Ovariohysterectomy
spay, "Fixing,"  female animals

To Breed or Not to Breed

Pre-Operative Care:
Your veterinarian can discuss the benefits of spaying vs. the risks of anesthesia during a pre-surgical visit.  This visit provides an opportunity to discuss any specific concerns regarding each individual pet.  Older animals are required to have pre-operative bloodwork prior to the procedure, and it is strongly recommended for younger animals.  Depending upon the age and/or health of the pet, chest x-rays, a urinalysis, an ECG, and other lab tests may be requested prior to the procedure to identify and address any underlying diseases.  Dogs that are in their heat cycle may have the surgery postponed until the cycle is over.

Description:
Ovario-hysterectomy is the surgical removal of the ovaries and uterus.  The surgery is performed under general anesthesia. An incision is made into the abdominal cavity to allow access to the entire reproductive tract. Each ovary is loosened from its attachment near the kidney to exteriorize the ovary and uterine horn.  The ovarian vessels are then ligated, or tied off. The ovary is detached using a scalpel blade and the remaining pedicle is observed for bleeding. The ligaments of the uterus are detached and the uterus is double-ligated just above the cervix. The ovaries, uterine horns, and uterus are removed and remaining cervical tissue is examined for bleeding. Before closing the surgery site, all ligatures or sutures are checked again to ensure that there is no bleeding. The abdominal incision is then closed in multiple layers. The internal muscle layer, the subcutaneous tissue, and outer skin are all closed separately. The surgery is more difficult when the dog is in heat or pregnant, as both of these conditions result in increased uterine size and blood supply.  Therefore, the surgery is normally discouraged during these times.

Some veterinarians select skin sutures that are non-absorbable, requiring a suture removal appointment 10 to 14 days following the surgery. Other veterinarians elect to close the skin with absorbable suture and skin glue, which does not require a return visit to the veterinarian unless there are complications.

Prognosis:
The prognosis is excellent for young, healthy animals.  Complications that can be seen with any abdominal surgery include anesthetic problems, infection, delayed wound healing or breakdown due to suture reaction, self-inflicted trauma (such as licking and chewing at incision, and self removal of sutures), and seroma (blood-tinged fluid accumulation at the surgery site).

More rarely seen complications include hemorrhage (bleeding), recurrent estrus cycles due to the inadequate removal of the ovarian tissue, body weight gain if diet and exercise are not monitored, accidental ligation of a ureter (tube leading from kidneys to bladder), and urinary incontinence due to the lack of estrogen.  Most of these can be prevented by careful surgical technique and proper postoperative care. If the proper precautions are taken, the risk of complications is minimal.

 If complications do occur, however, the veterinarian should be notified promptly. Dehiscence, or separation of the incision layers, can be an emergency situation requiring surgery to replace abdominal contents. Animals that chew out their sutures can cause great damage to the abdominal organs in a very short period of time.

Post-Operative Care:
Most veterinarians will keep your pet hospitalized for the first 12-24 hours after surgery to watch for any of the more serious complications.  After the animal is released to go home, they will need to have their activity levels reduced for 10-14 days following surgery. Pets should be monitored for any licking or chewing of the incision. An Elizabethan collar can be purchased from your veterinarian to limit access to the incision.  Outdoor animals should be kept indoors until healed. Dogs should be leash walked outside for eliminations only.  Running, jumping, and climbing stairs should also be discouraged during the healing process. The surgery site should be checked daily for any abnormalities.  Post-operative pain management is recommended to ensure the pet will feel a minimal amount of discomfort and will heal faster.  Therefore, be sure to give all the prescribed pain medication even if the pet is not showing any signs of discomfort.

Prevention:
The indications for the procedure include preventing unwanted litters of puppies and the nuisance of repeated heat cycles; decreasing the probability of mammary or breast cancer; and in treating many reproductive tract disorders including, most commonly, pyometra infection within the uterus and uterine cancer.  Spaying a dog before her first heat cycle decreases the chances of mammary cancer by greater than 90 percent.