Changing with the seasons

Hi,

My name is Louise I have four dogs of different breeds, German Shepherd bitch 10 years, Patterdale male 8 years, mini Jack Russell bitch 3 years, Parsons Jack Russell bitch 2.5 years.

I run a boarding kennels, and over Christmas had the Parsons Jack Russell in for boarding. On the owners' return they told me they were going to just take her to a rehoming centre. They had got her from some sort of puppy farm, where she was kept in a stable, for the son who had left school and wasn't going out. They thought they would their son a dog to give him something to do and get him out of the house. That was fine until he started college and got a girlfriend; he then wasn't bothered with the dog, who suffers from separation anxiety, so once everyone was out she was barking non-stop and weeing and pooing everywhere so they decided to get rid.

When she was in my kennels she was a nervous, under-nourished, under-fed dog of under 6 kilos. I agreed to find her a home as I knew she would be hard to place in a rescue centre and would be in danger of being destroyed as people do not understand the time and commitment of separation anxiety.

She wasn't coping with the kennel life and was self-harming, so my partner and I decided as I had been socialising her with my three dogs at work she could come home as a foster dog. Well, she fitted in like she had always been there! The two Jack Russells cuddled up like cats, all of them best of friends.

Once she had been fed properly, nourished and put on some weight, she came into season. The owner said she had been spayed but we had our reservations, and we now know she had not been spayed. Well, it's like a switch had been flicked. She has turned into a monster to the other Jack Russell she was such good friends with before. She has now been in season seven weeks, and we have taken precautions to keep them separated with cages for the short time I have to do things. Then, when she is out, I keep her on a lead and muzzled, as at sight of my other Jack Russell she is going for the kill - she would rip her apart if she got hold of her. She did attack the other one twice when she first came into season.

The vet has now said we should spay her early this Friday 3rd May, but I have been reading up so much on this, and in the book I read it is best to avoid spaying bitches for two months after estrus. It says spaying during this time can result in a precipitous drop in progesterone levels with possible accompanying emotional disturbances, irritability aggression and depression. So I am now concerned as to whether this is going so solve the problem, or as to whether we will have to let her go, as this is not an option we want to do we really want to give her every chance as before this happened she was the most loving beautiful soft girl to all.

Hope you can help I'm at my wits end, with what is the best decision.

Yours,

Louise Bramhall, by email


Karen Wild, behaviourist, advises...

Hi Louise, 

Whilst this is a veterinary question, from a behavioural point of view there is concern that to spay a dog during this period may prolong the problem. Each case must be looked at individually and perhaps there are temporary measures that can help whilst things are settling down. I would recommend asking for referral to a Veterinary Behaviourist without delay, who specializes in these problems. Please either email me on info@karenwild.co.uk or contact the APBC ( www.apbc.org.uk ) for someone in your area.

Weighing up the risks

I have a small Jack Russell cross who weighs just under 7 kg. I have not had her spayed and during her last season she developed a false pregnancy. I was told to have her spayed because she is more at risk of developing a pyometra. Is this correct? I am not going to breed from her and her seasons are well controlled, but I am worried about incontinance and a few other things if I have her spayed.

Thank you,

S. Tasker, by email



Alison Logan, vet, advises...

To spay or not to spay – that is the question. And there is no simple answer because there is no disputing that it is the most involved of the routine surgical procedures, and your bitch will need a general anaesthetic. Equally, do remember that because spaying is so commonly performed it is also a procedure which your vet will be very used to doing.

I am not sure that having a false pregnancy will make your bitch more at risk of developing a pyometra. It is true to say, however, that with every season there is an increased risk of any bitch going on to have a womb infection. Pyometra is a very serious condition, developing a few days to a few weeks after a season. There are essentially two possible scenarios:

- closed pyometra: abdominal enlargement and pain, fever, lethargy, increased thirst, vomiting

- open pyometra: the owner may notice little more than an unpleasant discharge from the vulva

There are medical options for treating a bitch with a womb infection or pyometra. Spaying is, however, generally the main course of action, although the risks are obviously far higher than for a routine planned spay when the patient is fit and well and usually much younger so without any health concerns associated with ageing.

As vets we would therefore prefer to spay when a bitch is young and healthy. There is a risk of urinary incontinence which can usually be managed, although I have not encountered a case for some years now so there may be other factors which have changed. The often-quoted association with mammary tumours and a protective effect of early spaying is unclear and still under investigation. When I first qualified more than twenty years ago, I would be regularly finding mammary tumours when running my hands along the underside of bitches at routine visits, whereas I have certainly noticed that this has become a real rarity in recent years. Seeing a patient booked in for a mastectomy is noteworthy, not at all common.

Weight gain after spaying is another reason that puts owners off having their bitches spayed. In my view, it is far outweighed by the advantages of spaying, especially as it is simply a matter of appreciating that when a bitch is spayed her body slows down by as much as 20%. Cutting back on her ration, coupled with a switch to a food formulated for a neutered dog if feeding a commercially-prepared diet, should prevent weight gain. If it is a planned spay, then it is going to be best performed when the bitch is at her ideal bodyweight as it will be hard to shift weight after spaying. This is another reason to avoid being rushed into spaying by the development of a womb infection.

Then there is the matter of unplanned pregnancy. I assume this is what you mean by having good control of your bitch’s seasons. It is alarming how often accidents do happen…

The decision to have your bitch spayed is very much your own decision and does merit careful thought. I hope this has helped, and would urge you to discuss it further with your vet in order to come to a reasoned decision.

When is it best to spay?

My vet is advising I spay my eight-week-old pup at six months old before her first season, as it reduces the risk of mammary cancer by up to 85%.

With my previous dogs I have always allowed a number of seasons before spaying but does it matter whether a bitch has come in season or not before spaying? Are there any psychological issues with spaying a bitch who hasn't had a season?

This is causing me a real dilemma because I want to do what's best for the health of the dog.

Thanks for your guidance.

Dianne Evans, by email

Decision making

Hi

I'm trying to find out all that I can about neutering before making the decision about my miniature Labradoodle bitch. She's seven months old now but hasn't come into season yet.

My vets advise having small breeds neutered before they're six months, with ovariohysterectomy, but I have my doubts about this after having read Richard Allport's column recently about a new drug for pyometra.

My thinking so far is to put off neutering until after Cookie's first season, at least. I have a neutered male five-year-old Border Terrier and how he copes with her being in season will be part of the decision. Their relationship with each other is very important.

We have had the experience of having a dog neutered prematurely - we had a Springer
Spaniel from The Dogs Trust and had him neutered at six months, as they stipulated. We regretted it because it really wasn't necessary - he was not very "male" in the first place and remained rather immature. After neutering he also had a lot of unwanted attention from other males, presumably because he didn't smell right? So I recognise the importance of hormones for the dog's physical and emotional wellbeing!

In addition, I believe there are various options for surgery: remove the uterus and the ovaries, remove the uterus or remove the ovaries. If only the uterus is removed then Cookie will have the benefit of having hormones, but does this mean she still comes into season (but can't get
pregnant)?

Can you help me please?

Thanks.

Sue Issac, by email


Alison Logan, vet, advises...

Oh, this question has been on my mind all day, and I was pondering it as I drove home from the practice this evening. Deciding to have a bitch spayed is indeed a very important decision to make and does need careful consideration – although it is routine surgery, it is major surgery.. The advantages and disadvantages have been debated in the pages of Dogs Today and elsewhere for years, and I think there is probably not a single ‘yes’ or ‘no’ answer which will suit everyone.

All I would say, from my side of the table so to speak, is that pyometra is a particularly nasty condition for a bitch to experience, however it is treated. The chances of an unspayed bitch developing a womb infection are high and, as it tends to occur later in life, there are often other health issues associated with ageing complicating the picture which may affecting the choice of treatment and the ultimate outcome. Additionally, if a bitch has her womb and/or ovaries then there is the potential for growths (cancer, to stop beating around the bush) which would have been preventable through ovariohysterectomy.

There is also the issue of pregnancy, planned and otherwise. Mismating does happen. It is possible to inject a drug to terminate a pregnancy but, to be honest, I would rather not be placed in that position in the first place. When an unplanned pregnancy goes to term, there is not only the worry of the birth and whether there will be complications, but also rearing the litter and then finding homes for the puppies.

Pseudo- or false pregnancy is an important factor. If a bitch is not mated, or does not become pregnant after a mating, the hormones circulating still trigger some of the changes associated with pregnancy. There may be mammary gland development, often with milk production. There may be changes in appetite, nesting behaviour, hiding toys and becoming possessive over them, and general moods swings. Aggression is a rare but worrying feature.

Preventative surgery has always been and will continue to be a contentious issue. Neutering is a form of preventative surgery, but there are multiple benefits. Also, and this thought hit me as I turned into our drive, our canine friends age at a far more rapid rate than we do, resulting in them having far shorter life expectancies. Surely, therefore, it is in their interest to prevent health problems which could potentially reduce their life span further?

Perhaps I have digressed, and I did not mean to be drawn into the whole range of issues raised by neutering when I started this answer. It does occur to me that, with Cookie having reached seven months of age, I would probably be advising you to let her have one season anyway before spaying because she could come into season at any time. Standard procedure is to remove uterus and ovaries – leaving the ovaries will mean the bitch will still come into season, show the signs of false pregnancy and, of greater significance, there is the risk of an infection developing in the remnant of the uterus, a so-called stump pyometra.

I do hope this has helped. Go back to your vet and talk it through further with him or her because either way you need to make an informed decision. Your vet is the person who will be caring for Cookie’s health for the rest of her life.

More than one way to spay?

I've been looking into how best to have my new dog spayed and I am wondering which is the best operation to go for?
I have heard that some vets take out the ovaries and the uterus, but others only take the ovaries. And that there are even some vets who are now using keyhole surgery to do this, but I guess there are very few vets with the equipment. What are the benefits of using this method? Can you be referred to a specialist?
I thought one of the benefits of neutering was the avoidance of pyometra - but if the uterus is left behind, could that still get infected, or does the lack of ovulation remove the risk?
Which of the methods is the least likely to result in incontinence?
And that age old question - when do you do the operation? After the first season, after the second? Earlier?
Paula Thompson, Cheshire

Edward Davies, Veterinary Surgeon, Cheshire Pet, says...

Hi Paula,

Here at Cheshire Pet we are regularly using keyhole surgery (or laparoscopy) to spay bitches. The main advantages are a significant decrease in pain with smaller incisions and a considerably quicker recovery time.

Postoperative recovery is so quick that often owners can’t tell their pets have had an operation; in fact, I actually did an exploratory procedure on my own dog, Henny, for a suspicious lump and my wife didn’t realise I had done anything, as Henny showed no signs at all.

We aim for the pets to leave the surgery as they came in – bright and alert and looking well – and we feel that the recovery period from laparoscopic spay is generally far faster than the traditional method of spaying – and a lot less painful.

I think the benefits of this technique will grow and I believe that perhaps in the not too distant future this technique will become the norm and will replace the standard spay procedure to a large extent. Bear in mind that this has only really been available in the UK for the last three to four years and at present it is only performed by very few practices, as the investment in training and equipment is significant. We feel really privileged to be able to offer this at Cheshire Pet.

Routinely only an ovariectomy is performed when a spay is done laparoscopically. (An ovariectomy is the removal of just the ovaries, not the uterus and the ovaries.) The uterus can be removed as well but it has been shown that this is unnecessary and of no benefit. Removing the uterus seems to be done as a historical technique in the UK rather than for clinical reasons. In most European countries ovariectomy has been performed for years, even using the traditional spay technique. It has been very well recognised and documented that once the ovaries have been removed then removing the uterus is of no value because the prolonged progesterone hormone production from the ovary is the drive behind the cause of pyometra. Once the ovaries are removed then that drive has gone and the risk of pyometra has gone.

I do not think the incidence of urinary incontinence is any different between laparoscopic spaying and traditional spaying. We would tend to suggest that if the dog is small i.e. less than 10-15kg then spaying before the first season is absolutely fine; however, in larger dogs spaying them between the first and second season seems to be preferable. This as we know avoids the risk of pyometra and can significantly decrease the risk of mammary tumours. The surgery – as with any spay – is best performed two to three months after the last season or in small dogs before the first season is anticipated.

Dear Paula,

Thank you for your letter, you have raised some excellent questions that are particularly topical at the moment given the increasing availability of key-hole procedures in veterinary surgery. I will try to address each of your questions in turn but unfortunately, and somewhat surprisingly, the veterinary profession does not have definitive evidence based answers for all of them!

Does the uterus have to be removed as well as the ovaries?

Historically, neutering or a 'spay' operation for a bitch has involved removal of both ovaries and the uterus to the level of the cervix (called an ovariohysterectomy or OVH) via an open approach (the surgeon makes a hole large enough to use their hands and fingers). Ovariectomy (OVE) is an alternative technique that involves removal of both ovaries whilst leaving the uterus in position and can be performed open or using a key-hole technique.

Ovariectomy has been the preferred technique in mainland Europe for many years because it can be performed through slightly smaller incisions, achieves the same overall effect as a 'traditional' spay, minimises the surgical trauma from neutering (by leaving the uterus in place) and does not increase the risk of urinary incontinence or pyometra compared to ovariohysterectomy. The uterus is only left in position if it appears normal during the procedure.

In theory, leaving the uterus in position could allow a uterine tumour to form in later life. In reality, uterine tumours are very rare in dogs and most are cured by removal of the uterus in the unlikely event that this becomes necessary.

What are the potential benefits of a key-hole spay?

Laparoscopic (key-hole) ovariectomy results in less tissue trauma than an open approach because the operation is carried out from within the abdomen which reduces the requirement to pull on the ovaries or uterus. In Humans, laparoscopic surgery has been shown to reduce pain, promote faster recovery and reduce hospital stay times. Accurate and objective pain assessment in veterinary patients is very difficult and whilst some studies have suggested that dogs spayed via laparoscopy are less painful than those operated via a conventional open approach, others have not been able to demonstrate a significant difference. Most vets who perform key-hole spays regularly do feel that the patients recover very quickly and suffer low levels of discomfort.

Humans obviously prefer to undergo operations that involve smaller scars, and many prefer the same for their dogs. Laparoscopic ovariectomy is usually performed by two or three incisions between 5-10mm long. In the unlikely event of a breakdown of an incision following laparoscopy, the small size of the 'hole' should minimise the risk of any vital structures becoming trapped. Many experienced veterinary surgeons are able to perform open spays through relatively small incisions but most are likely to be at least three to five centimetres long. Limiting any one laparoscopic wound to approximately 10 millimetres results in most surgeons allowing off-lead exercise sooner than they perhaps would following conventional open spay surgery.

Overall, key-hole spay surgery has a number of attractive qualities that can benefit veterinary patients, namely that of reduced tissue damage, excellent visualisation for the surgeon, and smaller wounds requiring shorter periods of postoperative rest. However, conventional spay surgery carried out by an experienced surgeon using an open technique usually carries a similarly low risk of complications and most dogs recover relatively quickly.

When should I spay my bitch?

Your last question involved the age-old debate of when is the best time to spay a bitch regardless of the technique used. The two main concerns are the possibility of increased risk of urinary incontinence after a spay but also minimising the risk from development of mammary tumours. Many of the actual numbers often quoted on this subject are not very scientific as they were based on reports written before veterinary surgeons appreciated the necessity for robust statistical analysis.

It is likely that the risk of development of mammary tumours significantly increases after the first season and then continues to rise slightly with each subsequent season thereafter for at least the first few years. Therefore, in order to minimise the risk from development of mammary tumours, bitches should be spayed before the first season, but there is also likely to be some benefit from spaying after later seasons until at some point, presumably during middle age, the benefit regarding mammary tumour development becomes minimal.

The risk of urinary incontinence is present following any neutering procedure, and unfortunately some bitches will become incontinent whether they are spayed or not. Investigations suggest that there may be some benefit from waiting for the urogenital tract to reach sexual maturity before spaying, to reduce the risk of developing incontinence, and therefore concerned owners may choose to wait until after the first or second season. It is also clear that urinary incontinence is the result of a complex interaction of many factors and therefore it cannot be simply attributed to an effect of sexual maturity alone.

There are some breeds with a particular predisposition for development of incontinence and therefore consideration should be given to spaying after the first or second season, or perhaps not spaying them at all. On the other hand, those breeds with a low incidence of urinary incontinence can be considered for early neutering, and this offers the maximal potential benefit in terms of mammary tumour development in later life and also of avoiding unwanted pregnancy.

Overall, when considering the issue of the timing of a spay surgery, your vet will be the best person to help you weigh up the factors relevant to your own dog. In many cases, neutering after the first season may represent a balanced compromise.


Chris Shales MA VetMB CertSAS DipECVS MRCVS
European Specialist in Small Animal Surgery
Willows Veterinary Centre & Referral Service
Highlands Road
Shirley
Solihull
West Midlands
B90 4NH
WWW. Willows.uk.net
Tel: 0121 712 7070