do carry a potential additional risk of peritonitis (infection in the tummy) if the wound does not heal sufficiently. This could lead to gut contents (containing lots of bacteria) entering and infecting the abdomen. If this happens your vet will need to re-open the abdomen to quickly fix the leakage and flush the abdomen clean. Peritonitis can be a fatal complication. Success will largely depend on how quickly it is treated.
What aftercare will my pet need?
When it is time for your pet to go home, your vet will provide you with instructions specific to your pet. Your pet will be given pain killers and any necessary additional medication.
It is important to follow all the instructions closely to reduce the risk of complications. You should monitor the wound daily for any bleeding, swelling or discharge and contact your vet should this happen. It is important to prevent your pet from licking the wound by using an anti-licking device and to ensure that they are well-rested to give it the best chance of a speedy recovery.
Your vet will schedule a post-operative check one to two days after discharge to see how your pet is doing. They will usually schedule another appointment approximately 10-14 days after the surgery to remove any stitches (if necessary).
If you are unsure about anything or concerned about the recovery of your pet at home, you should contact your vet as soon as possible.