Taking a fresh look at familiar things can be wonderfully enlightening.
Sometimes, the little light bulb overhead begins to sizzle and sparkle, illuminating a new and better way of doing things. Consider this example: when some savvy veterinarians took a fresh look at performing spays, a surgery we’ve been doing the exact same way for decades, they came up with a revised technique that accomplishes all the objectives of the surgery with fewer complications.
Spay is the common term used for neutering a female dog. The medical jargon for spaying is ovariohysterectomy (OVH). “Ovario” refers to ovaries, “hyster” refers to uterus, and “ectomy” means removal of, so traditional spaying involves surgical removal of the uterus and both ovaries. The objectives of the spay surgery are to render the dog infertile, eliminate the mess and behavioral issues associated with a female dog in heat, and prevent diseases that may afflict the uterus and ovaries later in life.
Thanks to some innovative veterinarians, what we now know is that ovariectomy (OVE) – removal of just the ovaries – accomplishes these objectives just as effectively as does the OVH. And this less extensive surgery is less prone to complications than the traditional spay.
Here’s some background that will help explain why leaving the uterus behind makes sense. The shape of the uterus resembles the capital letter “Y”. The body of the uterus is the stem and the two uterine horns represent the top bars of the “Y”. An ovary is connected to the free end of each uterine horn by a delicate structure called a fallopian tube, which transports the egg from the ovary into the uterus. While the uterus has only one purpose, housing developing fetuses, the ovaries are multi-taskers. They produce eggs and release hormones that, in conjunction with those released by the pituitary gland, dictate when the female comes into and goes out of heat, when she ovulates, and when her uterus relaxes and stretches to house a developing fetus. When the ovaries are removed from the body, the eggs and hormones are no longer produced. The dog never again shows symptoms of heat, nor can she conceive. Additionally, any chance of developing ovarian cystic disease or cancer is eliminated.
Fortunately, the incidence of uterine disease in dogs whose ovaries have been removed is exceptionally low. Pyometra (pus within the uterus) is the most common uterine disorder in unspayed dogs, but without the influence of progesterone, a hormone produced by the ovaries, it does not naturally occur. Hence, no ovaries, no pyometra. Furthermore, the incidence of uterine cancer is extremely low in dogs (0.4% of all canine tumors) – hardly a worry – and studies have shown that the frequency of adult onset urinary incontinence (urine leakage) is the same whether or not the uterus is present.
If you are not already convinced that the new spay is the better way, consider the following complications that can be mitigated or avoided altogether when only the ovaries are removed:
An OVE requires less time in the operating room than an OVH, meaning decreased likelihood of anesthetic complications.
Removing the uterus requires more difficult ligations (tying off of large blood vessels and surrounding tissues before making cuts). A uterine body ligation that isn’t tied quite tightly enough can result in excessive bleeding into the abdominal cavity and may necessitate blood transfusions and/or a second surgery to stop the bleeding.
The ureters (delicate tubes that transport urine from each kidney to the bladder) run adjacent to the body of the uterus. It is possible to ligate and obstruct a ureter in the course of removing the uterus, causing serious complications
Removal of the uterus occasionally results in the development of a “stump granuloma” – a localized inflammatory process that develops within the small portion of uterus left behind. When this occurs a second “clean-up surgery” is typically required.
We know that the degree of post-operative patient discomfort correlates with the degree of surgical trauma, and OVH certainly creates more trauma that the OVE.
European veterinarians embraced the new way to spay years ago. Slowly, veterinarians in the U.S. are catching on, and some veterinary schools are now preferentially teaching OVE rather than OVH techniques to their students.
What should you do if you are planning to have your dog spayed? Talk with your veterinarian to determine if OVE surgery is already his or her first choice. If not, perhaps it’s time your vet took a fresh look at performing this old-fashioned surgery.
Dr. Nancy Kay is a board-certified specialist in small animal internal medicine at the VCA Animal Care Center in Rohnert Park and the author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life (Trafalgar Square Books). Dr. Kay shares her life with two dogs, three cats, three goats, and two horses. View her blog at www.speakingforspot.com.
Ed. Note: February 22 marks the 17th annual National Spay Day, sponsored by the Humane Society of the United States, and Humane Society International. To help stem the tide of pet overpopulation, we urge you to consider spaying or neutering your dogs. The following article by Dr. Nancy Kay, which originally appeared in Whole Dog Journal, explains a new spay procedure that eliminates some of the risks traditionally associated with the surgery.
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