Spay Complications

I am having my female dog spayed next week. What are some complications of this surgery?

There are many benefits to spaying your bitch once you have made the decision that she is no longer going to be bred. There will be an end to messy heat cycles, hormonal mood swings, and the risk of an accidental breeding. Studies have shown that spaying will increase her life expectancy and decrease her chance of developing diseases such as mammary cancer and uterine infections.

With all the positive aspects of a spay, also called an ovariohysterectomy, it is also prudent to consider the possible complications. While a spay is a routine surgery, meaning it is done on a regular basis, it is not necessarily an easy surgery to perform, especially on large, older female dogs. Having your bitch in good body condition going into surgery is one way to decrease the possibility of a complication.

Any time an animal is anesthetized, there is the chance of an anesthetic reaction or other serious complication, including death. With modern anesthetics and monitoring equipment, this is a rare occurrence. Pre-operative bloodwork and the placement of an intravenous catheter before surgery will help avoid any unexpected problems.

Bleeding during or after surgery is a serious, life-threatening complication. Multiple strong sutures are tied around the blood vessels of the ovaries and uterus, as well as the body of the uterus, during the surgery. It is critically important to keep the bitch quiet for at least a week to 10 days following the surgery to avoid causing any of these ligatures to slip out of place. This may result in internal bleeding, which if not caught in time, could result in death.

Infection develops if your dog excessively licks or chews at the incision site. The area around the incision will be red, swollen and hot to the touch. She may develop a fever as a result of the infection. The fever will make her lethargic and reluctant to eat. If you see any of these signs, or there is discharge from the incision, contact your veterinarian immediately.

A seroma is a fluid-filled lump or swelling that occurs at the incision site. Seromas form when fluid from the surrounding tissue is inflamed as a result of the dog being too active post-operatively or licking at the incision. Your veterinarian can determine if your dog has a seroma by using a needle and syringe to aspirate a fluid sample from the swelling. In the case of a seroma, the fluid will be watery in consistency and red in color. Seromas resolve on their own with time and rest.

If your veterinarian withdraws pus from the swelling, your dog may have an abscess. An abscess is caused by bacteria and is painful to the touch. If the swelling is oozing puss, it is an indication of an abscess that will require medical treatment.

When performing the spay surgery, after the ovaries and uterus are removed, the incision in the abdomen is closed with strong sutures, or stitches, in three layers. The abdominal wall is closed with a number of individual stitches. Next, the subcutaneous area is closed with a running stitch, or continuous line of suture. Finally, the skin is closed with individual sutures.

The suture material used for the abdominal wall and the subcutaneous layer is usually a type of absorbable suture, such as gut, vicryl or PDO. This suture material will slowly dissolve over time as the incision heals. The stitches used to close the skin are monofilament and do not dissolve. They cause minimal reaction when placed and need to be removed 10 to 14 days after the surgery.

Your dog may be able to open the incision if she is allowed to lick or gnaw at the site. This is a very serious post-surgical complication called dehiscence. If the suture lines are broken down, the intestines or other abdominal organs may protrude through the open wound. This can lead to a life-threatening infection of the inner abdomen known as peritonitis. The blood supply to the abdominal organs may also be compromised, requiring emergency surgery and the loss of sections of the bowel.

Prevention of abdominal dehiscence is a far better option that trying to treat it. There are several things that can be employed to prevent the dog from getting at the incision. The Elizabethan collar, or “cone of shame,” is effective, but can be awkward and uncomfortable for the dog as well as the owners.

Inflatable or stuffed neck-roll collars, similar to travel pillows worn by humans, are a less stressful option, as long as the dog cannot get around them. Belly wraps provide support and prevent access to the incision. “Surgi-Suits” that look like baby onesies are a good option, especially for short-coated breeds. Just remember to lift the flaps when the dog is let outside to potty.

A hernia is another possible post-operative complication. The definition of a hernia is the protrusion of tissue through the muscles normally containing it. If the abdominal sutures break down while the skin sutures remain in place, a hernia will develop. It will look like a bump protruding from the abdomen at the incision site.

If the material in the hernia is only fat from the abdomen, the dog may not experience any pain. Some hernias result from organs slipping through the opening in the body wall, such as intestines or the urinary bladder. Most likely, surgery will be required to correct the problem. If the blood supply to the tissue in the hernia is compromised, it is termed a “strangulated” hernia. This is a life-threatening emergency.

One rare post-spay complication is the presence of an ovarian remnant. Proper surgical technique instructs veterinarians to examine the ovaries closely during the surgery to ensure the entire structure has been removed. When part of the ovary is left in place, the bitch will continue to go into heat.

If an ovarian remnant is present, it must be removed surgically. Performing the surgery while the bitch is in heat will make locating and excising the remaining ovarian tissue easier.

It is important to take into consideration the time in the bitch’s heat cycle when the surgery is scheduled. Although a bitch can be spayed when she is in heat, it is not recommended. During estrus, the blood supply to the uterus is increased, making the tissue enlarged and more fragile. While this is not an issue for an experienced surgeon, others may find it more difficult, so why take the risk?

Another consideration is the possibility of the bitch developing a pyometra, or infected uterus, in the weeks following her heat cycle. After estrus, the hormone progesterone remains elevated for up to two months, causing the lining of the uterus to thicken in preparation for pregnancy. If the bitch is not bred and the uterine lining continues to increase in thickness, cysts may form within the uterine tissues. This condition is called cystic endometrial hyperplasia. The thickened cystic lining secretes fluids that create an ideal environment for bacterial growth.

If the bitch is spayed while this process is in motion, the infection can become entrapped between the ligatures on the uterine body. This is known as a uterine stump abscess. Symptoms include lethargy, loss of appetite, fever and tenderness in the abdomen. A second surgical procedure will be required to remove the infected tissue. A culture and sensitivity should be performed to determine the type of bacteria growing and the antibiotics needed to treat the infection.

The best time to have your bitch spayed is the midpoint between her estrus cycles. Surgical complications are always a possibility in ovariohysterectomy surgeries, but certain practices can help minimize problems.