luvk9ines gives a tutorial on how to tie a two-handed suture tie for veterinary purposes. To begin the two-hand suture tie, knot the two ties together and continue to knot but you will alternate the direction of each knot. One knot/tie will be interlinked from the top and the next knot will be interlinked from the bottom. In other words, pretend that you are making a knot on a tie and each time you make the knot, the tie on the left will be going in the bottom direction. The next knot, the tie will be connecting from the top position. Continue in this fashion. This creates the two handed suture tie on an animal.