The Myth of the Simple Snip: The Truth About Spaying

Veterinarians often make spay and neuter sound easy to get people motivated to fix their pet, but it’s not the simple snip it seems.

spay-surgery
Spaying your dog has health benefits. By: Katie Brady

“Yeah, I have an appointment to have my dog spayed this week.”

Or:

“Oh, if you have to sedate her for that anal gland, could you just keep her and spay her now?”

How about:

“I heard about a way that I can get her spayded way cheaper.”

Spaid (it’s paid?), spade (as in shovel?), fixed (as in broken?), spaded (playing cards?), sterilized (as in dirty?) Whatever people like to call it, these attitudes about spaying make it seem like it’s a simple procedure.

Drop the dog off, have ‘er fixed and pick ‘er up. Routine surgery. Vets spay dogs and cats every day. That’s what they do.

Routine? Yes. Simple? No.

The spay surgery can be fairly straightforward in trained hands, but it is nevertheless an open abdominal surgery. A dog spay is one of the more difficult surgeries general veterinarians perform. Spays usually go well, but they are not “easy” by any means. Young vets learn a lot about surgery pretty quickly when they are unable to do their first dog spays without lots of assistance from a seasoned surgeon.

The veterinary community has encouraged folks to spay and neuter their pets for decades because the majority of practicing vets are huge animal welfare nuts. We are also aware of the health benefits of spay/neuter. But in order to encourage most caretakers to spay or neuter, I think veterinarians have made the surgery sound like a walk in the park.  We don’t want to scare pet parents away from having it done, so we minimize the complexity of the procedure. Veterinarians may be at fault for leading the public to think that spaying a dog is like sticking a band-aid on the reproductive tract.

Vets have also under-charged for spays for decades. If it doesn’t cost much, it must be easy, right? Wrong. Drive-by spay/neuter clinics, where you basically pass your pet through a bank window and the teller returns her at the end of the day, help control “the pet population” tremendously. But they don’t help people to understand the complexity of a spay.

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What Is a Spay, Anyway?

Let’s get our terms straight. You “spay” a female. You “neuter” a male. (It complicates the issue that technically, a spayed female dog is, in fact, neutered!)

Neutering a male, whether it be dog or cat, is a much simpler procedure than a spay. When you perform a castration, those testicles are openly displayed! A spay, on the other hand, is an internal abdominal surgery. You’re inside the abdomen, hunting through stuff like kidneys, the bladder and miles of intestines.

In veterinary terms, a spay is called an ovariohysterectomy, meaning the ovaries, the fallopian tubes and the uterus are all removed. Those structures are hiding inside the abdomen, hanging out with that other valuable stuff that you don’t want to mess with!

A spay entails removing one ovary from each side of the abdomen and carefully tying off all the blood vessels beneath that ovary so there is no internal bleeding.  Exposure of the ovaries can be difficult in some dogs. You don’t make your incision through the skin, into the abdomen and see a neon sign blinking “Here I am, underneath this pulsating intestine!” No, you have to fish around that sea of intestines, find the pink ropey thing that is actually not an intestine, and carefully follow that slippery rope down to Mrs. Ovary, who is hiding in a big blob of fat and tissue and blood vessels.

Now that you’ve located the big O, you have to get underneath her and get your sutures around all the blood vessels and attachments. Then it’s time to remove the big U, the uterus. Ms. U is easy to find but is much larger than Mrs. O with an even bigger blood supply. Making sure there is absolutely no bleeding from the ovaries or uterus after you remove them is, to say the least, of extreme importance.

To find out the additional benefits of having your pet spayed or neutered, review this clip of veterinarian Dr. Chea Hall for the Oregon VMA:

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All Spays Are Not Equal

There is more surgical technique required for a spay, particularly a difficult spay, than many other surgeries performed in a general practice. What makes a spay “difficult?”

  1. Age of the dog. The structures in a young dog are smaller with smaller vessels. The difference between spaying a 6-month-old and an 8-year-old dog can be huge.
  2. Body condition. Obesity may be one of the biggest nightmares when we approach a spay. Think about opening up that 12-pound Dachshund and having 8 pounds of gelatinous fat pop out of the abdomen. Yuck!  Seriously, it is not the yuck factor that is at issue here. A fat dog also has extra fat around the ovaries and uterus, complicating the procedure.
  3. Multiple litters or heats. With every year that passes, heat cycles and/or litters can change the uterus, making it larger, bloodier or more friable (fragile.)
  4. Breed. A German Shepherd surgery is not the same as a Maltese. That being said, the bottom line is you never know what you’re going to find until you get in there. Larger does not always mean more difficult. A deep-chested dog may actually be easier than a fat little pug. Remember, too, that our patients are under full anesthesia.  Special care has to be taken with tiny animals, brachycephalic breeds with respiratory issues, etc.
  5. Health status. Concurrent conditions such as heart or kidney disease, or diseases of the reproductive tract, obviously complicate a spay.

“Hey Doc, the Incision Looks a Little Funny”

So, say the spay surgery went great. Your patient is a fun loving 8-month-old Golden Retriever. The caretaker goes home with written and in-person discharge instructions, to leash walk only for a week, and use the Elizabethan collar if she’s a chewer.

The dog comes back 5 days post-op with a little swelling and redness at the incision site. No big deal. A little rest, some warm compresses, and Ms. Post-Op will be 100%. I ask the caretaker if that was him, throwing a frisbee for Ms. Post in the parking lot before our appointment. Yes, it was him. And I see he declined to take home the E-collar because he said Ms. Post is not a chewer. He says this as I watch her happily lapping her incision on the exam room floor. (Have you ever known a Golden not to lick a little?)

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I guess he thought I meant she could play frisbee immediately after abdominal surgery as long as the leash was attached to her collar. And constant licking at the incision wasn’t really chewing, right? Ms. Post-Op wore her collar for 5 days. Mr. Frisbee kept her athleticism to mild runs instead of competitive Ultimate tournaments and she did just fine.

The wrap up of this little tale for tails? Spays desire respect and diligence, both from the pet parent and the surgeon. Your dog may be bouncing about at home post-op, but she went through a major surgery, and you need to be her guardian. Even if you yourself have felt ok after a surgery and your pain is managed, you know enough to be careful about your incision. Ms. Post-Op is hard-wired to show no weakness. She will leap and bound on that newly sutured abdominal wall unless you put a lid on it (and E-collar).

In surgery as in life, you never know what you’re going to find until you open it up.

Dr. Debora Lichtenberg, VMD

View posts by Dr. Debora Lichtenberg, VMD
Dr. Debora Lichtenberg, VMD, is a small animal and exotics veterinarian who has split her time between a veterinary practice in Pelham, Massachusetts, and her studio in New York City. Dr. Lichtenberg is a graduate of the University of Pennsylvania School of Veterinary Medicine with 30 years of experience. Her special interests are soft tissue surgery and oncology.

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