Canine Ovariohysterectomy

A Procedure Description By Julie Welebir

Figure I: Canine Ovariohysterectomy Procedure

What is Canine Ovariohysterectomy?
With much of American’s owning pets today, ovariohysterectomy has become a pretty routine surgical procedure for both dogs and cats. Ovariohysterectomy is also known as “spaying” and is the complete removal of the female reproductive tract. It is done to prevent a female dog from becoming impregnated, essentially sterilizing them. This procedure is equivalent to the neutering procedure in male dogs and is mandatory, by law, if adopting from a shelter. In this surgical procedure there are multiple steps involved, starting with the use of anesthesia and ending with the stitching of the incision. Anesthesia is done first and foremost to provide the animal with comfort during the surgery itself and without it the animal would be in a large amount of pain. The procedure involves the removal of the ovaries, oviducts, uterine horns, and uterus. The surgery also removes the source of progesterone and estrogen that would normally be produced in the body and play an important role in maintaining pregnancy. In addition to preventing dogs from becoming pregnant, the procedure prevents dogs from going into heat, from getting breast cancer, and from getting uterine infections later in life (known as pyometra). Overall, this procedure can save a female

pet’s life and can prevent the number of homeless dogs from increasing. Millions of dogs are euthanized each year because they are strays and this procedure decreases this problem significantly.

What are the Components of the Female Canine Reproductive Tract?
There are many components of the canine reproductive tract and each has a specific function in the reproduction process. Overall, the components of the female canine reproductive tract are quite similar to the reproductive tract in the human female.

Figure 2: Female Canine Reproductive Tract

a) Ovaries: The beginning of the female reproductive tract, where the ova (eggs) and many of the hormones responsible for induction of heat cycles and maintenance of pregnancy are produced. When a female puppy is born, every egg that will ever be released by her ovaries is already present.

b) Oviducts: The area of the tract composed of tiny tubes that run between the ovaries and the uterine horns. This is the location where fertilization occurs (uniting of the sperm and egg) to form a mature egg. c) Uterine Horns: Muscular section of the uterus between the uterine body and oviducts. These can vary greatly in length and diameter from dog to dog, but generally increase in diameter during pregnancy and increase in thickness during heat. Most puppies will develop within the uterine horns during pregnancy. d) Cervix: Where the uterus ends in the female dog, leading into the vagina. e) Vagina: Fibromuscular tubular tract that leads from the interior of the female dog’s reproductive tract to the exterior of the body.

What does the Procedure Involve?
Pre-surgical:
The surgical procedure can vary slightly from veterinarian to veterinarian but in general has most aspects in common. The procedure is preceded by a complete physical examination, a blood test for a pre-anesthetic, a small sedative to calm the dog prior to general anesthesia, and finally the actual general anesthesia. All of these steps are critical before the surgical procedure itself can be performed. After these precautions are taken, the dog is hooked up to a monitor and the vital signs are checked. If all readings (such as heart rate and blood pressure) are normal, then the surgical procedure is ready to be preformed.

Surgical:
Application of Betadine Surgical Scrub:

The surgery begins with the addition of a scrub containing betadine (a topical antiseptic containing the chemical povidone-iodine). This scrub is somewhat sudsy like soap and has the power to kill bacteria and viruses. The solution is added to the area of the skin where the incision will take place in order to prevent any form of infection during the surgical procedure. This preparation is very important in

preventing serious complications caused by infection during and after the surgery.

Figure 3: Scrubbing for surgery. Incisions:

Throughout the surgical procedure multiple incisions are needed beyond the outer skin layer. The initial incision is about 3-5 inches in length and is made near the umbilicus (navel or belly button in humans), in the vertical direction of the tail.

Figure 4: First incision

The second incision made is in the tissue directly underneath the skin, known as the subcutaneous layer which consists of mainly fat and smaller blood vessels. The smaller blood vessels will bleed but should stop after a few minutes. If they do not stop within this time, they are sometimes clamped or cauterized (closed off through use of extreme heat).

Figure 5: Secondary incision

The last incision that needs to be made before reaching the internal area of the abdomen is known as the linea alba (a layer of muscle located in the center of the abdomen which is covered by a tough layer of tissue). The proper suturing of this layer is critical in order to hold the diaphragm together and prevent formation of hernias. Forceps are used to hold the tissue up and a scalpel is used to make the incision.

Figure 6: Third incision

A scissors will often times be used in order to lengthen the incision in the linea alba, but must be used with care in order to prevent puncturing any internal organs like the bladder.

Figure 7: Scissors use Locating the Uterus and Ovaries:

After making all necessary incisions, the uterus needs to be located within the abdomen for removal. In many cases a tool known as a spay hook is used to dig underneath abdominal organs and pull out one of the uterine horns. This horn is then used to locate the ovaries and eventually gently pull those through the small incision as well. (The entire procedure is repeated for each ovary, one at a time)

Figure 8: Location of the uterus and ovaries (The arrow shows the ovary) Applying the Clamps:

Clamps are then used cut off most of the blood supply to the ovary and prevent hemorrhaging. The clamps will make it easier to insert a suture and will stop the flow of the blood from the abdomen to the ovary. Usually three clamps are used with the first being place to the left of the ovary, the second above the first, and the third to the right of the ovary. All of the tissue that lies to the right of the second clamp will be cut off and removed during the surgical procedure (shown by the arrow).

Figure 9: Clamping off tissue Removing the Tissue and Suturing:

After preparing the tissue for removal through use of clamps, the tissue located directly within the second and third clamp is removed through use of the surgical scissors. This removal of the tissue includes the removal of the third clamp.

Figure 10: Removal of third clamp

Two sutures are then placed underneath each ovary to replace the clamps. The surgeon can then use the still attached ovaries to locate the cervix and gently slide it out of the abdomen through the same incision.

Figure 11: Ovaries still attached

After the cervix and remaining body of the uterus has been located, clamps can be placed at the base of the cervix. The clamped off area, containing the uterine body and the two ovaries, is cut away through use of a scalpel. Stitches are then inserted under the clamped off area, as they were in the case of the ovaries. After the sutures are in place, the clamps are able to be removed and the cervix is placed back into the abdominal cavity.

Figure 12: Clamping off the Cervix Suturing of the Initial Incisions:

The first tissue layer to be sutured is the linea alba. As stated previously, this suturing is very important and needs to be done in a careful manner. Strong and secure suture material, such as stainless steel, must be used in order to ensure minimal tissue damage.

Figure 13: Suturing of the Linea alba

The next tissue layer that is closed up is the subcutaneous layer (tissue immediately under the outer skin layer). This layer is not as muscular as the linea alba but should still be sutured with care. In addition, the suture material used is much different than the stainless steel in the sense that it dissolved over a period of a few months.

Figure 14: Suturing of the subcutaneous layer

The final layer to be sutured is the outer skin layer. Sutures can be placed on the outside and removed within seven to ten weeks or can be placed under the skin and will dissolve on their own. Finally, a pain injection is dispensed in order to relax the dog after waking and allow the healing process to begin immediately.

Figure 15: Suturing of the outer skin layer

Post-surgical:
Many dogs are either released the same afternoon as the surgery or the day after the surgery. Due to the pain injection given immediately following the procedure, the dog may be slightly disoriented when she returns home and may not have much of an appetite because of the anesthesia. Therefore, only a small amount of food or water is offered about an hour after returning home from the hospital. Some dogs will be hungrier than others and more food will be given. Dogs that have undergone this surgery should not be extremely active outdoors for a few days or until the outer incision wound has healed. Though these post-operative instructions seem limiting and severe, it would be much more debilitating, not to mention devastating, if the dog were to develop cancer or extremely painful uterine infections later on in life. In addition, this procedure prevents more dogs without a home from becoming pregnant and giving birth to more stray puppies. The procedure saves lives by preventing dogs from ending up in overcrowded shelters and from reaching an extremely upsetting fate.

Information Sources:

1) Major Source: "Canine Spay." Long Beach Animal Hospital. Web. 29 Mar. 2010. <http://www.lbah.com/canine/spay.html>. 2) "Spaying - Procedure & Recovery - Animalhealthchannel." Animalhealthchannel, Your
Animal Health Community - Developed by Veterinarians - Animalhealthchannel. Web. 29 Mar. 2010. <http://www.animalhealthchannel.com/spay/procedure.shtml>.

3) "Spaying (Ovariohysterectomy) Female Dogs." Dog, Cat, and Pet Care Tips, Health and Behavior Information by Veterinarians. Web. 29 Mar. 2010. <http://www.peteducation.com/article.cfm?c=2+2112&aid=926>. 4) "ACVS - Ovariohysterectomy." American College of Veterinary Surgeons. Web. 29 Mar. 2010.
<http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/Ovariohysterec tomy

Image Sources:

Figure 1: "ACVS - Ovariohysterectomy." American College of Veterinary Surgeons. Web. 29 Mar. 2010.
<http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/Ovariohysterectomy

Figure 2: "Spaying (Ovariohysterectomy) Female Dogs." Dog, Cat, and Pet Care Tips, Health and Behavior Information by Veterinarians. Web. 29 Mar. 2010. <http://www.peteducation.com/article.cfm?c=2+2112&aid=926>. Figures 3-15: "Canine Spay." Long Beach Animal Hospital. Web. 29 Mar. 2010. <http://www.lbah.com/canine/spay.html>.