"My vet does not spay big dogs," the young couple said. "So I was asked to see you."
Big dogs take longer to spay. Big dogs with some fat as in this case may be much more difficult to spay if the vet uses hook and a small incision.

Personally, I do not look forward to spaying big fat dogs too. The spay hook gets obstructed and one gets omental fat coming out of the spay incision so many times.

In this case, the dog has a skin disease, with hair loss from back to past the chest. Now, if the vet has not informed the owner of this finding, the worsening of the skin condition some weeks after spay, leading to a "botak" (bald) dog might be attributed to the vet having spayed the dog or not informing the owner.
 

Xylazine sedation IM and isoflurane gas anaesthesia for the spay was uneventful

I advised treatment of the skin disease first. But the dog was already at the 4th month after the ending of heat in January 2008. This would be the appropriate time for spaying without too much bleeding happening during the operation.

The owners would need to wait another 4 months for the next spay and for the treatment of the skin disease.

"I will not be able to manage when she comes on heat in 2 months' time," the lady said she would be in later stages of pregnancy herself. Cleaning up the blood stains dripping over the floor for at least 2 weeks during the dog's estrus can be quite exhausting for anybody.

The dog was spayed and the gentle couple would need to follow up and monitor the skin disease.

Vets need to examine and let the owners know about pre-existing skin conditions before spaying the dog so as to build positive relationships and avoid misunderstanding as the treatment of skin diseases add to the veterinary costs.