SCROTAL NEUTERS IN DOGS This is a subject that is on the minds of many of us and one that I can address with the confidence that comes from years of experience. I started my practice limited to surgical sterilization in 1976 and the sterilizations performed by my associate and I now number in the 100,000s. I have done many dog neuters with the traditional procedure. In 1991, I started performing scrotal neuters and immediately recognized the advantages. Since then, all dog neuters at all my clinics have been scrotal entry. It is a much easier surgery with less trauma, and post surgery complications are rare rather than occasional. I was able to completely give up the use of the clumsy, restrictive, humiliating and house-destroying Elizabethan Collars. Through my instructional program, I have introduced the procedure to over 100 veterinarians, some of whom not only adopted the procedure, but also passed it along to their colleagues. Perhaps the biggest hurdle is to stand up for the appropriateness of the approach to colleagues who are not open to innovations in surgical techniques. Some feel that if it is different, then it must be wrong and attack it at all costs. They are not giving credit to those of us specializing in this field who are adopting a new and superior technique. The fact that the approach is not widely recognized is also a problem. It is championed by a small, close-knit group of specialists who share their experiences and advances in their field. How do we begin to educate the DVM who is just sure that we have landed from another planet? To those who believe that pre-scrotal is the only acceptable way, ask them to name any other animal we work with, large, small or exotic, that we neuter with the pre-scrotal approach. There are none. Then ask why they suppose that the profession has made the dog an exception. The probable answer has to do with sensitivity, self-mutilation, etc. I respond with the fact that I thought that same thing for years, but now know that to be one of the most unfounded continuing myths in our profession. I was shocked to discover that I was flat wrong…but it was a pleasant surprise. The statement, “We have always done it that way, therefore it must be right” is shameful. Please consider these facts: Canine Surgery, second edition, Archibald, was the veterinary schools’ reference text in the 1970s. He describes “a second method of castration, a skin incision is made over the neutral aspect of the scrotum…”. The spay/neuter specialty was generally scorned by colleagues and it was many years before volume spay/neuter clinics came into the main stream of special services in our profession. As they become more established, changes and refinements are inevitable. No veterinarian has been exempt from castration “issues”, large or small, be it the stitch, clipper burn or hematoma; however, where the incision is located is not ever the issue. The approach is not the issue. The veterinarian who claims to have had zero complications has performed very few neuters. That there are no published studies is unfortunate but also not the issue. We do what we see works and my associates and I have successfully used the scrotal approach for over 17 years. Two years ago, a junior vet student at U.C. Davis spent two days observing at my clinics. She took her observations to the U.C. Davis veterinary surgeons and, although none of them had tried the procedure, none of them saw a fundamental problem with the scrotal approach! |