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SPAYING PROCEDURES PERFORMED BY DR SING FROM 2005
Absorbable sutures, antibiotic powder and a plaster are used in dog spays at Toa Payoh Vets. Some owners are concerned about the length of the skin incision. They compare and contrast with other friend's female doges spayed. They assess that a veterinarian who spays with the shortest skin incision is more competent. Shorter incisions can only be achieved using the spay hook and if there are no complications during surgery. Antibiotic powder may be used to cover the skin incision wounds before plastering. Dogs will be given pain-killers and antibiotics after the spay.

The shortest incision is around 1.25 cm long for a spay hook removal. A longer incision may be necessary depending on the location of the ovaries and uterus, bleeding complications and the experience of the veterinary surgeon.	Antibiotic powder covers the dried wound area. From 2005, antibiotic powder or antibiotic injections is used instead of antibiotic cream

	A plaster covers the wound for the next 10 days. It may be removed earlier if the female dog feels itchy. Consult your vet at Toa Payoh Vets.
SPAYING PROCEDURES PERFORMED BY DR SING IN 2003

A Cocker Spaniel in her 2nd heat (vulva swollen) on the operating table. After tranquilisation, she was given an anaesthetic gas using a gas mask. In most cases, the mask is replaced by a breathing tube (endotracheal tube).	A 1.5 cm skin cut is made. The muscles and peritoneum are then incised at the mid-line. A spay hook is inserted into the abdomen to fish out the uterine horn. The above picture shows the hook during the spay of a Jack Russell as no photograph was taken for the Cocker Spaniel.

If the female dog is on heat, the uterus and blood vessels are fragile. In rare cases, there is bleeding as the vessels disintegrate under the clamping by forceps. The vet has to make a long skin incision to check for the source of and to control bleeding to prevent death.	Some pet owners are concerned about the length of the skin incision as they contrast and compare the incision lengths of their friends' spayed dogs.

In 2005, in Toa Payoh Vets, absorbable stitches are used. They need not be removed as they dissolve later. There is no need to see the vet for stitch removal. Antibiotic powder is used for the wound instead of antibiotic ointment. If non-absorbable nylon stitches are used, please get them removed at day 14.	A water-proof plaster prevents the female dog licking her wound. Replace the plaster 3 days later. If the female dog does not lick the wound, there is no need to replace the plaster. Usually the plaster can be removed at day 10. Any swelling of the wound due to licking should be referred to the vet. The female dog goes home in the afternoon in uncomplicated cases. You can request for your female dog to stay over-night to rest at the Surgery.
DR SING'S RECOMMENDATIONS FOR SPAYING A FEMALE DOG
Females to be spayed 3 months after the first heat. Males neutered at 6 months. No chance of getting pyometra (infection of the womb) at an older age when the owner is too busy for her, if you spay your female dog early. In this case, the Silkie survived. But this is not always the case if the owner ignored signs of poor health in the female dog. Signs of a closed pyometra include vomiting daily, not eating much (attributed by some owners to being fussy). Vomiting daily or frequently is NOT a normal sign of health in a female dog. Consult your vet quickly. Spaying at a young age would have prevented this problem of pyometra from developing. Or the female dog dying as a result of a busy owner not having time to bring her to the vet, till she becomes critically ill. See: Closed pyometra in a Silkie Terrier
SURGERY CASE - SPAYING DURING THE DOG'S HEAT PERIOD
"Red blood staining the bed, the floor, the sofa sets and all over the apartment," the first-time owner of female dogs aged from 6 - 8 months complained. "It is such a chore to clean up. Other family members are upset by the dirtying of the flat." So the owner went to the vet to get the female dog spayed immediately. In this operation, the ovaries and uterus of the female dog is removed. "It will not be in the best interest of the female dog as there is a rare possibility of bleeding complications during or after surgery," I advised. "Bleeding may or may not lead to the death of the female dog after surgery". "So, you can't perform the surgery?" the first-time owner asked me when I explain that the blood vessels and the womb are more fragile during the heat period and bleed easily when they are clamped by forceps during the operation. "Well, other vets can do it." Therefore, I must be incompetent as I can't even "spay" a female dog. Sometimes, the bad mouthing of such prospective clients to their friends harms the reputation of the veterinarian. There is no point telling the prospective client that it is not in the best interest of the female dog to spay her when the owner has to clean up the apartment for the next 10 - 14 days. There are new pet owners who do understand the risks and take my advice to delay surgery till 3 months after the end of the heat. Pet shops do sell the protective pants to prevent the blood staining the apartment, but that means more financial expenses. An advantage of spaying 3 months after the end of the heat is that the female dog has time to mature. It is in the best interest of the female dog, but this may not be in the best interest of the uneducated owner. So, do I turn away the female dog on "heat"? And lose revenue to other vets. And lose respect from new clients? If I have the trust of the pet owner, I will advise delaying the surgery to 3 months after the heat. The female dog usually comes into first heat at 6 - 8 months of age. The subsequent heat is usually 6 monthly. A spay is a major surgery although it is a common procedure and nearly 100% of the female doges do not die from such surgeries. Unless there are bleeding complications not detected by the veterinarian. The alternative is to spay the female dog at 6 months of age, before the onset of heat. There are recommendations by the American Veterinary Medical Association in 1993 to spay at 8 - 16 weeks of age (see References below) in an effort to control strays. If owners wish to spay their dogs at less than 6 months of age, please let us know. The puppy must be healthy and not suffering from kennel cough, hypothermia or hypoglycaemia.
EARLY SPAY/NEUTER: AN OVERVIEW
Source: From the Spring 1998 Illinois Veterinary Bulletin Early Spay/Neuter: An Overview By Theresa A. Fuess, PhD, VM-3 "RESOLVED, that AVMA* supports the concept of early (8-16 weeks of age) ovariohysterectomies/gonadectomies in dogs and cats, in an effort to stem the overpopulation problem in these species." This resolution (1) passed an AVMA House of Delegates vote in the summer of 1993 and has also been approved by the ISVMA. As with other AVMA positions, it is up to each member to decide whether to adhere to this guideline. Having been taught that 6 to 7 months of age is the proper time to spay/neuter puppies and kittens, and having no information regarding the effects of early spay/neuter on the long-term health of the animal, many veterinarians have been reluctant to advise their clients to have their pets spayed/neutered at 6 to 7 weeks of age. However, there is an accumulating body of evidence indicating that the positive results quite possibly outweigh any remaining unknown risks. Studies conducted on early spays and neuters on kittens (2-10) and puppies (9-13) report that the anesthetic and surgical risk is minimal, providing proper protocols are used. These protocols are described in these references and they do differ from those for a 6- to 7-month-old animal. It is emphasized and that, in addition, special care must be taken to choose only healthy animals for surgery; prevent hypoglycemia, hypothermia, and blood loss; and keep thorough records so that these animals can be followed. These studies report that anesthetizing 6- to 7-week-old puppies and kittens was uneventful. Spays are reported to be easier and faster at 6 to 7 weeks than at 6 to 7 months because there is little subcutaneous fat to hinder entrance to the abdominal cavity and the lack of vasculature reduces hemorrhage. Finding organs was no harder than on the older animal. The speed of castrations at 6 to 7 weeks and at 6 to 7 months is the same, and the testicles are easier to remove and break down. Finally, the younger animals recovered faster and with less pain. Several of these studies addressed the question of long-term effects on the health** of the animal by comparing, at maturity, groups of animals neutered at 6 to 7 weeks and at 6 to 7 months. The resulting resting metabolic rate and predisposition to obesity of cats neutered in these two age categories have been compared after 24 months of age (5,7). The urethral diameters of male or female cats neutered in these categories was compared at 22 months of age (8). Many aspects of skeletal dimensions, body weight and composition, physical maturation, secondary sex characteristics or behavioral development of cats (6) and dogs (11,13) neutered/spayed in the two groups were compared at one year of age. The only notable difference found was that the animals neutered at 6 to 7 weeks of age were more likely to have immature external genitalia at maturity; this has no known clinical significance (6,8,11). The benefits of neutering are the same at either age: reduced risk of reproductive disorders and of mammary neoplasia. Animal shelters, being closest to the tragedy of mass euthanasia, were first to adopt early spay/neuter policies. [The LA/SPCA adopted its policy, requiring mandatory spay/neuter of all adoptable dogs and cats prior to leaving the shelter, in 1992] Even though the majority of animal care and control facilities have a mandatory spay/neuter policy, typical compliance rates are from 50% to 60%, in spite of pre-adoption screening, spay/neuter contracts, and follow-up reminders (14). Early spay/neuter provided the potential for 100% compliance by requiring pups and kittens to be neutered before being adopted out. However, only a small percentage of pets are acquired from animal shelters, so neutering these animals can only have a small effect on the overpopulation problem (10). If veterinarians were to recommend neutering pups and kittens at an early age, a significant decrease in unwanted animals could result. These studies indicate that early spays benefit the animal, the owner, animal population control, and you, the veterinarian. The animal benefits because the anesthesia is fast and uneventful; surgical procedure is well tolerated and animals recover faster. If made part of the standard puppy/kitten vaccination program, it would also benefit owners by decreasing the number of veterinary office visits necessary upon acquiring a new pet. This convenience to owners would lead to increased compliance on their part and thereby decrease the number of unwanted dogs and cats produced each year. The veterinarian benefits because spays and neuters at 6 to 7 weeks of age are easier and faster than at 6 to 7 months, they help reduce animal overpopulation, and higher owner compliance means more business. It also gives veterinarians the opportunity to interact with shelters, pet stores, and breeders and be seen as leaders in animal welfare in our communities. References AVMA News Spaying/neutering comes of age JAVMA 1993; 203:591-593. Aronsohn MG, Faggella AM. Surgical techniques for neutering 6- to 14-week-old kittens JAVMA 1993; 202:53-55. Faggella AM, Aronsohn MG. Anesthetic techniques for neutering 6- to 14- week-old kittens JAVMA 1993; 202:56-62. Guarneri-Boe MA, Lange D. When to Neuter: the Con-Controversy Iowa State University Veterinarian 1995; 57:6-9. Root MV. Early Spay-Neuter in the Cat: Effect on Development of Obesity and Metabolic Rate Veterinary Clinical Nutrition 1995; 2:132-134. Stubbs WP, et al. Effects of prepubertal gonadectomy on physical and behavioral development in cats JAVMA 1996; 209:1864-1870. Root MV, et al. Effect of prepuberal and postpuberal gonadectomy on heat production measured by indirect calorimetry in male and female domestic cats Am J Vet Research 1996; 57:371-374. Root MV, et al. Effect of prepuberal and postpuberal gonadectomy on penile extrusion and urethral diameter in the domestic cat. Veterinary Radiology & Ultrasound 1996; 37:363-366. Mackie WM. It's Time For Early Age Neutering. California Veterinarian 1992; 46:19-21. Theran P. Early-age neutering of dogs and cats JAVMA 1993; 202:914-917. Salmeri KR, et al. Gonadectomy in immature dogs: Effects on skeletal, physical, and behavioral development JAVMA 1991; 198:1193-1203. Faggella AM, Aronsohn MG. Evaluation of anesthetic protocols for neutering 6- to 14-week-old pups JAVMA 1994; 205:308-314. Crenshaw WE, Carter CN. Should dogs in animal shelters be neutered early? Veterinary Medicine 1995; 90:756-760. Moulton C, Early Spay/Neuter: Risks and Benefits for Shelters American Humane Shoptalk 1990; 7:1-6 and 8:1-9. * American Veterinary Medical Association ** Illinois State Veterinary Medical Association Illinois Veterinary Bulletin Volume 6, Number 1, April 1998
REFERENCES: 1. It's possible to spay a dog during estrus, or heat, but it's not the best time. Most veterinarians prefer not to spay a dog in estrus because the uterine tissue can be swollen, fragile, and more prone to damage. Dogs also have a tendency to bleed more when they're in heat. Because of this, estrus makes surgery more risky for dogs. Most veterinarians prefer to delay spaying a dog until she has been out of estrus for a month or more. Since a recently spayed dog may still be attractive to males, performing the surgery during heat will not stop your neighbours' dogs from looking for your female dog. Keep her inside and have your veterinarian perform surgery 3 months later. 2. www.asiahomes.com/singaporetpvet/dogs/0706JackRussell_spay.htm Pictures - Spaying a Jack Russell. 3. Why you should spay your dog or cat? 3.1 www.petrescue.com/spay-neuter.htm. 3.2 www.thepetcenter.com/sur/mam.html (breast cancer & spay). 4. www.la-spca.org/early_spay_neuter.htm (Louisiana SPCA report)
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