spaying laprascopic ovariectomy or traditional hysterectomy?

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jans
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spaying laprascopic ovariectomy or traditional hysterectomy?

Post by jans » 07 Jun 2009, 21:55

Hi everyone, hope you don't mind me picking your brains. I am looking into spaying and would love to know more about the pros and cons of traditional spaying and the newer laprascopic technique where only the ovaries are removed ? If any one has any info or opinions i would appreciate them ? Many thanks all

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Carole g
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by Carole g » 07 Jun 2009, 23:24

Does this help?


Comparison of long-term effects of ovariectomy versus ovariohysterectomy in bitches.Okkens AC, Kooistra HS, Nickel RF.
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, University of Utrecht, The Netherlands.

Although ovariectomy is less invasive and less time-consuming than ovariohysterectomy, most surgical textbooks recommend ovariohysterectomy for routine neutering of bitches. This advice is probably based on concerns about the development of uterine disease after ovariectomy. However, there is no evidence that conditions such as cystic endometrial hyperplasia (CEH)-endometritis develop in the ovariectomized bitch, unless progestagens are administered. The purpose of this study was therefore to compare the long-term effects of ovariectomy and ovariohysterectomy, including the incidence of urinary incontinence. Questionnaires were sent to 264 owners of bitches, in which ovariectomy (126) or ovariohysterectomy (138) had been performed as a routine neutering procedure 8-11 years earlier. Complete data were available for 69 bitches of the ovariectomy group and for 66 bitches from the ovariohysterectomy group. There were no indications that endometritis had developed in bitches of the ovariectomy group. None of the bitches was sexually attractive to male dogs after neutering. The occurrence of a clear to white vaginal discharge was reported in two bitches of each group, but none of these four bitches appeared to be ill during the periods when the discharge was present. Furthermore, with the exception of urinary incontinence, no problems were reported that could be related to the surgical neutering. Six of the ovariectomized bitches and nine of the ovariohysterectomized bitches eventually developed urinary incontinence. Of these 15 bitches (11%), 12 weighed more than 20 kg. Bouvier des Flandres bitches were at a higher risk of developing urinary incontinence than were those of the other breeds. The possibility that the urinary incontinence was due at least in part to other conditions must be considered, since eight of the bitches were 9 years or older before urinary incontinence occurred and seven of the incontinent bitches also had polyuria or polydipsia. There were no significant differences in the incidence of urogenital problems listed above between the bitches of the ovariectomy and ovariohysterectomy group. It is hypothesized that a uterine disease such as CEH-endometritis cannot develop after complete ovariectomy, unless progestagens are administered. The results of this study indicate that ovariectomy does not increase the risk of CEH-endometritis or other complications in comparison with ovariohysterectomy. It is concluded that there is no indication for removing the uterus during routine neutering in healthy bitches. On the contrary, ovariectomy should be considered the procedure of choice.

PMID: 9404289 [PubMed - indexed for MEDLINE]
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jans
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by jans » 07 Jun 2009, 23:28

thank you for the info, hope you dont mind me asking but have you made a choice on this for any of your dogs ? thanks again , jan

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Carole g
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by Carole g » 07 Jun 2009, 23:33

Not as yet, Jans. You would need to find a surgeon happy with the modified surgery. I will say though that I will be perfectly happy for a vet to perform an ovariectomy on a bitch sold by me under a spey/neuter contract. I would be concerned though, if the buyer would only accept an ovariectomy when such an operation was not available to them.
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jans
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by jans » 07 Jun 2009, 23:42

Thanks for your reply, my own vet does not offer this surgery yet but plans to asap, however he can reccomend a couple who do. I am researching and have found a couple of articles reccomending this surgery. It involves travelling and is doouble the price but it seems that the benifts are many.... any other thoughts gratefully recieved .


amber
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by amber » 08 Jun 2009, 07:24

I'm uncertain about the questionaires as only just over half were completed :?

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Carole g
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by Carole g » 08 Jun 2009, 08:55

1/2 returned is quite good for this sort of questionnaire, particularly as, if there was a problem, they are more likely to return them. As pyometra and metritis are very much related to the bitch cycling, I would not expect pyo to be a significant problem after an ovariectomy.
Here is a study.

Pros and Cons of Neutering
E. Hardie

Department of Clinical Sciences, North Carolina State University, Raleigh, NC, USA.

Spaying (ovariectomy or ovariohysterectomy) has been shown to reduce unwanted pregnancies, prevent pyometra and decrease the risk of mammary gland tumors in female dogs and cats. However, increased tendency to develop obesity may occur in either species. In dogs, an increased incidence of certain cancers, aggressiveness, sedentary behavior, and urinary incontinence may develop after spaying. The ideal spay would result in positive effects from spaying with the least risk of developing negative effects. It would also result in minimal pain and immediate postoperative complications. Controversy thus continues to surround the best time and method of spaying.

A major controversy is whether ovariohysterectomy or ovariectomy is the preferable surgery. The rationale for removing the uterus is that stump pyometra may develop if the uterus is not removed. The rationale for ovariectomy is that the surgery is less invasive and the risk of pyometra is minimal once the animal is no longer cycling. In several long term studies of dogs and cats under going ovariectomy, stump pyometra did not occur in any animal after surgery. Studies have also shown that there is no difference in the incidence of urinary incontinence after ovariectomy or ovaraiohysterectomy in the dog.

A second controversy surrounds whether or not a midline approach or a flank approach is preferable. The advantages of the midline approach are that it is technically easier to perform an ovariohysterectomy from this approach, the incision can be quickly opened if needed, and both sides of the reproductive tract are easily accessible from one approach. The advantage of the flank approach is that, in experienced hands, it allows ovariectomy or ovariohysterectomy to be performed through a very small lateral incision. The flank approach can be closed with a few buried sutures and has a minimal risk of dehiscence. The flank approach is used in many feral cat neutering programs to avoid the risk of dehiscence. More recently, techniques for laparoscopic ovariectomy and ovariohysterectomy have been described for the dog. Although the surgery is technically challenging, the advantage of performing a spay using minimally invasive surgery is that the dog experiences less postoperative pain and distress.

A third controversy surrounds the best time to perform a spay. This controversy has been widely discussed in the United States literature in regard to the issue of neutering at a very young age compared to the traditional age of 6 - 8 months. Initial studies of 200 - 300 dogs and cats followed for up to 4 years did not indicate physical or behavioral differences between early age spaying or traditional age spaying. A larger study of 983 dogs found that 12.9% of dogs spayed at < 3 months developed urinary incontinence, while only 5% dogs spayed at >3 months became incontinent. Other differences documented in early age neutered dogs compared to traditional age neutered dogs were an increased incidence of cystitis, hip dysplasia, noise phobias and sexual behaviors, and a decreased incidence of obesity, separation anxiety, escaping behaviors, and inappropriate elimination when frightened. In 859 cats, an increased incidence of shyness was found in early age neuters compared with traditional age neuters, whereas a decreased incidence of asthma, gingivitis and hyperactivity were found.

In Europe, the debate has centered on whether or not to spay before or after the first heat. The mammary carcinoma data would suggest that performing a spay before the first heat would result in the lowest chance of mammary cancer. The pyometra data would suggest that as long as a spay was performed in the first 4 years of life, pyometra is not likely. One study of 809 bitches showed no difference in urinary incontinence in animals spayed before or after the first heat at the 5% significance level, but a difference at the 10% level. Other studies have documented urinary incontinence in 9.7% of bitches spayed before the first heat compared to a 20% incidence in bitches spayed after the first heat. Even though the incidence of incontinence was lower in bitches spayed before the first heat, severity of the incontinence in these dogs was much worse than in dogs spayed after the first heat.

The effect of spaying on behavior is controversial. Some studies have shown few effects, while others have demonstrated more reactivity and aggressive barking in spayed compared to intact bitches. In a study of 227 dogs that had bitten humans, neutered female dogs and male dogs were overrepresented. In a study of cats that had bitten humans, owned female Siamese cats were over-represented. The neuter status of the cats was not recorded, but most owned female cats are spayed.

In male dogs, neutering (castration) has been shown to reduce the incidence of prostatic hyperplasia and infection, but not prostatic cancer. Castration reduces the incidence of perineal hernia and the chance that perineal hernia will recur, if fixed. Castration will prevent perianal adenomas from occurring and cause regression of many perianal adenomas, once present. The incidence of urinary incontinence associated with castration in male dogs is much lower than the incidence of urinary incontinence associated with spaying in female dogs, but it does occur. Castration has been shown to reduce urine marking, mounting and roaming, but is effective in reducing aggression in only about one third of dogs. Castration appears to increase the speed with which age-related cognitive impairment progresses in the male dog.

In male cats, neutering (castration) reduces urine spraying, fighting and roaming. In one study, cats that were castrated before 5.5 months of age had fewer abscesses, aggression towards veterinarians, sexual behaviors and urine spraying compared to cats that were castrated at an older age.

Orthopedic conditions associated with neutering (spaying or castration) include hip dysplasia, cruciate injury and slipped capital femoral epiphysis. Dogs that are spayed or castrated before bone growth is complete are taller than intact dogs or dogs that are spayed or castrated at a later age. Orthopedic diseases in neutered animals are thus likely to be conditions associated with late or incomplete closure of growth plates or altered joint anatomy due to changes in skeletal growth.

The risk of obesity associated with neutering appears to be higher in sexually mature animals compared to immature animals. Animals that undergo early spay or castration can often self-limit their feed and maintain a healthy weight with free choice feeding. Animals that undergo spay or castration as adults are very likely to be unable to self-limit their feed and become obese with free choice feeding. Obesity can be controlled by limiting access to feed, but the owner must be warned that controlled feeding will be necessary.

Neuter status obviously affects tumor development and growth, if the tumor tissue is hormonally responsive. Less obviously, it may affect the development and growth of cancer in other tissues. Studies in Rottweilers have shown that the risk of osteosarcoma is increased in spayed and castrated animals compared to intact animals. For each month that an animal remained intact, there was a 1.4% decrease in osteosarcoma risk. The overall incidence of osteosarcoma in the study population of 683 Rottweilers was 12.6% during the study period. Spayed female dogs have been shown to have an increased risk of developing cardiac hemagiosarcoma.

The question must be asked: Is there a group of animals, particularly dogs, in which the risks of spaying may outweigh the benefits? The most likely candidates would be large breed dogs at increased risk for cruciate rupture, osteosarcoma, urinary incontinence and/or aggression. Osteosarcoma may result in early death, while urinary incontinence and/or dominance aggression can result in a pet becoming unacceptable and at risk of euthanasia. Weighing the risks of these conditions may shift the balance of "spay to prevent mammary cancer and pyometra" to "do not spay or delay spay to prevent severe urinary incontinence or biting". Regarding castration, the benefits of reduced aggression in some dogs, decreased prostatic disease and decreased perineal hernia and perianal adenoma development must be weighed against the risks of developing orthopedic disease or bone cancer.

References
1. Okkens AC, Kooistra HS, Nickel RF. Comparison of long term effects of ovariectomy versus ovariohystrectomy in bitches. J Reprod Fertil Suppl 1997; 51:227-231.
2. Spain CV, Scarlett JM, Houpt KA. Long term risks and benefits of early age gonadectomy in dogs. JAVMA 2004; 224:80-387. -
3. Cooley DM, Beranek BC, Schlittler DL, et al. Endogenous gonadal hormone exposure and bone sarcoma risk. Cancer Epidemiology, Biomarkers & Prevention 2002; 11:1434-1440.
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jans
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by jans » 08 Jun 2009, 09:01

As far as i have read so far pyometra is caused by the hormonal changes during the cycles, the hormones cause the endometriun to become cystic ( please correct me if i am wrong, i am no expert !!). With the removal of the ovaries the hormones are non existent and therefore pyo should not occur. The recovery period is the biggest benefit, no stitches no abdominal wound... i think this must be so much better for the dog.My vet and a couple of others whom i have spoken to on the phone most certainly agree. I want to make the best decision for my dog and feel unsure about this, does anyone know an owner who has had this done laparoscopically ? we have a male dog so this is all very new to us. !!! All opinions gratefully recieved , thank you. Thanks for the information Carol, really informative and helpful :D

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Carole g
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by Carole g » 08 Jun 2009, 09:11

Pyo can still occurr even in the tiny remains from an ovariohysterectomy, but these are very rare and I can't tell you whether there is any difference in this small risk of stump pyo between the two different surgeries.

I have not asked my own vet whether he would perform the modified op, he does a very neat ovariohysterectomy with minimal recovery time, and I would stick with it. The bitches are very comfortable within a day of the op.
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bagpussy
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by bagpussy » 08 Jun 2009, 16:36

I am also investigating the lap or midline spay options.

My vet does do the lap spay but it is about £100 more expensive! I know I maybe should go for the best recovery option for my dog but I'm also thinking about the finances!

I'm still undecided.

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Jeanny
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by Jeanny » 08 Jun 2009, 19:26

I have been rather unhappy about spaying since owning Dobermans. They seemed particularly prone to urinary incontinence after spaying. It got worse as they got older and is quite hard to live with.

I just wondered if anyone had had any problems with the bigger labradoodles after spaying?

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Jeanny
Arianne, dirty, hot and scruffy - now a whole year old - with her pal Mollie.
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MrsAdmin
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by MrsAdmin » 08 Jun 2009, 21:21

Jeanny wrote: I just wondered if anyone had had any problems with the bigger labradoodles after spaying?
I have had problems with Becky that were apparent immediately she recovered from the anaesthetic. :roll: She has become far more aggressive, especially towards Jack, and barks loudly at us and is very assertive.

From being quite a soppy, cuddly, purr against you, sort of girlie, this has been a bit of a shock :oops: However, she is also lovely with it and full of life and seems very happy with her new found confidence. Jack, however, is not happy, especially at being humped and bossed about :twisted:

She was given Galastop by the vet (used in false pregnancies I believe - although I am convinced Becky was not having one when speyed) but that was no use at all. The vet can't understand what has happened and muttered about another op in case anything was left but at the moment I am awaiting developments and letting her hormones settle before going that extreme.

She's certainly chock full of testosterone but hopefully this will wear off and she'll even out a bit.

Don't be put off speying because of this. Apparently it is quite rare and Beccles was just unlucky. :?
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PennyAli
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by PennyAli » 09 Jun 2009, 07:02

Molly my Labrador is going in in about four weeks, I will post pics of how her belly looks, my vet will do the midline speying through a tiny incision

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Katie Rourke
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Re: spaying laprascopic ovariectomy or traditional hysterectomy?

Post by Katie Rourke » 10 Jun 2009, 11:38

I'll be getting Flossy spayed when she has fully recovered from her current litter. This is my vet's view on the procedure:
Tim Hosken wrote:as far as spaying concerned the incision is fairly small anyway, it is essential to get below the ovaries to achieve effective hemostasis and ALSO AVOID CONTINUED HEATS AND IF ANY SIGNIFICANT WOMB iS LEFT THEN PYOMETRA AFFECTING THE STUMP CAN OCCUR, ignore caps, which twit put caps lock next to the a. Dogs heal very well and as far as i can see true keyhole surgery similar to human gall bladder ops etc performed with endoscopes would have no advantage but an increased risk, x tim
Katie is a passionate canine professional who has been working with dogs all of her adult life. She is an experienced clicker trainer and has trained dogs for Films and TV. Katie now runs http://www.centrestagedoggrooming.co.uk/home.html.

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