Category: dog

Fluid Therapy

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Fluid therapy might just be the most important medical therapy we perform on sick animals. Dehydrated pets feel ill, cannot fight disease, do not eat well, and cannot metabolize drugs efficiently. Dehydration decreases the circulation to two very important organs, the liver and the kidney. These organs are then unable to perform vital functions, some of which include detoxifying drugs and removing waste products.

We give fluids to a wide variety of species in addition to dogs and cats. They can be ill, and need fluids for many different reasons.

This guinea pig being examined by one of our externs has a problem with overgrown teeth and cannot eat well. This has caused him to become dehydrated, and in need of supplemental fluids.

Before coming in for treatment this rabbit was painful from a broken leg and not eating well, so it became dehydrated. Supplemental fluids to correct the dehydration, and a splint to take away the bone pain and allow the healing, were needed to get him back to being a normal bunny again. You can see how we treated his fracture here

Yup, we even give fluids to 120 pythons when they are ill or dehydrated. This is probably not something you want to try at home!

Fun Facts

Before we get started on the specifics, lets go over a little background on fluids.

The body weight of a normal dog or cat is about 60% water, puppies and kittens are up to 80% water. These numbers show the importance of a proper fluid balance for normal physiology, especially in puppies and kittens when these animals become dehydrated.

The fluid in the bodies of normal animals resides in 3 areas:

Inside the cells of an individual organ, called the intracellular space. 65% of the total fluid in the body resides in this intracellular space.

In the bloodstream, called the intravascular space. 25% of the total fluid in the body resides in bloodstream.

In the tissue surround the cells, called the interstitial space. 10% of the total fluid in the body resides in the interstitial space.

When the intravascular fluid is low hypovolemia results. Hypovolemia means the body cannot deliver adequate oxygen to the cells, and a pet can go into shock. If not treated death can ensue. We assess this low oxygen problem with an instrument called a Pulse Oximeter, which measures the oxygen saturation of the hemoglobin molecule in the red blood cells. It should be in the 90 percent range.

This pot-bellied pig, with a 92 % oxygen saturation, and a heart rate of 82 beats per minute, is normal

Pets with hypovolemia are very ill and can exhibit some of the follow symptoms:

Elevated heart rate, called tachycardia.

Slow heart rate, called bradycardia. This occurs when your pet is in the act of dying.

Weak peripheral pulses. We detect this on an exam by palpating the femoral pulses while simultaneously listening to the heart.

Prolonged capillary refill time (CRT). For a normal animal this should be under 2 seconds.

This is how we check the CRT. This pet is under anesthesia, a time when we carefully monitor this parameter

Cold extremities

Low blood pressure (hypotension).

Hypothermia (low body temperature)

When the interstitial fluid is low dehydration results. This is not usually life threatening until the dehydration progresses to around 10%, which now causes hypovolemia. Dehydration is detected during an exam when any of the following occurs:

Tacky or dry mucous membranes (the gums)

Skin tenting

Sunken eyes

Elevated BUN or Creatinine on a blood panel

Elevated hematocrit and total protein

blood sample will also give clues to dehydration, especially the total protein level and the hematocrit.

This is the hematocrit test, checking the percentage of red blood cells in the serum, giving us information on the state of your pet’s hydration

After the hematocrit is measured we break the tube in the middle and place the serum on an instrument called a refractometer to check the protein level. In conjunction with the history, exam findings, and hematocrit level, the protein level helps us determine the degree of dehydration.

Hypovolemia and dehydration can occur independently. A dehydrated patient might not be hypovolemic, and a hypovolemic patient might not be dehydrated.

Our doctors decide on how much fluid to give your ill pet based on the following:

The normal (called maintenance) amount of fluid your pet needs every 24 hours to maintain normal physiology (called homeostasis).

For a dog this is 60 ml for each kg of body weight. For a 20 pound dog this is 545 ml (1/2 of a liter, or 30 ounces) per 24 hours.

For a cat this is 45 ml for each kg of body weight. For a 10 pound cat this is 204 ml (0.2 liters or 7 ounces) per 24 hours.

The degree of dehydration of your pet

A 20 pound pet that is 7% dehydrated needs 600ml to correct this dehydration. This is more than pet owners realize, and why proper fluid therapy is so important when we hospitalize your pet.

Ongoing fluid losses like vomiting or diarrhea. As pet that has been burned has tremendous fluid losses due to seepage of serum at the burned skin area. This ongoing loss is subjective, but it needs to be added to the calculation above if your pet continues to have these fluid losses.

Symptoms of Dehydration

Signs of dehydration include lethargy, anorexia (poor appetite), sunken eyes, sticky gums, constipation, and a general feeling of malaise. It is diagnosed based on a history of anorexia, vomiting, diarrhea, or extra fluid loss, in combination with a physical exam and diagnostic tests. During an exam a dehydrated pet will shows signs of dehydration when the problem is greater than 5 %. The page talks about the two primary methods used to give fluids to pets. The first is intravenous, and is performed only by us in the hospital. This is not a treatment method you will do at home.

Types of Fluids

The type of fluids we will be describing are called crystalloids. This are the kinds most people are used to, and are usually lactated ringers solution (LRS) or sodium chloride (NaCL), and variations thereof that we might use in specific situations.

These are some of the ingredients in LRS

Another type of fluid is called a colloid (hetastarch or hydroxyethyl starch). Colloids are used only in specific situations, which are not common. For the remainder of this page we will be referring to crystalloids.

Intravenous (IV) Fluids

I.V. (intravenous) catheters are used extensively in pets that are sick or those pets that are about to be anesthetized. These catheters allow us to administer medication directly into the venous system for rapid distribution to the whole body. Medication given this way acts faster and is more controllable, a significant advantage for an ill pet or in an emergency. IV administration of fluids is critical in pets that are hypovolemic.

Intravenous fluids are important during surgery. We monitor this closely in many ways, especially with the blood pressure.

If your pet is ill and staying in the hospital, or about to undergo anesthesia for any reason, an I.V. catheter to allow fluid administration is one of the most important therapies we can institute, and can literally be life saving.

This dog getting his teeth cleaned was put on IV fluids before the procedure to stabilize the kidneys for the anesthesia. The fluids are continued for the duration of the procedure, and will be administered until this pet is fully awake and its owner is picking it up.  

The placement of the catheter requires technical skill and knowledge, particularly in small or dehydrated pets (the veins in these pets are small and damage easily). Improper placement of the catheter can literally cause more harm than good. Our nurses excel at placing I.V. catheters in all species.

Because the catheter is introduced directly into the venous system, it must be placed in an aseptic (sterile) manner. The hair over the vein is shaved, and special tape is placed over the catheter. 

Comfort is also important when placing the catheter due to the small nature of some of our patients, and the duration the catheter must stay in the vein. This tape and catheter is constantly monitored by our staff for comfort and sterility. After 3-5 days we usually replace the catheter in order to minimize the chance of the catheter causing an infection. 

I.V. catheters are usually placed in one of three veins:

Cephalic Vein-This is by far the most common vein to use. It runs along the top of the foreleg of dogs and cats. The illustration below shows the placement of this catheter in a large dog.

Jugular vein-This vein is in the neck. A catheter placed in this vein allows longer term use and the ability to give larger volumes of medication with different viscosity’s.

Saphenous-This vein is on one of the back legs. It is mostly used when the cephalic vein is unusable, but can be used at any time.

Various other veins are sometimes used, by they are reserved for some of the more unusual species of animals we deal with. In some of these pets like birds, that have minuscule seized veins, we cannot give the necessary emergency fluids intravenously. In these cases we use what is called an intraosseous catheter. This catheter goes directly into the bone marrow, and allows us to give the necessary fluids to a small creature rapidly and effectively. In birds it is put in what is called the tibia tarsal (tiboitarsus) bone. This is equivalent to our tibia or shinbone. It is put in at the knee joint.

This radiograph shows the placement of an intraosseous catheter. It is going down the shaft of the tibiotarsal bone in this bird that came in collapsed and in shock. The bird responded and recovered completely after we administered fluids through this catheter. 

Your pet’s catheter will stay in for the duration of its hospitalization or procedure, and will not be removed until you return to pick up your pet. Your pet may go home with a small piece of tape and cotton where the catheter was. It can be removed several hours later after you return home.

We use many different types of fluids, the most common one being Lactated Ringer’s Solution. The amount of fluids given are calculated and  monitored carefully.  We use a special fluid pump that gives a consistent amount of a period of time.

Each patient receiving fluids has a custom fluid chart outside its cage for close and constant monitoring of the fluids. Our doctors make adjustments in the type and amount of fluids as diagnostic tests like blood panels, and your pet’s response to treatment, are analyzed. 

Subcutaneous (SQ) Fluids

The second method used to administer fluids is subcutaneously (under the skin) between the shoulder blades. The administered fluid slowly absorbs over several hours. In this hospital and on an out-patient basis, this method is used for pets that are not seriously ill, but just need some additional fluids to maintain hydration, fight a fever, or stimulate the appetite.

If your pet needs to be on SQ fluids on a long term basis due to a chronic disease, think of it as bonding time and make it a positive experience

This section on SQ fluids contains  detailed step-by-step descriptions on how to give fluids at home on an ill pet, an older pet, or a pet with kidney disease. When you first read it you might think there is no way I can do all of that. Once you observe us do it in front of you, and then do it yourself, you will realize it is not anywhere is difficult as you think when you read about it the first time.

This video is how we give sq fluids at our hospital. Notice how calm this dog is.

SQ fluids are of special benefit for pets that need long term fluid administration at home, usually older (geriatric) cats or those with kidney disease. This is the animal version of dialysis in people, and it works extremely well. These fluids at home are highly beneficial, and have had cats with chronic kidney disease do well for years with this treatment at home.

If your doctor feels your pet needs SQ fluids at home you will be taught how to administer them by our nursing staff. At first it might seem an impossible notion to give your pet fluids at home. Not only is there the psychological fear of using a needle, or worry about hurting your pet, there is also a worry that your pet will not stay cooperative long enough for the few minutes it takes to give the fluids.

Rest assured that you will not be forced into giving these fluids if you feel uncomfortable, although we have yet to encounter a client that was not able to perform this procedure at home. This is because we have extensive experience in this area, and we teach you at your own individual pace. Only when you feel you are ready will you proceed on your own.

You will be given as many personal demonstrations as necessary, and can return to the hospital at any time for further demonstrations or to make sure you are performing the procedure properly. You are welcome to bring your pet in at any time for assistance in giving the fluids, so do not feel you are on your own. If you are out of town, your house sitter can bring your pet in for these fluids. We consider you part of our nursing team and are willing to give any assistance needed. Before you are given a live demonstration the following basics will help prepare you.

The scariest part of the whole procedure for most people is the actual insertion of the needle into the skin so that the fluids flow under the skin (SQ). You will watch us do this as many times as you need to overcome any fear you might have. When you realize it is not all that difficult by watching us do it, we will hold your hands when it is your turn if needed.

Practicing by inserting a needle into an orange or similar fruit can be helpful. Different sized needles, ranging from 22 gauge to 18 gauge, are used to give SQ fluids. During the demonstration we will show you which one works best for your pet.

The 18 gauge needle, at the top, has the largest diameter. Fluids flow fast through this needle, taking less time to give them. If this size needle is uncomfortable for your pet, we will try the 20 gauge next because it is smaller, although the fluids will flow more slowly. On small pets we might even use the 22 gauge needle. 

During this demonstration you will be told exactly how much fluids to give. For most cats with chronic kidney disease, this is 100ml once or twice daily. The fluid bag has 1000ml (1 liter), so for the average cat you will be able to give these fluids for ten days. This might vary depending on many factors, and your doctor will determine the amount and frequency. Do not change this unless instructed to.

Keep children and other pets away if they are disruptive during the process of giving the SQ fluids at home. Have all of your equipment readily available, usually on the same table as your pet. Depending on the size of your pet, the table should be around waist to chest high. It is helpful to set up one area of your house to give the fluids. Hang the fluid bottle in this room for easy access. It should be at least a few feet above the table for optimum flow. You will be shown how to set this up by one of our staff.

Store the fluid bag at room temperature and cover the bag so no light hits it. We sometimes add medications like vitamins and electrolytes to the bag, and light can affect them.

When you purchase a fluid bag from us it needs to be set up with the IV line. We will show you how to do this in person. You only need to set it up when you purchase a new bag. After that, you give the fluids with a new needle each time, keeping the IV set attached, until the bag is empty.

Never use the needles more than once since they are sterile and very sharp when first opened. Repeated use could cause an infection in your pet, and makes the needles dull, causing discomfort on administration. Needles are inexpensive, so don’t take the chance by re-using them.

When you purchase the bag it comes wrapped in a plastic wrapping. Remove the wrapping at home when you are ready to set it up to give fluids to your pet. After you remove the outer wrapping lay the bag on your table or hang it from a coat hanger. 

Open the sterile IV set and lay it on the table


These are the components of the IV set

The large white end with clear receptacle goes into the fluid bag once the white cap is removed. The clear container above will be filled part way with fluid once attached. 

 At the opposite end of the IV line is a small blue cap. You remove this blue cap when you attach a needle, which you will learn about later. 

The large blue plastic piece in the center allows you to turn the flow on and off, and also adjusts the rate of flow. Make sure the white wheel is in the off position like this when first setting it up. 


Remove the white plug from the bottom of the bag. The cap is in solidly, so you will need to pull hard to remove it.

 You can do this while the bag is hanging, or while it is laying on the table. Discard the white cap, it will not be used again. 

Remove the white cover from the IV set receptacle. It is sterile, so do not touch it to anything at this point. 

Hold the hanging bag steady, or lay it flat while doing this, so you can put it straight in without touching anything else. 

Insert it all of the way into the fluid bag 

Hang the bag, then squeeze the receptacle until the fluid fills half of the receptacle

It should look like this when you are done

Lay the needle next to the end of the IV set that has the blue cap

Remove the clear plastic at the base of the needle by twisting it either direction. The open base of this needle is sterile, so do not touch it to anything until you insert it into the IV line. 

Remove the blue cover at the end of the IV set. Turn the fluids on and let a few seconds of fluids flow through the IV line to remove the air. Let these few drops flow into a small bowel or on to a towel. Do not touch the end of this line to anything. 

A few air bubbles left inside the IV line will not cause any problems 

Insert the needle straight into the opening. Hold you left hand still as you twist clockwise with your right hand to lock it tight

Hang the IV set over the fluid bag. You are now set to give the fluids. 

Every pet reacts differently to the actual giving of the fluids, and they feed off of your emotions, so cool and calm usually works best. If either one of your gets worked up, stop and try again later.

Make sure the location to give the fluids is subdued and calm, with no excessive lighting or noise to alarm your pet. Take your time by bringing your pet to the table and interacting with it by petting it and holding it. You can even feed it while giving the fluids. A towel for restraint, or another person holding the head, might even be appropriate.

Hold your pet to the side, make a small tent of the skin between the shoulder blades, remove the cap over the needle, and rapidly insert the needle between the shoulder blades in one motion.

Insert it all of the way in until the hub touches the skin. Turn on the fluids completely on by moving the white wheel all the way to the top, and give the prescribed amount of fluids. For most pets, this takes only a few minutes of your time daily, a few minutes of your time that will be highly advantageous to your pet. 

When you are finished giving the fluids remove the needle from your pet and cap it. Remove the used needle and place a new sterile needle at the end of the IV set, and hang the IV set over the bag as before. You are now ready to give the fluids again the next time one of our doctors prescribes.

Finally, pat yourself on the back for a job well done, have a seat, and breathe deeply (or get a stiff drink if needed to calm your shaking hands).

Place all used needles in a safe place with no access to children or pets. A sharps container to hold these needles is the best place to put them until disposal. Dispose them according to the guidelines in your community. Here are some local disposal centers for needles. If you are not near one of these areas call us at 562-434-9966 for other locations:

EDCO Recycling and Transfer Center

2755 California Ave.

Signal Hill, CA 90755

562-597-0608

L.A. County Sheriff- Lakewood Station

5130 N. Clarke Ave.

Lakewood, CA 90712

Huntington Beach Collection Center

17121 Nichols Lane

Huntington Beach, CA 92647

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Gall Bladder Removal in a Dog

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Surgical removal of the gall bladder is called cholecystectomy. Most of us have heard of gall bladder surgery in people. It is not as common a surgery in animals. This page has pictures of a surgery to remove the gall bladder in a dog. At the end of this page you can see what gall stones look like.

Graphic surgical pictures on this page.

Our patient is an 11 year old Silky Terrier that came to us with some significant symptoms. They included anorexia for several days and lethargy. Her initial blood panel showed high elevations in Alk Phos., AST, and bilirubin.

Her blood panel is typical of a dog with this problem. You can see the significant elevations in her liver enzymes and bilirubin. Even the electrolytes are abnormal.

Her urinalysis showed significant amounts of bilirubin 

We could see hepatomegaly on her radiograph. Initial treatment consisted of antibiotics, fluids, vitamin supplements, and I/D food. Heather rapidly got better on the treatment.

This is what the liver looks like on an abdominal radiograph

She had a recurrence of the problem 3 weeks later. At that time an ultrasound was performed and it was determined that she had a  problem with her gall bladder.

Her gall bladder, the dark area on the top left had a problem. The line in the center is measuring the size of her common bile duct, which is large in her case. 

This is her ultrasound report

She responded well to treatment with antibiotics and actigoll. When her enzyme test were almost back to the normal range we removed her gall bladder.

Before we do any surgery on the liver we make sure the clotting system of the body is working well. The liver is intimately involved with the bodies clotting mechanism, and we need to make sure we are not going to encounter a severe bleeding problem during and after surgery. This test is making sure her red blood cells are adequate (no anemia is present), along with the 4 clotting tests on the bottom, starting with Prothrombin Time. 

Our patient is now ready for gall bladder removal This is a specialized surgery that is tedious and requires an experienced surgeon. In Heather’s case we called in Dr. Linda Larsen, a specialist in surgery.

Dr. Larsen is a board certified surgeon, and experienced at this surgery

Monitoring of anesthesia is critical in an older pet with liver disease. Monitoring Heather’s blood pressure is an important aspect of anesthesia.

Surgery-Monitor

We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.

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Once our surgeon has scrubbed up and is  in sterile gown, gloves, and mask, the surgery begins

The incision into the abdomen is made at a special location called the linea alba. It is here that the tendons of the stomach muscles come together, and will hold the sutures after we close the abdomen.

The swollen liver is apparent as soon as she enters the abdomen

The first thing our surgeon does is locate the gall bladder

Now the careful dissection of the gall bladder starts so it can be removed

After careful dissection it almost full exposed at this point

As dissection of the gall bladder continued she traced it down to the common bile duct. The arrow points to the gall bladder under our surgeon’s finger. The vertical bluish structure below the gall bladder is the enlarged common bile duct.

The bile that is stored in the gall bladder is removed with a suction apparatus. This allows better visualization.

When she is satisfied with the exposure she puts several very strong sutures where the gall bladder attaches to the liver

Here is the trouble maker after it has been removed


A biopsy is taken of the liver to give us substantial information as to its health

The abdomen is flushed many times to remove any contaminants 

The long incision in the linea alba is sutured. After this layer, there are several more layers of sutures placed in the subcutaneous tissue and the skin.

At this point our patient is given a local anesthetic on the suture line, an additional pain injection, and the skin incision is treated with companion laser to decrease swelling and aid in healing,. You can its use on the video below.

Gall Stones

This is a different gall bladder removed from a different patient. This gall bladder was thickened due to stones in it.

The inside of the gall bladder after removal. The chronic thickening is apparent.

These are the gall stones that were found inside of it

The pathology report on this gall bladder

This is the analysis of these stones

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Labrador Retrievers

Labrador Retrievers are one of the most popular breeds we care for at our hospital. They are predisposed to certain diseases though, so careful observation of your pets daily routine is important. Any significant change in this routine is cause for an examination. Our web site in the Diseases Section has detailed information on many of the diseases they are prone to.

Labrador Retrievers are susceptible to hip dysplasia, a disease characterized by malformation in the hip socket, which eventually causes arthritis.  The symptoms of this disease can vary, from a pet that is just not as active as it should be, to a dog that can barely get up after laying down. This breed also gets joint problems in other bones, particularly to the elbow joint and shoulder joint. Problems here are usually manifested by limping in the front legs. A physical exam and x-rays will help make the diagnosis.

If your young lab seems lethargic, disoriented, or just not with it, especially after eating, it might have a liver disease called a portosystemic shunt.

Unfortunately, the also can get a malignant cancer of the lymph nodes called lymphosarcoma. Please refer to our Learning Center to learn how to perform a lymph node exam. One of our doctors will help you find them.

Active labs that run and jump vigorously are prone to tearing a ligament in their knee call the cranial cruciate ligament. This occurs where there is a twisting or tweaking motion. Symptoms range from a subtle lameness to complete limping.

Labradors are also at risk for several eye problems including PRA (Progressive Retinal Atrophy), cataracts, and retinal dysplasia. All of these eye problems manifest themselves by a loss of vision. If we suspect one of these problems we will refer you to our ophthalmologist. Hereditary cataracts can also occur. The problem can occur at an early age, and while cataracts may or may not interfere with the dog’s vision, some do progress into severe or total loss of vision.

Labrador Retrievers can also have an inherited deficiency in one of the clotting factors of the blood. Dogs affected with this disease may have symptoms varying from very mild to severe bleeding.  If your pet bruises easily or bleeds excessively, this disease is a possibility.

Hypothyroidism, a metabolic disease characterized by inadequate thyroid hormone circulating in the bloodstream, is common in the breed. Symptoms include obesity, lethargy, and/or coat problems. Affected animals may also have various reproductive problems, including irregular or absent estrus (heat cycle), and lack of fertility.

Other hormone problems include Hyperadrenocorticism (Cushings), Diabetes Mellitus (sugar diabetes), and insulonima (causing low blood sugar). Symptoms vary, and usually include excess drinking and urinating.

If your Lab is underweight and regurgitates its food it might have an esophagus problem secondary to myasthenia gravis.

This breed is prone to many skin problems, particularly allergies and hot spots. The usual symptoms are excessive scratching, flaky or bumpy skin, an odor to the haircoat, and hairloss. Also watch for a lack of pigmentation on the nose or flakiness to the nose.

Run your hands over its haircoat daily because they can even get a malignant skin cancer called a mast cell tumor. These can appear as minor bumps or areas of inflammation, yet they can be highly malignant.

A vast array of eye problems can occur. Any discharge, redness, swelling, squinting, or pawing at the eyes is reason for an immediate exam.

Labs are also prone to ear trouble, which can be very painful without your realization. Any sign of head shaking, pawing at the ears, inflamed ears or odor requires veterinary attention. Daily checking for odors or discharge, and proper cleaning when needed, will help prevent this problem.

Several different types of heart problems can affect them. Look for symptoms of lethargy, exercise intolerance, coughing, and poor appetite as a clue.

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Dachshunds

Doxies are full of personality. They are predisposed to certain diseases though, so careful observation of your pets daily routine is important. Any significant change in this routine is cause for an examination. Our web site in the Diseases Section has detailed information on many of the diseases they are prone to.

They are susceptible to a problem with their spinal cords called Intervetebral Disk disease (IVD). This is a serious problem that can lead to paralysis. Symptoms can include lethargy, lack of appetite, crying or whining, reluctance to move or jump, or even anxiety, is cause for immediate examination. Please use our web site to learn much more about IVD.

Several different types of heart problems can affect them. The most common is one called a Patent Ductus Arteriosis (PDA). Look for symptoms of lethargy, exercise intolerance, coughing, and poor appetite as a clue.

This breed is prone to many skin problems, particularly allergies and hot spots. The usual symptoms are excessive scratching, flaky or bumpy skin, an odor to the haircoat, and hairloss. Run your hands over its haircoat daily because they can even get a malignant skin cancer called a mast cell tumor. These can appear as minor bumps or areas of inflammation, yet they can be highly malignant.

Hypothyroidism, a metabolic disease characterized by inadequate thyroid hormone circulating in the bloodstream, is common in the breed. Symptoms include obesity, lethargy, and/or coat problems. Affected animals may also have various reproductive problems, including irregular or absent estrus (heat cycle), and lack of fertility.

Two other hormone disease that can occur include Cushing’s disease and Diabetes Mellitus (sugar diabetes). Symptoms here vary, but commonly represent as excessive thirst and urination.

Many cancers can occur and affect a wide variety of organs. Look for lumps or bumps on the skin, mouth and anus. Also check the feet for swelling of the toes or lameness because they can get a cancer called Squamous Cell Carcinoma.

A vast array of eye problems can occur. Any discharge, redness, swelling, squinting, or pawing at the eyes is reason for an immediate exam.

Doxies can also get a bladder stone (called urolithiasis). Look for symptoms of straining to urinate, blood in urine, licking, or urinating small amounts frequently.

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Canine Spay Long Beach CA

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Long Beach Animal Hospital offers canine spay services for dog owners in Southern CA

One of the most common surgical procedures we perform on dogs is a spay, known medically as an ovariohysterectomy (removal of the ovaries and uterus). We usually abbreviate it as an OVH.

It is performed for several medical reasons:

  • It prevents dogs from going into heat
  • It prevents dogs from getting pregnant
  • It significantly helps prevent dogs from get breast cancer later in life

canine dog spay Long Beach

The arrows point to two lumps at the mammary glands that are cancerous

It prevents dogs from getting uterine infections later in life. An infected uterus is called a pyometra, and is a serious disease. After you view the pictures of a routine surgery on this page you will be given an chance to see a picture of the uterus of a dog that has a pyometra at the end of this page.

In addition to these medical reasons, it prevents unwanted pregnancies, a significant problem in our society. Millions of dogs are euthanized every year because they are strays.

We usually spay a dog when it is around 6 months of age. This timetable is variable, the important point is to perform the surgery before it goes into heat. The ongoing old wives tale that states dogs should go into heat before spaying is incorrect. Most dogs go into heat starting around 9 months of age, and do it twice each year.

On the day of surgery we need your dog in the hospital between 7:30 AM and 8 AM. Please take away all food when you go to bed the evening before surgery. Let your pet have water during the night. Do not give your dog anything to eat or drink the morning of surgery.

Our surgeon will call you after the surgery is complete and your dog is awake. It can go home in the late afternoon the day of surgery. Please call our office at 4 PM for pickup time, you will be given written post operative instructions then. We are open in the evening if you need to pick up later.

This area contains graphic pictures of an actual surgical procedure performed at the hospital. They are put here to show you that this is major abdominal surgery, and not “just a spay”.

Pre-surgical Preparation

We need you to come in to our hospital so one one of our doctors can examine your pet several days prior to surgery, go over any questions you have, and submit a blood panel to our lab to make sure all important organs are functioning normally and your pet is ready for anesthesia and surgery.

dog spay Long Beach Ca

Dr. Wood  is carefully checking the heart rate on this dog as part of this exam

The blood panel is very thorough and checks many organ systems

Surgery Day

Pre-anesthetic preparation is important in every surgery we perform, no matter how routine, because surgery is not an area to cut corners. On the day of surgery all of our spays receive a physical exam just prior to surgery.

canine spay Long Beach Ca

Talia and Dr. Kennedy are performing this exam just prior to giving anesthesia

 When everything is to our satisfaction we will administer a sedative. This will calm your pet down and make the administration of the actual anesthetic, along with post operative recovery, much smoother. Once your pet is anesthetized, prepared for surgery, and had its monitoring equipment hooked up and reading accurately, the surgery can begin.

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Once our surgeon has reviewed lab data and performed a physical exam he starts his sterile scub while our patient is being anesthetized

After scrubbing and gowning instruments are prepared.

When our surgeon first opens up the pack he checks to make sure the gauge confirms that the instruments have been properly sterilized by our autoclave

OVH-rabbit-3

After this confirmation the instruments are organized and the scalpel is put on the scalpel blade handle

Our surgeon is ready to start before our patient is at a proper plane of anesthesia. Once the anesthetist gives the green light the surgery starts immediately. We want our surgeon waiting for his patient, not the other way around.  All of this is to minimize anesthetic time.

Anesthesia

We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.

Surgery-Monitor

This machine monitors:

Temperature

Heart Rate

Heart rhythm

Oxygen saturation

Carbon dioxide level

Respiratory rate

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In addition to our monitoring equipment our anesthetist stays “hands on” in monitoring important physiologic parameters like heart and respiratory rate and quality

She also checks something called Capillary Refill Time to make sure the heart is pumping enough oxygenated blood to the organs. When she presses on the gums to make them blanch white for a second, she measure how long it takes them to go back to their original pink color. It should be less than two seconds. 

We have a detailed page on anesthesia to learn more.

Surgery

Every major surgery we perform begins with proper patient preparation. This will help prevent infection, which could be a serious complication in this surgery because during a spay we have an opening into the abdomen.

Our nurse is using a special cleaning agent and scrubbing the skin 3x in a circular motion. After our patient is clean our surgeon completes the draping. 

When our surgeon is comfortable that everything is in order he starts the sterile draping procedure

The surgeon makes an incision near the umbilicus (the belly button). We try to make our incisions as small as possible to minimize anesthetic time when we suture the incision, decrease post operative discomfort, and minimize healing time.

The final layer we need to cut before we are actually into the abdomen is called the linea alba. It is an area of muscle in the center of the abdomen that is covered by a tough layer of tendinous tissue. This is the most important layer resutured at the end of the surgery because it is the only layer strong enough to hold the abdominal muscles together to prevent a hernia. In this picture the linea is being held up with a forceps and a scalpel blade (held upside down) is being used to make the incision.

A scissors is commonly used to extend the linea incision and facilitate exposure to the abdomen. Care has to be taken not to puncture internal organs like the bladder.

The incision is complete and our surgeon is holding up the cut linea, and now has access to the abdomen

 A special instrument called a spay hook is utilized to gently pull one of the uterine horns through the abdominal incision. This lets us keep the incision small.

The spay hook is traced into the body cavity until the ovary is found. It has to be gently teased from its location near the kidneys in order to be able to pull it out through the abdominal incision. In older dogs this part of the procedure is more difficult.

The ovaries and uterus are buried in fat. The arrow points to the ovary.

Once the ovary is completely exteriorized two clamps are put below the ovary. You can see the ovary above the top clamp. These clamps are were the sutures will go and allow us to cut the ovary away. 

A third clamp is put above the ovary to control bleeding when we cut the ovary away

The two lower clamps have been removed and you can see where our surgeon is tying the second of two ligatures. We always use two ligatures for safety reasons, and is one of the ways we do not cut corners on this surgery. 

You can see the knots from our two ligatures

When our surgeon has confirmed that both knots are secure the ovary is cut away. This is repeated for the ovary on the other side.

With both ovaries removed our surgeon works on the body of the uterus at the cervix. The arrow points to the cervix where two sutures will be placed.  Everything above the arrow, which includes both ovaries under the surgeon’s thumbs, will be removed. 

You can see the extensive blood supply to the body of the uterus

The uterine body is double ligated just like the ovary. Everything above the top suture in this picture will be cut away. 

Our surgeon checks to make sure there is no bleeding before placing the remainder of the uterine horn back in the body cavity

Suturing the muscle layer back together at the linea alba is crucial in order to prevent a hernia. You can see the needle coming through the linea alba, which is the whitish area. The abdominal muscles do not have the strength to hold the suture like the linea alba. 

This is what the linea alba incision looks like a after all of the sutures have been carefully placed. The subcutaneous (the fatty area just under the skin) is now sutured as a second layer of strength to prevent a hernia.

The third layer of sutures are called subcuticular because they are put just under the skin. These will dissolve on their own and your pet does not need to come back for suture removal. Being just under the skin they are also harder for your pet to pull out. 

All of our pets that have abdominal skin incisions are given cold laser treatment before they wake up from anesthesia. This decreases post operative pain and swelling and aids the healing process.

We use the companion laser in many different surgeries. In this video it is being used after a laser neuter.

During the procedure your pet is given a pain injection, which will be in full effect when it wakes up. This pain injection, along with oral pain medication you will receive when you pick up your pet, works well to keep your pet comfortable during the night. Your pet might seem quiet and groggy during the night because of this medication.

Post Operative Care

After surgery our surgeon will call you. When you pick up your dog you will be given a chance to talk to one of our staff and you will also be given detailed post operative instructions.

Most dogs go home late in the afternoon on the day we perform the surgery. They might be groggy from the pain injection which is advantageous because they will remain calm and allow the healing process to start immediately. By the following morning the grogginess will have worn off. If your pet has an E-Collar leave it on until healing is complete.

When you first get home do not be in a big rush to feed. After 1 hour at home offer a small amount of food and water. If the appetite is good, offer more several hours later. Do not over do the feeding the first night because anesthesia can make them nauseous.

Keep contact with children and other pets to a minimum the first night, and restric activity for several days to allow the incision to heal. Do not let your dog go outside until healing is complete.

We have a page called Home Care of the Surgical Patient to give you much more information.

Infected Uterus (pyometra)

This is a picture of a uterus in a female dog that has an infected uterus, called a pyometra. The uterus is completely filled with pus, and this dog is very ill.

It turns out that the uterus in this case had already ruptured before the owner brought it in for diagnosis and surgery. This causes sepsis, and can easily lead to death. This patients need intensive medical care prior to surgery, which includes intravenous fluids and antibiotics, in addition to pain medication.

This is the original incision in the dog above. The inner lining of the abdomen, called the peritoneum, is severely inflamed and infected. This is called peritonitis. This is painful, and can lead to shock and death. 

There is so much inflammation that the abdomen is filled with fluid (called ascites) and our surgeon needed to suction this fluid before she could visualize the internal organs properly and bring out the grossly distended uterus you saw above. 

A diagnosis of pyometra is made based on several findings. There is a history of being in heat a few months prior, along with lethargy, lack of appetite, and sometimes even vomiting. Most dogs will be drinking and urinating excessively because of the toxic effects of the infection on the kidneys. These toxic effects on the kidneys are usually from an anaerobic bacteria called E. coli (Escherichia coli).

A blood sample will commonly show a very elevated white blood cell count. This is called leukocytosis, and is a major clue to a pet that has pyometra.

This blood panel is from the dog with the ruptured uterus above. It has 30,000 white blood cells (WBC’s), when the high end of normal is 16,000

Abdominal radiographs (X-rays) are also used to make a diagnosis. Normally you cannot see the uterus on a radiograph. Click here to learn why from our X-ray page.

The enlarged and pus filled uterus can be seen in the red circle. 

If you would like to learn more about how we do surgery at the Long Beach Animal Hospital on a wide variety of animals please follow this link.

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