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Vet Talk

A Tale of Two Spays
June 4, 2018 (published)

I was spayed about a month ago. Now that I have an intimate knowledge of how it feels to have my uterus removed, I thought I'd share how that's similar and different to what I've seen dogs and cats experience.

Most dogs and cats are spayed as juveniles, generally between two to six months of age. While it seems like operating on a small patient would be more difficult and dangerous than waiting until adulthood, it's actually easier once you get inside. Puppies and kittens are using all their food to fuel growth rather than storing it up, plus they're sexually immature. It's easier to identify the relevant bits of anatomy when you're not constantly shoving globs of fat out the way, and it's easier to tie off blood vessels that aren't engorged from supplying blood to a uterus that's gone through hormonal changes or even pregnancy. As I am in my 40s and have accumulated my fair share of fat cells, I'm equivalent to what we in the biz refer to as an "old dog spay."

While puppies and kittens are generally spayed as part of routine, preventative health care, adults are generally spayed for a particular reason. Perhaps the owner is just tired of managing a bitch in heat, perhaps the animal developed a massive infection called pyometra, perhaps something went wrong while delivering a litter — there's usually some singular something that prompts the decision to go to surgery. In my case, it was the sudden growth of benign tumors called leiomyomas by the sciencey types and fibroids by everyone else. 

There was about a month between the time I noticed the mass in my abdomen until the day of surgery so I had weeks to worry about what the mass was, how well I'd manage the pain of recovery (I'm a giant weenie about needles and pain), dealing with health insurance preauthorization, and working madly ahead so I could take a week or two off for recovery. Mind you, I'm knowledgeable about the medical aspects and I've never regarded my uterus as anything other than an annoyance so I really wasn't all that stressed. Some women might have been terrified the whole time, while some might just be eager to get it all done with. Animals don't care at all about the wait for surgery day; the first inkling for most of them is, "Oh, we're going in the car? How interesting! Wait, what about breakfast?"

Animals start caring about surgery day as soon as they get to the veterinary hospital. Cats are usually especially nervous as they tend to be less socialized to dealing with strange people in strange situations. The clinic staff does their best to make things less frightening and reassure their patients, but it's still a scary thing for many animals. Hence the effort to go quickly from drop off to sedation to surgery. It's not that your veterinarian wants to be done in time for an early lunch (though she probably dreams of that too); it's so that your pet has the happy drugs on board quickly so they don't spend hours with high stress levels. After surgery, when the anesthesia has worn off so animals are breathing safely on their own, they're left to rest quietly in a cage for a few more hours. Once they've slept off the drugs and can walk steadily, they're ready for their owners to pick them up and return to the comforts of home. 

My surgery day was a more prolonged affair but not particularly stressful as the hospital staff explained things every step of the way. There are a lot more people involved in human surgery and they all seem to come bearing paperwork. There's the registration staff, the check-in nurse, the pre-op nurse, the anesthesiologist, the surgeon, (and as it's a teaching hospital, a handful of students and residents), a few other nurses in the OR, the recovery room nurse, a few more nurses while I was in my regular hospital room, plus assorted aides, housekeeping, and food service people. From the time you drop your pet off to the time you pick her up, that's probably six or eight hours. From the time I arrived at the hospital to the first time I was able to toddle my bandaged belly to the bathroom, it was at least that long, then another 24 hours until I went home.

So what about pain control? Mine was wonderful: physicians and veterinarians use pretty much the same drugs for anesthesia and analgesia during surgery, but I got a bonus of an on-demand morphine pump for another 12 hours. Dogs and cats can't be quickly trained to press the green button when it lights up, so their immediate post-op meds are limited to occasional injections. A few days of oral pain killers are appropriate for all species, two- or four-legged. 

Otherwise, human and canine/feline recovery is very, very different. While your cat may just curl up and go to sleep on the back of the couch and your dog may try to chase squirrels in the back yard as soon as you get home, I can tell you that for me bending over was a horrifying concept for a couple of weeks and the thought of running is still right out unless both bears and zombies are chasing me. There was an entire week where something that fell on the floor was completely inaccessible to me unless someone else was nice enough to pick it up. This is NOT an indication that animals don't feel pain and don't need pain killers; they absolutely do. It IS an indication that this human is a complete wimp about pain and hides behind excuses of not wanting to pull stitches.

Which brings me to the other major difference between recovery in humans and pets: the Elizabethan collar, aka the Cone of Shame. Humans can (usually) be trusted not to lick, chew, or scratch at their incisions. Dogs and cats instinctively do any or all of those things to their injuries. At minimum, that behavior can irritate the skin and slow healing. Some animals, with enough motivation and time unsupervised, can chew the incision completely open so their intestines spill out. Nobody wants that. If your veterinarian gives you the collar, use the collar!

Psychological effects of being spayed are apparently non-existent in animals, especially in those spayed before their first heat cycle. There's the occasional report of a cat nesting with a favorite sock or a dog that tries to herd all the baby sheep, but as long as they can have access to their favored thing to nurture, they seem perfectly happy. I'm also perfectly happy without a uterus. I never have to worry about having a period (or about a late one!) again. I never had any desire to be pregnant so my uterus never seemed like a necessary or even useful organ. Many other human females do miss their uteruses, however. Maybe they really wanted to have children and now they'll never be able to carry their own babies. Maybe missing a uterus makes them feel like 'less of a woman,' or they don't like the idea of instant menopause. Make no mistake: these women suffer. 

Finally, I'd be remiss if I didn't address what's perhaps the biggest difference between surgery in animals and people, which is the financial cost. The fees for a hysterectomy in a dog or cat vary, but it's maybe $200-700 to spay an adult, depending on where you live. And that's without insurance or discounts or charity: it’s pure out-of-pocket discretionary income. I'm in the U.S. and have excellent health insurance. I haven't seen all of the bills yet, but they're already pushing $10,000. When I get the bill for the hospital stay, the surgeon, and the anesthesiologist I expect that'll double or even triple. Happily, my insurance takes that down to just a few thousand in co-pays and deductibles. If someone had to pay out-of-pocket for this simple surgery, they could end up deep in debt or even bankrupt.

It's been interesting to muse about the similarities and differences in surgery in human and non-human species. I’ve moved past the "hobbling gingerly" stage and am solidly into the "all is well as long as I avoid sudden movement and chafing” stage. But right now, I shall return to resting on the couch next to the dog that wonders why I still won't let her sit in my lap (way too close to that incision!) and the cat who perpetually sneers at me for being a light weight.

4 Comments

Carla Burris, DVM, MS
July 10, 2018

I had a midline incision that didn't extend above my belly button. Knowing that laparoscopy wasn't an option due to uterine size, that's exactly what I was hoping for. Cutting through the avascular linea vs. slicing through muscle bellies? Seems an obvious choice to me! I was a firm believer in better living through chemistry and took my pain meds for a few days -- and like you, had no problems being upright and moving. At my 6-week recheck, I told my surgeon it was the best surgical experience I could have expected but still not looking to repeat it anytime soon. Thanks for reading!.


Pamela
July 6, 2018

I am wondering if your surgeon cut you along midline? Or from side-to-side?     I was spayed When i was 40,and had been a veterinarian for 10 years. During the anticipation phase I mused, “if i spayed a 130lb rottwieler, ( the most popular k-9 breen at that time) I would be looking for midline.   In fact it would be antethema to malpractice if I cut her side-to-side.   I requested my surgeon to use midline, she said to me,” I will use the best approach when i get there”.    I begged for midline.  She did midline.  I, like my k-9 patients walked 2 miles on day 2 post op.  Never took any pain meds.    Am grateful to this day!


Cathy Hicks
June 6, 2018

Ditto!!


Jacki York
June 4, 2018

Thank you for such an informative and funny article!


 




 
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