tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   06 March, 2010  
Focus: Small animals - dogs, cats, hamsters, guinea pig & rabbits.

Toa Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures

UNCOMMON POST-SURGICAL
COMPLICATIONS IN A SPAY 
 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written:  06 March, 2010

 
  toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

E-MAIL DATED DEC 5, 2009 TO DR SING & REPLY FROM DR SING

Thank you for your e-mail. Please see my reply in CAPITAL LETTERS below:
 
Hi Dr. Sing, 
 
This is Xin.  I have brought my toy poodle, Nicole, to see you last month for her leg sprain, if you still remember. She has since recovered and is walking normally, thank you.
 
I would like to make an appointment for my dog to be spayed and have 2 of her puppy tooth to be removed at the same time (2 have since dropped on their own), since she has to be under general anaesthetic for these procedures respectively. My thought is that she need not go through general anaesthetic twice if done together.

 
She is currently coming to 9 months, weights around 4.3kg, has not have her first heat yet, and is not on heat at the moment. I hope to seek your advice on the following:
 
1. What is the main difference spaying her now at 9 months, before her first heat, compared to 3 months after the first heat? any major downside if I wish to spay her now?

 
SPAYING BEFORE HEAT AT 9 MONTHS OF AGE - The female dog is no longer a puppy. There is no problem in spaying if she is healthy. I recommend spaying 3 months after the first heat to ensure that the surgery is much less bloody as the uterine, ovarian and omental blood vessels are not enlarged at this time. Therefore they are not so fragile when clamped and ligated. Most likely, your poodle may have her first heat with little vaginal bleeding, from 6-9 months, but you did not know.

You could observe a period of her cleaning her private parts for a week and that would be her first heat.
 
9 2. What are the things to observe with regards to food intake before her surgery?  
 
NO FOOD AND WATER AFTER 10 PM the night before the surgery.
 
3. How long is the procedure and how soon can I pick her up from the clinic after the surgery?
 
ANAESTHESIA AND SURGERY TAKE AROUND 30 MINUTES normally. You can pick her up in the evening around 7-10pm during weekdays. 

4. After surgery, any medications or special diet required?  ANTIBIOTICS AND PAIN-KILLERS ARE GIVEN. NO SPECIAL DIET normally. Do i need to cage her to restrict or minimise her movement?  RESTRICTION OF JUMPING FOR FIRST 7 DAYS WILL BE IDEAL.

5. How big/long is the incision usually? AROUND 2.5 CM USUALLY IF THERE ARE NO COMPLICATIONS.

6. What is the cost for spaying and removal of 2 puppy teeth?  COST FOR SPAY IS ESTIMATED AT $200 excluding medication. PUPPY TEETH REMOVAL + ANAESTHESIA  estimated to be around $100.

 
Thank you for your time, Dr Sing.
E-MAIL TO DR SING  DATED DEC 16, 2009

Picture from owner
Small circle (abscess)
Large circle (skin bruises)
Hello Dr. Sing,  
Good evening. 
 
We brought Nicole (toy poodle) to you for a spaying procedure on 13th Dec 09, Sunday. We put on the e-collar for her and she's been wearing the collar since. 
 
We have some concerns with Nicole's conditions, and also like to update you on Nicole's post-op recovery based on our observation.
 
1. Diet
 
Nicole ate well after her op, diet was normal from Day 1 onwards.
 
2. Behaviour
 
For the first 3 nights, Nicole's behaviour was different from usual. She's been pacing around and is always hiding in some corners or under the bed/furniture. Also, she panted harder than usual. It's only today that she began to regain some normalcy when she started playing with her toys.
 
3. Surgical Area
 
This is our greatest concern and worry. We noticed 2 things that appear very unusual. Please refer to attached picture.
 
A - There is this small yellowish boil-like thing that is above her surgical area.

B - There are 2 patches of dark purplish areas on the lower part of her belly.
 
Can you advise please if these are causes for concern? What are the possible causes of these, and how can these be treated?  

Thank you for your advice.
 
Regards,
Name of Owner

 

REPLY TO E-MAIL DATED DEC 16, 2009

Nicole's behaviour for the first 3 nights is part of the discomfort of surgery (spay).  

The boil could be a small pimple. If it is still present, I have to see the dog. Two dark purplish areas are due to the licking of the wound and/or trauma to the skin caused by Nicole trying to get at the surgical wound. 

It is best to bring her down for an anti-inflammatory/antibiotic injection to help her. A small percentage (1%) of dogs spayed encounters this situation of trying to clean their wound, traumatising the skin with the e-collar when you are not looking.  Phone 6254 3326 to let us know when you will be coming with Nicole.

E-MAIL TO DR SING. March 5, 2010

Hi Dr Sing,
 
Good day to you.
 
Thank you for performing the spay operation for my toy Poodle, Nicole. Her wounds have healed extremely well after the operation. The surgical area looks very neat and in fact, I can hardly detect any traces of scars or stitching when I look at the area now!! Once again, thank you so much!
 
I recalled that I have yet to pick up the spay certificate since the operation. For the purpose of applying for AVA permit, I would like to pick it up from you soon. Can you advise if it will be ready if we pick it up anytime from Sat, 06 Mar, onwards? 
 
Thank you for your time.
 
Best Regards
Name of owner

POST-OPERATION COMPLICATIONS OF SPAY

As spay is a common surgery, my replies to the post-surgical conditions encountered in this spayed dog may be of use to dog owners who have their dogs spayed.  Boils may be pimples. Bruised skin will be due to traumatic injuries from the dog licking or e-collar friction.

Higher Expectations of Wound Healing by the younger Singaporeans
Many younger owners are happy with the absence of post-operation spay scars as dogs are family members. This poodle was stitched using 3/0 absorbable sutures in a horizontal mattress pattern. I went to look for this case in my picture files and one picture of is presented below to share with readers.
 

Poodle, No vaginal bleeding from month 6-8. Spayed at 9th month. On heat. Toa Payoh Vets

tpvets_logo.jpg (2726 bytes)  2840. Some bleeding as the dog was on heat at the 9th month when spayed. 

The dog had a pimple and skin bruises after the spay (see picture above). She has had recovered normally according to the March 2010 e-mail from the owner. 

Veterinary Tips
I don't place subcuticular sutures as these may irritate. No walk-in interrupted sutures. Although such sutures pull the skin closer, they are additional "foreign material" which may be reactive under the skin, causing discomfort and licking. Linea alba is closed with interrupted sutures at 0.5 cm apart. No herniation complaints in nearly 100% of my cases.

Keep stitching simple to prevent stitch abscesses and irritation. Surgery books do recommend subcuticular sutures to close wound tightly and reduce haematomas.

The wound heals well in most of my spay cases done over the past 30 years. Nowadays, dogs do get painkillers unlike a decade ago. An e-collar is also worn just in case but sometimes I don't prescribe e-collars to save the owner some money.

The owner is usually very with the outcome of a spay with beautiful healing. Just like the bikini-cut for female Caesarean sections in women. The lack of scar is so important.

As absorbable sutures are used, this saved the owner one return trip to me to get the sutures out. So, in most cases, there is no follow-up and no more interaction with the owner. As I don't have feedback about post-spay complications and wound healing, due to no need to return for stitch-removal, the above correspondence is valuable for me and hopefully, for readers.     

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Be Kind To Pets
Veterinary Education
Project 2010-0129
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Clinical Research
 

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