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Thursday, August 4, 2011

This Is Why You Spay...**GRAPHIC IMAGES**

We veterinarians talk to clients all of the time about spaying pets.  It's one of the most frequent recommendations we make, and we have very good reasons for doing so.  Even though spaying helps prevent numerous serious medical problems, many people don't do it.  And that can lead to disaster.

A couple of weeks ago we had an 11 year old German shepherd come in for lethargy and vaginal discharge.  She was unspayed because the owners originally had intended to breed her.  This never happened (as is usually the case...most clients who tell me that they may breed never end up doing so), but they never had her spayed.  A few x-rays and lab tests later and we validated our suspicions...she had a pyometra.

Pyometra is the medical term for a uterine infection.  This isn't like a urinary tract infection, skin infection, or sinus problems where we can prescribe antibiotics and everything will be fine in a few weeks.  In a case with a pyometra the uterus fills with pus and is something that rarely responds effectively to antibiotics alone.  This is a life-or-death situation that requires immediate emergency surgery.  If surgery isn't performed quickly the uterus could rupture, releasing pus and bacteria throughout the abdomen and almost assuredly resulting in death.  The surgery itself cares a high degree of risk as the uterus is usually very fragile and could rupture during routine handling. Also there is a risk of pus and infection leaking from the cut areas of the uterus, resulting in contamination of the abdomen.  Serious problems!

Thankfully the owner agreed to the surgery.  When I got inside, the uterus was large and distended with pus just like I expected.  Here's what we found...WARNING...The following images are graphic photos of the surgery and are not for those offended or nauseated by such images.  Scroll down at your own risk!!!!

This uterus is many, many times larger than it should be.  A normal uterus in a dog this size and age should be somewhere between the size of a large pencil and a small marker pen, or similar in diameter to one of the instruments in the picture.  However, this is not the largest pyometra I've dealt with.  And this wasn't the only problem.

Sometimes I'll see cysts on ovaries when I'm doing a spay, especially on an older pet.  Normally there are just a couple of cysts, usually no more than 2-4.  This dog had literally around 20 on each side, and whereas cysts are normally on the ovaries, in this case they extended along the uterus itself.

Thankfully the surgery was as uneventful that we would want, the uterus didn't rupture, and the patient did spectacularly. Here's the uterus once it was removed, again many times larger than it should have been.

I just saw her a couple of days ago for her 10-day postoperative recheck, and she was in great condition, wagging her tail and acting like nothing had ever happened.  This was a very successful surgery with a great outcome.  But there was no reason why this needed to have happened.

Situations like this one are why we recommend having pets spayed.  A routine spay at our clinic runs around $350.  This client paid around $1400 for diagnostics, surgery, and medications.  That's more than four times what she would have paid if she had simply had her dog spayed!  She would have also prevented the life-threatening risk to her pet.  Thought this turned out well, it may not have and could have resulted in the dog's death.

The moral of today's story?  Have your pets spayed and neutered!!!!!


  1. very interesting piece. As a pet owner I can understand why someone may not want to have their pet spayed or neutered. I was always of the opinion that surgery should be done when there is a real need and I did not want either of my dogs to have to have surgery (when they were healthy and it was not necessary). However when one of my dogs got older (around 11) he developed a lump on his tail and the fur fell out and despite meds the lump continued to get bigger and hard and began to cause discomfort as my dog began to bite it as it was obviously itchy. Vet said then that he would have to be neutered - he was and all was well then. However I worried about the operation as he was now a senior dog and wished that I had had him neutered earlier in his life. Then I read this blog and if I am right Chris, somewhere in your blog you have said that it is "easier" to neuter a young dog (around 6mths than it is to do a dog when s/he is older). I guess really what I am trying to say is that owners, well I can only speak for myself, would worry, what if something went wrong in the surgery and I was left with an incontinent dog (terrible for the animal and terrible for the owner - and I know of three cases where this has happened)I would be annoyed at myself for putting a perfectly healthy dog into a surgical operation with a negative outcome when there was no immediate medical need. Still for this I worried very much for my 11 year old when he had to have surgery as the complaint would not have happened if he had been neutered earlier.

    Very glad to see that the dog you refer to in your post Chris, is doing well.

  2. I am impressed at the low cost of your procedure, especially as I'm fairly familiar by now with your (extremely responsible) tendency to run the necessary bloodwork and other diagnostics--I often wish I could convince my clients the way you can!

    I've worked in ER practices all my life and I can tell you that just the diagnostics and aftercare would have cost well over $1500, not including the surgery itself at all!

    And yet, (with any luck, at least) those are most often the clients who spay or neuter the next one much much sooner.

  3. Anonymous, the risks of surgery are almost always lower than the risk of disease. Besides eliminating the risk of pyometra, spaying also dramatically lowers the risk of mammary gland cancer. Any surgery carries risk, but with modern anesthetics the risks are usually minimal (however, not every vet does anesthesia the same way...ask questions of your vet). Incontinence is rare but can happen no matter what the age of spaying; the benefits of spaying still outweigh this risk.

    Orli, I wish I could always convince clients to follow my recommendations! Every day I face situations where the clients hamstring my attempts to diagnose their pet by declining tests and treatment. Costs were lower in this particular case because she was very stable before and after surgery and didn't have to stay on IVs overnight or be transferred to an emergency clinic.

  4. Glad she did well, great illustration of the need to spay. I find a lot of vets and pet owners wanting to wait until 6 months or later (or never) for various reasons-mainly orthopedic disease. I'm not sure I see where the research at this point really backs that up and just can't agree with waiting. The surgery is so much less traumatic at 3-6 months than later.

  5. Good evening. I was wandering what those cysts are. I understand the cysts on the ovaries. They are follicles. But how can they appear on the body of the uterus?

  6. We never identified the specific cause of the cysts. They were fluid-filled and likely unrelated to the infection. Occasionally I'll find cysts like this on a mature uterus, and it's typically an incidental finding.

  7. spaying does not guarantee they will not get pyometra. my kitty cat was spayed at around 9 months old. when she was 5 or 6 years old she had to have emergency surgery because she developed uterine stump pyometra. she recovered well. but all the same no guarantees.

    1. While a good point, this is very, very rare, even more rare than standard pyometra. When vets say "pyometra" we are generally referring to the uterus, not the stump, and spaying does completely remove that particular risk. A stump infection is rare, especially that long after the initial surgery.


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