— By Dr. Henri Bianucci, Board-Certified Veterinary Surgeon
Q: I recently had my dog spayed by a veterinarian at (name deleted) veterinary hospital. I have no issue with the job that they did. My dog recovered well, the scar is very small, and she has had no problems.
This is my first dog, and I am just learning the various options regarding pet health care providers. I did not know that there were dog surgeons, and I am now wondering if I should have had this spay done by a specialist. I know it’s a common procedure, but it's still a hysterectomy.
A: This is a question that I (Henri Bianucci) hear all the time. I recently read a study in a human medical journal that compared the rates of successfully complete colonoscopies between two gastroenterology centers. One was a long-established facility but had no specialists on its staff; the other was newer and staffed entirely with board-certified specialists. In that report, the success rate was actually greater for the clinic without specialists.
The explanation for this example is, of course, experience. The nonboarded doctors performing colonoscopies were doing far more scopes every year than the newer clinic, and had been doing so far longer.
So, back to the question at hand. As a board-certified veterinary surgeon, the cases that come to me are referred by general practitioners who don’t have the experience, equipment or time to do them.
What is an unusual surgery in a general practice is relatively common for us. I spent the greater part of a recent Saturday repairing a shattered spinal fracture on a dachshund. While placing pins into the vertebrae, I used familiar landmarks to guide me so as not to skewer the spinal cord in the process. In these areas, surgeons feel at home. Likewise with implanting a hip replacement, taking out a lung tumor, plating a fractured bone or performing intestinal surgery.
Every day for the past 18 years, some variant of the above cases awaits me. I know just how much liver I can remove with a single suture. By feel, we determine if a tumor is going to separate easily, or tear the blood vessels as it is removed. By its change in color, we can see if a wire will break if it is twisted any further.
With time, we develop sensitivities of smell, touch, sight and sound that serve as guides as we navigate various procedures. Spays are no different. When removing the ovary, there is a small ligament that must be gently stretched and ruptured. One has to apply just the right traction. Too little, it won’t tear, too much and you rupture the ovarian artery, or worse, tear away a kidney.
As a referral surgeon, I am occasionally asked to spay a dog or a cat “while you’re in there.” So, I do a smattering of these procedures each year. Many, if not most, referring veterinarians do more spays in a day or a week than I do in a year. With those numbers, specialist or not, one develops the intangible skills and sensitivities that makes one truly expert in the procedure. The result is an efficient, quick and minimally invasive procedure.
With any surgical procedure, go where the experience is. Sometimes that’s your vet, sometimes it’s a specialist. Nobody is an expert in everything, but when it comes to spays, the general practice vet is generally the best bet.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.
