# Laparoscopic Spay & Gastropexy..Opinions?



## Debbie Skinner (Sep 11, 2008)

A puppy buyer of a female Beauceron (turns 1 year Feb 5 2010) just emailed me for my opinion on laparoscopic spay and also having the vet perform a gastropexy as the same time. See her question below: 

"We will soon be getting her spayed (it's scheduled for 2/12/10). The vet said he could do a laparoscopic gastropexy at the same time (the spaying is be done laparoscoply (I hope that's a word.) Anyway, I would really like to know your opinion on the gastropexy."

You can see my answer below. Does anyone here have experience with the Lap. spay vs traditional spay? From what I see there are still incisions made..just smaller, but more. Also, I've owned Beauces for years and would not consider to "routinely" tack the stomach to prevent bloat. Opinions and information would be greatly appreciated! :grin:

My answer thus far is: 
I don’t know why the vet would suggest that you “tack” her stomach so to speak. Does the vet believe that she Elsa would have a high risk for bloating (stomach torsion)? What reason did the vet give for wanting to do this?

 It’s done by some Great Dane owners routinely, but not for Beaucerons. Also, now with the grain-free dog foods available and the popularity of feeding fresh/raw diets, I bet we will see less bloating in dogs. I’ve “googled” to read up on the surgery: http://www.vetsurgerycentral.com/proph_gastropexy.htm and http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2753&Category=431 

Also, info on lap spay: http://www.veterinarypracticenews.c...laparoscopic-spay-in-cats-and-dogs-video.aspx (has video) Also, this page has photos: http://www.vet.uga.edu/mis/cases/derby.php 

I’m going to ask and see what else I learn."


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## Kristen Cabe (Mar 27, 2006)

It is becoming more and more common for Vets to tack the stomachs of large breed dogs while they're in there doing a spay, simply as a preventive measure. It does not prevent bloat; it prevents gastric torsion.


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## Maren Bell Jones (Jun 7, 2006)

Basically a laparoscopic spay just means they go in with a small camera to do the procedure and there will be smaller incisions, as you noted. They aren't super commonly done in dogs yet, but are getting more popular with both cryptorchid stallions, as there is a lot more guts to be moved out of the way when you go hunting for the undescended testis. So the dog may be slightly less sore afterwards, but I honestly don't know the literature on this (I like orthopaedics more than soft tissue :wink. A one year old dog should heal without any problems with a normal spay incision (usually just a few inches long) as long as they are kept quiet and clean for 7-10 days. So I'd say if she wants to have it done, no big deal, but if it's a bunch of extra money to do it with laparoscopy, probably not needed. One advantage I can think of is if they do the gastropexy, it saves the animal a good bit of anesthesia time because doing a 3 layer suture for doing both procedures takes quite a while, especially with us novice surgeons. :wink:

As far as the gastropexy goes, they do indeed prevent gastric dilatation and volvulus (bloat), but not 100%. If I recall correctly, they don't prevent bloat about 5% of the time. Two weeks ago, I saw a Great Dane that was pexied when he was neutered and it indeed saved his life as there was no question the stomach would have rotated (the stomach was dilated on radiographs, but had not filpped). Even though diet will help, as we have unfortunately seen with Mike Suttle and Jerry Lyda's dogs, it can happen to about any large breed dog and I don't think those guys probably had their dogs on a poor quality diet. If a dog was used for breeding, I would personally not recommend prophylactic pexy as you would want to see if it comes up in your lines and unscrupulous breeders could have all their dogs pexied and claim there is no bloat in their lines. But if the dog is not being used for breeding, it's not quite so big of a deal. Hope that helps!


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## Debbie Skinner (Sep 11, 2008)

Kristen Cabe said:


> It is becoming more and more common for Vets to tack the stomachs of large breed dogs while they're in there doing a spay, simply as a preventive measure. It does not prevent bloat; it prevents gastric torsion.


Do you think they are doing this because it's necessary or just to pad the bill would be the question then..:?:

I know vets recommend spaying and neutering to prevent cancer of the reproductive organs, which is true..if you don't have them then you can't get cancer there...Spay/Neuter surgeries are called preventatives too...

Do you know anything about the Lap Spay vs the traditional spay as far as actual benefits? I'm wondering if it's more expensive..my bet would be "yes". But, better for the animal?


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## Maren Bell Jones (Jun 7, 2006)

I think our teaching hospital charges an extra $100-150 to pexy along with a spay or neuter, compared to $2000-3000 for surgery that in 50% of cases, the dog will die anyways even if the surgery goes smoothly. So yeah... :-k If I was a pet owner, I think I would go for the former.


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## Debbie Skinner (Sep 11, 2008)

Maren Bell Jones said:


> Basically a laparoscopic spay just means they go in with a small camera to do the procedure and there will be smaller incisions, as you noted. They aren't super commonly done in dogs yet, but are getting more popular with both cryptorchid stallions, as there is a lot more guts to be moved out of the way when you go hunting for the undescended testis. So the dog may be slightly less sore afterwards, but I honestly don't know the literature on this (I like orthopaedics more than soft tissue :wink. A one year old dog should heal without any problems with a normal spay incision (usually just a few inches long) as long as they are kept quiet and clean for 7-10 days. So I'd say if she wants to have it done, no big deal, but if it's a bunch of extra money to do it with laparoscopy, probably not needed. One advantage I can think of is if they do the gastropexy, it saves the animal a good bit of anesthesia time because doing a 3 layer suture for doing both procedures takes quite a while, especially with us novice surgeons. :wink:
> 
> As far as the gastropexy goes, they do indeed prevent gastric dilatation and volvulus (bloat), but not 100%. If I recall correctly, they don't prevent bloat about 5% of the time. Two weeks ago, I saw a Great Dane that was pexied when he was neutered and it indeed saved his life as there was no question the stomach would have rotated (the stomach was dilated on radiographs, but had not filpped). Even though diet will help, as we have unfortunately seen with Mike Suttle and Jerry Lyda's dogs, it can happen to about any large breed dog and I don't think those guys probably had their dogs on a poor quality diet. If a dog was used for breeding, I would personally not recommend prophylactic pexy as you would want to see if it comes up in your lines and unscrupulous breeders could have all their dogs pexied and claim there is no bloat in their lines. But if the dog is not being used for breeding, it's not quite so big of a deal. Hope that helps!



Thanks for the info. I'll pass it on to the Beauce owner. I don't want to make the decision for her. I've encouraged her to research as well as ultimately it's her decision. I agree though that I would go for the traditional spay vs paying a bunch of extra $$ on a young, healthy bitch.


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## Debbie Skinner (Sep 11, 2008)

Maren Bell Jones said:


> Even though diet will help, as we have unfortunately seen with Mike Suttle and Jerry Lyda's dogs, it can happen to about any large breed dog and I don't think those guys probably had their dogs on a poor quality diet. If a dog was used for breeding, I would personally not recommend prophylactic pexy as you would want to see if it comes up in your lines and unscrupulous breeders could have all their dogs pexied and claim there is no bloat in their lines. But if the dog is not being used for breeding, it's not quite so big of a deal. Hope that helps!


I don't mean to say or imply at all that anyone's dog(s) were fed a poor diet and this caused bloating. 

Regarding diet though, do you know if there are many dogs or any dogs that bloat on a grain-free kibble exclusively? 

Also, a dog fed raw "prey" model exclusively has there been dogs that bloat and/or torsion?


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## Debbie Skinner (Sep 11, 2008)

Maren Bell Jones said:


> I think our teaching hospital charges an extra $100-150 to pexy along with a spay or neuter, compared to $2000-3000 for surgery that in 50% of cases, the dog will die anyways even if the surgery goes smoothly. So yeah... :-k If I was a pet owner, I think I would go for the former.


For all dogs of 60lbs or more??

Debbie


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## Maren Bell Jones (Jun 7, 2006)

I'm confused...for all dogs 60 lbs or more what?


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## Debbie Skinner (Sep 11, 2008)

Maren Bell Jones said:


> I'm confused...for all dogs 60 lbs or more what?


Sorry! I was trying to multi-task..on the phone and typing doesn't mix too well! :-(

I meant to write: Do you recommend tacking the stomach on all large dogs (60lbs or more for example) regardless of the breed or mix as a precaution? 

Is torsion such a consideration in large dogs that this should be a recommendation when dogs go in for spay/neutering? 

I just haven't seen it in my malinois or beaucerons. My old Beauceron did torsion about 10 years ago after attempting to eat a bag of Eukanuba and the surgery was successful. But, other than that I've not considered bloat/torsion a big risk so haven't done any research on the subject.


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## Maren Bell Jones (Jun 7, 2006)

I'm honestly not sure I can make any formal medical or surgical recommendations for a little more than a year or so. :lol: It would probably depend on the owner and on the dog. Particularly for dogs known for dietary indiscretion (like you, my Rottie got into the food tub of EVO Red Meat and threw up 8-10 quarts worth about 1.5 months ago, blech!). I don't have any of my dogs pexied, but I don't have a Great Dane, lab, or German shepherd either. Since most of my dogs are rescues, I didn't really get an option to pexy them before they were altered. But if I had a boisterous lab or something that I wasn't using for breeding and who was especially good at getting into things he/she shouldn't, I'd consider it if he/she was getting neutered/spayed anyways.

To your earlier question on food type, it's been suggested for quite some time that cereal based foods may be more problematic. One of the studies I found (it's in JAAHA, so I don't think the public can access the full article without a subscription) concluded it was not, but it was a prospective study that basically polled owners of susceptible breeds and I had some issues with their classification of food. The dogs were fed all sorts of brands (whatever their owner happened to feed), so it was not very controlled. I would love to see a controlled study with a grocery store type 60-70% high carb, plant based protein diet vs a true low carb, animal based protein diet and see what we get, but I couldn't find anything in the literature. Here's the abstract of the article from Purdue I did find:



> J Am Anim Hosp Assoc. 2004 May-Jun;40(3):192-203.
> *Diet-related risk factors for gastric dilatation-volvulus in dogs of high-risk breeds.*
> 
> Raghavan M, Glickman N, McCabe G, Lantz G, Glickman LT.
> ...


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