Neutering
Neutering, from the Latin neuter, is the removal of an animal's reproductive organ, either all of it or a considerably large part. "Neutering" is often used incorrectly to refer only to male animals, but the term actually applies to both sexes. The male-specific term is castration, while spaying is usually reserved for female animals. Colloquially, both terms are often referred to as fixing. In male horses, castrating is referred to as gelding. Modern veterinary practice tends to use the term de-sexing.
Neutering is the most common method for animal sterilization. Humane societies, animal shelters, and rescue groups urge pet owners to have their pets neutered to prevent the births of unwanted litters, which contribute to the overpopulation of unwanted animals in the rescue system. Many countries require that all adopted cats and dogs be sterilized before going to their new homes.
Methods of sterilization
Females (spaying)
In female animals, spaying involves abdominal surgery to remove the ovaries and uterus. Another option is to remove only the ovaries, which is mainly done in cats and young dogs. Another, less commonly performed method is an "ovary-sparing spay" in which the uterus is removed but one ovaries are left. Traditional spaying is performed commonly on household pets as a method of birth control. It is performed less commonly on livestock, as a method of birth control or for other reasons. In mares, these other reasons include behavior modification.A complete ovariohysterectomy may involve removal of the ovaries, uterus, oviducts, and uterine horns.
The surgery can be performed using a traditional open approach or by laparoscopic "keyhole" surgery. Open surgery is more widely available, as laparoscopic surgical equipment costs are expensive. Traditional open surgery is usually performed through a ventral midline incision below the umbilicus. The incision size varies depending upon the surgeon and the size of the animal. The uterine horns are identified and the ovaries are found by following the horns to their ends.
There is a ligament that attaches the ovaries to the body wall, which may need to be broken down so the ovaries can be identified. The ovarian arteries are then ligated with resorbable suture material and then the arteries transected. The uterine body and related arteries are also tied off just in front of the cervix. The entire uterus and ovaries are then removed. The abdomen is checked for bleeding and then closed with a three-layer closure. The linea alba and then the subcutaneous layer are closed with resorbable suture material. The skin is then stapled, sutured, or glued closed. For suturing the feline linea alba, the most appropriate suture bite and stitch interval size was suggested to be 5 mm.
Laparoscopic surgery is performed using a camera and instruments placed through small incisions in the body wall. The patient is under anaesthesia and lying on the back. The incisions are between and the number varies according to the equipment and technique used. The surgeon watches on a screen during the operation. The first port is made just behind the umbilicus and the camera is inserted. The abdomen is inflated with carbon dioxide gas to create a space in which to operate. A second port is introduced a few centimeters in front of the navel and a long grasping instrument called a Babcock forceps is inserted. The surgeon finds the ovary with the instrument and uses it to suspend the ovary from a needle placed through the abdominal wall. This lifts the ovary and uterus safely away from other organs. The surgeon then removes the grasping instrument and replaces it with an instrument that cauterizes and cuts tissue. This instrument uses electricity to heat the blood vessels to seal them and to cut them. No sutures are placed inside. The ovary is separated from the uterus and round ligament. The cautery instrument is removed and replaced by the grasping instrument, which is used to pull the ovary out through the small abdominal incision. This is repeated on the other side and the small holes are closed with a few sutures.
The benefits of laparoscopic surgery are less pain, faster recovery, and smaller wounds to heal. A study has shown that patients are 70% more active in the first three days post-surgery compared to open surgery. The reason open surgery is more painful is that larger incisions are required, and the ovary needs to be pulled out of the body, which stretches and tears tissue in the abdomen.
Spaying in female dogs removes the production of progesterone, which is a natural calming hormone and a serotonin uplifter. Spaying may therefore escalate any observable aggressive behaviour, either to humans or other dogs.
The risk of infections, bleeding, ruptures, inflammation and reactions to the drugs given to the animal as part of the procedure are all possibilities that should be considered.
Males (castration)
In male animals, castration involves the removal of the testes, and is commonly practiced on both household pets and on livestock. Often the term neuter is used to specifically mean castration, e.g. in phrases like "spay and neuter".There is a not-uncommon belief, especially among dog fanciers, that castrated male animals psychologically suffer from the loss of their testicles. This has fueled a small but growing market for prosthetic testicles, especially for dogs.
Surgical alternatives (vasectomy, tubal ligation, "gomerization")
Tubal ligation: Snipping and tying of fallopian tubes as a sterilization measure can be performed on female cats, dogs, and other species; it is essentially the female equivalent of vasectomy, but a more invasive procedure. Risk of unwanted pregnancies is insignificantly small. Only a few veterinarians perform the procedure.Like other forms of neutering, vasectomy and tubal ligation eliminate the ability to produce offspring. They differ from neutering in that they leave the animal's levels and patterns of sex hormone unchanged. Both sexes will retain their normal reproductive behavior, and other than birth control, none of the advantages and disadvantages listed above apply. This method is favored by some people who seek minimal infringement on the natural state of companion animals to achieve the desired reduction of unwanted births of cats and dogs.
"" is breeders' informal term for surgical techniques by which male livestock, such as bulls, retain their full libido, but are rendered incapable of sexual intercourse. This is done to stimulate and identify estrous females without the risk of transmitting venereal diseases or causing a pregnancy by a male other than the one intended for selective breeding. Animals altered for this purpose are referred to as teasers, or gomers. Several methods are used. Penile translocation surgically alters the penis to point far enough away from its normal direction that it cannot manage vaginal penetration. Penile fixation permanently attaches the penis to the abdomen so that it cannot be lowered for penetration. Penectomy is the partial or complete removal of the penis.
Nonsurgical alternatives
Injectable
- Male dogs – Two intratesticular injectable formulations are known to sterilize male dogs. Zeuterin was approved by the United States Food & Drug Administration for permanent sterilization of male dogs ages three months and older by causing necrosis of the testicle. It is not currently available commercially. Calcium chloride dissolved in a variety of diluents have also been studied, with the majority of research and most promising results using calcium chloride dissolved in ethyl alcohol. Calcium chloride formulations can be purchased for use in animals from compounding pharmacies, but the use of calcium chloride for sterilization of males is not approved by the FDA or any other international regulatory agency.
- Male cats – Calcium chloride formulations have also been studied in male cats.
- Male rats – Adjudin, induces reversible germ cell loss from the seminiferous epithelium by disrupting cell adhesion function between nurse cells and immature sperm cells, preventing maturation.
- Male mice – injection of a solution of the JQ1 molecule to bind to a pocket of BRDT necessary for chromatin remodeling, which gives the proteins that regulate how genes act access to the genetic material
- Male sheep and pigs – Wireless Microvalve. Using a piezoelectric polymer that will deform when exposed to a specific electric field broadcast from a key fob the valve will open or close, preventing the passage of sperm, but not seminal fluid. Located in a section of the vas deferens that occurs just after the epididymis, the implantation can be carried out by use of a hypodermic needle.
- Female mammals – Vaccine of antigens encapsulated in liposomes with an adjuvant, latest US patent , CA patent . Product commercially known as SpayVac, a single injection causes a treated female mammal to produce antibodies that bind to ZP3 on the surface of her ovum, blocking sperm from fertilizing it for periods from 22 months up to 7 years. This will not prevent the animal from going into heat and other than birth control, none of the above-mentioned advantages or disadvantages apply.
Other
- Male mice – reversible regulation of the KATNAL1 gene in the Sertoli cell microtubule dynamics of the testes.
- Female mammals – orally administered phosphodiesterase 3 inhibitor ORG 9935 daily before and during ovulation, which blocks the resumption of meiosis resulting in ovulation of a non-fertilizable, immature oocyte without rupturing the follicle.
Early-age neutering
While the age-unrelated risks and benefits cited above also apply to early-age neutering, various studies have indicated that the procedure is safe and not associated with increased mortality or serious health and behavioral problems when compared to conventional age neutering. Anesthesia recovery in young animals is usually more rapid and there are fewer complications. One study found that in female dogs there is an increasing risk of urinary incontinence the earlier the procedure is carried out; the study recommended that female dogs be spayed no earlier than 3 to 4 months of age. A later study comparing female dogs spayed between 4 and 6 months and after 6 months showed no increased risk.
One study showed the incidence of hip dysplasia increased to 6.7% for dogs neutered before 5.5 months compared to 4.7% for dogs neutered after 5.5 months, although the cases associated with early age neutering seems to be of a less severe form. There was no association between age of neutering and arthritis or long-bone fractures. Another study showed no correlation between age of neutering and musculoskeletal problems. A study of large breed dogs with cranial cruciate ligament rupture associated early-age neutering with the development of an excessive tibial plateau angle.
Of particular note are two recent studies from Lynette Hart's lab at UC Davis. The first study from 2013, published in a well-known interdisciplinary peer-reviewed journal demonstrated "no cases of CCL diagnosed in intact males or females, but in early-neutered males and females the occurrences were 5 percent and 8 percent, respectively. Almost 10 percent of early-neutered males were diagnosed with LSA, 3 times more than intact males. The percentage of HSA cases in late-neutered females was 4 times more than intact and early-neutered females. There were no cases of MCT in intact females, but the occurrence was nearly 6 percent in late-neutered females"
The second study from 2014 highlighted significant difference in closely related breeds, suggesting that inter-breed variability is quite high and that sweeping legal measures and surgical mandates are not the best solutions to canine welfare and health. Specifically the study states: "In Labrador Retrievers, where about 5 percent of gonadally intact males and females had one or more joint disorders, neutering at 6 months doubled the incidence of one or more joint disorders in both sexes. In male and female Golden Retrievers, with the same 5 percent rate of joint disorders in intact dogs, neutering at 6 months increased the incidence of a joint disorder to 4–5 times that of intact dogs. The incidence of one or more cancers in female Labrador
Retrievers increased slightly above the 3 percent level of intact females with neutering. In contrast, in female Golden
Retrievers, with the same 3 percent rate of one or more cancers in intact females, neutering at all periods through 8 years of
age increased the rate of at least one of the cancers by 3–4 times. In male Golden and Labrador Retrievers neutering had
relatively minor effects in increasing the occurrence of cancers."
In terms of behavior in dogs, separation anxiety, aggression, escape behavior and inappropriate elimination are reduced while noise phobia and sexual behavior was increased. In males with aggression issues, earlier neutering may increase barking. In cats, asthma, gingivitis, and hyperactivity were decreased, while shyness was increased. In male cats, occurrence of abscesses, aggression toward veterinarians, sexual behaviors, and urine spraying was decreased, while hiding was increased.
Health and behavioral effects
Advantages
Besides being a birth control method, and being convenient to many owners, castrating/spaying has the following health benefits:- Sexually dimorphic behaviors such as mounting, urine spraying and some forms of male aggression are reduced due to the decrease in hormone levels brought about by neutering. This is especially significant in male cats due to the extreme undesirability of these male cat sexual behaviors for many pet owners.
- Early spaying significantly reduces the risk of development of mammary tumours in female dogs. The incidence of mammary tumours in un-spayed female dogs is 71%, but if a dog is spayed before its first heat cycle, the risk of developing a mammary tumour is reduced to 0.35%—a 99.5% reduction. The positive effects of spaying on reduction of later mammary tumours decreases with each heat the dog has, and there is no added benefit to spaying to reduce recurrence of a mammary tumour once it has been diagnosed.
- Neutering increases life expectancy in cats: one study found castrated male cats live twice as long as intact males, while spayed female cats live 62% longer than intact females. Non-neutered cats in the U.S. are three times more likely to require treatment for an animal bite. Having a cat neutered confers health benefits, because castrated males cannot develop testicular cancer, spayed females cannot develop uterine, cervical or ovarian cancer, and both have a reduced risk of mammary cancer.
- Without the ability to reproduce, a female necessarily has zero risk of pregnancy complications, such as spotting and false pregnancy, the latter of which can occur in more than 50% of unspayed female dogs.
- Pyometra, uterine cancer, ovarian cancer, and testicular cancer are prevented, as the susceptible organs are removed, though stump pyometra may still occur in spayed females.
- Pyometra is a life-threatening condition that requires emergency veterinary treatment. The risk of a non-spayed bitch developing pyometra by age 10 is 25% across all breeds, but can be as high as 54% in some breeds. The treatment of choice for a closed-pyometra is admission to hospital, commencement on intravenous fluids and appropriate antibiotics and, once stable enough for the anaesthetic and surgery, emergency removal of the infected pus-filled uterus. Medical management can be attempted if the animal's condition allows or dictates, if the owner wishes to keep the dog entire to breed or if the owner is unable to afford the veterinary fees associated with surgery. Emergency removal of the infected uterus carries a much higher degree of risk of death than a routine 'spay' operation. The risk of death from in dogs undergoing surgical treatment for pyometra is up to 17%. Thus the risk of death in entire female dogs from a pyometra, even if given correct veterinary attention can be up to 9% by 10 years of age. This risk is reduced to virtually zero if spayed.
Disadvantages
General
- As with any surgical procedure, immediate complications of neutering include the usual anesthetic and surgical complications, such as bleeding, infection, and death. These risks are relatively low in routine neutering; however, they may be increased for some animals due to other pre-existing health factors. In one study the risk of anesthetic-related death was estimated at 0.05% for healthy dogs and 0.11% for healthy cats. The risks for sick animals were 1.33% for dogs and 1.40% for cats.
- Spaying and castrating cats and dogs may increase the risk of obesity if nutritional intake is not reduced to reflect the lower metabolic requirements of neutered animals. In cats, a decrease in sex hormone levels seems to be associated with an increase in food intake. In dogs, the effects of neutering as a risk factor for obesity vary among breeds.
- Neutered dogs of both sexes are at a twofold excess risk to develop osteosarcoma as compared to intact dogs. The risk of osteosarcoma increases with increasing breed size and especially height.
- Studies of cardiac tumors in dogs showed that there was a 5 times greater risk of hemangiosarcoma, one of the three most common cancers in dogs, in spayed females than intact females and a 2.4 times greater risk of hemangiosarcoma in castrated dogs as compared to intact males.
- Spaying and castrating is associated with an increase in urinary tract cancers in dogs, however the risk is still less than 1%.
- Neutered dogs of both sexes have a 27% to 38% increased risk of adverse reactions to vaccinations. However, the incidence of adverse reactions for neutered and intact dogs combined is only 0.32%.
- Neutered dogs have also been known to develop hormone-responsive alopecia.
- A 2004 study found that neutered dogs had a higher incidence of cranial cruciate ligament rupture, a form of anterior cruciate ligament injury.
- A study of golden retrievers found that castrated males were 3 times more likely than intact males to be diagnosed with lymphoma and 2 times more likely to have hip dysplasia.
- Castration and spaying can also increase the risk of geriatric cognitive impairment, as noted in Laura J. Sanborn's meta-analysis.
- About 2% of castrated male dogs eventually develop prostate cancer, compared to less than 0.6% of intact males. The evidence is most conclusive for Bouviers.
- In a study of 29 intact male dogs and 47 castrated males aged 11–14, the neutered males were significantly more likely to progress from one geriatric cognitive impairment condition to two or more conditions. Testosterone in intact males is thought to slow the progression of cognitive impairment, at least in dogs that already have mild impairment.
- As compared to intact males, castrated cats are at an increased risk for certain problems associated with feline lower urinary tract disease, including the presence of stones or a plug in the urethra and urethral blockage.
- Neutering also has been associated with an increased likelihood of urethral sphincter incontinence in male dogs.
- There is evidence that spaying can increase the risk of urinary incontinence in dogs, especially when done before the age of three months. Up until 12 months of age, the risk decreases as the age at spaying increases. Urinary incontinence can affect up to one out of five spayed female dogs, and develops an average of 2.9 years after the dog has been spayed.
- Spayed female dogs are at an increased risk of hypothyroidism.
Current research