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Sunday, May 29, 2011

The kindest cut: A better way to spay

May 24, 2011

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In this week’s syndicated newspaper feature, Pet Connection advisory board member Dr. Timothy C. McCarthy, a board-certified surgeon in the Portland, Ore., area who has pioneered the application of many minimally invasive diagnostic and therapeutic techniques that are now becoming the standard of care, talks about “The Kindest Cut” — a better way to spay.

The first spaying I ever watched was in a small rural practice in 1958 when I was 13 — the same time I first became interested in veterinary medicine.

The surgery was performed using ether and catgut suture from a spool that had to be manually threaded onto a needle. There was no surgical cap, mask, gown or gloves, and only a postage stamp-sized surgical drape. There was no pain medication, and the ovaries were pulled up to the incision by tearing their attachment to the abdominal wall. This was the state of the art at that time.

Today, nearly all aspects of spaying have improved. We have better anesthetics that have minimal negative effects on the patient. We use individual sterile packages of suture with attached needles made using the same synthetic suture material used in human surgery, which causes minimal tissue reaction and is completely removed by the body with time.

We also use caps, masks, gloves and gowns, and use drapes of adequate size to prevent any contamination of the surgical field. We no longer need to pour antibacterial agents into the surgery site. Aggressive pain management with drug combinations is used before surgery to block pain before it starts, and the medications are continued during the post-operative period.

However, we are still using the same barbaric blind tissue-tearing technique to rip the attachment of the ovaries away from the abdominal wall. This technique does work — because we’ve been spaying dogs and cats this way for more than 50 years. But now there is a better way: laparoscopic spaying. It changes our technique from tearing tissue blindly to cutting tissue where we can see what we are doing, and it is the final step toward achieving modernization of this surgery.

Can our pets be windows into understanding human obsessive-compulsive disorder (OCD)? From Dr. Marty Becker and Mikkel Becker:

“Like people can have compulsive behaviors, such as famously washing their hands until their skin is raw, animals can have similar behaviors,” veterinary behaviorist Dr. Nicholas Dodman, director of the Behavior Clinics at Tufts University’s Cummings School of Veterinary Medicine in North Grafton, Mass., told the International Association of Animal Behavior Consultants 2011 Conference in April.

“We’re on our way to proving compulsive behaviors may be genetic,” Dodman said. “If it’s true in dogs, there’s a good bet it’s true in people.”

Compulsive disorders in dogs are associated with what they were bred to do. Dogs bred to chase prey or herd are more likely to chase shadows or light. Research in Dobermans with flank sucking has shown a link between their behavior and a specific alteration on a chromosome for dogs with this disorder. Some cats, primarily Oriental breeds, such as Siamese, may compulsively suck on fabric, a behavior commonly called “wool-sucking.”

All this and more in the complete feature, here!

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