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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Spaying the unspayable: Making veterinary mistakes in spades

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December 23, 2008 / (42) comments


I imagine most of you won’t find this topic amusing but I can’t help presenting it here by way of soliciting your impressions. Here’s the deal: Over on VIN (mostly for vets only), there’s a thread about a vet who “spayed” her first male cat.

Well, not exactly…she just started to, making an abdominal incision and seeking out a set of tubes that weren’t there…before realizing it was a boy cat whose invisible reproductive innards she sought. In the wake of her mistake, this mortified veterinarian wanted to ask US, her colleagues, if we’d ever committed such a blatantly stupid act.

Well…

My name is Patty Khuly and I’ve “spayed” a male cat.

The first (yes, technically more than one) was an older, longhaired tomcat with hypoplastic testicles. They were tiny. He really looked like a mature female in every other respect.

That’s my excuse but, truth be told, I didn’t perform a full physical before anesthetizing him. He was a feral cat (in for sterilization only). I got into his abdomen and rooted around (cursing the fact that I couldn’t find the uterus) before realizing my horrible mistake.

The other one? Another feral—this one a young, bilaterally cryptorchid male (both testicles undescended). Again, I’d failed to check him out fully beforehand. This time the tech saved me after she’d scrubbed his belly and found two little lumps (his testicles, thankfully just under the skin instead of lurking in the abdomen). OK so technically I didn’t attempt to spay him by opening him up but I would have had someone else’s vigilance not stayed my hand.

(By the way, those of us who do lots of trap-neuter-release colony work don’t often even get the chance to get a good physical in. It’s all about tranquilizing the wild beast and asking questions later. )

So you understand how it can happen, here’s some background: It’s hard to confuse a male dog for a female. But it’s shockingly easy to confuse a boy for a girl kitty, especially if you take an owner’s word for it (and don’t do a thorough check yourself).

Because the typical physical exam in a kitten doesn’t dwell on the reproductive anatomy, and because the testicles on a kitten are little things until about month four or five, your surgery schedule at month six might say “spay” if you’re not careful.

The first time this happened to me in a non-feral it was my aunt’s cat. She’s a cat person. I took her word for it. The spay was on the schedule. Again, he was longhaired and the fuzz obscured the obvious. Again, a tech caught the mistake—this time before anesthetizing him, but late enough so that my foible became the brunt of a week-long inside joke.

It’s happened to almost every vet I know. And if those of you non-vets reading this think you would never commit the same heinous mistake…you’re wrong. It’s just too easy to do.

Based on the sixty-plus comments in this thread on VIN, it would seem that “spaying” a male cat only proves that you’ve done enough feline spays and neuters to qualify for this popular club: The club of veterinarians with enough experience to have seen and made the most obvious mistakes. There’s even talk of designing a T-shirt to celebrate this particular brand of human stupidity.

Don’t get me wrong—we’re not pleased to have put cats through an unnecessary procedure. Indeed, far from it. God knows we take these mistakes very seriously. But we are aware that having done so makes us more sensitive to how things can go wrong. In fact, I think it makes us better at what we do in the long run. If nothing else, it puts us in touch with our frail humanity. And the humility that comes with this knowledge can only be a good thing.

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COMMENTS (42)
1
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2
by dkrmwiz on 07/17/2009 09:14am

just got a litter of kittens from who we thought was patrick! i swear to you, it looks like balls back there! but i guess we have patricia now and her brood of 4. we thought he was just getting fat... and i did maybe think that kinda looks like a pregnant cat... but again, the balls. this is soooo weird. i grew up with cats, have had them all my life... you'd think i'd be able to tell...

3
by Theo on 02/23/2009 01:15am

Is there any change in the external aspect of the testicles after the operation? The boy shall look different there??

4
by tammym on 01/26/2009 04:56pm

well, i have had the problem of thinking a female was a fixed male...i rescue cats, and one solid black cat i rescued looked like a fixed male, even has a face structure like a male...then he got pregnant.
as for hermaphrodites...we were given a orphaned, injured, abandoned 5 day old kitten. we successfully raised him, definitely a him, had a healthy pair of testicles. but upon reaching sexual maturity, we were amazed to watch him act as though he were in heat, and he successfully courted and allowed a tomcat to mount him. nothing ever came of it, but i did some research and talked with my vet and learned all about hermaphrodites. he then went through a confused stage, but seems to have straightened out and knows he is all boy now. we thought that was the end of that until recently. we had a siamese female go into heat. we put her in a cage in a room we keep for this purpose, in this room is other cages with other kittys. they are males, in for one reason or another, and one is the hermie kitty. anyway, we figured we could deal with the 3 or so weeks of yowling she would go through...but it went on for over 3 months. we were at our wits end. we began to feel we might have a nymphomaniac kitty on our hands. finally, we brought her in the main living area...but the yowling continued, from the kitty room. we looked at each other and rolled our eyes...Moses must have gotten confused again, due to the proximity of the female. so while i was taking care of the kittys in the room, i checked him out, nothing unusual. i looked over at Pixie, a cat we rescued from the local dump when he was a kitten, he was rubbing against the cage bars, prrrng, and doing all the things a cat in heat would be doing. i rolled my eyes and thought to myself...great, i have two hermies!

5
by Laura V on 01/13/2009 03:33pm

Re: trying to re-spay pets who have already been spayed.


The vet who spayed my dog (before I got her) tattooed the incision.  The first time I took her to my vet, my vet exclaimed in delight over the tattoo -- she's gone in to spay only to find out that the animal's already spayed multiple times over the years. 


It's also a convenient distinguishing mark.

6
by Barb in TN on 01/10/2009 02:40am

Over the last 30 years I've had a lot of cats. About 4 years ago I adopted a litter of 3 that had to be bottle feed as they were only a couple weeks old. As they grew I told my husband 2 were female and one was a male so we named the two little girls, Wanda and SweetPea. About 3 months later Wanda and Sweetpea became Willie and PeeWee when they started spraying my lamp. ASAP they were neutered. Fortunately that did stop the spraying. My husband still teases me about being wrong. I also took a cat in once to be spayed and the vet called me saying the cat had already been spayed, when they shaved her she had a scar. However the scar was due to a different surgery for a blockage in her bowels. Which he had been told about and it was in her records so I had to kind of wonder why he didn't look at her records before the surgery. I go to a different vet now.

7
by Cat on 12/30/2008 05:27pm

I've seen a hermaphrodite cat. Litter of feral kittens from a genetically-suspect line of ferals (many deformities, notably undersized or undeveloped male equipment) ... all three were female when I caught and checked them at 6 weeks... one was a somewhat deformed male when caught and checked again at 3 months. Neutered at that point. Testicles were underdeveloped even for that age; penis was undersized and had a longish slit rather than a pinhole. Closed up to look more or less normal by maturity. Lived to 12yo.

8
by cl on 12/27/2008 11:51pm

I'm fortunate that I have about a 75-85% accuracy in sexing kittens 3 weeks and older (I suck at younger ones). It's a trick that's for sure. Longhaired cats are definately harder to figure out though.

As for the calling an animal he/she, I've noticed most people tend to call animals with long hair she and short haired ones he.

9
by Dr. Patty Khuly on 12/26/2008 09:18am

Oooh the nipples argument. I love that one. It must be a girl. She's got nipples! And where are yours, Mr. X? As if even human males don't have nipples! Sheesh!

10
by Miss Kitty's Mom on 12/25/2008 01:19pm

There's a shelter I've heard of that puts tatoo ink along the cats' spay incisions.


Then, if they were shaved for a second operation, there's the visible line.  Right now, there's a local government that has passed draconian pediatric sterilization laws for dogs and cats.  I actually discussed with my vet, HOW would I prove that my 9-year-old cat is actually spayed already.   (She has never shown ANY evidence of coming into season since we got her, but I don't think there's a scar there.  The records we have say she was spayed around 10 months of age; she was from a show cat background.)  At least right now there isn't enough money in the budget to pay for door-to-door cat police.  


Since she was spayed at such a late age, she doesn't have the extra height that early spaying or neutering is supposed to cause, so she probably looks like an intact female in terms of conformation.

11
by G on 12/24/2008 11:52pm

"Our" feral kitties were spayed through the side, not the belly; does that leave a scar that vets can distinguish later?  (The ferals in our county--Operation Catnip, most of the state north of you--get the left ear cropped so no one gets done twice, so shouldn't be a problem for these guys...just curious about the procedure.) <br>


I don't recall why they were done that way, if they even explained it.  Perhaps it had something to do with their age; they were barely 2 months at the time. 

12
by PaulaO on 12/24/2008 07:05pm

Meant to add that sometimes, people just don't use their common sense. Like, a boss of mine had a kitten and she called me one night all in a tizzy. Her female cat was a hermaphrodite! She assumed that only girl cats would have nipples so when she realized her girl cat had testicles, she was sure she had a hermaphrodite cat. Sigh.


A friend at church adopted a kitten we were fostering and she publically humiliated me by teasing me (every Sunday) that the boy cat I'd raised was really a girl. Her son, who was working for me at the house, told me that the vet had a good laugh when they took in the female cat to get spayed. She still insisted it was a girl until the vet held the cat and gave her an anatomy lesson.  The reason she thought it was a girl? Nipples. The testicles were not a clue.

13
by PaulaO on 12/24/2008 06:57pm

All our female dogs and cats have a tattoo on their belly. The vet or spay/neuter clinic puts it there after the procedure. It's not visible until the belly is shaved, though. It is now a common practice. The first time we saw one was, wow, I guess over 10 yrs ago.


The tattoo is the female symbol.

14
by regina on 12/24/2008 01:35pm

Many times I have seen new ferret owners pop up in ferret mailing lists and forums commenting on their female ferret's cute little belly button--that's not a belly button, and that's not a female ferret!  If one is ever in any doubt with a ferret, male ferrets do have a bacula which can be easily felt from outside, assuming the ferret is cooperative about having his privates poked at ;-)  And the simplest test is observing what's in the litterbox.  Female ferrets leave one pile of urine and feces, male ferrets leave two separate piles, due to different plumbing arrangements.  I don't know if that would be true of cats or not.

15
by Marlys on 12/24/2008 12:59pm

The dog gender confusion wasn't the only reason we switched vets, just the camel breaking straw. The vet was a bad listener. Every time we corrected her, she would immediately call Kesey a "she" again. Our dog was a rescue and we told the vet he had gained about 15 pounds on purpose since we got him. She only heard the part about weight gain and told us "she" was hypothyroid even though we told her again that the weight gain was on purpose (he is at a good weight but was painfully skinny when we got him). She insisted "she" needed expensive medication (which we would have paid for if we thought he needed it.) She said "her" teeth looked clean, but that "her" bite was off and said several teeth needed to be pulled. We went to a different vet, who tested his thyroid and found it to be normal and looked at his teeth and said that there were a few things he could do cosmetically, but that he wouldn't bother with it if it were his dog. He also removed a growth from his eyelid that the first vet completely ignored.

16
by Dr. Patty Khuly on 12/24/2008 09:05am

Tatyana: Yep. That happens. Though we look for scars and ask if the pet has come into heat by way of determining whether they've been spayed or not, sometimes you just can't tell. With cats it's fairly obvious if the cat is in heat. With dogs you usually see spotting during a heat cycle. But scars can hide--especially if the pet was spayed very young (the way it's done in many shelters now).


If we do try spaying a spayed one, we just close them up and explain to the owner our findings. Most people are understanding. It's much less of a "mistake" than actually trying to spay a male.

17
by Donna on 12/24/2008 02:42am

My two female cats were easy...and obvious. The male, well, we called him Speedy because it's unisex and honestly couldn't tell until he turn about 4 months. One night I was playing with them and layed on the floor so they could walk on me and he walked right over my face and...I'll be darned if he didn't have a giant pair! No wonder the ladies were all over him! The last batch of ferals we took in (5) I only got two right...oops. Good thing the vet techs were better at figuring out sex than I am.

18
by Tatyana on 12/24/2008 02:17am

Also I'm assuming that the age a male cat is neutered makes a difference? My guy was cryptorchid and neutered at 7 or 8 months and he still has a definite scrotum that looks like it could fit marbles. A cat that used to live where i work was also definitely neutered but had a scrotum big enough to look intact. There was no mistaking him for a girl cat. On the other hand, my other cat is longhaired and I've never seen any hint of marbles on him (although i have seen him take his peeper out when cleaning himself, so he definitely a boy cat ;)

19
by Tatyana on 12/24/2008 02:11am

What I'm curious about is whether anyone has tried to spay an animal that has already been spayed. Like if the owner acquired a dog they know nothing about and those spay stitches aren't evident?

20
by PaulaO on 12/24/2008 01:45am

We have a cat that showed up at the house a few years ago. Long haired, and we assumed tri-colored meaning it was a girl. Until we realized the only cat in the house it picked on was the other male.  But when we checked, there were no testicles. The next time we were at the vet's, I asked how we could tell in a neutered male cat. She said, after both of us giggling like school girls, that females look like commas and males look like periods (as in punctuation marks). She even drew me pictures to take home for reference.


I get home and flip Sass over. Looked like a period to me. Along comes Callie, a definite female, and I scooped her up for comparison. She wasn't happy with being examined without permission. But she has very different from external genitalia, confirming that Sassafras is really a Sass!


We are still wondering if Sass doesn't have three colors of fuzz but he's not insane so it must be just a slight enough variation.

21
by Ramen Connoisseur on 12/23/2008 11:50pm

The "Gender Fairy" has indeed visited our house before. I was quite certain my last rabbit (acquired as a baby) was a boy.. until she hit 3 months and certain "bits" had yet to make an appearance. This was bunny numero 5 (I'd previously had two of each sex), and I thought myself perfectly capable of sexing a rabbit. Evidently, not so much.


A few years ago, my friends took in a young stray cat (a rather masculine-looking orange tabby) with a pair of fuzzy little tufts "back there" that looked rather convincingly like something they evidently weren't, seeing as kitty eventually turned out to be a spayed female. (I guess it's a good thing they ultimately decided on "Ginger" instead of "Matthew"!)


It happens to everyone. I wouldn't begrudge a vet the oops as long as they were honest about it. The vet in the above post, who "spayed" the neutered male and didn't bother to fess up, however? Not cool.

22
by beth on 12/23/2008 11:10pm

Classic mistake - especially when the owner says the cat is a female.  The important thing is that you fess up afterwards - we once saw a 15 year-old "female" cat that the owners had had since it was a kitten.  During her physical exam, we found that she was actually a neutered he - the owners had had her/him "spayed" at their previous vet, and had used that vet for all their care up until moving to our area.  Awesomely ethical.  The cat had a very feminine name, and after 15 years, it turned out to be just too much of an identity crisis to change names, so the owners just carried on in semi-denial.

23
by LC on 12/23/2008 06:47pm

Dr. K said "If nothing else, it puts us in touch with our frail humanity. And the humility that comes with this knowledge can only be a good thing." Exactly. We all make mistakes, it is how we deal with them that measures the man (or woman), not the mistake itself.

24
by Kate M on 12/23/2008 05:46pm

It's more fun to try to sex bunnies. Some exotic vets even have trouble.  The Gender Fairy can visit a bun a few times.  I have not been visited by the Gender Fairy yet, but I know people who have. Telling the difference between bunnies who have been neutered can also be hard (or so I am told). So cats are not the only ones who can have gender identity issues.

25
by Brandy on 12/23/2008 04:36pm

I've mistaked one the opposite way before.  The stray that eventually gave birth to kittens under our house I thought was a neutered male.  Named her Felix and everything.  Oops.  Turns out she'd given birth to a litter that didn't survive not long before she started hanging around my house so her parts were just a bit swollen.


She has since been spayed, and all 4 kittens under our care were sterilized as well - 3 males and 1 female.

26
by Dr. Patty Khuly on 12/23/2008 04:16pm

OK now here's a pic of an intact male cat's normal scrotum with testicles inside. Interestingly, I was unable to find a pic by Googling images for "feline scrotum." But I did find this one under "cat balls"--of course. ;-)


27
by Marjorie on 12/23/2008 03:25pm

Marlys :-) I find that a lot of people assume gender based on species (and/or size). I run across a lot of people who call all dogs "he" and all cats "she". My dog is a big girl, and I honestly don't think anyone has ever called her a "she" without checking or asking. Lots of "he" comments right off the bat, though. My male cat is indoor, so he doesn't meet a huge number of people. But in conversations, people will still refer to him as "she". Leave it to me to have a female dog and a male cat, for these types. :-)

28
by Deanna on 12/23/2008 03:02pm

Marlys, my boy dogs get called "she/her" all the time at the vet's office and elsewhere. They have gender neutral names, so I don't even correct anymore unless gender is important. My vet has mad diagnostic skills, so I can forgive the recurring transgressions. (Besides, they are just so purty I can understand the mistake.)


Dr. K., phew, now I don't feel so bad not being able to figure out if the latest stray cat to show up at the barn is an intact male or already neutered. (There's some bilateral puffiness in the right area, but is it a scrotum with all its contents? Thoughts?)


So, how many times has someone brought you one of either gender for altering that had already been spayed or neutered?

29
by Lis on 12/23/2008 02:43pm

When I was a kid, my cousins acquired a young cat, whom they named Sam. This was nearly fifty years ago, and the question of having him neutered did not arise. At least, not until Sam had a litter of kittens. One of the kittens was born dead, another (who was very obviously not healthy) was rejected by mom and died quickly, and the survivors all had to be found safe, responsible homes. After the litter was weaned, Sam was spayed. Oh, and since I was staying with my aunt and uncle that summer, I never forgot the lesson of Sam's dead kittens.

30
by Dr. Patty Khuly on 12/23/2008 02:21pm

Marlys: Guilty!! I do that sometimes. I know it makes some clients mad but it's hard to change tack once you've made the mistake the first time. It's sometimes the owner's "fault," too, like when they name a dog Coco Chanel (and it's a boy) or when they name the dog Marley (and it's a girl). I get sooooo confused sometimes. We dont even know we're doing it, I swear!!

31
by Marlys on 12/23/2008 02:12pm

We took our dog to a vet once who couldn't seem to get it that he is a boy and kept calling him a she while examining him. We got a new vet.

32
by Julia on 12/23/2008 01:07pm

I was once semi-responsible for putting a neutered male cat on the table and telling the  student) surgeon to spay him. In my defense, two people besides me agreed that the cat was female, whom I asked because I thought the rear looked rather suspect. The surgeon couldn't find the uterus, and the vet supervising the whole thing (it was a high-volume spay-neuter clinic) came over to give a tutorial on how to tell them apart.


Basically, she said to look for a penis, not a scrotum. While those holes look similar on cursory glance, on closer inspection, the penis lives in a teeny hole, and the vulva is a slit. Also, the anus and vulva are closer together than anus and penis.


Mostly I think it just takes a lot of experience. But ever since, I've been very diligent about checking cats' butts before putting them on the table.

33
by Dr. Patty Khuly on 12/23/2008 12:06pm

Xslf: Reference the photos above. That male cat looks like he's either very young or recently neutered. (Should've explained that.)

34
by Fairyblastt on 12/23/2008 12:00pm

This reminds me of all those cool, manly man parrots named Sally or Miss Peaches. My fave story is how, growing up, our neighbor's 'tomcat' had his own litter of kittens. :)

35
by Xslf on 12/23/2008 11:39am

Any tips for telling apart neutered male cats and females?


I always find that the most confusing...

36
by KateH on 12/23/2008 11:14am

Sorry, the original owner said it was a boy!

37
by KateH on 12/23/2008 11:11am

Many years back, when I was a teen who read every animal book I could find, and thought I was the resident 'animal expert' in the family, my dad brought home a 6 week-old kitten, who I swore was a girl, although my dad had been told by the woman who'd given him the kitten, that it was a girl. While we waited through a holiday to take the kitten to the vet, names where argued about, with the temporary name of "Little Kitty" being given. After the vet gently disabused me of my 'expert' knowledge, we couldn't agree on a good boy's name anyway, so he stayed "Little Kitty" to the end.

38
by Dr. Patty Khuly on 12/23/2008 11:03am

MPL: I do it, too, though my editor gives me the opportunity to erase my comment after the fact. Don't stress the typos. We can tell you're not illiterate. ;-)


And on the pee-pee poking out at you? Nope. It's teensy. And it's real close to the testicles--not anywhere near where we shave. Here are a couple of pics to illustrate:


Boy cat: Penis in prepuce. testicles in scrotum:       Girl cat:


   

39
by Michigan Pet Lover on 12/23/2008 10:13am

I guess I was having a typo party...Dr. Khuly, is there some chance a way to edit comments that I'm not noticing, for the perfectionistic typists amongst us? 


Inscise = incise


Sourse = source


 

40
by Michigan Pet Lover on 12/23/2008 10:10am

Lynn, that reminds me of a story my dad told me. 


When he was a kid, his family acquired a "female" cat.  My grandfather took "her" to a vet who I guess he knew personally, to be "spayed".  When he went to pick the cat up, the friend/vet said to him:  "I was a little confused about what you wanted me to do so I neutered your male cat." 


Whether or not the cat was prepped or inscised for a spay or not, I do not know.  Hmm...maybe the sourse of the vet's "confusion" was rooting around for an absent uterus...

41
by Michigan Pet Lover on 12/23/2008 10:04am

Just over a year ago, I did a job shadow at the animal hospital my pets go to.  I was watching a few surgeries, one being a cat spay.  The vet inscised, did some poking around, and wondered if she might have a male on the table.  A peak at the rear and more internal prodding confimed the kitty was, in fact, a female.  She did tell me though that she actually did cut open a male, attempting a "spay". 


Now...if I may ask a question...not sure how to put this delicately...but if you have a male, once you have the underside exposed...wouldn't his little, um, pee-pee look up at you and say hello?  (This is a genuine question, but typing this has me in giggles!)

42
by Lynn on 12/23/2008 09:45am

When my husband and I brought our first cat home, we named her Cleo. We took her to the vet and we were highly embarrassed to find that our sweet little girl was actually a sweet little boy who ended up being renamed Felix. I guess in a way, it makes me feel better that it's not just us...

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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