All our spays are performed under sterile conditions. Our surgeon is making this incision near the umbilicus (belly button) on this cat.
One of the most common surgical procedures we perform is a cat spay, known medically as an ovariohysterectomy (removal of the ovaries and uterus). It is performed for several medical reasons:
In addition to these medical reasons, it prevents unwanted pregnancies, a significant problem in our society. Millions of cats are euthanized every year because they are strays.
We usually spay a cat when it is around 6 months of age. This timetable is variable, the important point is to perform the surgery before she goes into heat. Increasing daylight encountered in late winter and early spring stimulate female cats to go into heat.
On the day of surgery we need your pet in the hospital between 8:30 AM and 9 AM. Please take away all food when you go to bed the evening before surgery, and do not give your cat anything to eat or drink the morning of surgery. She will go home the next day. Please call our office after 10:00 AM the next day for pickup time; you will be given post operative instructions then.
Pre-anesthetic preparation is important in every surgery we perform, no matter how routine, because surgery is not an area to cut corners. All of our spays receive a physical exam prior to surgery. Only if they pass this exam will we draw a small amount of blood for an in-hospital pre-anesthetic test. When everything is to our satisfaction we will administer a sedative. This will calm the pet down and make the administration of the actual anesthetic, along with post operative recovery, much smoother. Once a pet is anesthetized, prepared for surgery, and had its monitoring equipment hooked up and reading accurately, the surgery can begin.
The spay procedure begins with an incision in the skin. We make a small one (we call it a bikini scar when it heals) because it minimizes anesthetic time when we have to suture the skin and muscles back together, and to minimize post operative discomfort. Smaller incisions also heal faster and minimize the chance of complications. We pick a specific location on the abdomen to make our incision. This location minimizes skin bleeding, gives us direct access to the muscles we need to go through to get into the abdomen, and puts us directly over the ovaries and uterus.
All our spays are performed under sterile conditions. Our surgeon is making this incision near the umbilicus (belly button) on this cat.
It is important to go through the abdominal muscle in the proper location. This location is called the linea alba, and is the area where the abdominal muscles meet. Making the incision here will yield almost no bleeding, and gives the surgeon a strong anchor to sew the muscles back together.
We start the muscle incision with a scalpel, then complete it with the scalpel or a scissors, taking special care not to cut any internal organs. 
An instrument called a spay hook is commonly used to bring the uterus out of the incision through the small opening in the muscle. The surgery is performed outside of the abdomen. 
We gently pull up the uterus until we have the ovary exposed. The ligament that attaches the ovary to the bottom of the kidney is gently stretched to allow complete visualization of the ovary and its blood supply. The metal tip of the hemostat on the left is pointing to the ovary. 
This is a picture of an ovary cyst from a different cat. This is one of the problems that can occur when a female cat is not spayed. 
Three clamps are used before we cut any tissue. The first two clamps on the left are where we will put 2 separate sutures. To the right of these two clamps is a scissors that is in the process of cutting the ovary (arrow) away from the body. The last clamp on the right prevents any bleeding from the other direction.
All that remains when the ovary has been cut away is called the pedicle, shown as a second suture is being applied. What remains will be placed back into the abdomen.
The first ovary that is removed (labeled on the right) is left with a hemostat on to minimize bleeding. The surgeon is starting to gently pull the other ovary out of the abdomen, and will repeat the same clamping, suturing, and cutting process as the first ovary. 
When both ovaries have been removed from their position in the abdominal cavity they are gently pulled to the right. This brings the cervix out of the abdomen and allows the surgeon to remove the uterus from the cervix to the ovaries. 
Two sturdy sutures are placed on the cervix before it is cut. When the surgeon is certain there is no bleeding where the cervix was cut the cervix is gently placed back into the abdomen.
This uterus was removed from a sick cat, and includes the ovaries (arrows) at the left along with the cervix at the far right. If you look closely you will notice the swollen appearance to this uterus. This is an infected uterus that was removed from an older cat. If this cat had been spayed before its first heat, there is minimal chance it would have had to suffer this infection. 
When the surgeon has made sure that all internal sutures are holding well and there is no bleeding, the process of sewing up begins. The linea alba is sewn first, seen here with stainless steel sutures. Stainless steel is very strong and causes minimal tissue reaction, so it is commonly used. These sutures can easily be seen on an x-ray, a nice way to tell if a female has been spayed, especially for stray pets. 
In many cats we place the skin sutures just under the skin, so there is no need to return for suture removal. In some cats stainless steel is used in the skin. These sutures are removed within 7-10 days, and when the hair grows back in, it is impossible to tell any surgery was performed. 
It is at this point that we will give a pain injection, which might make this cat groggy for the evening. When you pick up a pet after a spay operation you will be given detailed post operative instructions.
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