Neutering

Question 1

When should we spay bitches?

Answer 1

Perform during anoestrus - avoid seasons
Typically at 6 months (before first season) or 3 months after end of first season/any season after that
Most benefit in terms of prevention of mammary cancer if performed before or after first season
3 months after end of season is to avoid false pregnancy

Question 2

When should we castrate dogs?

Answer 2

Frequently at 6-9 months, common to consider waiting longer especially with larger breeds (commonly >1yr) unless behavioural issues associated with male behaviours

Question 3

When should we spay cats?

Answer 3

Usually at 4-6 months, before coming into season

Can spay at any time after that, even if in season but uterus is more friable if in season at time of operation

Question 4

When should we castrate cats?

Answer 4

Usually done from 4-6 months, provided testicles are big enough

Question 5

What are some reasons for spaying?

Answer 5

Population control
Prevention/treatment of health conditions, e.g. pyometra, mammary cancer, false pregnancy
Control hereditary diseases

Question 6

What are some reasons for castration?

Answer 6

Population control
Management/behavioural modification, e.g. roaming, male aggression, unwanted sexual behaviour, spraying/smell in tom cats
Prevention/treatment of disease e.g. testicular disease, perineal rupture, perianal adenoma, prostatic diseases
Infectious disease control e.g. FIV/TVT

Question 7

What are some possible side effects of spaying?

Answer 7

Weight gain
Coat change
Urinary incontinence
Perivulvar dermatitis
Hypoplasia of external genitalia
Increased risks of orthopaedic diseases and some cancers - unclear evidence

Question 8

What are some possible side effects of castration?

Answer 8

Weight gain, increased appetite and decreased activity
Coat change
Behavioural - nervous dogs may get worse after castration
Some evidence of increased risk of development of bladder and prostate cancer (rare)
Delayed closure of growth plates with early neutering, especially giant breeds

Question 9

What techniques can we use to spay?

Answer 9

Surgical - ovariohysterectomy (removal of both ovaries and uterus) or ovariectomy (removal of both ovaries)
Medical possible (use of the drug Delvosteron) - temporary but not common

Question 10

What surgical approaches can we use to spay?

Answer 10

Via a midline laparotomy
Laparoscopically - increasingly common, ovariectomy performed, more expensive, uses smaller incisions (faster return to normal activity, reduce post-op discomfort)

Question 11

How do we position for bitch spay?

Answer 11

Midline approach (for both traditional or lap spay)
Dog in dorsal recumbency, surgeon usually has dog's head to their left

Question 12

How do we clip and prep for a bitch spay?

Answer 12

Clip includes umbilicus and reaches pubis, usually approx. 2/3rds width of animal
Wide clip important as drapes move and incision may need to be extended
Routine aseptic skin prep

Question 13

What instruments do we need for a bitch spay?

Answer 13

Standard soft tissue kit
Must include at least 3 large artery forceps (either curved or straight)
Some vets might like a spay hook

Question 14

How do we position for a cat spay?

Answer 14

Flank approach most common in UK, midline used if pregnant or not known if already neutered
Cat lies in right lateral recumbency, surgeon has cat’s head to their left
Hindlegs often tied back

Question 15

How do we clip and prep for a cat spay?

Answer 15

Incision site is found by making a triangle between wing of the ilium and the greater trochanter
Wide area surrounding this should be prepped in case incision needs extending
Routine aseptic skin prep

Question 16

What instruments do we need for a cat spay?

Answer 16

Standard soft tissue kit
Must include at least 3 small artery forceps (either curved or straight)
Spay hook use can be more common in cats

Question 17

What possible complications can we see after a spay?

Answer 17

Haemorrhage
Ovarian remnant syndrome
Stump granuloma/pyometra
Urinary tract injury
Abdominal hernia
Wound infection

Question 18

What should we be monitoring for post-spay?

Answer 18

Standard GA monitoring and post-GA care
Signs of internal haemorrhage - dropping BP, pale MMs, lethargy
Problems with wound - oozing, swelling, discomfort
Ensure no patient interference with wound

Question 19

What post-op care plan should we have for spay patients?

Answer 19

Pain relief - opioids and NSAIDs injections, oral NSAIDs taken home
Use of buster collar/bodysuit
Rest for ~10 days
Bland diet immediately post-GA, then back to normal food but need to reduce calorie intake in the long term (consider transition to neutered food)
Post-op checks - 2-3days and 10 days post-op

Question 20

What techniques can we use for castration?

Answer 20

Surgical - orchidectomy (removal of testicles), or rarely vasectomy
Medical - chemical castration (Suprelorin implant) in dogs, temporary

Question 21

Describe open vs closed castration.

Answer 21

Open = vaginal tunic incised
Closed = vaginal tunic left intact
Both can be used, but surgeons may choose one over the other

Question 22

How do we position for a dog castration?

Answer 22

Pre-scrotal midline approach
Dog in dorsal recumbency, surgeon may stand on either side depending on preference
Check both testicles present

Question 23

How do we clip and prep for a dog castration?

Answer 23

Clip area between tip of penis and scrotum and several cm on either side
Avoid clipping too close on the scrotum itself - skin very sensitive, beware clipper rash!
Routine aseptic skin prep
Local anaesthetic sometimes used - injected in testicles/incision area during prep

Question 24

What instruments do we need for a dog castration?

Answer 24

Standard soft tissue kit - at least 3 haemostats

Question 25

How do we position for a cat castration?

Answer 25

Scrotal approach - 2 incisions, one on each testicle
Cat lies in lateral recumbency
Check both testicles present

Question 26

How do we clip and prep for a cat castration?

Answer 26

Clip just the scrotum and surrounding area, plucking also possible but can cause more bruising
Routine aseptic skin prep, but usually no drapes used
Local anaesthetic sometimes used - injected into testicles during prep

Question 27

What instruments do we need for a cat castration?

Answer 27

Surgeon dependent
Common to only use a scalpel blade and no kit
Some surgeons prefer to use a pair of haemostats

Question 28

Do we use suture material for a cat castration?

Answer 28

Usually, no - the cords are often tied on themselves rather than using ligatures, and incisions are left to heal on their own

Question 29

Describe cryptorchid castration.

Answer 29

If testicles not descended by 6 months, surgical removal of both testicles is advised due to increased risk of neoplasia
Retained testicle can be anywhere along normal path of descent - pre-scrotal/inguinal/abdominal
Unilateral (more common) or bilateral
If testicle is abdominal then an exploratory laparotomy is required (or can be done laparoscopically)

Question 30

What are some possible complications due to castration surgery?

Answer 30

Scrotal bruising/swelling
Haemorrhage - scrotal haematoma/haemoabdomen
Infection
Self-trauma

Question 31

What should we be monitoring for after a castration?

Answer 31

Standard GA monitoring and post-GA care
Signs of haemorrhage - internal (dropping BP, pale MMs, lethargy) or external (swelling/bruising of scrotum)
Problems with wound - oozing, swelling, discomfort
Ensure no patient interference with wound

Question 32

What should we include in a post-op care plan for castration patients?

Answer 32

Pain relief - opioid and NSAID injections, dogs sent home with oral NSAIDs
Use of buster collar (bodysuit less reliable), cats usually do not need a collar
Rest - dogs ~10 days, cats usually ~2 days
Feeding - bland diet immediately post-GA, then back to normal food but warn owners about need to reduce calorie intake long term (consider transition to neutered food)
Post-op checks - dogs usually 2-3 days and 10 days post-op, cats variable but usually one check at 2-3 days post-op