Archive for the ‘Medical Advocacy’ Category

A Recap of 2011

Sunday, January 8th, 2012

Photo Credit: Susannah Kay

It’s hard to imagine that five years or so ago, I had no idea what a blog was. In fact, my current spell check doesn’t recognize “blog” as a word.  Does yours? When I first learned about blogging, it took me awhile to buy into the notion that people would actually take the time to read another person’s musings. Well, I’m sure as heck glad and grateful that you are interested in mine! Many thanks for taking the time to post your thoughtful and insightful comments.

Out of the fifty or so blogs I posted last year, I’ve selected the ten best that I thought might be worthy of showcasing, particularly if you did not get a chance to read them the first time around. Now, here’s a look back at 2011!

The Elephant in the Middle of the Exam Room

The so-called “elephant” in the exam room that I discussed was money. I addressed the following questions: Are veterinarians only in it for the bucks? Are clients being charged too much? How are vets to make a living with soaring overhead costs and monumental school loans? Are “fixable” animals being euthanized because the price of making them well is too high?

Dog Auctions

I shared some of the gruesome details about dog auctions, a venue where puppy millers buy and sell their “livestock”. I also told you about a woman named Mary O’Connor-Shaver, a leader of the peaceful protests at Ohio dog auctions. Mary just informed me that she and a crew of other hard-working volunteers are just inches away from having enough signatures to create a 2012 ballot initiative which would ban dog auctions in Ohio. Way to go Mary! I hope the ballot initiative passes and the work she and her volunteers have done will set an example for other states.

The Time of Year to Think About Colorblind Adoptions

As it turns out, dark coated dogs and cats are often the hardest animals to rehome. This blog addressed the reasons why and was timed to coincide with Halloween, a time when many adoption agencies restrict adoption of black-coated animals.

Criticism Welcome Here

This blog was generated from some negative feedback I received from a reader about my support of the American Kennel Club Health Foundation.

A Primer on Leptospirosis

Your comments in response to this blog let me know that the information I provided about Leptospirosis helped you make better-informed choices about whether or not to vaccinate your own dogs against this disease.

Pedicures: Definitely Not for Everyone

Some dogs turn pedicures into wrestling matches! Many trainers provided comments containing excellent advice about how to desensitize dogs to having their feet and nails handled.

Who Was Dr. Leo Bustad?

I was the incredibly fortunate recipient of the 2011 Leo Bustad Companion Animal Veterinarian of the Year Award (presented by the American Veterinary Medical Association). I did some research to learn more about the man behind the award and then shared that information with you.

Anesthesia Free Dental Cleaning

Cleaning teeth on awake animals has been steadily becoming more popular. I present the positive and not-so-positive results of doing so.

Can You Take Your Dog By Surprise When It’s Time For a Walk?

This is a blog post about how adept our animals are at reading our minds!

Age is Just a Number

When making medical decisions for their pets, many people factor in the animal’s age. I discuss the importance of considering the animal’s functional age rather than their chronological age.

As I begin a new year of blogging, I invite your ideas. What would you like to read about in 2012?

Best wishes for a happy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Resolutions for the New Year That Will Benefit You and Your Pet

Sunday, January 1st, 2012

The transition to a new calendar year may inspire you to muster the resolve to make good changes in your life. How about the lives of your pets? No time like the present to make some new year’s resolutions that will benefit both of you. Here are three suggestions:

More Face Time With Your Pets

Our furry family members are more than happy to be our exercise partners, confidantes, psychotherapists, and nonelectric heating blankets. Take advantage of such pet-facilitated services as much as possible this year!

What dog doesn’t crave attention from their favorite human? Teach your best friend some new tricks. Begin working on that long overdue grooming. Get your pup out for more exercise (lose the sedentary human behavior at the dog park). Don’t let the winter weather be a deterrent. Go shopping for some canine winter apparel and gift yourself with Dr. Phil Zeltzman’s book, Walk a Hound, Lose a Pound to glean some inspiration!

What about our kitties? Well you know how it is- cats tend to like things on their terms. However, even the most curmudgeonly of cats will benefit from a feather toy tempting them to expend some energy and some affectionate scratches under the chin. The challenge is to spend more quality time with your kitties while convincing them that the activity is of their choosing.

Fewer Vaccinations

Your adult pet’s good health requires inoculation with core vaccinations no more than once every three years. The term “core” is reserved for those vaccines, such as distemper, that are recommended for every adult animal. Overvaccinating (vaccinating more than once every three years) exposes your best little buddy to needless risk (yes, there is some risk associated with every vaccination). Besides, why spend your hard earned money on something that is completely unnecessary?

If your veterinarian has remained on the “once a year bandwagon” and the thought of convincing him or her otherwise gives you a case of the willies, I encourage you to read the chapter called, “Discussion About Your Dog’s Vaccinations” in Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet. Kathie please make this a live link to the Amazon page The information found there will provide you with all the inspiration you need to broach the vaccination conversation with your vet. (For those of you who are cat fanciers, please know that my hope is to create the feline version of this book within the year. In the meantime, know that the basic principles provided in Your Dog’s Best Health apply to kitty care as well.)

Recruit a Professional to Help With Your Pet’s Behavioral Issues

Would you love to be able to leave your dog home alone for more than ten minutes without the house being destroyed? Would you be ecstatic if your precious puss quit spraying your walls with his version of graffiti? Would you relish the idea of taking your dog for a walk without having to ice your shoulder afterwards? There is no time like the present to tackle such behavioral issues. I encourage you to get the professional help you need so that you and your pet can fully enjoy cohabitating. Chronic behavior issues tend to gradually result in more and more isolation for the pet until most of their waking hours are spent within a crate, a single room of the house, or the backyard. Such isolation begets even more negative adaptive behaviors, and the end result may be relinquishment to a shelter or rescue organization; worse yet, euthanasia.

Please know that if your dog or cat has a significant behavioral issue, you are certainly not alone. Also know that the sooner the issue is dealt with, the happier the outcome will be for both you and your pet. Hiring a pro to help you work out a behavior bugaboo will be one of the best investments you make this year!

When choosing a trainer or behaviorist, check in with your veterinarian for a recommendation. Additionally, check out the websites below. You’ll find lots of information about how to choose the right person to help you with the issue at hand. These sites also have “locators” to help you find a professional in your area.

Association of Pet Dog Trainers

Certification Council for Professional Dog Trainers

International Association of Animal Behavior Consultants

Animal Behavior Society

American College of Veterinary Behaviorists

Have you made any “pet resolutions” this year? Does your pet have a behavioral issue that is affecting the quality of your life? Have you successfully dealt with a significant behavioral issue in the past? Please share what you know so that others may offer advice and/or benefit from what you have learned.

Best wishes for a happy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Ovariectomy (OVE) Versus Ovariohysterectomy (OVH) Revisited

Monday, December 26th, 2011
Licensed under a Creative Commons Attribution License.

Photo Credit: Roger H. Goun

If you’ve been reading my blogs for awhile now, you may remember two of my previous posts. While OVH surgery involves removal of the uterus and both ovaries, with OVE surgery just the ovaries are removed. Both are effective techniques for spaying (neutering) female dogs and cats. I am bringing this topic to your attention for a third time based on a recently published article within the Journal of the American Veterinary Medical Association.

The article is titled, “Ovariohysterectomy Versus Ovariectomy for Elective Sterilization of Female Dogs and Cats: Is Removal of the Uterus Necessary?” Let me get right to the article’s punch line by presenting the authors’ final paragraph:

We do not believe that there is any scientific evidence for the preferential teaching of ovariohysterectomy instead of ovariectomy by schools and colleges of veterinary medicine in the United States and Canada, and it is our view that ovariectomy provides an equally effective technique for elective sterilization of female dogs and cats with no recognized disadvantages. Potential advantages of ovariectomy include a smaller incision, better viewing of the ovarian pedicle, and possibly less risk of complications associated with surgical manipulation of the uterus.

The authors’ conclusion is based on a review of recent literature comparing these two surgical techniques. When I’ve previously recommended OVE as the spay surgery of choice, here are the two concerns that you, my readers have voiced:

  1. You are unable find a surgeon who will perform OVE surgery. Here is what I recommend. Call multiple veterinary hospitals in your community and ask if the vets on staff are willing to perform ovariectomies (if the receptionist is uncertain about what you are asking, you may wish to tactfully ask to speak with a veterinarian or technician). If nothing else, you will be raising awareness about this recommended alternative. Based on what you’ve told me, some of your vets have been willing to educate themselves and perform their very first OVE surgery in response to their client’s request, and the results have been fabulous. If one is adept at removing ovaries and uterus, removing just the ovaries is a “no brainer.” So, it is perfectly fine if your vet performs his or her very first OVE on your dog or cat (I would normally strongly advise against your pet being your vet’s “first” surgery or procedure of any kind). Board certified surgeons gladly perform OVE surgery and may do it the conventional way (incision made on the underside of the abdomen) or via laparoscopy (a method that employs scopes which are introduced into the abdominal cavity via small incisions). The only drawback to having a specialist do the work is that the price tag for the work will be considerably higher than the norm.
  2. You have voiced concern that if the uterus is not removed, your pet could develop pyometra, an accumulation of pus/infection within the uterus that necessitates its surgical removal. Please don’t buy into this ridiculous notion! Pyometra only occurs under the influence of progesterone, a hormone produced by the ovaries. Without the ovaries no progesterone is produced and there is no risk for development of pyometra. Period!

I want to emphasize that if you cannot find a surgeon who will perform OVE surgery on your dog or cat, no biggee! There is truly nothing wrong with removing the uterus. I only wish to create recognition for the fact that it is completely unnecessary to do so. Lastly, if you are contemplating spaying your older pet (her uterus has been around the block a few times), visual inspection of the uterus at the time of surgery is warranted. If the uterus appears abnormal, it should definitely be removed- the one situation where OVH rather than OVE makes perfect sense.

Has your pet recently been spayed? Which surgical procedure was performed?

Happy holidays to you and your loved ones,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Introducing Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet

Sunday, December 4th, 2011

A few months ago, as I sat nestled with my laptop crafting a new blog post, my husband queried if I thought I might ever run out of words. Yes, he was joking, but this is the sort of thing authors worry about from time to time as they ponder if the day will come when they will have run out of worthwhile ideas and the right words to convey them.

I sense that I have the reserves to write with a purpose for many years to come. In large part, this is thanks to the inspiration I continually glean from you, my readers. Every time I hear that something I wrote guided someone through a difficult medical decision, provided moral support during the euthanasia process, or helped a person hold their ground with their veterinarian, I am inspired to write that next sentence. Thank you for this!

Speaking of writing new material, with no further adieu, I would like to introduce you to my new “baby” titled, Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet. It is sizzling hot off the press and is available via Amazon, other online retailers, and soon, your neighborhood bookstores. I invite you to give it a read, and if you happen to be looking for a unique holiday gift for your dog loving friends and relatives, search no further!

With Speaking for Spot my goal was to teach you why we need to be medical advocates for our pets and how to fulfill this important role. Now, with Your Dog’s Best Health my intent is to take you to the next level by spelling out what is reasonable to expect from your vet. Included are some expectations that may just surprise you. For example, did you know that it’s reasonable to expect email communication with your vet, discussion about your Internet research, and explanations of all options for your pet, regardless of cost? In the spirit of saving the best for last, I reserved the final chapter of Your Dog’s Best Health for clarifying what is reasonable for your veterinarian to expect from you! Needless to say, visits to the vet will never be the same!

Happy holidays to you and your loved ones,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Black Friday Special – 2 for 1

Saturday, November 19th, 2011

 

Click on the picture to access the special 2 for 1 purchase link – http://www.speakingforspot.com/holiday2for1.html.

You can purchase single copies of Speaking for Spot via http://www.speakingforspot.com/purchase.html and designate your favorite participating non-profit group to receive $6 per copy.

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Advocacy Aids

Monday, May 16th, 2011
 

Photo © Susannah Kay

I use the term Advocacy Aids to describe a set of health forms I’ve created to help you excel as your pet’s medical advocate. Where can you find them?  It’s easy.  Simply go to www.speakingforspot.com and look for “Resources” in the red horizontal main menu.  The first item in the Resources pull down menu is Advocacy Aids.  I invite you to download, print, copy, and use them to your heart’s content.  Feel free to share with others as well.  By the way, while you’re there  please check out my new website! 

The Advocacy Aids include: 

Health History Form:  This form provides an easy way to keep track of your pet’s vaccinations, test results, prior medical issues, surgical procedures, and adverse reactions to medications or vaccinations. 

Current Medications:  List all of your pet’s current medications (including supplements, flea and tick control products, and heartworm preventive).  Be sure to bring along a copy to every hospital visit. Your vet will be profoundly grateful and this paperwork will help you both catch any prescription errors. 

Current Health Issues:  This form helps keep track of all of your pet’s current medical issues.  It’s helpful to maintain a written list so none of the issues will be overlooked or forgotten. 

Medication and Treatment Schedule:  This template is wonderfully helpful if your pet requires medications/treatments multiple times daily and/or at different times of day.  I’ve provided you with the same template we use when treating animals in my hospital.  On my website you will find a sample template form that I’ve filled out (so you can see how it works) as well as a blank template for your use. 

Emergency Contact Information:  You will want to have ready access to this completed form in order to avoid spending time tracking down necessary information while in the midst of an emergency. Be sure to provide a copy to the person caring for your pets when you are away. 

Contingency Plan: Use this form when you are going out of town and may not be one hundred percent reachable.  The form lets your veterinarian know which trusted person you’ve designated to make medical decisions about your pet should you not be reachable.  Distribute a signed copy to your pet-sitter/boarding facility and your veterinarian. 

Veterinary Office Visit:  This form will help you keep track of the purpose of your visit as well as important questions to ask your veterinarian. 

For those of you with pets other than dogs, please forgive me as many of the forms contain the word, “dog”.  Feel free to cross this word out and substitute in any species you like!  After you’ve had a look at the Advocacy Aids, please let me know which ones you like and think you will use.  If you can think of other Advocacy Aids, please don’t be shy.  I would love to hear your ideas. 

Best wishes for good health, 

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

When the Doctor Becomes the Patient: Not Always a Pretty Picture

Monday, May 2nd, 2011

While in the midst of my post-surgery “down time” I’ve been chuckling a bit about what my own physicians have endured as a result of my medical background.  How commonly is a surgeon interrogated about what type of suture pattern and material he intends to use? How often does an anesthesiologist need to provide a detailed pharmacologic rundown of the anti-emetic (anti-vomiting) drugs that will be used to keep the patient with a queasy stomach from puking post-operatively? 

© Steve Horton

I remember one particular appointment with my family physician a few years back.  When we discussed the reason for the visit I began with, “I think I have cancer!”  I explained that I’d been losing weight even though I’d been eating normally.  After all, a diagnostic workup on a middle-aged dog or cat losing weight in the “midst of plenty” often results in the diagnosis of cancer.   My physician worked hard to hide a grin as he explained that, given my age, sex, and overall vigor, other diagnoses were far more likely. Thankfully, he was right, and the next time I saw him he asked for permission to share this “amusing patient story” with some medical students he was training.  

Sometimes, the medical knowledge I have can be a detriment to my own peace of mind.  As the story above illustrates, I’m always keenly aware of the worst-case scenario (tough on a person who is a natural born worrier). Would I trade being a veterinarian for any other profession?  Not in a million years.  Not only do I love what I do, I love that my medical background (along with a bit of chutzpah) allows me to be a stellar medical advocate for myself.  And if you’ve read much of what I’ve written in the past, you know that I am all about medical advocacy! 

Do you work within the medical profession?  If so, how has this been helpful or detrimental when interacting with your health care professionals (including your veterinarian)? 

Best wishes for good health,             

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Age is Just a Number

Thursday, April 14th, 2011

When my clients make decisions on behalf of their senior dogs and cats, they routinely factor in their pet’s age.  I often hear statements such as, “I would pursue a diagnosis if only she weren’t so old.” and “I would treat him if only he were younger.”  When my clients voice such “senior objections” I gently encourage them to consider the situation a bit more objectively by considering their pet’s functional age rather than their chronological age.  For example, it might be far safer for me to anesthetize the vigorous, playful thirteen-year-old Labrador with normal liver and kidney function I evaluated on Monday compared to the debilitated eleven-year-old Labrador with impaired kidney function I examined on Tuesday. Functionally speaking, the thirteen-year-old is, by far, the younger of the two.  When making decisions, savvy medical advocates evaluate the whole package- spryness, organ function, overall comfort, joie de vivre- rather than considering age alone.  Just because a dog or cat is, by definition, a senior citizen doesn’t mean their body is functioning like that of a senior citizen.

I thoroughly enjoyed explaining this point on NPR’s popular show, Fresh Air With Terry Gross. “Terry, you and I could both be 80 year old women in need of knee replacement surgery.  You might be a terrific candidate for surgery, whereas I might be a horrible candidate!”

When making medical decisions, my clients frequently ask about their pet’s life expectancy. Life expectancies for cats and dogs of varying breeds are nothing more than averages.  This means some individuals will never reach “average” and others will far exceed it. 

Here’s the bottom line. If you have a happy, lively, interactive, and agile senior dog or cat on your hands, throw those age-related numbers and averages out the window.  Rather, I encourage you to observe your pet’s overall quality of life, share some nose-to-nose time with your best buddy, look deep into those beautiful eyes, and make important medical decisions based on what’s truly important rather than simply a number.  Have you ever needed to be a medical advocate for a senior pet?  If so, please share your story.

Best wishes for good health,         

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook         

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Even More to Say About a Better Way to Spay

Thursday, March 17th, 2011
In January I wrote a piece called, “A Different Way to Spay” (http://speakingforspot.com/blog/?p=1931) describing two techniques for performing spay surgeries.  The method widely embraced in the United States is ovariohysterectomy (OVH) in which both ovaries as well as the uterus are removed.  The second way to spay- popular in many other countries- is ovariectomy (OVE) in which only the ovaries are removed and the uterus is left behind.  

Charlotte, OVE spay at 7 months © Kathie Meier

Since publishing the piece, many of you wrote to me expressing your frustration at not being able to find a veterinarian willing to perform OVE surgery.  I’ve written about those comments and provided an overall update on this topic for PetConnection.com- I sure hope you will read it (http://www.petconnection.com/blog/2011/03/15/a-better-way-to-spay-your-dog-that-you-probably-never-heard-about/).  Additionally, Dr. Tim McCarthy, a wonderful PetConnection colleague provided a response blog discussing the benefits of performing spays via laparoscopy- a form of minimally invasive surgery (http://www.petconnection.com/blog/2011/03/17/another-better-way-to-spay-that-you-probably-never-heard-of/).     

I look forward to your feedback about both articles.  If you are new to PetConnection, I hope you will follow my blog posts there as well as the ones you find here at Spot Speaks.     

Best wishes for good health,      

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook          

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.   

    

 

A Different Way to Spay

Sunday, January 2nd, 2011

This blog presents an idea that will be new for many of you and may be new for your veterinarians as well.  I thought presenting a novel idea would be a great way to kick of the new year! 

Taking a fresh look at the things we take for granted can be wonderfully enlightening.  Sometimes, the little light bulb overhead begins to sizzle and sparkle, illuminating a new and better way of doing things.  Consider this example- when some savvy veterinarians took a fresh look at performing spays, a surgery we’ve been doing the exact same way for decades, guess what happened!  They came up with a revised technique that accomplishes all of the objectives of the spay surgery with fewer complications!  How cool is that!

Spay is the term used for neutering a female dog.  As I was taught in veterinary school, the medical jargon for spaying is ovariohysterectomy (OVH). “Ovario” refers to ovaries, “hyster” refers to uterus, and “ectomy” means removal of.  In other words, spaying the traditional way involves surgical removal of the uterus and both ovaries.  The objectives of the spay surgery are to render the dog infertile, eliminate the mess and behavioral issues associated with a female dog in heat, and prevent diseases that may afflict the uterus and ovaries later in life.  Thanks to some innovative veterinarians, what we now know is that ovariectomy (OVE)- removal of just the ovaries sans uterus accomplishes these objectives just as effectively as does the OVH.  And, here’s the icing on the cake- removal of the ovaries alone results in fewer complications when compared to removal of the ovaries and uterus combined.

Here’s a simple short course in canine female reproductive anatomy and physiology that will help explain why leaving the uterus behind makes sense. The shape of the uterus resembles the capital letter “Y”.  The body of the uterus is the stem and the two uterine horns represent the top bars of the “Y”.  An ovary is connected to the free end of each uterine horn by a delicate structure called a fallopian tube (transports the egg from the ovary into the uterus).  While the uterus has only one purpose (housing developing fetuses), the ovaries are multitaskers.  They are the source of eggs of course and, in conjunction with hormones released by the pituitary gland, ovarian hormones dictate when the female comes into heat and becomes receptive to the male, when she goes out of heat, when she ovulates, and when her uterus is amenable to relaxing and stretching to house developing fetuses.  After the ovaries and the hormones they produce have been removed from the body the uterus remains inert. The dog no longer shows symptoms of heat, nor can she conceive. Additionally, any chance of developing ovarian cystic disease or cancer is eliminated.

What happens when we leave the uterus behind- is it not subject to becoming diseased later in life?  Here’s the good news- the incidence of uterine disease in dogs whose ovaries have been removed is exceptionally low.  Pyometra (pus within the uterus), is the most common uterine disorder in unspayed dogs, and typically necessitates emergency surgery to remove the uterus.  Without the influence of progesterone, a hormone produced by the ovaries, pyometra does not naturally occur. The incidence of uterine cancer is extremely low in dogs (0.4% of all canine tumors)- hardly a worry, and studies have shown that the frequency of adult onset urinary incontinence (urine leakage) is the same whether or not the uterus is removed during the spay procedure. 

If you are not already convinced that the “new spay is the better way”, consider the following complications that can be mitigated or avoided all together when the uterus remains unscathed:

– Compared to an OVH, an OVE requires less time in the operating room.  This translates into decreased likelihood of anesthetic complications.
– Removal of the uterus requires that the surgeon perform more difficult ligations (tying off of large blood vessels and surrounding tissues with suture material before making cuts to release the organs from the body).  A uterine body ligation that isn’t tied quite tightly enough can result in excessive bleeding into the abdominal cavity and may necessitate blood transfusions and/or a second surgery to stop the bleeding.
– The ureters (thin delicate tubes that transport urine from each kidney to the bladder) run adjacent to the body of the uterus.  If a surgeon is not being extremely careful, it is possible to ligate and obstruct a ureter in the course of removing the uterus.  This devastating complication requires a second corrective surgery, however damage to the affected ureter and adjoining kidney may be irreversible. 
– Removal of the uterus occasionally results in the development of a “stump granuloma”- a localized inflammatory process that develops within the small portion of uterus that is left behind.  When this occurs a second “clean up surgery” is typically required. 
– We know that the degree of post-operative patient discomfort correlates with the degree of surgical trauma.  No question, of the two surgical options the OVH creates more trauma.

European veterinarians have been performing OVE’s rather than OVH’s for years.  In fact, the bulk of the research supporting the benefits of leaving the uterus behind has been conducted in Europe.  Slowly, veterinarians in the United States are catching on, and some veterinary schools are now preferentially teaching OVE rather than OVH techniques to their students.  What should you do if you are planning to have your dog spayed?  Talk with your veterinarian about this article and provide a copy for him or her to read.  Perhaps OVE surgery is already their first choice.  If not, perhaps your vet will be willing to take a fresh look at performing this old fashioned surgery.

Wishing you many blessings for the new year,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
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Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.