Part of being a good professional is to make sure we have our clients on board. And talking about neutering may be one of the most common things we do in our daily work. The profession and client have different views on female neutering and it’s important to take this into consideration when discussing the procedure with a pet owner. So what should you be discussing?
What is the procedure?
Being able to explain what happens during the procedure is an important part of getting the client to give informed consent. What is done during the procedure? What is the outcome? Is it an ovariohysterectomy? An ovariectomy? A hysterectomy? Will the patient continue to cycle? What happens with pregnancy?
OVH removes the ovaries and the uterus, therefore the patient will no longer show any signs of heat and pregnancy is impossible.
Ovariectomy removes the signs of heat and the lack of hormones prevents pregnancy from developing, even though the uterus is present.
Hysterectomy removes the uterus only, so the patient will continue to cycle and show signs of heat, but will not be able to carry a pregnancy.
Reasons for choosing one or another are strongly cultural and will be the topic of a different article!
What are the benefits of the procedure?
Explaining the benefits is what allows the clients to decide if they want to put their pet through the procedure. Female neutering prevents unwanted pregnancies and that’s a relevant benefit in cats, particularly feral communities. However, there are other pros to neutering, such as reducing the risk of mammary neoplasia (when done before the first season) and virtually eliminating the risk of pyometra and uterine neoplasia. Ovarian neoplasia is also not possible if both ovaries are fully removed.
But what are the risks?…
However, there are also downsides of the procedure and you must make sure the owner is aware that they may happen. One known complication of the procedure is the possibility of urinary incontinence in females. It’s also known that females are more likely to develop obesity when not properly fed due to their reduced calorie requirements post-surgery. However, there is also increasing debate on when to neuter female dogs. This is because there seems to be an association between sexual hormones and skeletal development. Therefore, there is now increasing evidence that early neutering in female dogs of large breeds may predispose to musculoskeletal disease and some vets are now recommending neutering after 12 or 18 months of age to ensure full skeletal development before removing ovarian hormones. This is why hysterectomy procedures are starting to become more commonplace too, allowing for earlier neutering while preventing unwanted pregnancies.
What about anaesthesia?
You must also warn the owners about the risks of anaesthesia, because they are always present, and what you do to mitigate those risks. This is also how you explain why you want to run pre-op bloods and administer fluids during the procedure (if that’s the case). You should also explain what type of anaesthesia is going to be used (volatile vs. fixed) and make sure the client understands that it’s a risky procedure that requires the patient to be fully asleep.
So what about possible complications with the procedure itself?
This is what you must explain to owners so that they truly understand what happens during the procedure and what can go wrong. The main complication of the procedure is bleeding, even if the procedure is done correctly it’s a known risk, especially in female dogs. There are also possible complications such as inadvertent ligation of the ureters, resulting in hydronephrosis, risk of wound breakdown and abdominal herniation. It’s important the owner understands this to understand why we ask them to do certain things when their dog or cat returns home!
This is the part of the procedure we are less worried about, but it’s often the most stressful for clients. This is when the owners see the actual results of the procedure, the pain and the discomfort, and having a bad experience here can cost you the client. It’s particularly important that the client understands why you may want to send the patient home with an e-collar or a vest, why you want to give them pain relief and why the owners shouldn’t let their dogs run around the house like crazy. They have to understand why it is that you want to see the patient again and when, as well as what are signs that they should contact you about immediately – such as something poking out of the wound or the stitches breaking!
Being able to explain everything properly will allow the client to make an informed decision and look after their pet before and after you do the procedure, increasing your chances of a successful procedure.
Teach your hands and your brain!
For those of you interested in getting surgical principles in place and training your hands to do what it takes when the time comes (even if it takes a long time for the time to come), have a look at our distance-based simulation surgery course to walk you the trickiest of the routines – spays. For 4 weeks, lovely Agata Witkowska will be guiding you through the principles of surgery, how to perform spays in dogs, cats, rabbits and ferrets, how to prepare your patients and how to deal with complications. And you get a training kit with a uterine model to actually apply those techniques in a safe – and repeatable way. Quoting some very smart people, “new for entertainment, repetition for results”! Check out our course information page and pop down your questions in the comments below.