I am writing to share
my over 30 years of experiences in spaying dogs and cats
done by me and by other vets in Toa Payoh Vets.
I started Toa Payoh Vets in 1982 and it is 2011 now. I
have seen a few cases of stitch breakdown using the
method as advised by the university professors and
veterinary surgery text books (Method 1).
The vet university professors since my time in 1974 when
I graduated from Glasgow University and even recently in
Australian Universities, advocate the following steps
after removing the ovaries and uterus:
1. suture the
linea alba 2. suture the subcutaneous fat to seal up dead
spaces
3. suture the skin
The theory is
sound and many newly graduated vets adopt this system
(Method 1). Over the years, I encountered a few cases of
stitch breakdown and infection in dogs and cats using
Method 1 done by other vets. Or intense redness and
inflammation at the surgical area.
My method does NOT use Step 2 and I have less than 1% of
post-op stitch breakdown. I have no figures to
substantiate my claim. I am merely sharing my
experiences as I am in my retirement era, being
61 years of age.
I just hope that this knowledge may benefit the
dogs and cats. In the early years of 1970 - 1980, I did
not prescribe pain-killers unlike nowadays and I don't
have many post-op spay problems. Times have changed.
Pain-killers inclusive of antibiotics are a must.
There are many reasons for stitch breakdown but one of
them is the irritating subcutaneous suture. The
dog or cat keeps licking the wound or just use the hind
paws to scratch it. E-collars do not help much. Soon,
the unhappy owner brings in the dog or cat for review.
In private practice, the vet earns his reputation by not
getting less or no post-op spay stitch breakdown as
owners will compare and complain. Obviously, in other
surgery like breast tumour removal, subcuticular sutures
are needed to close the dead spaces. I use "walk-in"
sutures. This involves suture needle going into the
skin, then into the subcutaneous fat and out of the
subcutaneous fat, then out of the skin on the other
side. From there, I transverse, needle goes into the
skin, subcutaneous fat and out from the initial side.
This makes for a horizontal mattress skin suture as seen
from the skin. In this method, surgical time is reduced,
unlike separate subcuticular sutures of the subcutaneous
fat. See case report at:
http://www.bekindtopets.com/dogs/20081235Mastectomy_Female_Dog_ToaPayohVets.htm
Then simple interrupted sutures of the skin as this is a
usual method by many vets.
The two methods of SPAY IN THE DOG AND CAT are
illustrated by real cases as follows:
METHOD 1 - BY THE
(VETERINARY SURGERY) BOOK
1298.
Subcuticular sutures have been used. The stitches under
the skin hinder healing due to infections or traumatic
injury from licking.
1299.
Stitch breakdown and infection. Re-stitch again but no
more subcuticular suturing.
METHOD 2 - BY DR SING
1296.
A spay hook enables the vet to make spay incision small
in the dog and cat.
1297.
Dr Sing's dog spay procedures. No subcuticular sutures.
All the years, I use
absorbable PDS sutures and this means the owner does NOT
need to return for stitch removal. I just use one
packet of sutures. However, with Method 1, I note that
some of the younger vets must use two packets and
sometimes three packets in dogs that are pregnant and of
bigger breeds.
I have seen cases where a vet uses 3 packets of sutures
to spay a medium sized dog. This is definitely too many.
One packet is chromic catgut. Two packets of absorbable
monofilament. With my method, one packet of absorbable
suture is sufficient for dogs up to medium size, using
the spay hook.
Keep spay simple. I hope this report is of use to some
practising vets. It cuts down on expenses in using more
sutures and in private practice, costs keep rising as
bureaucrats think of ways and means to generate income
from the industry by increasing regulatory fees. Keeping
spay simple and using walk-in sutures make economic
sense as well as keep owners of dogs and cats
happier.
TOA
PAYOH VETS
