Hysterectomy

Because of recent advances in veterinary medicine, there are now multiple options for “spaying” a pet. The procedure can be performed as a traditional open surgery or as a minimally invasive laparoscopic surgery. Spaying may involve an ovariohysterectomy (removal of the ovaries and uterus) or an ovariectomy (removal of the ovaries only). All approaches require general anesthesia. Many primary-care veterinarians recommend spaying at about six months of age, but it can be performed at almost any age. It may be done electively or as treatment for reproductive disease.

Reasons to consider spaying include:

• Major reduction in the risk of mammary (breast) cancer
• Reported as ~200× less likely if an ovariohysterectomy is performed before the first heat
• Prevention of pyometra (uterine infection)
• Elimination of estrous (heat) behaviors and associated bleeding
• Prevention of unwanted pregnancy and reduced risk of dystocia (difficult birth)

Most young, healthy animals spayed routinely have no clinical signs beforehand. If a pet has reproductive disease (e.g., pyometra, dystocia, ovarian/uterine cancer), signs are usually related to that underlying problem.

For routine ovariohysterectomy or ovariectomy, the work-up typically includes:

• A complete physical examination
• In older dogs: CBC, serum chemistry, and urinalysis may be added
• In suspected pyometra or dystocia: abdominal x-rays and possibly ultrasound may be needed

Laparoscopic surgery

Techniques vary, but commonly 2–3 small incisions (often <1 inch) are made for a camera (laparoscope) and instrument ports. The abdomen is inflated with carbon dioxide to create working space. The reproductive tract is visualized and handled with instruments, and vessels are sealed/ligated using clips, suture, or a vessel-sealing device. Either ovariectomy or ovariohysterectomy can be completed, followed by closure of the port sites.

Open surgery

An incision is typically made on the ventral midline, though a flank approach is sometimes used. Incision length depends on patient size and other factors. The ovaries and/or uterus are brought into view, vessels are tied off, the reproductive tissue is removed, and the abdomen is closed in layers (body wall, subcutaneous tissue, skin).

Ovariohysterectomy vs ovariectomy

Ovariohysterectomy has historically been the most common spay in the United States. More recent literature is described as showing no long-term difference in outcome between ovariectomy and ovariohysterectomy, so they are often considered broadly comparable options.

Typical aftercare includes:

• Strict rest at home (no running, jumping, or rough play) for about two weeks
• Pain medications for several days
• An Elizabethan collar if needed to prevent licking/chewing at the incision
• Additional therapy may be required if the surgery treated pyometra or other disease

Possible complications include mild issues such as bruising, swelling, and infection. Serious complications (e.g., hemorrhage, urinary obstruction) are uncommon but can be life-threatening. Surgery may be more challenging in large or obese patients and may carry increased risk. Urinary incontinence can occur and may require long-term medication.

Overall prognosis is excellent for routine ovariohysterectomy or ovariectomy, and more variable when surgery is performed for pyometra or dystocia.