Dr. Paul Hodges
Veterinary Endoscopy
Minimally Invasive Procedures
Rigid Endoscopy
Flexible Endoscopy
General Surgery
"Penny" the dog
History:
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"Penny", a 6 year old, female spayed mixed breed dog, presented to her regular veterinarian because of a sudden onset of signs consistent with being in heat.
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At presentation "Penny" was eating and drinking normally, had good energy and seemed otherwise fine, with the exception of signs of heat including enlarged vulva and spotting (blood drops from vulva)
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General physical exam was normal except for signs of heat. Comprehensive general bloodwork was all within normal limits.
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"Pennys" veterinarian was concerned that she was showing signs of heat despite being spayed over a year earlier, and worried that she might be suffering from Ovarian Remnant Syndrome.
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Vaginal cytology as well as additional bloodwork to evaluate progesterone levels both confirmed signs consistent with Ovarian Remnant Syndrome and her veterinarian recommended exploratory surgery to identify and remove the remaining tissue.
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The referring veterinarian recommended the use of minimally invasive techniques to help visualize/identify the tissue as well as decrease the discomfort and recovery time required after open abdominal surgery.
Findings:
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An exploratory laparoscopy was performed which involved passing an operating scope through a 1cm abdominal incision into the abdomen.
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The abdomen was explored and remaining ovarian tissue was identified on both sides (bilaterally).
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The ovarian tissue was removed using laparoscopic techniques and "Penny" made a full recovery.
Discussion:
Ovarian Remnant Syndrome (ORS) is (fortunately) not all that common in day to day practice. The most common cause of ORS is failing to remove all ovarian tissue during an ovariohysterectomy (spay). While this is rare in immature (young) spays, it can happen in a mature spay due to the increased difficulty in visualizing the ovary within fat surrounding the ovarian tissue. In certain situations where visualization is exceedingly difficult, the attending surgeon may not be aware that tissue has been left. Performing a second surgery to find and remove remaining ovarian tissue can be very difficult due to the often small size of tissue left. However, with the use of operating laparoscopes (with their magnification) confidently finding and removing this tissue is more straightforward and less disruptive to the patient.