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Date:   11 February, 2009
Focus: Small animals - dogs, cats, hamsters & rabbits

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Case 1. A Bitch's First Heat
Case 2. A Cat's First Heat

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:  11 February, 2009
Case 1. A Bitch's First Heat - Should she be spayed when she has bleeding? 

Case 1 was first written in 11 Nov 2003 when a digital camera was first purchased. Pictures of a spay done by Dr Sing Kong Yuen in 11 Nov 2003
 to educate dog owners regarding spaying in their female dog.

Jack Russell X chihuahua one-year-old, Singapore.  Before spay.

Swollen vulval lips and the vaginal bleeding for the past 7 days indicate that estrus has set in. The bitch is "on heat" and may conceive if mated. The owner decided to spay the bitch as the bleeding stains dirty the house. 

Use of spay hook reduces surgical opening of abdomen

The hook catches the left uterine horn. It is pulled through the incision. The left ovary, being part of the reproductive system follows through and is then pulled out. 

Small skin incision if a spay hook is used to sterilise the bitch. Toa Payoh VetsA tranquiliser and then gas anaesthesia is given. 

The vet cuts the skin and peritoneum near the umbilicus with a scalpel. This "keyhole" incision of about 1.25 cm for a small breed, permits the  spay hook to enter the abdomen.  

The vet fishes out the left uterine horn from inside the abdomen using the hook.
The ovarian ligament anchors the ovary tightly to the abdomen

The fingers pull out the remaining part of the uterine horn and the ovary. The ovarian ligament is broken so that the main body of the ovary can be detached and clamped. 

The rest of the uterine horn is then pulled out. 

The right ovary and uterine horn are then removed in the same way. 


It is best not to spay a bitch during estrus.

The ovaries and uterine horns in the estrus period are larger and have bigger and more fragile blood vessels.  

Two layers of stitches or one, over the muscle and skin close the incision. The nylon skin stitches are removed in 14 days' time by the owner or the vet.

UPDATE:  From 2003, Toa Payoh Vets use absorbable skin sutures which will dissolve after 14 days and do not need to be removed.

The bitch's first heat in your apartment

Dirtying the apartment with blood stains is the main complaint

The bitch will become sexually mature from 6 - 8 months and will pass bright reddish blood from her vagina.

You may wish to spay her

1. to benefit from a large decrease in the annual dog licence fee payable.
2. to prevent pregnancy if you have a entire male dog around.
3. to keep the apartment free from blood stains for the around 10 days for around every six months till the bitch is old.
4. to maintain her trim body condition.  The usual observation is that a mothering bitch will have large nipples and some owners do not like this situation.       

WHEN TO SPAY? When is the best time to spay your bitch?  This is a frequently asked question with many answers varying from 4 - 18 months old depending on the concerns of various organisations:

1.  THE INTEREST OF THE REGULATORY AUTHORITIES & ANIMAL SHELTERS.  For stray bitches and cats, the earlier the better to reduce the stray animal population.  4 weeks of age to spay a stray cat and 8 weeks to spay a stray dog have been recommended.    

2.  THE INTEREST OF THE BITCH.  I would say that the best time will be after the bitch has matured mentally as an adult and this will be around 1 year of age for the smaller breeds like the Maltese and 2 years for the Labrador Retriever. However, sexual maturity occurs at 6 - 8 months old. 

Shih Tzu X Silkie. 7 years. Mammary tumours, nodules. MG4. Toa Payoh VetsIf the female is spayed before maturity, e.g. at 4 months of age, the urethra will not have developed to its adult width and consequently, some females have difficulty in passing urine.

There are internet articles saying that the chances of the bitch getting breast cancer is higher if the spay is after the first heat. Mastectomy in older dogs with breast cancers costs money and trauma to the owner.

3.  THE INTEREST OF THE DOG OWNER. The dog owner may feel that it is un-natural and cruel to neuter the bitch. There is the worry of the obesity, lack of vigour, inability to control bodily functions and debilitating lifelong health problems after spaying. Some spayed bitches do suffer from urinary incontinence and itchy skin problems similar to symptoms suffered by women after menopause, but there are medication available. 

The owner may may use dog sanitary pads available from the pet shop when the bitch is on heat. Family members dislike the blood stains dirtying the house for around 10 days when the bitch is in heat and there is a lot of cleaning up to do. 

However, the yearly dog licence for a spayed bitch in Singapore is much lower and this is a powerful economic incentive to spay. 

1. The yearly dog licence for a sterilised male or female dog is S$14.00. Previously, the male dog was S$14.00 whether he was neutered or not.
2. Non-sterilised male and female dogs - the licence fee is S$70.00
3. If the puppy is licensed before 5 MONTHS of age, the licence fee is S14.00.

4.  THE INTEREST OF THE VET. Vets who have strong views on reducing the stray dog population and sufferings of the homeless dogs or cats will recommend the bitch to be spayed before her first heat, at 4 -6 months of age.

When the bitch is spayed at around 6 months old and before the first heat, she will not have much abdominal fat and the operation is much easier.

Breast cancers and infection of the womb are seldom seen in older bitches spayed.
However, many bitches seem to put on excessive weight and some have skin problems after spaying and this may deter the owner from spaying her. Usually this increase in weight is due to the lack of control of feeding and the lack of exercise.

SPAY DURING THE HEAT PERIOD. Owners want to spay their bitches when they have bleeding.  In my opinion, it is best to spay the bitch during the inactive phase of the reproductive cycle.
This will be three months after the bleeding period as the uterine horns are not so fragile and the ovaries not so large. 

You can see that the ovaries are large, being active as the bitch was in heat and her blood drops stained the home. 
Unfortunately, most busy Singapore owners will have forgotten about the urgency to spay since there is no nuisance blood stain in the house.

CONCLUSION.  If you have decided to spay your bitch, do it when she is 6 months old.  If not, 3 months after the first heat.  


Case 2. A Cat's First Heat
Written: 11 February 2009
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
In the cat, no owner has ever complained about vaginal bleeding dirtying the apartment. There is some vaginal discharge but the cat cleans herself. However, the main complaint is the caterwauling noises.

Some female cats meow so loudly and noisily (wanting to go out to mate) such that the owner can't sleep. Neighbours in apartments get irritated. In such cases, the owner usually rush to the veterinarian to get the cat spayed.

The female cat shown below did not caterwaul at 6 months of age although she is sexually mature. The owner wanted her spay at 6 months as recommended.

From 2008, I use xylazine/ketamine injectable general anaesthesia in cat spay and neuter as I find it to be a very effective and safe anaesthesia. Generally the owners come to collect the cat later. But in one case, the owner came within 1 hour after the end of spay and was quite shocked to see her cat "dead."  All cats will wake up 1 hour after spay, as if from a deep and peaceful sleep. But they still need to rest and not be taken home so soon. 

In order not to traumatise owners and in the interest of the cat, it is best to let the owner know that the female cat can go home only in the evening or when the cat has waken up and is able to walk. 
Ragdoll Cat 6 months, Female, just spayed. Toa Payoh Vets Ragdoll Cat 6 months, Female, just spayed. Toa Payoh Vets
Ragdoll Cat 6 months, Female, just spayed. Toa Payoh Vets UPDATE ON CAT SPAY

In most cases, I don't advise Elizabeth collars in cats.

She will be given the pain-killers and antibiotics after the spay unless the owner does not want them. Her wound heals well in most cases.

The plaster can be changed on Day 3 or replaced with a new one if the cat licks it off by Day 2.

There is no need to come back to remove the absorbable skin sutures (3/0). The sutures disappear after 21 days if the cat has not got rid of them.

Internet references:
Why you should spay your dog or cat? (breast cancer & spay) 

Pictures of female dogs spayed by Dr Sing Kong Yuen
Dog spayed at Toa Payoh Vets

Mastectomy: Breast cancer in a female dog not spayed.
Mastectomy done by Dr Sing Kong Yuen

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