Ovariectomy or ovariohysterectomy?

Dear Editors, — I have read with interest the timely articles and correspondence in JFMS on neutering of cats. 1–5 The debate as to whether to perform an ovariectomy or an ovariohysterectomy from a student instructional perspective is germane. I wish to add some observations from our geographic region. A phone survey of local practitioners (Furneaux 2010, unpublished data) on their neutering practices resulted in a wide range of clinical options. The questions asked included: (1) In cats, do you perform ovariectomy or ovariohysterectomy? (2) Do you use progesterone-based medications in your daily practice? Answers to the first question varied. The following statements summarise the findings: I make a small incision and remove what portion(s) of the uterus I can reach; I remove the uterus at the body, leaving a short, viable piece of uterine body attached to the cervix; I remove the entire cervix, or part thereof. The first two statements beg a couple of questions of their own. Is the net effect of this surgery the same as would have been achieved with a simple ovariectomy? And, having failed to do a complete hysterectomy, is the surgeon leaving the patient vulnerable to progesterone-related pyometra? To the second survey question, regarding progesterone-based medications, several practitioners answered in the affirmative. The progesterone is being used for one of three purposes: appetite stimulation, behavioural modification or, most usually, ‘miliary dermatitis'. In the latter two uses, the duration of therapy tends to be prolonged. These findings suggest that patients are vulnerable to iatrogenic progesterone-related uterine pathology if a complete ovariohysterectomy has not been performed. As a consequence of this survey, we teach students that, in the cat, ovariectomy alone may leave the patient vulnerable to iatrogenic progesterone-related pathology; that incomplete removal of the uterine body results in a similar exposure to iatrogenic progesterones; and that, while progesterone remains in the pharmaceutical armamentarium of clinicians, the preferred amputation of the genital tract is either through the body of the cervix or through the vagina. Letters to the Editors. Letters commenting on articles published, or expanding on topics covered, in the ‘Clinical Practice’ editions of JFMS are welcome and will be considered on their individual merit. Please e-mail correspondence to [email protected]. Letters may be shortened for publication. References - 1. Sparkes A. Neutering cats — assessing attitudes and challenging conventions [editorial]. J Feline Med Surg 2011; 13: 1–2. [DOI] [PMC free article] [PubMed] [Google Scholar] - 2. Joyce A, Yates D. Help stop teenage pregnancy! Early-age neutering in cats. J Feline Med Surg 2011; 13: 3–10. [DOI] [PMC free article] [PubMed] [Google Scholar] - 3. The Cat Group. Cat neutering practices in the UK. J Feline Med Surg 2011; 13: 56–57. [Google Scholar] - 4. Thomas C, Robertson S, Westfall M. AAFP position statement. Early spay and castration. J Feline Med Surg 2011; 13: 58. [Google Scholar] - 5. Romagnoli S. Reproduction control — new developments, old debates [letter]. J Feline Med Surg 2010; 12: 724. [DOI] [PubMed] [Google Scholar]