The Spay Procedure

The surgical procedures are performed under general anesthesia and employing sterile instruments and a sterile surgical field.  Medical emergencies can arise if a pet becomes infected during these procedures.  No surgeon approaches a spay or neuter as if it were "routine" because each surgery is different from every other, each pet is different, and while neutering might be deemed a minor surgery a spay certainly qualifies as a major procedure. (So if you wonder why the charges for these procedures seem high, you just may reconsider after visiting The Surgery Room.)

The photos are of a cat spay.   Essentially, the structures and procedure are the same for a dog spay.  As you can imagine, though, there are differences between working on a 180 pound Saint Bernard and a 3 pound kitten!

The Dog Neuter Procedure

	The dog is given a general anesthetic and placed on the surgery table.  The area forward of the scrotum is shaved and scrubbed with special surgical soap.  Following the scrub an antiseptic solution is placed on the surgical area.
	The single incision is made in the skin, not through the scrotum, and slightly forward of the scrotum. Staying in the midline diminishes the slight amount of bleeding that generally occurs.  In this photo the surgeon, Dr. Ron Reupert of Rhinelander, Wisconsin, pushes on a testicle to advance it forward to where the skin incision was made.
	Viewing the testicle in the incisional opening, the surgeon cuts through the fibrous capsule surrounding the testicle.  Now the testicle is visible and is exteriorized through the incision.
	The testicle is pulled through the incision and the spermatic cord containing the vas deferens and blood vessels is clamped and an area is inspected where the ligature will be placed.  It is at times like this that the marvels of modern anesthesia are really appreciated by man and dog!
	To allow for the removal of the testicle the spermatic cord must be cut.  Having a generous blood supply, the cord must be tied securely (ligated) to be sure there is no post operative hemorrhaging. The second testicle is removed in the same manner.  The surgeon inspects the surgical area for "bleeders"...little vessels that cause nuisance, but not dangerous, bleeding.
	The incision is closed by placing sutures through the deep tissues first and then working upward to the subcutaneous layer.  Here Dr. Reupert chooses to place subcutaneous closing sutures instead of visible surface sutures.   There is less chance of the dog licking or chewing the area with subcutaneous sutures.  The skin is usually healed in 6 to 8 days; the dog is confined for 7 to 10 days postoperatively.

Now to see a cat neuter...
The benefits of neutering a male house cat far outweigh any disadvantages.   After neutering, male cats seldom spray urine, the urine loses its skunky odor, and the cat seems contented to stay home more, fight less, and we humans have the assurance that he won't be fathering any more litters!

	The cat is anesthetized and placed on his side on the surgery table.  The surgical area from the anus to below the scrotum is clipped free of fur.  Then the area is scrubbed with antiseptic soap and an antiseptic solution is sprayed on the area. The antiseptic spray gives the area an orange color.
	The scrotal skin is incised and the testicle is exposed.
	The testicle is pulled from the scrotum and the spermatic cord with its blood vessels is in view for the ligating procedure that prevents bleeding.
	A small suture is tied around the spermatic cord and the testicle is removed.  The cord is placed back into the scrotum and an antibiotic is applied to the surgical area.  The scrotal skin closes the incision itself so no skin sutures are needed.  The cat goes home the same day and acts as if nothing ever happened!

Should have had her spayed !
by T. J. Dunn, Jr.  DVM

Owning a dog or cat is a huge responsibility. Basic care and maintenance are sometimes equivalent to a full time job, so if you consider the decision to breed your female and raise a litter, you'll really have your hands full!

For some dog and cat owners the decision not to breed their female pet is simple and decisive. . . and the young dog or cat has surgery before her first heat cycle. But for others the finality of having their female "fixed" is just too uncomfortable. What if she turns out to be that once-in-a-lifetime super dog and everyone who sees her in the field wants a pup at a "name-your-price" fee?  What if everyone who sees her demands that you notify them as soon as she's bred so they can have a puppy or kitten just like her?

There are lots of questions, lots of "what ifs", and lots of advice from other dog and cat owners. . . . Let's take a few minutes and make some spaying facts clear; any decision is made more convincingly if at first we get the data right.

To spay your female dog or cat is to remove both ovaries and the uterus; the medical term is ovario-hysterectomy.(There is no such thing as SPADE or SPADED, the correct terms are SPAY or SPAYED). It is major intra-abdominal surgery performed under general anesthesia. If it isn't done precisely and in a sterile environment the outcome can be disastrous. During my career I've never considered any spay "routine"; every one is different and each presents a challenge.

Usually the procedure is done prior to the first estrus (heat) cycle and having it done at this time greatly lessens the dog's chances for later development of mammary gland cancer. Some dog owners, for various and often unfounded reasons, want their dog to have one estrus cycle or even one litter of pups before she's spayed.

Probably 80% of dog spays are done prior to the first heat cycle. The other 20% will go into their first heat around 9 -12 months of age and then about every 6 to 7 months thereafter until about 9 or 10 years of age. An unspayed dog does incur some special health risks throughout her life. Mammary cancer, unwanted pregnancies, ovarian cysts and cancer, difficult pregnancies . . . oh, yea, and fights with wandering male dogs who seem to appear from nowhere during the three week estrus cycle are a few troubles that readily come to mind.  Cats generally go into their first heat cycle at 6 to 7 months of age.  It seems like they go back into heat whenever they feel like it after that!  Technically, cats are seasonally polyestrous...which means they go in and out of heat during certain seasons of the year.

Here's a real nasty problem . . . pyometra. This term means pus in the uterus. Any time a veterinarian is presented with a dog or cat suffering from pyometra the condition is considered serious and immediate surgery is nearly always indicated. This pus formation in the uterus results from infection, hormone imbalance or mucous buildup inside the uterus. Most dogs and cats suffering from pyometra are presented because of loss of energy, increased thirst and poor appetite. Plus a good tip-off would be a foul smelling, purulent (means pus) vaginal discharge. Most of the cases of pyometra I've seen in dogs  occurred about six weeks after the bitch's last heat cycle. They may not look it on the outside, but on the inside these dogs are really sick! If that swollen, enlarged uterus happens to rupture internally, the dog will rapidly go into endotoxic shock and whatever the veterinarian does may not be enough to save the dog.

Normally, even in a large dog, the uterine horns aren't much thicker than a pencil. See the photos above for normal anatomy. When pyometra is present the uterus looks and feels more like a stuffed venison sausage. I've removed eight-pound uteruses that should have weighed no more than eight ounces!

For whatever reason, if your female dog or cat hasn't been spayed be alert for pyometra. The condition is more probable in females eight years or older and who experience infrequent or irregular heat cycles or episodes of false pregnancy. Poor appetite, increased thirst, poor stamina and vaginal discharge are cardinal signs. And some patients' white blood cell count can go from a normal of 9,000 all the way up to 75,000. X-rays often reveal two large sausage-like structures in the abdomen . . . time for surgery! These patients should almost always be operated on right now, not after work, not in the morning, not after a few days of antibiotics "to build her up."

The surgery is not a minor procedure. A patient with a uterus swollen with a foul and putrid soup, is simply carrying a bucket of poison that would eventually kill the cat or dog. Many of these patients require I.V. fluid therapy, antibiotics and nutritional support post-operatively. These pyometra patients, once recovered, act like puppies once their near death experience is over!

Every veterinarian has heard the following conversation when the owner is informed that their dog has pyometra and needs surgery:

"I guess I should have spayed her, Doc, but . . .

a) I wanted her to have at least one litter first.
b) She's got papers a mile long so if I breed her, the pups will be worth big bucks.
c) My brother-in-law says not to spay her because he heard they can die from the anesthetic.
d) I was afraid she'd get fat and lazy.
e) You vets charge too much for just a little poke-and-a-stitch.
f) I thought it would ruin her spirit.

years of practicing small animal medicine and surgery have convinced me that healthy dogs and cats become overweight from either insufficient exercise or consuming too many calories. Unless your pet is sneaking into the fridge at night and making it's own ham and cheese sandwiches, you the owner are directly responsible for what and how much your dog eats. And I don't want to hear any excuses because I've heard them all. Lots of unspayed dogs and cats are overweight too, so don't blame the weight gain on the surgery!

You'd be surprised how many dogs (especially Golden Retrievers) are hypothyroid. This condition almost always leads to weight gain. Weight problems should always suggest the possibility of hypothyroidism. Be sure to have your veterinarian check for this.

If you choose not to spay your dog or cat, be on the alert for pyometra. It can be a killer.

Scroll back up to see the spay surgery.