If you guessed this post would tackle the topic of spaying pets while they’re in heat…you’d be right on target.
In case you’ve missed my other rants on this topic let me first explain: Cats in heat are easily altered. Dogs in heat—especially older, large breed and/or fat ones—can prove a nightmare for any vet (even the most experienced among us).
Granted, I never set out to spay a dog in heat. In fact, the only time I ever do is when it’s not obvious from the outside that she is in fact “in season.” Whenever I suspect a bitch is in heat (btw, I love using the b-word in a medical context) I go the extra mile to make sure that I don’t open her up until I’ve checked with the owner.
In the event the owner seems to know exactly when the animal’s last heat occurred, I’ll usually take their word for it. If an intact male dog in the hospital appears to be freaking out over her, however, I’ll take his word for it, too.
In these questionable cases I usually perform vaginal cytology (gently scrape a few cells from the vagina and examine them under a microscope). If the appearance of the cells there suggests they may be coming into heat—especially in a large or overweight dog—I defer the surgery.
so you know, not all dogs bleed when they’re in heat (this called a “silent heat”). Not all dogs come into season on a dime every six months (like they’re supposed to). And not all owners know when their dogs have cycled (yes, I know this sounds strange to you but it’s the norm among my clients).
But, unfortunately, even vaginal cytology can be unhelpful. What ends up happening is the obvious: We open them up only to find that their uterus is bigger than it might otherwise have been. We note engorged blood vessels in the ligaments and along the uterine body. And the tissues we’ve planned to cut? They have a tendency to want to rip.
It’s no fun.
But what’s my alternative? Stitch her back up and send her home?
Nope. The standard of care is to undertake the spay anyway. I don’t know any vets who will abort the procedure once the abdomen is already breached.
The owner of the three year-old Rottweiler I spayed this week did not agree, however. She’s angry I undertook to spay her dog anyway. Since I had previously explained that I did not want to spay her large, overweight dog while she was in heat (and asked her to be sure of her last heat date before the surgery) she was shocked that I would do so and angry that she was not give the chance to decline once I realized the state of affairs.
At the root of this problem, as with most veterinary-client issues, is communication. The owner was unavailable by phone immediately after surgery. She arrived so late to pick up her dog that day that I was no longer present to explain the situation. I did not call her in the evening to make sure she understood that the spay had to be undertaken anyway (I should have). She was not available by phone the following day—I had to leave a message.
Turns out, two days later, I come to learn she’s angry about the time I undertook the procedure, too (late lunchtime). She claims I provided “substandard care” to her dog by spaying her in heat…and late in the day. Though she was informed we’d had to delay her dog’s procedure to spend three hours in surgery with an emergency (a dog that had been kicked in the face by a horse), she did not feel that was a good enough reason.
Via voice mail, I offered to see the dog if she was not doing well (I thought that might be the problem and I was very concerned, of course). Turns out dog is quiet but otherwise doing just fine. It’s the owner who’s steamed and unhappy.
Sometimes it seems I just can’t win. I did a great job to the best of my ability yet because I did not go the extra mile to communicate a complication (which in no way hindered the success of the procedure but which certainly deserved an explanation) the client was unsatisfied. Granted, it sounds as if she might have been unsatisfied no matter what I did given the state of her distress over a 1:30 PM spay time.
As if spaying fat Rottweilers in heat isn’t enough…taking more heat from owners is sometimes our lot. And that’s OK…I guess…as long as by writing about it I can purge this stress once and for all.
Add Comment23 Comments
THANK GOD everything came out okay, because I'd guess this is a lawsuit-happy person. And lawsuits lead to unaffordable veterinary care - as they have in human medicine. Do you need this type of client? On the other hand, maybe she's suffering financial or other woes (who's not?) and taking her frustrations out on you. In either case, she's justified about being angry over the time of spay - it should have been delayed a week or two, not a few hours!
P.S. Thank you for taking such diligent care of Boo! You're the best!
Carol October 25th, 2008 10:21:00 AM
http://www.dolittler.com/index.cfm/2008/5/2/dogs.c...
Carol: This answers to your comment!
Fotini October 25th, 2008 10:42:00 AM
I had no idea that spaying a female dog in heat was an issue. We're fostering two puppy mill chihuahuas, and the oldest (12 years old) was in heat when the rescue got her. They spayed her as soon as possible, which was what I wanted too. Luckily, there weren't any complications.
I'm glad the rottweiler is okay. I hope the owner cools down. I'm so surprised reading your blog at how awful owners can be. I feel bad about a time a few years ago when I made a snide remark about the high cost of keeping my dog overnight at a vet hospital, but I still paid my bill and thanked them.
Jen (SLC) October 25th, 2008 10:55:00 AM
You aren't doing your job righ if you make everyone happy all the time! That is my theory anyway. I cannot think of anyone that would be happy if you sent their pet home sutured up, still intact, just to be cut open again in a few weeks for their real OVH. My vote is with your choice of care.
Brittany October 25th, 2008 11:32:00 AM
That dogs getting kicked in the face by a horse... ouch.
Sian October 25th, 2008 11:53:00 AM
You didn't do anything wrong. Like you said anything you did wouldn't of made this person any happier, or happy at all for that matter. There are some people in this world that are never pleased and only looking for more reasons to be upset. She is not a kind person and she also is definitely not an animal lover if she can't understand, an emergency surgery for a poor lil doggy that got kicked in the face by a horse. BTW- How is that dog doing? I pray he/she didn't get the full brunt of the horses strength.
Don't be hard on yourself, because you did a great job and asked all the right questions beforehand. It's not your fault that the owner wasn't honest about her dogs last heat and such. You called and left her a message and that was all you can do. She can't expect you to wait around the office at her beckin call, when she was that late picking up her dog. You did the right thing and have a great heart, so don't let people like her ever get you upset.
It's like my friend Rhyan said:
I can give to everyone but ultimately please no one.
Have a wonderful weekend and God Bless.
Josy
Josy October 25th, 2008 01:19:00 PM
You did nothing wrong. You know if you would've closed the dog up and sent her home she would've complained loudly about that. I've spayed dogs in heat b/c they owners had no clue and as you've stated, there were no signs. Nothing untoward ever happened.
This is the stuff that I'm glad you write about b/c the general public has no clue about the types of people we deal with on a daily basis and the lack of understand and gratitude that is out there.
My big complaint that goes along with what you find is that I find all too often is the so called "emergency" number or in many cases, numberS don't work (what I mean is they are not picking up on any line and don't get back to you in a timely manner AT ALL)...and I can't get a hold of clients when I need to - ie, while the pet is under or just before or after a surg for something we want to do while he/she is asleep. In this day and age it amazes me.
Christine October 25th, 2008 04:32:00 PM
bah! good riddance to her, you don't want high-maintenance customers that can never be pleased anyway.
charity October 25th, 2008 04:32:00 PM
Who's the bigger bitch here? Doesn't sound like the fat Rottie.
Gees, I can't tell you how many times,years ago, I'd drop one of mine off for whatever, and say, "look, if you ever have an emergency come in, don't think for a second, I will be upset postponing and rescheduling this appointment." Or, "if anything becomes complicated, stop the procedure, and get them out of anesthesia".
The only one I had difficulty with determining when her last season occurred, is my last to be spayed. Sealyhams often have little to no blood, go erratic times between seasons.
My last Scottie to be spayed was the required length of time post-season, but still her uterus was slightly enlarged and took a bit longer to spay. I really should have postponed it a few more weeks.
Now my question is: what is "sub-standard" about it?
Barbara A. Albright/New Hampshire October 25th, 2008 05:29:00 PM
What are the issues revolving around a spay/delivery. I.e. A pregnant dog that can't or shouldn't give birth normally, going in for a C-section, and getting a spay at the same time.
Christopher Landauer October 26th, 2008 04:45:00 AM
Christopher: Personally, I prefer to wait until the uterus returns to its normal conformation. But, frankly, it has more to do with the added pain of performing a spay at this time that keeps me from doing it at the C-section. Imagine nursing a bunch of pups with the added pain of an ovariohysterectomy. Youch!
Dr. Patty Khuly October 26th, 2008 09:54:00 AM
The dog that got kicked in the face by the horse is doing very well--horrible jaw fracture pics will be up in the Virtual Vet Hospital tomorrow.
Dr. Patty Khuly October 26th, 2008 09:57:00 AM
That so great to hear Patty!!!! My neighbors son was killed like that so even though it must be so painful for the dog, I am so happy to know that he/she didn't meet the same faith. Thank you so much for the update and for saving & helping our furry little friends. :)
Have a wonderful Sunday and God Bless
Josy October 26th, 2008 10:38:00 AM
I'm so glad to hear you say that about doing spays at the same time as a C-section! It also is a riskier procedure (so I've been told) than doing a straight C-section.
But I've heard that some surgeons - especially in emergency clinics - will really pressure the breeder to do a spay at the same time as the C-section. I can see that if the surgeon is confronted by an ignorant or irresponsible breeder they might try to talk him/her into a spay just to prevent future accidental breedings.
But I was even warned about being pressured into a spay if my girl needed a C-section by the staff of Whelpwise (a company that leases uterine contraction monitors for use in canines). They said they had that happen to some of their clients - and believe me, their clients are neither ignorant nor careless!! I can only suppose that there are vets out there who think all breeding is bad - understandable if the only breeders you've seen are scumbags but a shame nonetheless.
Barb October 26th, 2008 11:22:00 PM
Barb: I'm going to check out Whelpwise--never heard about this--thank you!
On the issue of wanting to spay at the same time--I, too, have felt the pressure (my own) to want to spay at the same time due to my perception of the owner's fitness as an animal caretaker. But we have to remember that in a C-section emergency 1) we are only responsible for the pet's well-being at this individual episode and 2) it's not our place to make judgments about what owners will and won't do in the future.
It's a tough tack to take but, ultimately, we have to concede that the animal's long-term well-being is not in our hands.
Dr. Patty Khuly October 27th, 2008 07:32:00 AM
Barb & Dr. Khuly, I am interested in reading the pros & cons of spay at the same time as C-section.
Although it will never personally affect me in the future, I did have 2 different bitches undergo C-sections without spay and my friend in Canada "always" has a spay with a C-section. It was my view, perhaps erroneous, that this would just add additional time.
But then again, my girls had their C-sections without full anesthesia (gas), and perhaps that made a difference also.
Barbara A. Albright/New Hampshire October 27th, 2008 12:00:00 PM
I have a rural practice, most C-sections/dystocias I am presented with are emergencies and dogs that have never been to a vet before. If I do not spay these dogs after the C-section they are quite unlikely to return for the spay later. Most will get pregnant again and suffer once more. In my hands, I can perform the Ovariohysterectomy almost as rapidly as I can close a uterine incision(s). Is there any evidence that a uterine stump or ligated uterine pedicles are significantly more painful than a sutures uterine body? Recovery seems to be about the same.
Hobson October 28th, 2008 10:26:00 AM
can anyone help please, my bitch has just had puppies, it was unplanned so i very much want to get her spayed as soon as possible, how soon after she has given birth can i get her spayed?
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