Sunday, September 14, 2014

A new look at neutering

The recommendation to spay and neuter all dogs is the standard of care, but recent evidence has thrown new light on that dogma – at least for two breeds.   

Two studies from the University of California-Davis School of Veterinary Medicine have taken the veterinary world by surprise.  The research was based on 13 years of health records from UC-Davis for neutered and non-neutered male and female Labrador and golden retrievers between 6 months and 9 years of age.  The most recent study, published in July of this year, compared 1,015 goldens with 1,500 Labs.  Those two breeds were chosen because of their popularity, similar size, and comparable behavioral characteristics.

The researchers picked several cancers (lymphosarcoma, hemangiosarcoma, mammary cancer, and mast cell tumor) and three joint disorders (hip dysplasia, cranial cruciate ligament tear, and elbow dysplasia) and compared the incidence in neutered and non-neutered dogs of both breeds.  The neutered dogs were grouped into four categories, according to the age at which they had been altered.  

It turned out that non-neutered males and females of both breeds had a 5 percent rate of one or more joint disorders.  But in Labs, neutering before 6 months of age doubled that rate, to 10 percent.  More alarming, the golden retrievers that had been neutered before 6 months of age had 4 to 5 times the incidence of joint disorders compared with non-neutered goldens.  The joint disorders found to increase in male goldens were hip dysplasia and cranial cruciate ligament tears, while lab males had more cruciate tears and elbow dysplasia. 

Lead investigator Dr. Benjamin Hart at UC-Davis says,  “The effects of neutering during the first year of a dog’s life, especially in larger breeds, undoubtedly reflects the vulnerability of their joints to the delayed closure of long-bone growth plates when neutering removes the sex hormones.”  In other words, we’re messing with Mother Nature!

Regarding cancers, the data also uncovered significant differences between the breeds.  The cancer rate of both breeds when they weren’t neutered was 3 to 5 percent, except in male goldens, who have an 11 percent cancer rate. Neutering didn’t have much effect on the cancer rate of male goldens.  However, in female goldens, neutering at any point beyond 6 months increased the risk of some cancers to 3 to 4 times the level of non-neutered females.  But that was true only for goldens; neutering female labs only negligibly increased their cancer rate.  According to Dr. Hart, “The striking effect of neutering in female golden retrievers … suggests that in female goldens the sex hormones have a protective effect against cancers throughout most of the dogs’ lives.”  Mother Nature again. 

What does all this mean?   Should we stop neutering our dogs to prevent joint disease and cancer?  Before sweeping changes are made, the limitations of the studies must be discussed.  First of all, they compared Labs with goldens; no other breeds were studied.  Comparing goldens with German shepherds probably would yield vastly different results. Even within a breed, there were significant differences based on gender.  To get solid data, hundreds of studies would have to be done, not just on a breed basis, but also on a gender basis.  

When I started practicing veterinary medicine in 1977, the unwavering recommendation almost every veterinarian made was to neuter all dogs at 6 months of age.  I don’t think compliance was nearly as good then as it is today.  I remember many male dogs coming in with prostate problems, perianal tumors, and perineal hernias, all conditions associated with not being neutered.  Spaying a female of any breed before her first heat has been associated with a lowered risk of breast tumors; performing surgery on unspayed dogs to remove breast cancer and infected uteruses was a frequent occurrence back then.  I rarely see those medical problems today; it’s likely that the early neutering of pets from shelters has had a big influence on preventing them.

The two studies looked only at the risks of neutering those breeds, but not at the benefits.  Neutering a female golden, for example, elevated the risk of one or more cancers three- to fourfold.  But not spaying dogs of all breeds causes the above-mentioned breast cancer and infected uteruses, as well as messy heats and the risk of overpopulation.   You might prevent joint disease in your male Lab by leaving him intact, but in addition the problems I listed above, the compromise might be aggression, wandering, marking in the house, and, again, unwanted puppies.  

So now we veterinarians and our clients are faced with a quandary:  to fix or not to fix.    I think it’s wise to discourage neutering in goldens and Labs before 6 months of age, and 12 months is even better.  I also think a discussion is warranted with the owners of other large-breed dogs, whose joints are more vulnerable when they are altered early.  As far as never neutering, we need more data before we make a blanket recommendation across all breeds.  For the owners of Labs and goldens, we can discuss the risk-benefit ratio with you, but the decision as to whether to neuter will ultimately be yours.