# Laparoscopic Spay



## sunnycleveland (Apr 3, 2010)

This is a very long post but I am just going to ramble on as someone may find bits of this info useful. 


I wanted to write about my experience with Laparoscopic Spay. I am always roaming SM for info on all kinds of things and I wanted to share my experience. Hopefully this will help someone.

We did two consults with local doctors (and by local I mean one an hour away and the other 2 hours away) – apparently not all vets do this procedure and not all vets do it on 4 lb dogs. Another vet offered laparoscopic spay but only for dogs 20lb and over. I discovered you have to call each clinic and ask if they offer it. We chose a private clinic an hour away, the other clinic was a University veterinary hospital and I felt like it was a conveyor line – we were ‘just another dog’; also they did not do a mandatory blood count and chemistry profile (which I thought was standard for a spay)…

Laparoscopic Spay is less invasive (although the vet hospital said instead of one large incision, it is 3 small ones and they do not see a big difference for a dog Fiona’s size). The belly is filled with gas, and with a camera and some tools they remove the ovaries (not the uterus like they do with general spay). Vet said she cannot say if removing uterus offers that much benefit – there is a risk of developing something on it (I think she said a tumor, but don’t quote me) but even with general spay the little ‘stump’ that is left may develop the tumor. We decided on the laparoscopic procedure.

(I wanted to mention that we had a spay and dental scheduled at the same time but then the vet hospital told us they do not recommend doing spay and dental at the same time – apparently anytime you mess with the mouth, some bacteria is released into the blood stream and risk of infection rises; also, if the dog is on pain meds and is recovering from surgery, that bacteria in the blood may slow the process or increase the risk of infection. The other vet told us the risk is minimal, but I did not feel comfortable taking this risk so we will be doing a dental at another time). Also, spaying reduces risk of Pyometra at any time but make sure you spay no later than 2nd heat cycle - spaying after 3rd heat cycle has no effect on reducing risk of breast cancer; I did not know this.

(Day of Surgery) Fiona has 2 small incisions, one about half an inch, one about quarter of an inch. I am very surprised how high those are, for some reason I thought they would be much lower, closer to hind legs.. She also has quite a few needle marks from maybe anesthesia or the gas or an instrument to assist surgery..? The veterinary hospital told us she would have 3 incisions, but this one did with only 2.. we dropped her off at 8am and picked her up at 4pm (general spays stay the night). I really liked the fact that she came home with us same day. The 24 hour supervision in my mind works like this – some overworked, underpaid student or nurse sitting at her laptop and unless the dog makes noise, he/she will not be looked at. I hope I am wrong about this but I tend to be a little bit obsessive when it comes to my 4 lb dog… Plus I KNOW my dog – I KNOW when something is off and the nurse may think its normal…

When we got home, she ate just a little bit of soft food and drank just a little. She laid around next to me and ate a little bit more before bed. She did not throw up. Did not pee, but did have loose stool.

We were given Buprenorphine for pain – syringes (no needle) filled with this stuff, to be given every 8-12 hours. Fiona really did not do well on it – first day we were told to wait 8 hours after procedure but by the time we gave it to her I could tell she’s in pain (she was breathing very rapidly with her nose in her little towel barely moving) – there was a good 15-30 minutes of this before the medication kicked in (per clinic it takes about 45 min to an hour for buprenorphine to kick in so give first dose half an hour before the time she’ll need it). I put towels everywhere so that if she pees herself it’ll be easier to clean and because I decided clean towels are cleaner than her doggie beds or the couch.. Well, she did not pee at all until about midnight on her puppy pad. 

(Day 1 post surgery) Next day she was like a zombie, she would just lay in one spot and not move with her eyes open (this was weird because my dog sleeps 20 hrs per day), she had 2 loose stools and 2 loose stools with mucousy blood. No pee for 24 hours, then finally she peed! I called the clinic and they said buprenorphine may be to blame, told us to try to give it to her every 12 hours instead of every 8. 

(Day 2 post surgery) Next day we went to the clinic and I asked for Metacam (thank you SM for helping me find this info). For the lazy people – a lot of spayed maltese respond very well to Metacam, some other pain meds are Tramadol, Torbutrol pill, but NO Rimadyl – read some bad stuff about Rimadyl. If you are asking for a different pain med – make sure you do not mix the two – ask when it is OK to give her the other medication…

(read about signs of pain here http://spoiledmaltese.com/forum/52-maltese-health-behavior/84752-signs-pain.html )

Metacam is once a day med – and I am teary eyed as I write this – Fiona is back to normal! She is a little bit more sleepy, but she is SLEEEPING ; she is barking at people waking outside, she even wanted to hump my leg that morning!!! She peed the night before bed but not again until very late at night – I don’t know how to explain this – the vet said to just let her be… I was really worried as almost 24 hours without peeing is strange, and she IS drinking water, not a lot but still…

Vet said there’s quite a difference between Buprenorphine and Metacam; no details except it was implied Metacam is not as strong and the fact that Fiona was 2nd day after surgery that Metacam would be fine.

I bought some onesies (newborn size, premie size was not available) - cut off sleeves, cut a large hole for a tail and she’s wearing those no problem. Although they get dirty when she goes to the bathroom sometimes so get a pack. Here’s where you can really tell how obsessive I am – wash the onsies before first wear; new onsies will have traces of dye on them so wash them before you put them on your baby – try to create a sterile environment for those stitches to heal. Also, I was very lucky – because the stitches were so high, a long hole for tail and her pee-pee let her go to the bathroom without my supervision. 

A tip I wish I would’ve had – cut that hair down before the surgery, trim it as short as possible. Fiona is covered in mats after 14 days of no bath, no brushing and constantly wearing a onesie. I will have to trim it very, very short; there is no point in brushing those mats out, they are everywhere…. The hair should grow back in no time…


Please do your research before you take your baby in for surgery, SM is such a wonderful source; I am so grateful for this site!
I compiled a list of questions (below) from these sources: 
http://spoiledmaltese.com/forum/52-maltese-health-behavior/116360-article-anesethia-dentals-malts.html
http://spoiledmaltese.com/forum/52-maltese-health-behavior/84779-anesthesia.html

This outline of questions is to take with you on a spay consultation (laparoscopic or not), and PLEASE do not be shy – ask open ended questions where possible, do not ask a question that gives the vet an answer you want to hear for example “after dental is done, the left over grooves are polished smooth with rotary dental polisher or gauze-wrapped finger tips with pumice polish”? – Ask “how the left over grooves polished smooth?” and listen to what they have to say…


Get a feel on how the doctor responds, an experienced doctor will be confident with the answers and will not hesitate…


1. What kind of anesthesia? NAMES, Dosages are specific to dog size? (thank you Dr. Jaimie!! )
...............a. Premedication
...............b. Induction (propofol)
...............c. Maintenance (isoflurene gas)

2. Who does anesthesia? Can they be present the whole time?

3. What kind of monitoring done during anesthesia?
...............a. Pulse oximeter
...............b. Stethoscope/audible pulse monitor
...............c. EKG monitor
...............d. Respiratory monitors/apnea alerts (when stops breathing)

4. Do you have small enough endotracheal tube for this dog (3mm, 3.5mm, 4mm)?

5. How will you keep dog warm during anesthesia?
...............a. Warm water recirculating blankets, heating pads wrapped in towels, uncooked rice heated in microwave, warm water bottles

6. How long under anesthesia for spay?

7. Blood work done prior
...............a. Complete Blood Count (Insist it is done)
...............b. Blood Chemistry Profiles (insist it is done)
..............................i. Liver values
..............................ii. Kidney values
..............................iii. Electrolytes

8. Pain management - NAME of meds
...............a. Pain injection prior to leaving
...............b. Pain meds to go, 5 days

9. Microchip

10. Dental
...............a. What exactly is done to clean teeth?
..............................1. Ultrasonic dental scaler?
..............................2. Left over grooves polished smooth with rotary dental polisher not gauze-wrapped finger tips with pumice polish
..............................3. Fluoride treatment?

11. If any teeth need to be pulled how is it done?
...............a. Power equipment to section off multi rooted teeth
...............b. Surgically closing the extraction site

12. Finally – is there a 24 hour contact number in case of emergency or a general question after the surgery. What if you need to come in – is there a doctor on call 24/7 even on weekends?



Finally a disclosure, I am not a doctor, I am simply a very concerned mommy; majority of info above is collected from consultations with the two vets. If you feel any of the info above is wrong or I am mistaken on something, PLEASE share – I am so grateful for this site and the people who post their questions, concerns and experiences!


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## aprilb (Jul 9, 2010)

Thank you so much for posting this!!! I hope your baby is feeling better. My new vet now offers laparoscopic spay and I have a puppy who will need spaying done in the next few months. My other two girls had the laser surgery and did great. There were no stitches to remove, and the incision was tiny. They were gven Metacam, too. I was considering the laparoscopic spay, but after hearing how it is done, I will not let my Eva have it. All of my girls are under 5 pounds..this info is invaluable... thanks again for posting the info for us.:blush:


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## edelweiss (Apr 23, 2010)

Can this be made into a sticky---very informative & documented.


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## allheart (Oct 3, 2008)

Wow how sweet and thoughtful of you to post all of this wonderful information. Kisses to your sweet baby and thanks so much again.


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## Orla (Jul 5, 2009)

Excellent post. Thank you for taking the time to write all of that


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## Kathleen (Aug 4, 2011)

Thank you so much for taking the time to provide all these details. The list of questions for the doctor is extremely helpful.
I am so sorry that Fiona had such discomfort, and I hope that your little girl is feeling better.
I just went through the same research and decision making process too. My Daisy is scheduled for a laproscopic spay this coming Wednesday. I am so nervous about it. I chose laproscopic surgery because from the research I did, it is supposed to be much less painful.
If you don't mind, I would like to add a couple of things I learned with the hope that it will help someone else trying to decide.
The most important thing that I learned is that dogs can now be spayed removing just the ovaries and not the uterus too. It is called an ovarioectomy. Removing the uterus does not seem to be necessary, and it's removal can cause tearing of tissue resulting in more pain, and other complications. Here is a link for more info:

A New and Safer Way to Spay Your Puppy - Whole Dog Journal Article

If you are looking into options for spaying, I think this is so important to consider because it is much less painful.
I initially started looking into laproscopic spays because I wanted Daisy to have just her ovaries removed. We met with a board certified surgeon at Angell, which is the major animal hospital in Boston, and I was pleasantly surprised to learn that she recommends this type of spay (just ovaries) all the time. She said it has been done this way for a long time in Europe, and here in the US we are just catching up. It is possible to just remove the ovaries using a traditional spay. It does not have to be laproscopic.
She also said that because Daisy is so small (5 pounds) there really will not be much of a difference in size between the two incisions they would make in a laproscopic spay added together, and the one incision there would be with a traditional spay. It would make a big difference with a bigger dog. She also said surgery time (so time under anesthesia) would be about the same. 
If anyone is considering laproscopic spay, I would also recommend that you ask the vet about his or her level of experience with it, especially for small dogs. It may be difficult to find an experienced vet, unless you go to a surgeon at a major hospital.


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## edelweiss (Apr 23, 2010)

Something else to consider. Should be added to the potential sticky. Decisions, decisions.


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## aprilb (Jul 9, 2010)

I read the article. I did not know all they took was the ovaries. I will talk to my vet about it. I'm kind of on the fence right now...


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## Kathleen (Aug 4, 2011)

Here is a link to another article that I found helpful as background information before talking to the vet about the options:

Announcing a New Safer Alternative to Traditional Spaying

Before I started researching this, I had no idea there were options other than a traditional spay. I guess it is good to have options, but it does make it confusing.


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## gopotsgo (May 21, 2009)

We considered a lap spay for our 4 lb foster, Storm. We R both physicians so had a good knowledge base from which 2 work with. Since she has a bleeding disorder, we and the vet decided against it because it was vital that the entire operative field was viewed 2 make sure there were no bleeders. We also were in total agreement with only the ovaries being removed. It makes so much sense. I would also like 2 add a couple of things that you all may consider. 
1. Have the surgical incision closed with a wound adhesive instead of stitches. So much easier for us & the pup. 
2. It is a bunch of bologna that you cannot get a wound wet. Waiting 14 days is crazy. We bathed Stormy the day before and had a professional groom one week after. She did get some spot cleaning like usual in-between.


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## aprilb (Jul 9, 2010)

I did talk to my vet, who is an experienced surgeon. He has done many lap spays and recommends them. However, he did tell me that it is difficult to do the lap spay on a 4 pound dog and that these tiny ones would be under anesthesia for a longer period of time. The lap spay is TWICE the cost of a traditional spay. The equipment is very expensive. I think the lap spay is great for medium and large dogs. If your Maltese is on the large size, and you can afford it, then the lap spay is a good option. IMHO, the laser spay/traditional is a better choice for the tiny ones.:thumbsup:


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