STEP BY STEP PROCEDURE FOR NEUTERING/SPAYING OR OVARIOHYSTERECTOMY IN THE FEMALE DOG

STEP BY STEP PROCEDURE FOR NEUTERING/SPAYING OR OVARIOHYSTERECTOMY IN THE FEMALE DOG

Neutering females is also known as ‘spaying’. Spaying is the more commonly used term for Ovariohysterectomy, which basically means the removal of the uterus and ovaries. ‘Spaying’ is also known as an ovariohysterectomy. This literally means removal of (‘ectomy’) the ovaries and uterus (‘ovariohyster’). This stops the bitch from having regular heat cycles and from being able to reproduce..The operation is a one off procedure and is not reversible. As responsible pet owners, we can all do our bit for the health and welfare of our animals. Spaying a dog at an early age can lengthen her life span and increase her quality of life. Generally, routine spaying is performed at six months of age, but this may vary from practice to practice, based on individual cases. Ovariohysterectomy can also be performed post-whelping when puppies have been weaned and the mammary glands have returned to normal.

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Key Benefits for Ovariohysterectomy in the bitch:

The main advantages of spaying are preventing pregnancy, preventing infection of the uterus (pyometra), preventing ovarian or uterine cancer and reducing the likelihood of mammary (breast) cancer, all of which can be life-threatening. It also prevents the inconvenience of having a bitch in season with unwanted attention from male dogs.

The main disadvantages are major surgery with associated risks, an anaesthetic with associated risks and the increased likelihood of urinary incontinence in later life. Fortunately, the risks involved in anaesthesia and surgery are very small indeed compared with the risks of the other conditions which are prevented by spaying. Urinary incontinence in later life is a nuisance but not very common, and can usually be controlled by drugs.

Heat Prevention: -To prevent oestrus and the associated problems such as bloody vaginal discharge, the nuisance of male dogs being attracted and unwanted pregnancies.

Mammary Tumour Reduction: – Spaying at a early age reduces the risk and severity of mammary cancers. It is important to be aware that 50% of mammary tumours are malignant in the entire (un-neutered) bitch.

Pyometra Prevention: – Pyometra is an infection whereby the uterus fills with pus and the dog’s condition deteriorates rapidly. It is a very serious condition, more commonly seen in the middle-aged and elderly bitch. Spaying is indicated as the treatment or prevention, prevention is best.

Phantom Pregnancy Prevention: – Spaying is also indicated as a permanent treatment for recurrent and severe false pregnancy, phantom pregnancy or pseudocyesis. Phantom pregnancy may cause behavioural changes (for e.g. depression, nest making) as well as physical changes (lactation, abdominal enlargement).

Ovariohysterectomy   Procedure

As a bitch spay is a major surgical procedure, it requires general anaesthesia, full theatre discipline and surgical technique. The uterus is an organ which comprises of a uterine body, two horns (to which the ovaries are attached) and a cervix. Strictly speaking the spaying of an animal means the removal of the ovaries (ovariectomy). When both ovaries and the uterus to the level of the cervix are removed this operation is known as an Ovariohysterectomy. An incision is made on the midline of the abdominal wall at the level of the umbilicus. The incision is made through three layers to expose the abdominal contents (skin fascia- outer skin, linea alba-outer layer of muscle under the skin and peritoneum- inner muscle layer). The uterus and ovaries are carefully located, surgically removed and ligated (tied off). At the end of surgery the abdominal incision is stitched up routinely in three layers. The outer layer of stitches on the skin fascia, if non -absorbable material is used, should be removed 10 days post surgery. Immediate post –operative treatment generally includes pain relief, exercise restriction recovery diet and plenty of TLC. An Elizabethan collar is often given to prevent the dog from licking at the wound. Long term dietary modifications are often indicated to prevent obesity, which often occurs after spaying due to alteration in hormone levels.

Deciding when to spay

It is not a good idea to spay when a bitch is in season or about to come into season, because the blood vessels supplying the uterus and ovaries are all larger and this will increase the risks of surgery. The other time we try to avoid is the 8 weeks after a season, when a bitch may suffer from a hormonal imbalance called a false pregnancy.

If this happens, she may be acting as if she is nursing pups and the operation at this time would cause such sudden changes in hormone levels that it would be unfair to her. Also if she was producing milk, the enlargement of the milk glands would make it more difficult for the spay wound to heal.

For all of these reasons, the time chosen to spay is usually either before the first season occurs, or 3-4 months after a season. A physical examination by the vet will determine whether a 5-6 month old bitch puppy is mature enough to spay before her first season.

Before the operation

As well as timing the operation carefully to reduce any risks, it is also important that the bitch is not overweight. Because this increases the difficulty of the operation, it may well be advised that an overweight bitch should lose weight before the operation.

Another important way of spotting avoidable risks is by taking a blood test before the anaesthetic. This could be done on the day of the operation or a few days earlier. This is used to check the liver and kidney function (both vital when dealing with anaesthetic drugs) and to rule out any unsuspected illnesses.

Before going to the surgery

Before any anaesthetic, the patient should be starved for a number of hours, according to the instructions of the surgery. This prevents any problems with vomiting which could be dangerous. It is also a good idea to allow the dog enough exercise to empty the bladder and bowels. Apart from that, it is best to stick as closely as possible to the normal routines of the day so that the dog does not feel anxious.

Being admitted for surgery

On arrival at the surgery, you can expect to be seen by a vet or a veterinary nurse who will check that you understand the nature of the operation and will answer any questions you may have. They will ask you to read and to sign a consent form for the procedure and ask you to supply contact phone numbers. This is very important in case anything needs to be discussed with the owner before or during the operation.

Before the anaesthetic

Your bitch will be weighed to help calculate the dosages of drugs and given a physical examination including checking her heart. If a pre-anaesthetic blood test has not already been done, it will be done now and the results checked before proceeding. If any abnormalities are found, these will be discussed with the owner before deciding whether the operation goes ahead or not. One possible outcome is that extra precautions such as intravenous fluids may be given.

A pre-med, which is usually a combination of several drugs, will be given by injection. This begins to make the dog feel a bit sleepy and ensures that pain relief will be as effective as possible.

The anaesthetic

There are several ways in which this can be given, but the most common is by an injection into the vein of the front leg. The effects of the most commonly used drugs are very fast, but don’t last for very long, so a tube is placed into the windpipe to allow anaesthetic gas and oxygen to be given. The anaesthetic gas allows the right level of anaesthesia to be maintained safely for as long as necessary.

Various pieces of equipment will then be connected up to monitor the anaesthetic. This is a skilled job which would usually be carried out by a qualified veterinary nurse. Apart from the operating table, the instruments and the anaesthetic machine, a lot of specialised equipment will be on “stand by” in case it is needed.

The area where the surgical incision is to be made will be prepared by clipping and thorough cleaning to make it as close to sterile as possible. The site is usually in the middle of the tummy, but some vets prefer to use an incision through the side of the tummy.

The operation

While the bitch is being prepared for surgery as mentioned above, the surgeon will be “scrubbing up” and putting on sterile clothing (gown, gloves, hat & mask) just as in all television surgical drama programmes. The surgical instruments will have been sterilised in advance and are opened and laid out at the start of the operation.

The operation involves removal of the ovaries and uterus (ovario-hysterectomy). The surgeon carefully opens the abdomen by cutting through the various layers. The first ovary is located and its blood vessels are tied off before it can be cut free at one end, then this is repeated with the second ovary. It is a delicate and fiddly job, needing great care and attention.

The main body of the womb or uterus is then tied off as well before the whole thing can be cut free and removed. After checking for any bleeding, the layers of the tummy can then be sewn closed again. A dressing might be applied to the wound. Further drugs may be given now as needed.

When the operation is finished, the gas anaesthetic is reduced and the bitch begins to wake up. She will be constantly monitored and the tube removed from her windpipe when she reaches the right level of wakefulness.

Recovery

Like humans, dogs are often a bit woozy as they come round, so she will be placed in a cage with soft warm bedding and kept under observation. Usually they will wake up uneventfully and then sleep it off for the rest of the day.

After-care

The bitch will not be allowed home until she is able to walk and is comfortable. Full instructions should be given by the surgery concerning after-care. The most important things would be to check the appearance of the wound, to prevent the bitch from licking it (with a plastic bucket-collar if necessary) and to limit her exercise by keeping her on the lead. Any concerns of any kind should be raised with the surgery.

Any medication supplied should be given according to the instructions. Pain relief can be given by tablets or liquid on the food. Antibiotics are not always needed, but may be supplied if there is a need for them.

Usually there will be stitches in the skin which need to be removed after about 10 days, but sometimes these are concealed under the surface and will dissolve by themselves.

After a couple of weeks, if all goes according to plan, the bitch can be allowed to gradually increase her exercise levels. This is the stage that Tilly has now reached and she is thoroughly enjoying a good run again now that she is feeling back to normal.

What are the potential complications and risks of the procedure?

Spaying is one of the most common operations performed in veterinary practice. Providing the bitch is in good health and aftercare protocols are followed, serious complications are extremely uncommon. However, despite being a routine surgery, minor to major complications can occur and it is important that you are aware of them.

• Slippage of ligatures and bleeding. This can be a life threatening complication that occurs during or after the surgery and requires immediate surgical intervention.
• Haematoma, abscess or seroma. Accumulations of blood or fluid below the incision may occur and will generally resolve without intervention. More rarely, pus may accumulation and require antibiotics. This is very rare due to careful aseptic technique.
• Infection and wound breakdown. Stopping her from licking her incision and restricting exercise is important in preventing this.
• Herniation. Rarely, the internal or external stitches fail allowing fat or abdominal contents to come through. This may have serious consequences and requires prompt surgical intervention.
• Anesethetic risk. Multiple measures are taken to reduce this risk and your pet will be closely monitored at all times. The weight of the patient and length of anaesthesia are some factors that increase the risk.
• Weight gain post surgery if her diet is not adjusted appropriately.
• Mild gastro-intestinal upset post surgery that is usually self-limiting.
• Very rarely a portion of reproductive tract may be left requiring further surgery.
• Though extremely rare, damage to the urinary tract or bowel are recognised possible complications.

Reference-On Request

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