Spayed bitches coming into season!

Re: Spayed bitches coming into season!

Bob Russell — Mon, 19 Jul 2010 12:45:03 GMT

[quote user="Peter Ding"]

Excellent.

Everyone has their own methods to ensure all ovarian tissue is removed.

I've always found Duvall Tissue Forceps are ideal to apply traction to the ovaries whilst applying ligatures to the ovarian arteries. The forceps encompass the ovary protecting it and delineating it.

[/quote]

Looked up Duvall Tissue forceps £5 on ebay!!!!

I presume you apply then in line with the ovarian arteries to apply traction - not an instrument I have met before. It seems to be a relatively atraumatic forceps.

Interesting idea would appreciate confirmation as to how they are used. May be worth a go but will probably give the ebay ones a miss!!!

Re: Spayed bitches coming into season!

Arlo Guthrie — Sat, 17 Jul 2010 14:34:19 GMT

[quote user="Elizabeth Smith"]

I'm a bit new to this and hope it isn't bad etiquette to 'steal' this thread

[/quote]

Hi, Elizabeth, and welcome. And it's not so much a question of etiquette as the fact that you might get a better response if you post your question as a new thread. Makes it easier for others to find.

Re: Spayed bitches coming into season!

ilanit — Sat, 17 Jul 2010 13:03:07 GMT

A colleague of mine had a similar story with a cat. After some researching he said he had found a mention in one of his books that rarely the adrenal gland can take over the hormone production of the ovary. To be honest I never heard anything or found any information on this myself so I don't know if this could be true. When I see him next week I'll ask him about it (if I remember )

Re: Spayed bitches coming into season!

Elizabeth Smith — Sat, 17 Jul 2010 00:05:32 GMT

I'm a bit new to this and hope it isn't bad etiquette to 'steal' this thread but I have experienced something odd at work this spring. A queen that was spayed by an experienced colleague 2 years ago came into a 'mild' season the following year but full blown season this year . I ex-lapped her expecting to find an ovarian remnant (or two??) but found nothing....and nothing looking remotely ovarian anywhere else. Surgical sites looked clean and lovely! Even got another colleague to peer inside in case i was being stupid. Spoke to 'the hormone lab' who said blood tests weren't much use in cats; spoke to local referral hospital who said 'mmmmmm..that is a bit wierd'. She has settled after a few weeks and owners decided to leave it but dreading a phone call next spring when she starts calling again......any ideas????

Re: Spayed bitches coming into season!

Peter Ding — Fri, 16 Jul 2010 18:46:43 GMT

Excellent.

Everyone has their own methods to ensure all ovarian tissue is removed.

I've always found Duvall Tissue Forceps are ideal to apply traction to the ovaries whilst applying ligatures to the ovarian arteries. The forceps encompass the ovary protecting it and delineating it.

Re: Spayed bitches coming into season!

Gillian Mostyn — Fri, 16 Jul 2010 17:01:55 GMT

Re: Spayed bitches coming into season!

Bob Russell — Fri, 16 Jul 2010 14:53:50 GMT

Update - saw the bitch in question - discharge stopped after 2 days on antibiotics so hopefully my technique is not so questionable. The owner realises there may still be an issue but less likely to be a season hopefully.

Re: Spayed bitches coming into season!

salome2001 — Thu, 15 Jul 2010 15:15:38 GMT

[quote user="Martin Atkinson"]

It surprises me how many vets only use 2 clamps.

[/quote]

I'll put my hand up here to being a 2-clamper, especially in cats. However, I place the clamps with a good distance of at least a few mm of complete clearance from the ovary to the first clamp and ligate under the second (cranial) clamp. So I'm happy with that. I don't think how many clamps you use is as important as exteriorising the ovary adequately to get good visual and palpable clearance into the ovarian ligament.

Re: Spayed bitches coming into season!

Edward Jones — Mon, 12 Jul 2010 12:29:44 GMT

A shot of delvo and wait and see? Then you can worry about it in a few months, or may be not if you're lucky

Re: Spayed bitches coming into season!

Bob Russell — Mon, 12 Jul 2010 12:16:00 GMT

Yes - on antibiotics awaiting results of swab - not ready for laparotomy yet. Will be talking to the lab ref hormone assays when I get my head above water.

This has been bugging me over the weekend!!!

Re: Spayed bitches coming into season!

Gillian Mostyn — Sun, 11 Jul 2010 18:46:09 GMT

[quote user="Jonathan Wray"]

New advice. Don't phone VDS. They have no experience of these things and how to deal with rigs or anything else to do with the quirks of neutering. In fact they're a complete waste of time. Don't even think about contacting them, even though you pay their levy annually. They're not interested in preventing claims arising, they're only interested in dealing with stuff when it comes unstuck and they are unpleasant and curmudgeonly people to talk to. Their telephone number for you not to use is 01565 652737

As the Bangor fella said, RCVS has nothing to do with negligence, by the way.

Apologies for offering inadequate advice.

JGW

[/quote]

Have been away for the weekend so only just seen your post. Made me laugh out loud - I've never met anyone so obnoxious in a forum before.

If you want to re-read my reply I didn't tell him not to ring VDS- indeed it would be the first thing I'd do too. (I would also credit someone with 20years in this profession with the intelligence to know this already.) I simply said not to worry. Many respondants were going on about fault and blame and I was simply ststing that any complaint to the RCVS was unlikely to get anywhere. If I used the incorrect term - negligence - where I should have said serious professional misconduct - then I heartily and completely apologise to the entire forum.

OK?

Re: Spayed bitches coming into season!

ms1083 — Sun, 11 Jul 2010 09:15:46 GMT

is it a young or old bitch? I have had someting vaguly similar in an old bitch but it turned out being a vaginal tumour, it was palpale by rectum as it grew.

Re: Spayed bitches coming into season!

Martin Jones — Sat, 10 Jul 2010 19:59:48 GMT

One slightly right-angled suggestion: this might not be a season, but a case of vaginitis. Certainly, the symptoms would fit.

Might I suggest any or all of hormone assay, vaginal cytology and vaginal swab BEFORE ex lap?

Martin

Re: Spayed bitches coming into season!

Bob Russell — Sat, 10 Jul 2010 11:02:36 GMT

Client is nice as pie (at the moment). We have a good working relationship with most of our clients but even this can be tested at times.

I posted because I am as certain as I can be that the ovaries were completely excised. I have no worries about it being a genuine negligence case just surprised!!

I am worried about the possibility that I may have seeded some ovarian tissue as there was a degree of difficulty exteriorising one of the ovaries. I will talk to one of the specialists nearby. The priority for me is not blame but sorting the bitch out. I am confident no negligence was involved but it is still my responsibility!

We introduced very strict procedures after a locum (very experienced) left a swab inside during a bitch spay many years ago. I was fortunately the other side of the world at WSAVA at the time this surgery was carried out!

I have always found VDS brilliant and usually have a chat whenever I have concerns. They are always reassuring and so far the above incedent has been the only time they have been involved with a compensation claim for this practice.

The patient with the unwanted swab continued to be seen by me for many years after!

Thanks for the replies.

Re: Spayed bitches coming into season!

Martin Atkinson — Sat, 10 Jul 2010 09:32:00 GMT

Given my post in a previous thread about a dog that turned up with an abdominal testicular tumour after I had castrated it and was 100% I'd removed both testes - anything goes! I also had a colleague who had a cat spay return pregnant which is bit more difficult to defend! But in order to avoid the risk of leaving some residual ovarian tissue, once I've identified the the ovary I always put on 3 clamps cranial to it and ligate the ovarian ligament cranial to the third clamp which virtually eliminates the risk of a bit being caught under a clamp or ligature. It surprises me how many vets only use 2 clamps. But that's probably teaching granny to suck eggs.

Re: Spayed bitches coming into season!

Clive Ansell — Fri, 09 Jul 2010 20:43:48 GMT

There should be no mention of negligence or the VDS at this stage, a bitch which was speyed by a colleague of 20+ years experience with a good track record (as far as we know), shows signs of coming back in to season.

Firstly, maybe, run bloods to demonstrate that ovarian tissue is present. if it is it may be an ovarian remnant, or it may be ectopic tissue.

If ovarian tissue is present, proceed to exploratory laparotomy to look for a remnant. if found submit for histology to confirm.

Even if ovarian tissue was left behind at surgery, that does not immediately constitute negligence. It could be considered as a known, accepted and acceptable complication of ovariohysterectomy.

I had a case about 10 years ago of a chocolate Labrador bitch speyed by an experienced competent colleague within the practice that came back into season after 6 months. It turned out that there was a speck of ovarian tissue, confirmed by histology, adjacent to where the cervix was transected. We assumed it had be auto transplanted during surgery on one of the instruments?. Following surgery the problem was resolved. The clients were difficult; screaming negligence, cover up, malpractice etc etc etc and demanding compensation. We had a meeting and the boss decided that although unfortunate it was an unusual and genuine complication. We carried out the second surgery and aftercare free of charge as a goodwill gesture, but that was the end of it with no compensation being paid.

Re: Spayed bitches coming into season!

Kate Richardson — Fri, 09 Jul 2010 20:33:56 GMT

[quote user="Jonathan Wray"]New advice. Don't phone VDS. They have no experience of these things and how to deal with rigs or anything else to do with the quirks of neutering. In fact they're a complete waste of time. Don't even think about contacting them, even though you pay their levy annually. They're not interested in preventing claims arising, they're only interested in dealing with stuff when it comes unstuck and they are unpleasant and curmudgeonly people to talk to. Their telephone number for you not to use is 01565 652737[/quote]

Please tell me you are being ironic?!

Re: Spayed bitches coming into season!

J G Wray — Fri, 09 Jul 2010 20:07:41 GMT

As the Bangor fella said, RCVS has nothing to do with negligence, by the way.

Apologies for offering inadequate advice.

JGW

Re: Spayed bitches coming into season!

Evelyn Barbour-Hill — Fri, 09 Jul 2010 19:52:23 GMT

[quote user="Gillian Mostyn"](About the VDS comment - don't worry, even if you did inadvertantly leave a few ovarian cells behind the RCVS is never going to see this as a case of negligence in a million years.)[/quote]

Eh? Negligence is nothing to do with RCVS (unless so extreme as to be misconduct).

JGW's advice was sound. Bob didn't say whether the client was complaining, angling for compensation, or not, but if they aren't now they might be later.

Odd things happen sometimes.

Re: Spayed bitches coming into season!

Hannah Wynne Richards — Fri, 09 Jul 2010 17:04:18 GMT

There but for the grace of God .................................

Be sympathetic, but not apologetic-if your technique was at fault, probs would have surfaced long ago

Wynne

Re: Spayed bitches coming into season!

Gillian Mostyn — Fri, 09 Jul 2010 16:46:31 GMT

I'd agree - obviously you need to check for ovarian remnant - but ectopic tissue sounds just as possible in this case.

(About the VDS comment - don't worry, even if you did inadvertantly leave a few ovarian cells behind the RCVS is never going to see this as a case of negligence in a million years.)

I'd do an ex-lap while still in season (best chance of finding the chunk of tissue causing the bother) and take photos during the op if it looks odd......if it is ovarian remnant maybe waive the fee as a gesture of goodwill - although make it clear it isn't due to any fault on your part. Can happen......

Re: Spayed bitches coming into season!

Rob Reid — Fri, 09 Jul 2010 16:35:15 GMT

Weird abnormalities can happen.

Few years ago, I speyed a Dogue De Bordeaux at 6mo (didn't recall any problems with the op) which then presented at 2yo having come into season again. My boss at the time perfromed an ex lap that revealed 2 tiny kidneys with what was confirmed as some ectopic ovarian tissue on top of each. The bitch died of renal failure about 9 months later.

I guess common things are common and a remnant would be the most likely, but never rule out the obscure esp if you trust your technique (which in your case has been tried and tested for 20 years.)

Re: Spayed bitches coming into season!

J G Wray — Fri, 09 Jul 2010 16:28:30 GMT

Phone VDS

JGW