By Dr. Timothy McCarthy
The first spaying I ever watched was in a small rural practice in 1958 when I was 13 -- the same time I first became interested in veterinary medicine.
The surgery was performed using ether and catgut suture from a spool that had to be manually threaded onto a needle. There was no surgical cap, mask, gown or gloves, and only a postage stamp-sized surgical drape. There was no pain medication, and the ovaries were pulled up to the incision by tearing their attachment to the abdominal wall. This was the state of the art at that time.
Today, nearly all aspects of spaying have improved. We have better anesthetics that have minimal negative effects on the patient. We use individual sterile packages of suture with attached needles made using the same synthetic suture material used in human surgery, which causes minimal tissue reaction and is completely removed by the body with time.
We also use caps, masks, gloves and gowns, and use drapes of adequate size to prevent any contamination of the surgical field. We no longer need to pour antibacterial agents into the surgery site. Aggressive pain management with drug combinations is used before surgery to block pain before it starts, and the medications are continued during the post-operative period.
However, we are still using the same barbaric blind tissue-tearing technique to rip the attachment of the ovaries away from the abdominal wall. This technique does work -- because we've been spaying dogs and cats this way for more than 50 years. But now there is a better way: laparoscopic spaying. It changes our technique from tearing tissue blindly to cutting tissue where we can see what we are doing, and it is the final step toward achieving modernization of this surgery.
To perform a laparoscopic ovariectomy, we first place a small endoscopic telescope into the abdomen, and the abdominal wall is lifted away from the internal organs by filling the abdomen with carbon dioxide gas so that we have a space to work. Specially designed surgical instruments are placed into the gas-filled abdomen. The first ovary is found and can be seen clearly on a video screen with magnification, which the surgeon uses for the duration of the procedure. The ovary is lifted gently away from the other organs, and its attachments to the abdominal wall are cut with a device that electronically seals the blood vessels. The freed ovary is removed from the abdominal cavity through one of the small incisions made for the telescope or the instruments. The procedure is repeated for the other ovary.
When the surgery is completed, no foreign suture material is left in the abdomen because we have electronically sealed the blood vessels, and we have only two small incisions in the abdominal wall.
The equipment and instruments needed to perform laparoscopic spaying are expensive, but they cost no more than many other advanced medical devices commonly seen in small-animal practices (such as ultrasound, digital X-ray systems and lasers) and are far less expensive than others (CT and MRI). Additional training is needed, but this surgery is easier to learn and perform, with fewer problems and complications than many other new surgical techniques that are being incorporated into small-animal medicine. This technique is well within a skill level attainable by most general practitioners.
The bottom line for pet owners: Animals spayed with laparoscopy recover faster and have less pain than those operated on using the traditional technique. It's time for a change!
Dr. Timothy C. McCarthy is a board-certified surgeon in the Portland, Ore., area who has pioneered the application of many minimally invasive diagnostic and therapeutic techniques that are now becoming the standard of care.
Q&A
Follow vet advice
on cancer diet
Q: My dog has been diagnosed with cancer, and I heard there is a special diet that can help. What is it and where can I buy it? -- via email
A: There's no doubt that the right diet can benefit dogs with cancer. Research on dogs with lymphoma has shown that in some cases, foods containing relatively low amounts of simple carbohydrates, moderate amounts of good-quality proteins, soluble and insoluble fiber, and moderate amounts of fats helped to reduce or eliminate some of the weight loss and muscle atrophy that occurs in dogs with cancer. The diet appears to help improve quality and length of life for some dogs with that type of cancer.
What we don't know is whether that type of diet can help with other types of cancer and whether it is effective only at specific stages of the disease. An oncologist or veterinary nutritionist may take into account factors such as where the cancer occurs or the dog's previous health history when making diet recommendations for a dog with cancer. For instance, if the cancer is targeting a specific organ, such as the kidneys, a diet designed for dogs with kidney disease may be the best choice. A dog who has a history of pancreatitis may not do well with a diet that is low in carbohydrates.
Certain supplements can also have positive or negative consequences in dogs with cancer, depending on the circumstances. Antioxidant vitamins such as E, C and beta-carotene are normally beneficial, but they shouldn't be given to dogs undergoing radiation therapy because they can interfere with the effectiveness of the treatment by preventing the radiation from killing the cancer cells.
What's most important for a dog with cancer is to continue to eat well, especially if he is undergoing chemotherapy or radiation treatments. The ability to take in nutrients and maintain a healthy weight is a big part of a dog's ability to fight cancer effectively. You, your dog's oncologist and a veterinary nutritionist should work together to design the best diet and supplement plan for your dog. -- Kim Campbell Thornton
THE BUZZ
Fido and Fluffy:
OCD just like me
-- Our pets' compulsive behaviors may be windows into our own compulsive behaviors.
"Like people can have compulsive behaviors, such as famously washing their hands until their skin is raw, animals can have similar behaviors," veterinary behaviorist Dr. Nicholas Dodman, director of the Behavior Clinics at Tufts University's Cummings School of Veterinary Medicine in North Grafton, Mass., told the International Association of Animal Behavior Consultants 2011 Conference in April.
"We're on our way to proving compulsive behaviors may be genetic," Dodman said. "If it's true in dogs, there's a good bet it's true in people."
Compulsive disorders in dogs are associated with what they were bred to do. Dogs bred to chase prey or herd are more likely to chase shadows or light. Research in Dobermans with flank sucking has shown a link between their behavior and a specific alteration on a chromosome for dogs with this disorder. Some cats, primarily Oriental breeds, such as Siamese, may compulsively suck on fabric, a behavior commonly called "wool-sucking."
-- Delta Airlines has joined American Airlines in banning snub-nosed dogs from flying on its airplanes following an increase in dog deaths on Delta flights. U.S. Department of Transportation data show that 122 dogs died on airlines from May 2005 to May 2010. Of those, 25 were English bulldogs and six were French bulldogs. Sixteen pets died on Delta Airlines in 2010, including six bulldogs. American Airlines banned snub-nosed dogs in November.
-- Toxoplasma gondii, a bacteria found in cat feces, is causing a deadly epidemic among California sea otters.
"Anything that harms sea otters will seriously harm the marine environment," said Mary Huebert, who studies tropical ecology at Humboldt State University in Northern California. "Sea otters eat sea urchins, and sea urchins eat kelp. Kelp is a big player in the marine ecosystem." The recommendation? Dispose of your kitty litter without flushing it.
ABOUT PET CONNECTION
Pet Connection is produced by a team of pet-care experts headed by "Good Morning America" and "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Gina Spadafori. The two are also the authors of many best-selling pet-care books. Dr. Becker can also be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker.