Spay Surgery: What’s Involved in a Simple Spay?

Medical articles
Spay Surgery

Almost every pet person in the US knows what a spay is. It’s like a snip-snip sterilization procedure, but for girl pets only, right? True. But that’s just the top line. The real story is more interesting than that.

According to a popular online etymology site, the word spay hails from the early 15th century. It means to stab with a sword (derived from the French word for sword, espee). Somehow, this brutal term managed to get transformed (rather unfortunately, in my opinion) to the common moniker for what is now the decidedly nonviolent removal of female animal parts.

Here’s how it works: The patient is assessed for good health, anesthetized, and a small linear incision is made between the umbilicus and the pubis. We then identify the uterus and ovaries and that’s where things start to get interesting. That’s because there’s different ways to go about handling the reproductive organs by way of rendering a pet sterile.

Here’s more basic etymology for you:

“ovari” = ovaries, the parts that produce the eggs and secrete female hormones

“hyster” = uterus, the Y-shaped organ (it’s said to have two “horns”) where the fertilized eggs implant and the babies develop

“ectomy” = removal

The “ovariohysterectomy” procedure, then, refers to the removal of both ovaries and the uterus. As such, this procedure takes out all major reproductive organs. Because no reproductive tissue is left behind, it’s favored by most US veterinarians.

An “ovariectomy” procedure, by contrast, removes only the ovaries. Which means leaving the uterus behind.

Ovary removal alone concerns some US veterinarians, who worry that reproductive diseases like cancers and uterine infections (pyometra) can still be an issue. However, plenty of studies, show that in the absence of ovaries’ hormones, the uterus becomes an inert bit of flesh. In fact, this is how most pets are spayed in Europe, with no higher incidence of reproductive diseases post-spay.

Lately there’s been some interest in alternative procedures, such as just “tying tubes” (tubal ligation) or in solely removing the uterus (so the pet gets to keep her hormones but not the messiness of the heat cycle).

With tubal ligation, pets are just sterilized. They can still come into heat, which has lots of health and behavioral problems associated with it, including the sexual transmission of disease, constant heat behavior among female cats, and continued heat cycles in dogs, which is problematic for residential and public settings alike.

Removing just the uterus but leaving the ovaries behind is even more problematic. While pets still can’t get pregnant, they have the same issue as the tubally-ligated pets along with a higher risk of developing an infection at the “stump” of the uterus (“stump pyometra”).

So a spay is not so simple after all, is it?

As it’s performed in most of the US (an “ovariohysterectomy”), removing the ovaries, and the uterus requires a few steps beyond the anesthesia, incision and organ identification. Here are the basic steps: Start with the ovaries:

Starting on one side, gently stretch or break the ligament that attaches the ovary to the rest of the body. This way we can lift it up and “tie off” the blood vessel that supplies it. Now we can safely remove the ovary from its attachments.

Repeat on the other side.

Now for the uterus:

  • At this point, both ovaries are still attached to the uterus, one to each of the uterine horns. If there are solid ligaments attaching the horns to the abdominal wall, they’ll be “tied off” with stitches just like the ones for the ovaries.

  • The horns are then lifted up and out of the abdomen, revealing the base of the “Y” of the uterus (called the “body” of the uterus).

  • At the lowest convenient location on the base of the body, we place a series of stitches. We then cut just above our stitchwork, thereby removing the uterus in its entirety.

Simple, right? Not so much, really. But with lots of repetition comes competency. And since we do so very many spays, most veterinarians make this complex procedure look pretty easy.

So now you know: The spay is no snip-snip, whatever you might’ve once thought!