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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.

 

Ovariohysterectomy versus Ovariectomy

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December 13, 2011 / (13) comments


At first glance, the terms "ovariohysterectomy" and "ovariectomy" look similar enough that you might think they refer to the same procedure, but that is not the case.

 

An ovariohysterectomy (OHE) is what we think of as a traditional spay where both ovaries and the uterus down to about the level of the cervix is removed. An ovariectomy (OE) is simply the removal of both ovaries while leaving the uterus in place.

In the United States, the OHE has long been and still is the surgery of choice when it comes to eliminating a female dog or cat’s ability to reproduce and preventing some common diseases of the reproductive tract (e.g., uterine infections and breast cancer). This might be changing, however. In other parts of the world, the OE is the more common surgery as long as a pet’s uterus is healthy. More veterinarians in the US are starting to move in this direction too, which can lead to questions from owners who are not familiar with OE surgeries.

The main benefit of an OE versus an OHE is the ability to perform the surgery through a smaller incision. This incision can also be locate a little farther forward on the pet’s abdomen, which improves the surgeon’s ability to locate, manipulate, and surgically remove the ovaries. This could potentially reduce surgery times, surgical complications, and the amount of discomfort a pet feels postoperatively, although the few studies that have looked into these factors have not shown a significant difference between OEs and OHEs. This could change, however, as a greater number of surgeons become more familiar and practiced in OE techniques.

Owners are often concerned that leaving the uterus in place increases the chance that their pets could develop uterine disease in the future. The two biggest issues are pyometra and uterine cancer.

Pyometras can only develop in a dog that is under the influence of progesterone. Progesterone is made by the ovaries, so as long as both ovaries are completely removed and a dog is not treated with a medication containing progesterone (something which is almost never done), a pyometra will not occur. Relying on OHEs is not completely protective either. We can and do see something called a “stump” pyometra (i.e., infection involving the small part of uterus that remains after an OHE) when a piece of ovarian tissue is mistakenly left behind during surgery or progesterone is supplied exogenously.

Uterine tumors are very rare in dogs and cats, and they also seem to be under hormonal influence. Therefore, removing a pet’s ovaries at a relatively early age should even further reduce the chances of their forming if the uterus is left in place. The most common type of uterine tumor is a leiomyoma, which is benign, so in the unlikely event that one should form, removing the uterus at that time should be curative.

What this all boils down to is that both OHEs and OEs can be an effective form of surgical sterilization, but the OE may have some potential benefits, particularly when performed by an experienced surgeon.

 

 

Dr. Jennifer Coates

 

 

Image: De Visu / via Shutterstock

 

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COMMENTS (13)
1
Heat
by TheOldBroad on 12/13/2011 06:17am

Will a critter still go in and out of heat if sterilized with an ovariectomy?

What are your thoughts regarding allowing the pet to go through unnecessary heat? Wouldn't that cause multi-critter households to possibly have behavior problems?

by Dr. Jennifer Coates on 12/14/2011 08:43am

Without ovaries, the dogs will not go through heat cycles. I do not beleive in letting pets go through heat cycles before spaying unless there is a specific reason to do so (e.g., puppy vaginitis). The consensus of most veterinarians is that the benefits of removing the ovaries (e.g., no unwanted pregnancies, no pyometra, and a greatly reduced risk of breast cancer if the surgery is performed early enough) outweigh any downsides.

2
Other alternatives?
by borzoi on 12/13/2011 12:19pm

Quite a number of well-known studies have shown the negative side-effects of stopping hormone production (c.f. Laura Sandborn's review paper, Farhoodi & Zink's behaviorial study, and Margaret V. Root Kustritz review paper in the JAVMA). In humans, tubal ligation is the more common form of sterilization. Are you aware of techniques in the vet community short of either OHE or OE? Something like a tubal ligation? My goal is sterilization, not messing with hormones whose functions go far beyond just reproduction.

by Dr. Jennifer Coates on 12/14/2011 08:43am

The consensus of most veterinarians is that the benefits of removing the ovaries (e.g., no unwanted pregnancies, no pyometra, and a greatly reduced risk of breast cancer if the surgery is performed early enough) outweigh any downsides.

by borzoi on 12/14/2011 11:26am

Dr. Coates - Thanks for the reply, but the fact the most vets, or vet schools, recommend a particular procedure does not mean that it is necessarily the best approach. How current are most vets wrt scholarly literature? How slow is the medical field to respond to advances? An obvious case is human nutrition, which for many years was not even taught in medical school! Another is stem-cell therapy. Partial ACL tears respond _very_ well to stem-cell therapy (>70% cure rate). And if that doesn't fix the problem, one can always later resort to TPLO, a _highly_ invasive, and imho somewhat barbaric, procedure which many vets consider the gold standard.

How much do societal pressures weigh in their minds? For example, the risk of pregnancy in an intact bitch is essentially zero if she is properly managed when she is in heat - ours do not leave the house except to potty, under supervision, in our double fenced back yard.

And the risks of spay/neuter are often downplayed. Are you aware of the Rottweiler study that concluded that "...the combination of breed risk and early spay/neuter meant that Rottweilers spayed/neutered before one year of age had a 28.4% (males) and 25.1% (females) risk of developing osteosarcoma."

Also, the Farhoody/Zink study, which is quite recent, was conducted on nearly 11,000 dogs, which seems like a good sample size!

A one size fits all breeds, large or small, approach does not seem correct.

Regards,
Doug

by telogen effluvium on 12/14/2011 01:36pm

I concur that stem cell therapy for cruciate ligament injuries in dogs is a very exciting prospect, but can you provide a citation for a cure rate of 70% for partial tears? I was not aware of any published studies with that conclusion, but I agree that it may be a useful modality in treatment.

Regarding the to-spay or not-to-spay issue, you are also correct that there is no one answer for every pet and every owner. Some owners are much more well equipped to handle an intact animal - that is, they take extra precautions to prevent accidental pregnancies and educate themselves about potential diseases (pyometra, mammary cancer, etc) so they can seek medical care early on, if needed. However, these owners are in the minority of the pet-owning population, so spaying and neutering remain the best option for large-scale pet health. In addition, we would be remiss as a scientific community if we accepted the results of every study without question - there are very few studies free of epidemiological flaws, so it is imperative to demonstrate repeatability in conclusions before overturning an accepted and decades-old practice.

by ASDMarlene on 12/16/2011 01:56am

Dr. Coates,
since none of the vets I have been to has ever presented the downsides of spaying to me, only the benefits, I wonder how familiar many vets with the downsides are. At least pet owners should be made aware of the risk of incontinence, the increased appetite and tendency to get obese, the changes in coat that can make certain breeds difficult to keep well groomed, the increased shedding, just to name a few. Several service dog organizations have done large scale studies comparing early spay/neuter to later spay/neuter and the negative effects in behavior of the early spaying (6 months or less) were so significant that they no longer perform early spays. there are other studies on the effects of behavior out there, the service dog organizations have never officially published their studies, so they have talked about it. Personally the risk of increased aggression and fearful behaviors alone would make me think real hard about taking the risk to mess with their hormones.

3
Hysterectomy
by ASDMarlene on 12/13/2011 08:45pm

Why not just do a hyesterectomy? It leaves the hormones intact, and by removing the uterus there remains the little risk of a stump infection but no pyometra or pregnancy possible.

by telogen effluvium on 12/14/2011 10:56am

This would be a viable option if pregnancy was your only concern. It would not confer the benefits of preventing ovarian cancer and cysts, reducing mammary cancer, and eliminating heat cycles. STD's would be a concern since the female would still attract males while in heat, and the eventual development of a stump pyometra would be rather likely.

For just preventing pregnancy and heat cycles, artificial hormone supplementation is also an option.

by ASDMarlene on 12/16/2011 01:44am

It would not confer the benefits of preventing ovarian cancer and cysts, reducing mammary cancer, and eliminating heat cycles. STD's would be a concern since the female would still attract males while in heat, and the eventual development of a stump pyometra would be rather likely.

For just preventing pregnancy and heat cycles, artificial hormone supplementation is also an option.

Personally I do not see major abdominal surgery that includes the risk of the bitch dying as a result of it as a reasonable choice to prevent cancer. If anybody would suggest doing that in humans they would be in serious trouble. Eliminating heat cycles is a convenience factor, and really should not be the major deciding factor to subject a bitch to major surgery. STDs are not a concern as attracting males and letting a bitch freely mate with males is not the same. Why does it seem to be so impossible that people simply keep a bitch in heat confined for a few weeks? Running at large is against the law in most places, so any dog should be confined to a fenced yard or be on a leash anyway.

by ASDMarlene on 12/16/2011 01:46am

oops, the first part of my message was what the previous writer wrote, I pasted it into my message so I would know what I was responding to, sorry about that

by dobiehund on 12/22/2011 09:30am

Ovarian cancer and STD s sre rare in dogs to the point of not being a great concern. Mammary cancer rates are not changed for dogs spayed after 2 years old . Cysts would have little affect on dogs with no uterus. If the hysterectomy is done right all the utreine tissue is removed so a stump pyrometra can not happen. I ve had 3 or 4 dogs that have had hysterectomies and they have done fine. The heats are shorter with only a little discharge and there was no weight gain or personality change. A hysterectomy eliminates the possibility of pyrometra, pregnancy and uterine cancer and is a less invasive surgery than a spay. I dont know why more vets and shelters dont offer it. It would get some people to sterilize their animal who wont have a neutered dog

4
pets and hormones
by cesg on 12/13/2011 11:09pm

I have always heard and read that one of the benefits of neutering an animal is the removal of the hormones that cause the pets to less then desirable pets. The desire to mate, to hump everything that will let it, the aggressive defending of territory and resources, wandering searching for mates, etc. I'm am currently dealing with my hormones being out of whack and I can understand why people assign such misery to the situations, but in all the cats I've seen, not one of them seem to miss the fact that their ovaries or testes are gone and that their hormones aren't raging. (and while I don't own dogs, I've never heard of a dog owner lamenting the lack of hormones in a dog)

I figure it is just another one of those situations that humans figure how it works for them must be how it works for everything - which is just not the case.

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About fully vetted

Jennifer Coates, DVM

Photo of Dr Coates

Image credit: Jim Piraino

...graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms: Vet-Speak Deciphered for the Non-Veterinarian. Dr. Coates also writes short stories that focus on the strength and importance of the human-animal bond, and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and various species of pets.

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