3. Spaying big dogs - bilateral alopecia

EDUCATIONAL ARTICLE FOR VET STUDENTS

"My vet does not spay big dogs," the young couple said. "So I was asked to see you."
Big dogs take longer to spay. Big dogs with some fat as in this case may be much more difficult to spay if the vet uses hook and a small incision.

Personally, I do not look forward to spaying big fat dogs too. The spay hook gets obstructed and one gets omental fat coming out of the spay incision so many times.

In this case, the dog has a skin disease, with hair loss from back to past the chest. Now, if the vet has not informed the owner of this finding, the worsening of the skin condition some weeks after spay, leading to a "botak" (bald) dog might be attributed to the vet having spayed the dog or not informing the owner.

I advised treatment first. The dog was already 4th month after the ending of heat. There would need to be a waiting of another 4 months for the next spay and for the treatment of the skin disease.



"I will not be able to manage when she comes on heat in 2 months' time," the lady said she would be in later stages of pregnancy herself. Cleaning up the blood stains dripping over the floor for at least 2 weeks during the dog's estrus can be quite exhausting.

The dog was spayed and the gentle couple will need to follow up and monitor the skin disease. Vets need to let the owners know about pre-existing skin conditions before spaying the dog so as to build positive relationships and avoid misunderstandings.

2. 40 minute-spay surgery from incision to last stitch.

May 23, 2008

12-year-old with large mammary tumours and sternal abscess.
Best not to operate immediately. Antibiotics for 2 weeks.
7.7 kg, 38.4 deg. normal.
Sternal abscess has reduced by 80% to 1 cm.

Young man brings in the dog as scheduled.
"Can spay be done together with removal of sternal abscess?" he asked.
"Yes," I said. "It is not good for the old dog as the anaesthetic time will be longer as the chances of the dog dying on the operating table increases as the anaesthesia is prolonged. The spay itself takes around one hour."

"I thought it takes 30 minutes to spay a dog?" the young man must have done his home work and research.

"Yes," I said. "In some cases, the surgery is as fast as 30 minutes. But if you include the pre-operation shaving, scrubbing and anaesthetic gas given, the whole procedure takes 1 hour.

He agreed to take one surgery at a time. Spay, then 2 weeks later, sternal abscess and then mammary tumour removal.

So, I started to time this spay surgery commenced at 10 am. The patient was not slim and there would be some difficulty accessing the ovaries.

Procedure:
The dog was clipped first. Then proceed to the operating room. Body stretched out tightly.

Gas anaesthesia was given by mask, taking around 15 minutes. Dog snoring. Intubated. Maintenance dose 2%.
Last 3 stitches 0.5% to 0%. Dog woke up within 2 minutes at end of anaesthesia.

SURGERY - Incision to last stitch is 40 minutes.
Incision 1 cm from umbilicus. Inserted the spay hook. Could not get the left ovary for 5 tries. Omental fat kept appearing. Getting desperate. Switch to hooking the right ovary. Intestine kept coming hooked out. What to do?

If the dog is slim, it would normally be easy for me to hook the left ovary after 1 or 2 tries. Hooked further caudally at 45 degree away from rib cage and liver.
Caught right uterine horn. What a relief. I hope not to get fat dogs to spay as they are very challenging hook cases.

So much fat surrounded the ovaries. Asked assistant to release the tension on front legs tied to strings. Ovarian ligament very tight. Extended incision cranially by 0.5cm, skin and linea alba. This extra space permitted the huge ovary to be pulled out.

How do I know it is the ovary? Connected to the uterine horn and a very tight ovarian ligament can be felt. High tension. I used the scalpel blade to rupture it. Ligate 2 times. Finally pulled out the left uterine horn and repeated process. Uterine body ligated 3 times. 3/0 absorbable sutures did not feel strong enough compared to 2/0. 3 simple interrupted sutures in the muscle layer. No fanciful continuous subcutaneous sutures. 2 horizontal mattress sutures in the skin. One packet of suture was fully used in this case.

This whole procedure took more than 60 minutes. Not much bleeding. Carprofen injection 0.5 ml given to prevent pain and swelling. Antibiotics. Dog should be going home in the evening.

NEXT STAGE
As the female hormones have had been removed, it is unlikely that the breast tumours will grow fast. 2 weeks later, scheduled for tumour removal plus removal of sternal abscess probably.

Could the dog be able to take the anaestehsia again?

1. FAQ. Dog Neuter - Owner's point of view

QUESTIONS ON NEUTER FROM THE OWNER'S POINT OF VIEW

--- On Tue, 5/20/08, Dog Owner wrote:

Subject: Hello
To: judy@toapayohvets.com
Date: Tuesday, May 20, 2008, 3:06 AM

Hi
May I check what is the price for sterilizing a male Shih Tzu dog about two years old... how many days for them to recover. . thanks

Warmest regards
Name of Dog Owner



----- Original Message -----
From: David Sing
To: Dog Owner
Sent: Wednesday, May 21, 2008 2:48 AM
Subject: Re: Hello, dog neuter

I am Dr Sing.
Cost of surgery is S$150 if it is less than 5 kg. $200 if more than 5 kg. Should be able to eat by day 2.


--- On Wed, 5/21/08, Dog Owner wrote:


Subject: Re: Hello, dog neuter
To: drsing_98@yahoo.com
Date: Wednesday, May 21, 2008, 12:30 AM

Thank you Dr Sing. Does he needs to be hospitalized? Any other charges...how many days do I need to book in advance the appt? May I have your clinic number and full address.
Name of Dog Owner


Dog neuter at Toa Payoh Vets
Wednesday, May 21, 2008 10:20 PM
From:
This sender is DomainKeys verified
"David Sing"
View contact details
To: Dog Owner

Thank you for your reply. Will not need to stay overnight. Come in at 9 am and goes home in the evening.

Additional charges may be $20 for e-collar (if you don't have one) and $15.00 for painkillers and antibiotics.

Book 1 day in advance. No food and water after 8 pm. the night before. Clinic tel no. is 6254 3326. Address: Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074.