Could this trend cause Urinary Incontinence?

Does size...

Really matter???

This has been a "pet peeve" of mine, for some time now.  Teeny, tiny spay incisions...  What is the point?  And, why should you care?  Read on to find out...  


If you can appreciate in the above picture, that is one teeny, tiny spay incision.  Considering that most dog's nipples, are not super huge, imagine just how tiny that incision is...  To me, it is far too tiny (not to mention that the suture style and tension is really poorly done, resulting in some severe tissue inflammation...)  But, we'll cover sutures in a newsletter another day...  

As a surgeon, I know how hard a "simple" spay surgery can be.  Cats are generally much easier, but in dogs - there can be quite a fun battle between visualizing your uterine and ovarian tissues, and tying suture material around them to prevent hemorrhage.  And, with this day to day experience of just how much tension it can take to "pull" a uterus up to the surface of an abdominal incision...I cringe when I see incisions that are unacceptably small.  A smaller incision - equals poor visualization of tissues, and also more tension needed to expose the tissues you are operating on.  And for what?  To say you make small incisions?  To brag that your dog's incision is smaller than your neighbors?  DOGS DON'T CARE!  I have never met a dog who was concerned with the scar on their belly.  "Darn it, my bikini days are over..."  "Now I can't shave my belly anymore, due to that unsightly scar..."

But, why do I think you should care about this?  Because, not only does yanking and pulling on the uterus to expose it through a tiny incision cause more tissue trauma, pain, and inflammation...but I think it has a distinct effect on the delicate bladder tissues and connections that are so intimately associated with the uterus.  In fact, if a bladder is not properly emptied prior to a spay surgery, it can make it down right impossible to work around.  

What could this secondary "bladder and urethra pull" do to your dog?  Well, I truly believe there is a connection with all of the "spay incontinence" we are seeing in spayed female dogs - and this trend of making tiny incisions - especially in the early spays that are being performed in shelters and rescues all over the United States and beyond.  The vast majority of spays I see from animal shelters and such, have these tiny little incisions.  Like the vet is getting some sort of badge of honor for performing through a key hole...  I can tell you - that it does not matter if I make a 1 inch incision or a 4 inch incision...the healing time will be the same.  And to me, the vast benefits of not creating more tissue trauma INTERNALLY is far worth the slightly longer incision and suturing that I will have to do to close the wound I created.

What I visualize, is based on doing thousands of spay surgeries during my veterinary career.  If I have to "tug" on a uterus during surgery, I elongate my incision and make it bigger.  If I had to continue to put traction on the uterus, to complete the surgery through a tiny little hole - I WILL be, by default, pulling on the bladder and its attachments.  This will result in inflammation.  Even if it can only be appreciated microscopically.  But, who would ever know?  It is inside your dog.  And you are not Super Man with x-ray vision...  Not only is there inflammation caused, but have you ever heard that you shouldn't "play airplane" with small children and swing them around by the arms?  Not only can this stretching sort of action cause harm to their joints, but it can actually stretch and damage nerves!  What does your dog's bladder need to function normally???  NERVES!  And, intact, fully functional, non-inflammed nerves.  Over time, could this initial insult of inflammation and nerve stretching actually create a situation that will cause urinary incontinence later in life for your dog?  I think it could!

I have kept mental notes, tracking the type of spay incisions that urinary incontinent dogs in my practice have.  I do think that small incisions, and early spay dogs are over-represented - but I do not believe it to be ONLY a hormonal change or from spaying too early.  They may factor in as well, but I still think my theory has quite a bit of importance to consider. 

So, how do you proceed?  What do you ask your vet to see what type of surgeon they tend to be?  I honestly would interview any vet that is going to be doing a surgery or anesthetic procedure on my pet.  (CLICK HERE to read a past newsletter on anesthesia.)  And, it is totally appropriate for you to ask, "How big of an incision can I expect?"  If they start bragging about how nice and tiny the incision is, you might want to interview another vet.  When I am educating clients on the value of the type of surgical procedures we do, I do explain that we make a larger incision (so that no one is shocked...), but explain the benefits of what that means for your animals.  Actually LESS tissue trauma, often shorter surgical time, better visualization of blood vessels, less risk of "unseen" complications such as hemorrhage...  Making the incision bigger from a scalpel, is far less traumatic than a ripping or tearing sort of action on the tissues.  Not only do I rarely have patients chew or lick at their incisions, our recovery times are far faster than what most people see routinely.  I contribute this to the much more gentle care of the delicate tissues that are within the entire abdomen of the dog.  I can only imagine what it could feel like to be spayed, but no matter which way you "cut it" - it is not natural, and it is not void of pain.

Pain and inflammation, and the resultant stress associated with both of those - also decrease healing and suppress the immune system.  Combine that with the other dangerous trend of blasting animals with vaccinations at the same time as a surgery...and we have a recipe for disaster.  Maybe not today, but what about years down the road?  (CLICK HERE for a past newsletter on vaccinating with surgical events...)    

Food for thought... and a quick little rant for this Friday Fun Fact!

Please, visit my website for information on classes, links to past newsletters, to purchase books on using Essential Oils in animals, to view You Tube Videos, and more!

And remember, I only recommend the use of what I term, "medical grade essential oils" for use with animals (or humans for that matter).  My recommendations and links to purchase high quality oils can be found at  The use of essential oils that have not been evaluated and proven safe for use in animals, is not recommended, and may prove dangerous for your animals.  Through research, case studies, and retrospective studies - I am documenting the difference in qualities of essential oils in my veterinary hospital - and we are continually striving to provide more information to everyone who desires to use essential oils for their animals. 


Until Next Time!
Melissa Shelton DVM

Disclaimer:  This information was provided for educational purposes only.  It is not intended to diagnose, prescribe or treat any illness.  If you or your animal have a health concern, you are encouraged to seek the counsel of a health care professional who is knowledgeable in your area of interest.



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Melissa Shelton?


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