“Mr. and Mrs. Smith, I have some bad news for you about Reny,” I say to a very worried older couple standing across from me at my exam room table. “I’m afraid she has a condition called a pyometra, which is an infection of the uterus.”
Delivering bad news is common for veterinarians who do emergency work, but it doesn’t get any easier with practice. In this case, the condition Reny has, a pyometra, is potentially life-threatening — and it was avoidable.
“When an unspayed female dog goes through heat repeatedly, the hormone cycles increase the risk over time of an infection developing in the uterine tissue,” I explain. “Once it has progressed to the point of illness, our only consistently successful treatment is emergency spay surgery. Essentially, we need to spay her to remove the infected uterus. And it is a much more difficult and risky surgery when the uterus is filled with infection.”
Understandably, the couple is looking increasingly concerned. I, too, am very worried for the well-being of Reny. Pyometra surgery is a difficult one for the surgeon, risky for the pet and expensive for the owners. However, Reny was an otherwise healthy 6-year-old dog who had experienced no problems until the family noticed the problem this morning with her.
The Benefits Of Spay/Neuter Surgery
Fortunately, pyometra is a condition that is completely preventable. Dogs who are spayed early in life do not receive the repeated hormonal stimulations that so frequently result in pyometras. There are other advantages, too, in spaying and neutering dogs on an elective (as opposed to an emergency) basis.
First, it allows the veterinarian to plan out the procedure and, if need be, delay or postpone the procedure should concerns arise on the pre-anesthetic examination or blood work. Altering a healthy dog also eliminates the risk of uterine, ovarian and testicular cancer, as well as minimizes the risks associated with prostatic disease, behavioral problems, and yes — prevents pyometras. For this reason, we recommend spaying and neutering dogs as young as possible.
Even performing the surgeries on healthy adult dogs has significant benefits, so don’t think that because it wasn’t done during puppyhood that you have lost your chance. Any healthy dog of any age will see benefits from having these procedures done electively.
Details Of Spay/Neuter Surgery
So, what exactly happens when a dog is brought into the veterinary hospital for spay/neuter surgery?
First, the veterinary technician visits with the owners and takes the vitals from the patient. Most adult dogs also receive a blood panel at this point in time. This checks to be sure that all of the organs are functioning properly and that the dog is able to clot blood properly. Although this is recommended for surgical patients of any age, it becomes increasingly important over time. As a veterinarian, I can safely say that we don’t like to discover surprise problems during surgery! Blood work is an important safety net for us, because if we find problems at this point, we still have the option to move an elective surgery to another date until the problem can be investigated or resolved. The veterinarian also examines the patient to be sure that he or she appears as healthy as possible prior to the procedure.
Once the dog is checked over and the lab results are available, the pet is usually given a sedative. In my hospital, we use something called “balanced anesthesia.” This means that we use very small doses of multiple different drugs. The approach allows us to maximize the benefits of these medications, without experiencing the side effects that can occur at higher doses. This means that very little sedative can be extremely effective in preparing a patient for a smooth and comfortable surgery.
After the dog has been sedated, the veterinary technician clips and prepares a small area on the dog’s front leg for an IV catheter. This catheter allows us to administer medications and fluids to the pet during the procedure. This is one of our most important safety features, particularly on a mature animal, because it allows us to give IV fluids to help stabilize any drops in blood pressure, administer additional pain medications and anesthetics if needed, and immediately provide emergency drugs should they be needed. If I had to pick only one safety measure for an adult dog, an IV catheter would be the one.
Once the sleeping dog has the IV flowing, a “breathing tube” (endotracheal tube) is placed through the mouth and into the windpipe. This allows us to assist the animal to breathe should he need help while anesthetized. It also allows us to provide a continuous flow of oxygen and anesthetic gas to the patient.
The nurses and technicians now prepare the dog to enter the surgical suite. For females, the belly is shaved from just above the belly button down to near the level of the pelvis. For males, only the area between the penis and the scrotum is typically shaved. The shaved area of the patient is then scrubbed with an antiseptic solution, and the dog is moved into the surgical suite.
During surgery on the female dog, the veterinarian removes the ovaries and uterus through a single incision just below the belly button. For the males, both testicles will be removed through a single incision located between the scrotum and the base of the penis. Most veterinarians use an absorbable suture to close their incisions, so often no sutures need to be removed from the patient after surgery.
Your Dog’s Recovery After Spay/Neuter Surgery
Older dogs must have ample time for healing. Mature dogs do not recover as quickly as their puppy companions, so if your adult dog has the surgery, plan on about two weeks of downtime and rest to allow your beloved four-legged family member to fully recover. In most instances, an Elizabethan collar (e-collar) that is shaped like a cone and encircles your dog’s head is used to prevent your pet from licking at the surgery site. This prevents infection or additional complications with the healing of the incision.
The veterinarian will likely send home pain medications for your pet. Mature animals are somewhat more sensitive to discomfort than puppies, and we certainly want to be sure that they are completely comfortable during their recovery. In most instances, five days of medication is enough to help the average pet recover — although your pet may need slightly more or less. Even if your pet appears comfortable, it is critical to continue with the medication as directed. It is much easier to prevent pain than to deal with it once it starts.
After a little bit of time and TLC has passed, your mature pet will be back up on his feet again like nothing has happened. And you can rest assured that you have done everything in your power to prevent several cancers and infections, and minimized the impact of other behavioral and medical problems by having your pet spayed or neutered. And this is all in addition to the benefit that is more obvious — the prevention of unwanted puppies.
And what of Reny? After a little hesitation, the family elected to have her undergo the emergency surgery to treat the pyometra. Although Reny was hospitalized for four days and received several blood transfusions, she survived the procedure and went home to live another eight years with her family, until she died of unrelated causes. I spayed their next dog when she was 16 weeks of age, ensuring she would never develop pyometra.
By: Dr. Sandra Mitchell
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