A Day in the Life of a Spay at CHV

By: Dr. Janette Blackwood, Charleston Harbor Veterinarians

At Charleston Harbor Veterinarians, we receive multiple questions from our clients about the spay and neuter process.  These questions range from asking how do we keep our patients comfortable to why is there a price difference between us and the local SPCA practices.  To help answer those questions and more, we were fortunate to have our patient Kona volunteer to have her experience documented for this blog and to show a “behind the scenes look” at how CHV handles our spay process from start to end.

My first experience having a pet spayed was unfortunately not the best.  This was back in the 1990s and I was a child.  We dropped our cat off at the veterinary clinic in our small town in Georgia and picked her up the next day.  I remember my entire family being squeamish and not wanting to look at her incision, but short of paying the bill, that was the extent our our involvement in her spay procedure.  I don’t ever remember meeting her doctor or surgical nurse.   Several years later, I was a teenager and looking to pursue a career in veterinary medicine.  I excitedly received my first job at that same veterinary practice.  I was dismayed to watch the process.  At this time, I found out that this particular veterinary practice had a habit of reusing surgical instruments as there were often more procedures scheduled in a morning than the surgical packs or technical staff available.  

What I saw a couple of decades ago shaped how I decided I would practice veterinary surgery in the future. Finding a veterinary partner in Dr. Kahuda was very exciting for me, as we quickly realized that we shared almost identical goals in how we wanted our surgical protocol and team to operate.   

Surgery is such an important event in a pet’s life that at CHV we purposely choose to keep our daily surgical numbers low.  While a veterinarian at a high volume practice may be scheduled to spay or neuter 6+ patients in a morning, CHV typically schedules a maximum of 3 surgeries in a day.  This number can be much higher even at high quality shelters, whose veterinarians may be scheduled for 20-30 surgeries in a morning.  Charleston Harbor Veterinarian’s lower volume allows for more personal attention to each patient and a process that is tailored to their comfort level and specific anesthetic needs.

A Day in the Life of a Spay at CHV

Drop off | Kona is dropped off at our practice between 7:30 and 8:00 am.  The night before, her owner received an email that contained her surgical paperwork and instructions to not feed her after midnight.  At drop-off, Kona’s owner received the option to speak directly with the surgical team to have any last minute updates, questions, and concerns addressed.

Physical Exam | After drop-off, Molly and I completed Kona’s examination.  She was nervous to be at the veterinary hospital, so we tried to ease her anxiety by performing the exam on the floor instead of the treatment table. She also had time to rest and acclimate to the hospital.

physical exam spay


Bloodwork | Once it was determined that her physical examination was normal, blood was drawn for preoperative screening.  Bloodwork checks are to make sure that Kona is not anemic (does not have a low red blood cell count), has normal electrolytes, is hydrated, and has normal kidney and liver values.

bloodwork for spay

Anesthetic calculations | Kona’s bloodwork was normal!  Jesse and I calculated the anesthetic doses that Kona will need during her surgery.  Kona’s anesthetic calculations and pharmaceutical choices were based on her age, the results of blood work and physical examination and her history of any previous or concurrent illnesses.  Fortunately, Kona is currently a healthy girl so no adjustments to our standard protocol was needed the morning of her surgery.

drug calculations for spay

Pre-medication | Next, Kona received a pre-medication injection.  Pre-medication helps provide sedation and a high level of pain control during the upcoming surgery.  The injection is placed in the muscle.  Kona was given 30 minutes for a final bathroom break and to allow the pre-medication to take effect.

pre-medication injectionfor spay

IV catheter placed | All patients receiving general anesthesia at Charleston Harbor Veterinarians have an IV catheter placed.  The IV catheter allows for additional anesthetic medication to be delivered intravenously.  During surgery, IV fluids will also be administered through this catheter.  IV fluids keep our patient hydrated and maintains the patient’s blood pressure at a normal level during anesthesia, both of which helps prevent anesthetic complications.  Here, Molly and Tara placed Kona’s IV catheter.

IV catheter placement

IV induction | Kona’s entire abdomen was clipped in preparation for surgery, and she is transported into the surgical room.  On the surgery table she received IV medication from Molly and me to induce her into going into general anesthesia.

IV induction

Intubation | It is protocol for patients receiving general anesthesia at Charleston Harbor Veterinarians to have an endotracheal tube placed.  This plastic tube is placed into the trachea to keep the airway open and to allow a steady stream of both oxygen and anesthetic gas to go into the airway, allowing us to easily adjust the level of anesthesia as needed.  This tube also prevents dangerous stomach contents from going down the airway, should the patient start to regurgitate under anesthesia.  Molly and I placed the endotracheal tube.


Positioning | Kona was then placed in dorsal recumbency (on her back).  She was provided a warming water blanket to help her body maintain a warm, comfortable temperature.


Sterile prep and gowning | Molly performed a sterile abdominal prep on Kona’s skin, as I scrubbed and prepared myself to perform surgery.  Afterwards, Molly helped me put on my sterile gown and gloves.


IV fluids start and sterile drapes | Kona’s IV fluids were started.  Sterile drapes were placed over Kona’s already sterile, prepped abdomen.


Spay procedure | I performed her spay.


Blood pressure monitoring | Meanwhile, Molly was very busy monitoring Kona under general anesthesia.  She monitored and recorded her blood pressure.

blood pressure monitoring for spay

Fluids monitoring |  Molly monitored that Kona’s fluids were running properly.

fluids monitoring for spay

More monitoring | Molly monitored and recorded Kona’s pulse ox, heart rate and respiration.

monitoring for spay

Adjustments | The information that our anesthetic team records helps determine how the patient is doing under general anesthesia.  This monitoring allows us to detect small changes under anesthesia early, as that can alert us that a problem could be slowly developing.  The goal is to catch small issues early before they could possibly develop into an emergency.  Molly adjusted Kona’s anesthesia as necessary during the procedure to ensure at all times that the patient was at proper anesthetic depth.

anesthesia adjustments for spay

Pain medication | Towards, the end of the procedure, Kona received a second injection for preventing pain.  At the time of discharge from the clinic, she also went home with oral medication to prevent discomfort.  Her type of pain medication was chosen again based on her physical examination, blood work and history of any type of other medical issues.

rimadyl for spay

Recovery | After the procedure, Kona is transferred into our surgical recovery area.   Kona was provided with a warm air blanket in recovery.  Molly sat with her until she was completely awake.   

Those who have toured our practice know that we have a relatively open floor plan.  This recovery area can be viewed from the surgical suite, the treatment area, the laboratory computers, and even one of our examination rooms.  One of the most critical times that an anesthetic mishap can occur is during the recovery period.  For this reason, our patients are not left alone until they are fully awake and recovered from general anesthesia, and our floor plan allows for easy monitoring, even during more busy days.  Molly in particular is known at CHV for snuggling her patients in recovery, making sure they recover in comfort and given her full attention.

 recovery for spay

Communication and discharge | Kona’s owner received a phone call from me after the procedure letting her know that Kona had recovered well.  Kona was kept in the clinic for a few more hours in order to continue to monitor her recovery.  Both Molly and I updated her medical record to include her anesthetic and surgical notes.  

At discharge, Kona’s owner met with both Molly and me.  Molly sat with Kona’s owner and reviewed Kona’s discharge instructions and pain medications to be administered at home.  She told Kona’s owner how to care for her surgical site and how to prevent infections.  She also showed Kona’s owner the “cone of shame” that would be needed to be worn until her recheck in 2 weeks.  

discharge of spay

Follow-up and recheck | Molly called Kona’s owner the next day to check and make sure that Kona had been comfortable overnight at home and was pleased to hear that she did very well.  

In 2 weeks, Kona returned for her surgical recheck examination.  She had healed very well and her sutures were removed with a little coaxing to lay down.

suture removal of spay

Clean bill of health | Kona had recovered well and was full of her old energy.  She was given permission to stop exercise restriction and return to her regular level of activity.

 recheck of spay 


Janette Blackwood, DVM

Osteoarthritis Pain Management for Our Senior Pets

Just like with people, it is not unusual for our senior dogs (and cats!) to start getting aches and pains as they age.  Owners often note a “slowing down”, which they may perceive and accept as part of the normal aging process.  This thought process may lead owners to be resistant to starting a chronic medication for treatment.  Osteoarthritis can be a common culprit for “slowing down”,  but what owners may not realize is that arthritis can cause significant pain for our pets and limit their quality of life.  Sometimes after starting a non-steroidal anti-inflammatory drug, the improvement to a pet’s quality of life can be dramatic.

One of my client’s dogs, Nala, did have such a drastic improvement after starting medication.  After the owner excitedly texted to me her third round of pictures showing Nala’s improvement, I asked her to contribute to our clinic blog.  My goal is to help other pet owners realize that the judicious use of pain medication tailored to their senior pet’s specific needs can result in improvement in their enjoyment of life and their relationship with the family.  

nala 1

Below is Nala’s story:

Nala is our nearly 11-year-old lab/shepherd mix. We adopted her at 12 weeks old from the SPCA and she has been a ball-loving, chase-loving, active girl her entire life. In the last couple of years, she has certainly slowed. She used to love (and I mean, LOVE) jumping up on her daddy to stretch and hug, but this has completely stopped in the last couple of years. She wants to play catch with the tennis ball for “forever” – but lately after 10 or 15 minutes, she’s exhausted… and later needs help to get up the stairs.

This summer, we noticed further changes. Not only did she not want to play, she would hide in our bedroom upstairs and seemed more distant than usual. It was a significant behavior change for our typically clingy dog who stays in our shadows. We’d been using Cosequin  to help with arthritis and it seemed to help for a little while, but wasn’t enough.

We are so grateful that we spoke with Dr. Blackwood. After voicing our concerns, she suggested we try an NSAID Nala could take twice a day. After a couple of weeks, we have a brand new dog. She is back to her super personable, playful, active self. She can play ball for longer periods of time, she is SO happy to jump up on her daddy again, and she is back to hovering in our shadow! We are getting her bloodwork followed regularly to monitor for side effects and are beyond thrilled with the results. As seen in the pictures, she is acting like a puppy again. Our senior dog is beyond happy, which makes us beyond happy as well.



nala 2

Janette Blackwood, DVM

Canine Influenza Update – Charleston, SC

Back on June 9th, we posted a blog that stated that the H3N2 strain of Canine Influenza was reported in South Carolina, but we did not know the location.  Recently, we have heard reports of a couple of confirmed cases in our lowcountry area.

Please, refer to the previously mentioned blog for information on the disease itself.   Veterinarian Charleston, SC 29403

Dogs who are the most at risk for catching this virus are dogs that will travel to locations such as shows or competitions, where they will have exposure to high numbers of dogs from many different locations.  For these dogs, we strongly recommend vaccination for influenza vaccinations H3N2 and H3N8 prior to travel to that event.

Dogs who are at moderate risk are locally social (visit dog parks or other pet friendly gathering spots) or attend boarding facilities.  Vaccination for these pets may be of benefit and something that you may wish to discuss with your veterinary practice.

Remember, that it takes 1 vaccination and then a booster vaccination 3 weeks later to complete the vaccination series.  Afterwards, it may take another week for your dog to have developed the immune response to be fully protected.  Therefore, pet owners who feel that their dog has a strong need to be vaccinated for travel or boarding should prepare a month in advance to make sure adequate time is allowed for both vaccinations to be administered.

Even with vaccination, there is no guarantee that your pet will not develop clinical signs if exposed to the influenza virus.  As with people receiving the human influenza vaccination, the goal is to lessen the severity of the symptoms should the disease develop.

We will continue to see all patients with respiratory infections outside in our parking lot for examinations, to decrease the chance of spreading this illness to any of our patients within the practice.  Thank you, for your understanding in this matter.

As always, thank you, for your trust in Charleston Harbor Veterinarians.  It is a joy to get to meet each one of your pets.

-Dr. Janette Blackwood

What Pet Owners Should Know About Canine Influenza

We know that many of our fellow Charleston dog owners have been wondering about the recent media posts about a “deadly” canine dog flu that has been documented in South Carolina.  We thought we would take a moment to share with you some bullet points that we know about this recent report, so that you can learn a little more about this virus.

Veterinarian Charleston, SC 29403

  1. There are actually two strains of the canine influenza virus:  H3N8 and H3N2.  Influenza H3N2 is the one that has been currently reported in South Carolina.  It has not been reported to spread to people, although nation-wide there has been the rare transmission to cats.
  2. As of the writing of this blog, we still do not know where in South Carolina this virus was reported or how many dogs have been affected.  It may simply be one dog in the upstate or several in the Lowcountry.  What we do know is that The University of Florida College of Veterinary Medicine is one of the many schools tracking this disease, especially after a recent new exposure at a dog show in Perry, Georgia.  The University of Florida issued a report this week simply listing the states that have had reported cases of H3N2.  South Carolina was on this list.
  3. H3N2 has actually been in South Carolina before this year.  A veterinarian in Mount Pleasant diagnosed it in 2 dogs traveling to our lowcountry, after staying in an infected boarding facility in Atlanta, in the spring of 2015.  The owner’s vigilant observation of her dogs’ newly developed respiratory signs and the quick thinking of the veterinarian to send off testing for the virus allowed these dogs to be isolated and likely prevented this virus from spreading to other local pets.
  4. The canine influenza behaves similarly to human influenza.  Dogs show signs of coughing, sneezing, lethargy, and fever.  The virus is highly contagious, and dogs can spread the disease some time prior to their symptoms becoming readily apparent.  Unfortunately, they can remain contagious for up to 4 weeks.  The good news is that while the dogs likely feel miserable (much like us when we have the flu), the infection is rarely fatal.  The University of Georgia’s College of Veterinary Medicine’s Infectious Disease Department speculates that there is a mortality rate of less than 1% for H3N2 (and less than 5% for H3N8).  Similar to people who become sick from the flu, cases are more likely to result in death for individuals who are older, very young, or immunocompromised from another disease.  While I appreciate the media for educating our community on the existence of this virus, the Charleston veterinary community sees a higher rates of pets passing away from other more common deadly diseases such as parvovirus, heartworm disease, and exposure to toxins such as antifreeze.  
  5. There are vaccines for H3N8 and H3N2.  Similar to vaccinating people for human influenza, vaccination does not result in a guarantee from a complete lack of illness should exposure occur.  The goal is to lessen the severity of symptoms should a dog become sick.  This is considered one of several “life style” vaccinations that we offer at Charleston Harbor Veterinarians, limited to dogs who complete certain activities regularly that would increase their risk of exposure to this disease.  This is similar to a conversation a person may have with their general practitioner about the benefits of receiving an annual “flu shot”.


What can you do to keep our community pets safe?


  1. Be a good neighbor!  If your dog is showing symptoms of coughing, sneezing, ocular drainage, and/or lethargy, this is a time for your dog to stay home and not socialize.  This is true for any contagious disease, not just canine influenza.  We have many contagious upper respiratory tract infections that are much more common in the Charleston area than canine influenza.  If your dog is sick, don’t go to dog parks or to the groomer’s office.  If you were making plans to board your dog, see if you can have a family member or a friend come to your home instead.  Your boarding and grooming facilities’ owners and your community’s neighbors will thank you for this kindness.
  2. If your dog is sick, contact your veterinarian.  Our physical exam can screen for complications to respiratory infections such as fever, dehydration, and pneumonia.  Testing to identify the offending pathogen is available, although it is completed at a reference laboratory and results can take about a week to return.  Dogs must also be tested soon after clinical signs start for more accurate results.  If indicated, we can prescribe medications to make your dog recover faster.
  3. Talk with your veterinarian about your dog’s lifestyle to see if vaccination is recommended.  Dogs that are exceptionally social or travel may benefit from the vaccination.  This would include dogs traveling to dog shows, dogs traveling for agility competitions, regular attendees at doggie day cares, and regular attendees to local dog parks.  Individual boarding facilities may start to require this vaccination, in an effort to minimize the chances of an outbreak within their businesses.


If you are making an appointment at Charleston Harbor Veterinarians to have a pet evaluated for a respiratory illness, please, do not be offended if we request to examine your pet in our parking lot, instead of bringing him/her into our building.  Like all veterinary practices, we routinely treat the elderly, pediatrics, and patients undergoing immunosuppressant therapy for other illnesses.  Due to the contagious nature of this disease, we do not want to place other individuals at risk and have a protocol in place to minimize the spread of respiratory diseases.


Charleston Harbor Veterinarians is here to answer questions that you may have concerning canine influenza and of course other medical concerns you may have.  Feel free to contact us at 843-410-8290 or chvteam@charlestonvets.com.  


You may also read more about it at both The University of Georgia and The University of Florida veterinary colleges’ websites:






Contributed by: Dr. Janette Blackwood

Hans and Sienna – Pets of the Month – May 2017

Hans and Sienna

Q: If your cats had to pick 3 things to bring to a deserted island, what would they be?

Hans: “a map of the island, a star chart and 15 yards of 22-gauge bronze wire to keep me company or to mold into a fishing net”

Sienna: “eye liner, earrings and a phone so I can talk to mommy when Hans is boring me”

Q: If your cats had a tagline, what would it be?

Hans: “I’m a philosopher, a realist, but also a dreamer and a lover!”

Sienna: “Some people just like me for my good looks, but there’s a heart of gold under this beautiful fur coat.”

Q: What are your cats favorite TV show?

Hans: “Sienna and I abstain from TV, but we listen to hours of NPR. One of our favorite shows is On Point with Tom Ashbrook. He has a smart and compassionate voice, and although I’ve never laid eyes on him, I’d let him pet me. Sienna and I need to know what’s going on in the world, which can be depressing at times. Wait Wait Don’t Tell Me is our weekly uplift.”

Sienna: “I enjoy watching the birds and cars go by on the eight TVs we have in our home.”

Q: What are your cats currently day dreaming about?

Hans: “Frolicking in an expansive grassy (catnip filled) field with butterflies”

Sienna: “Playing tennis with diamonds and pearls on a court made of crinkly gold foil”

Q: If your cats were to have a career, what would they be?

Hans:  “After five lives spent teaching astronomy at NYU, I’ve decided to focus my next two lives as a botanist before devoting my remaining two lives as the first feline astronaut on the Mars One mission.”

Sienna: “Absolutely without a doubt, a screen actress. Think: Elizabeth Taylor. Obviously!”

Q: Tell us why you have the best cats ever.

Hans: “My mommy is the best because when I want to play hide-and-go-seek she never grows tired of the game. We chase each other all over the apartment. When she goes to work, I wait at the door for her. She built a raised ledge so that I can see her when she walks up the steps. I give her the warmest greeting and let her scratch my back, no matter how long she’s been gone. I enjoy making funny faces and hearing her laugh. We like to dance while listening to her Spotify mixes. Sometimes she lets me sit on the porch with her. I know not to go running, and that’s why she lets me keep her company while she tends to her garden.”

Sienna: “I never pass up the opportunity to cuddle with mommy. She likes to use my belly as a pillow and I purr for hours. I taught her how to play fetch with my favorite toy – a simple straw, or really anything tubular. She doesn’t mind it that I like to follow her around, like everywhere, seriously. I think I’m a good helper in the studio. Sometimes she even takes me on adventures in the cat backpack. We go riding around on her bicycle. When I hear mommy’s alarm go off, I knead her belly to help her get up, since I know how much she hates mornings. We have a special secret language so I can tell her secrets that I don’t want Hans to know. She’s pretty much the best.”