What Could Have Been A Tough Spay Lesson Learned

I have a lovely young Great Dane female patient who is currently 15 months of age.  As a giant breed, the owners and I had collectively decided to push off her spay to after 14 months of age.  Also since she is a deep chested giant breed dog and therefore susceptible to bloat and a life threatening complication of bloat called gastric torsion, I suggested since we open her abdomen for the spay anyway, that we tack her stomach to her body wall; a preventative procedure called gastropexy. 

The owners were on the fence about going for the gastropexy and if there was not going to be the necessity for the more technical gastropexy procedure (in their mind – spays in giant breed dogs are not easy!), they would opt to save cost and have the spay done at a discount spay/neuter clinic.

The Dane had started the first 7 months of her life with chronic recurring diarrhea that we had great challenges controlling.  She had since outgrown that issue, but I bring it up because it is relevant to the ultimate decision the owners made to have the spay performed by me.  The Dane’s owners in the end saw the value of having the gastropexy done at the time of the spay.

As I entered the abdomen to begin the spay, I could locate the left ovary, but I could not find the uterine horn and uterine artery that you can normally follow back from the ovary.  I discovered that nearly the entirety of the uterine horn was adhered to the descending colon, likely the result of a congenital aberration during fetal development.  This was also the likely explanation for the chronic recurring diarrhea as she was going through hormonal development and rapid growth.

This was an abnormality that I had never come across and I had to work through the process to be able to complete the spay while accounting for the fact that the left uterine horn and the colon were sharing blood supply.  I had to have one of the technicians scrub in to aid in anatomical positioning.  Between having a readily available scrub nurse in addition to having been a general surgeon for 19 years with intimate knowledge of canine intra-abdominal anatomy, enabled me to complete the entirety of the surgery with no complication.

In hindsight, even if a strictly spay/neuter veterinarian would have had the comfort to work through this complication, would there have a been a scrub nurse handy in an assembly line like surgical environment?  Many discount spay/neuter clinics do not intubate their patients and keep them masked down for what is usually a brief procedure.  Would that have been enough to keep this patient under anesthesia for this breadth of surgery? 

With all of these things and more considered, there is a strong likelihood that had this occurred at a discount spay/neuter clinic, the patient would have simply been closed and the owners advised to have the procedure completed at full service veterinary clinic.  This patient and the owners were ultimately far better served by having had the spay done in my full-service general practice. 

Discount spay/neuter clinics to be fair serve a valuable function in veterinary medicine and animal welfare by getting more pets spayed and neutered.  I do not disparage the important role they play.  However, all things considered, if it will not break a pet owner’s bank to have a spay or neuter performed in a full-service clinic, perhaps when it comes to being frugal, surgery is perhaps not the best area to start?

Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms. He is the author of The Man In The White Coat: A Veterinarian’s Tail Of Love. In addition to being passionate about integrative veterinary medicine for which he is a globally recognized expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport.  He is president of Maybeck Animal Hospital , general partner of Grant Animal Clinic, and runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care.  Dr. Welton fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.