Spay and Neuter: When and If ever?

[megansmomma]

Originally Posted by 107barney

I have liked him for a while. He is into science and evidence based practices instead of conjecture and ill-grounded opinion. I look forward to his input on the many issues that we have here. Perhaps he can be our unpaid YT veterinary consultant as you suggested

Yes, it's too bad that he practices in CA which I discovered with a little bit of MM detective work. He might be an anonymous blogger but it wasn't too difficult to uncover his identity, his educational background and where he practices.

[107barney]

Originally Posted by megansmomma

Yes, it's too bad that he practices in CA which I discovered with a little bit of MM detective work. He might be an anonymous blogger but it wasn't too difficult to uncover his identity, his educational background and where he practices.

Yes he has his resume on his FAQs page also.

[gemy]

Originally Posted by pstinard

For me, this is the worst aspect of the vizsla study:

The data was collected though anonymous questionnaires completed by owners, often years after the events being asked about, and there was no way to confirm the accuracy or validity of these reports.

Accurate data collection is the most critical part of any study. If you have questionable data, then the results and conclusions are questionable. I almost can't believe this, but here is a quote directly from the vizsla study itself:

Procedures—Data on demographics, gonadectomy status, and age at diagnosis of disease or disorder were obtained with an anonymous online survey and analyzed.

Anonymous online surveys can be completed repeatedly in order to purposefully skew results. A good chunk of the discussion section is devoted to discussing the inherent flaws of this study, and their overall conclusion is that more research is needed on the effects of neutering in dogs. I agree that more research is needed, but I'm afraid that a lot of people will come away thinking that the results (Dogs gonadectomized at ≤ 6 months, between 7 and 12 months, or at > 12 months of age had significantly increased odds of developing mast cell cancer, lymphoma, all other cancers, all cancers combined, and fear of storms, compared with the odds for sexually intact dogs) are scientifically valid, when they are not.

Data collection—Data on estimated risk and age of



diagnosis of mast cell tumor, hemangiosarcoma, lymphoma

or lymphosarcoma, all other cancers, and all cancers

combined as well as estimated risk and age at diagnosis

of behavioral problems were obtained for Vizslas from


a survey conducted on that breed in 2008.1 The survey



was designed by statisticians at the West Chester Statistics

Institute and administered via an anonymous online

questionnaire at a site hosted by West Chester University

Internet Presentations Group. There was a direct link to

that site from the Vizsla Club of America website, and

the survey was advertised in a variety of email lists, websites,

magazines, and newsletters to which Vizsla owners

would have access. Responses were allowed to be posted

between January 21 and December 15, 2008.


I was looking at this method of collection. And it seems like this would be a grade school error and not what appears to be institutes/professionals in the design and administration of an on line survey.
I am pretty sure there are ways to do an on line survey and keep the indentity of the owner/kennel anonymous and still prevent multiplicity of entries for the same dog/person, etc.
After all there are some regions here that allow on line voting for elections! For sure they have figured a way to insure only one vote for one person.

The SkepVet has done one such review of this study, surely there will be more experts contributing their own opinion on the research methodology etc.

And maybe an opportunity for the authors of the study to comment or clarify questions with response to on line survey methodology.

Data integrity and collection is a very key point. If the folks who are owners of Viszlas who also financially contributed to this study, I propose they would be pretty carefull about their reporting. After all they want some answers and were willing to fund in part this study. And they would have access to their own vet records to "refresh" their memory. The age of death of a pet is hardly something one easily forgets, nor if they had cancer. If as argued people were incentivized to complete this survey, and by that I mean, they have a deep and abiding passion for the overall health of their breed, then what pray tell would be the motive to skew the results? To knowingly submit bad information. After all they will likely also be the ones to fund further research into Viszlas.

To argue as the SkepVet has done, that Viszlas might not represent the whole dog population is quite frankly obvious. It was a unibreed study, and designed to be a unibreed study to answer specific questions and start to build a body of research on Viszlas.

As a matter of note I also find it quite surprising, that none of the studies I have read in recent years, go back to compare their results to the "hallmark" studies that must have been done on "all breeds" that supported a veterinary position of s/n about six months old, and the risks across all breeds for many of the health concerns that are talked about if you don't do by six months old.

Another argument made can and will be made against any study every designed here in North America. If the fact that 80% of our dogs are neutered then if you limit the study to N.A only, intact animals will always represent only a fraction of the total dog population. And likely those animals in part will be used for breeding and or for sporting, hunting, and or performance dogs. Not your "usual" pet.

It is a fact that to find for many breeds enough intact animals to participate in studies is very difficult. They will come mainly from organizations like performance/obedience/protection and or from breeders. I do agree with the SkepVet in that a likely true assumption is that we take prime care of our athletes and our dogs used for breeding. Always of course excepting the puppy mills (which I hardly think would contribute to breed surveys) and bybers who likely would not as well.

If I put aside for one moment the data collection integrity etc, I have a problem with only having spay/neuter category greater than 1 yr old. This category must then include retired breeding dogs, and or dogs who were held for breeding but never bred for a variety of reasons. Most breeders will not s/n before 1yr old, in almost all dog breeds. But they will retire females and spay them at 4 or 5 or 6 yrs old. Males not so much, although some do get neutered for a specific health problem if one does occur. In the dog performance sport world for large breeds, many females will not get bred, but will get spayed at or after 18months old. Now for Vizsla females that might not hold true if indeed their incidence of ED HD etc is only at 9% which I find surprising.

Just some thoughts on this.






.

[gemy]

Originally Posted by megansmomma

Benefits & Risks of Neutering, an Evidence Update–Cancer and Behavioral Problems in Vizslas
Posted on February 11, 2014 by skeptvet
especially common in Vizslas, including Mast Cell Tumors (MCT), Hemangiosarcoma (HAS), and Lymphoma (LSA), as well as behavioral problems (noise phobias, separation anxiety, and various forms of aggression). The general results, broken down by age of neutering, are reported in the tables below.
The odds of MCT and LSA were higher for neutered than intact animals. The odds of HSA was higher for neutered females than for intact females, but there was no relationship between neutering and HSA risk for males. The odds of cancers other than these three were also higher for neutered than for intact animals. For all of these cancers, the odds were higher in those neutered after 12 months of age than in those neutered earlier. Yes but less for n/s male female dogs at least that is what I read in the chart.
For behavioral problems evaluated, the odds of having such a problem were higher in dogs neutered before 6 months of age than in intact dogs. There were no differences in the odds of behavior problems between intact dogs and those neutered after 6 months of age with the exception of storm phobia which was more common in neutered animals overall than in intact animals.
There was no difference in the age at death or the longevity of neutered dogs compared with intact dogs.
Limitations of the Study

The first potential limitation of this study is that the population of dogs included are potentially not representative of the general pet dog population. Only one breed was included, and only 60% were reportedly kept as “primarily a family pet,” with most of the others being used for show or hunting activities. Which is what the study was about Viszlas
About 23% were reported to have had offspring and almost half (43%) of the dogs were intact, whereas surveys suggest over 80% of the overall owned dog population is neutered.

If that is a true statistic this drawback is for all current and future studies.

The average age at death was also reported to be 9 years, which seems quite young compared to many other breeds and mixed-breed dogs of similar size. Since there are genetic factors involved in many health conditions, and potentially developmental and environmental factors associated with how dogs are kept, caution must be used in extrapolating results from one population to another.
Another significant limitation of this study is the method of data collection. All data was collected by anonymous online questionnaire, with no attempt to verify the accuracy or validity of these data. Diagnoses of cancer and behavioral problems and assessment of age at neutering were based entirely on reports of owners, sometimes many years after the fact.
This raises a host of concerns. Owners may have reported diagnoses incorrectly, such as misidentifying cancers or reporting benign tumors as “cancer.” Owners may have been more likely to report cancer and/or neutering information if they believed there to be a relationship between the two or if they knew one purpose of the study was to examine such a relationship. Owners also identified cancer and skin conditions as top health concerns, suggesting a population of respondents particularly interested in these conditions, which might have affected their rate of reporting them.
There is also no way to identify what if any differences there were between people who participated in the survey and people who did not, or between the dogs owned by these different groups. It is likely that people who were aware of the survey and motivated to complete it differed in numerous ways from other Vizsla owners and owners of other kinds of dogs, and this again could affect the health conditions reported and the risk factors affecting them.
Another issue is that this study looked at potential risks posed by neutering, but it did not include assessment of most of the potential benefits of this procedure in this population. For females, for ecample, neutering is believed to be protective against mammary cancer (though the evidence is not as strong as commonly supposed), which in some populations is a very common and frequently malignant type of cancer. In this population, mammary cancer was reported in less than 1% of the females in the study, a rate dramatically less than in other populations studied. This suggests either that this population is a much lower risk of mammary cancer than others, in which case the protective effect of neutering might not be meaningful, or that the incidence of this disease was underreported.
Similarly, uterine infections (pyometra) are a common and serious disease in intact females, and these can be completely prevented by neutering. Yet the rate reported in this study was quite low. 22 cases were reported, which would be a rate of about 4% of the ~535 intact females included. Other studies have reported rates of 10-50% depending on age, so either this population has an unusually low rate of this disease, or the incidence was not accurately reported. Yes very unusual low rate. How-ever this is one diagnosis an owner of an intact female is likely to forget or mistake. And there is no obvious reason for under reporting this.

Health problems and cost or disruption for owners associated with estrus, reproductive behaviors, or actual reproduction were also not evaluated in this study.
Overall, the study found no difference in the longevity or overall mortality of neutered versus intact dogs. This is in contrast to other studies which suggest neutered animals may live longer on average than intact animals. More importantly, it calls into question the significance of the reported increase in cancer risk in neutered dogs. If neutered dogs are truly at significantly higher risk of often fatal diseases like HAS and LSA, one might expect intact animals to live longer as a results of being less likely to experience these diseases. And if the two groups have roughly the same life expectancy, perhaps there are benefits to neutering not reported here that counterbalance the risks discussed? Yes that is an inbuilt flaw to the study.
Bottom Line
This study contributes useful new information to the ongoing process of evaluating the risks and benefits of neutering. It supports information from other studies, in Rottweilers and Golden Retrievers, that suggest neutering may increase the risk of some cancers, such as hemangiosarcoma and lymphosarcoma, in breeds predisposed to develop these diseases.
The study also has a number of significant limitations. The dogs in the study were all of one breed, and they differed in a number of ways from the general pet dog population, so findings in this group may not be applicable to other populations. *The data was collected though anonymous questionnaires completed by owners, often years after the events being asked about, and there was no way to confirm the accuracy or validity of these reports. There is also a high risk that the people who chose to participate in the survey, and the dogs they own, are quite different from the general pet owning population and their pets, in their concerns, knowledge, and pet care practices.
The study did not examine many of the risks posed by being intact, which have to be considered in weighing the overall risks and benefits of neutering. Rates of pyometra and mammary cancer, common and serious medical problems prevented by neutering females, were far lower in this study than generally reported elsewhere, suggesting either that the study population was quite different from other dog populations or that the rates of these diseases were not accurately reported.
And it is unclear how significant the reported increase in the risk of cancers in neutered animals really is since there was no overall difference in the longevity of neutered and intact animals. If neutered animals are much more likely to get cancer, it is surprising that they tended on average to live just as long as intact dogs.
Overall, this study supports the current trend towards questioning the dogma of routine neutering for all dogs. The risks and benefits are likely to vary according to breed, age, and many other variables, and a one-size-fits-all approach is not ideal. Unfortunately, a great deal of additional research will need to be done for dog owners and veterinarians to have confidence in specific recommendations for individual dogs.

Benefits & Risks of Neutering, an Evidence Update–Cancer and Behavioral Problems in Vizslas | The SkeptVet

Agree with this one

[gemy]

I emailed the Skepvet on the study design for Viszlas: Here in is his Here in is his response the bolding is mine.

skeptvet says:
June 20, 2014 at 4:44 pm

The problem with recall bias and with misclassification of different kinds in studies that use similar methods is a well-recognized source of error. It is not something unique to this study, nor does it automatically invalidate the results. However, it is an uncontrolled source of bias that potentially reduces the internal and external validity of the trial. Similarly, the limitation to one breed clearly does reduce the extent to which we can generalize the results to other breeds or mixed breeds. Again, that doesn’t mean the results aren’t worth considering, but it does mean we cannot reasonably use the results of this one trial to dramatically alter our understanding of the risks and benefits of neutering or our specific practices. It is one bit of evidence out of hundreds of studies with its own strengths and weaknesses, and it must be evaluated in that context.
Automatic neutering of all dogs of both sexes at 6 months of age is absolutely an arbitrary practice with little in the way of evidentiary support. The trick is that when we reject such an arbitrary, non-evidence-based practice we be careful not to replace it with another.

[megansmomma]

Originally Posted by gemy

I emailed the Skepvet on the study design for Viszlas: Here in is his Here in is his response the bolding is mine.

skeptvet says:
June 20, 2014 at 4:44 pm

The problem with recall bias and with misclassification of different kinds in studies that use similar methods is a well-recognized source of error. It is not something unique to this study, nor does it automatically invalidate the results. However, it is an uncontrolled source of bias that potentially reduces the internal and external validity of the trial. Similarly, the limitation to one breed clearly does reduce the extent to which we can generalize the results to other breeds or mixed breeds. Again, that doesn’t mean the results aren’t worth considering, but it does mean we cannot reasonably use the results of this one trial to dramatically alter our understanding of the risks and benefits of neutering or our specific practices. It is one bit of evidence out of hundreds of studies with its own strengths and weaknesses, and it must be evaluated in that context.
Automatic neutering of all dogs of both sexes at 6 months of age is absolutely an arbitrary practice with little in the way of evidentiary support. The trick is that when we reject such an arbitrary, non-evidence-based practice we be careful not to replace it with another.

Gail, again you only posted a portion of his response. Let me share the rest so we are all on the same page in his response.

I have used it on my own pets when it was sold under another brand name. One advantage or disadvantage is that the testicle still produces a reduced amount of hormone. I will be interesting what the company uses to promote a possible benificial effect of leaving 50% hormone production.
G McLarnon says:
June 20, 2014 at 2:43 pm
Let me start here. First the study was designed and partially funded by Viszla owners to be a study about their breed. Which for those that participated in the survey would I would think tend to make them more attuned to give correct answers. If their memory is faulty they have their medical records to rely upon. Most dog owners do not forget the date of death of their dog, nor if indeed they were told if that beloved dog had cancer, and when they were told this. And indeed if they were “incentivized” it would be to give accurate information. After all who is going to be funding future studies????

An on line survey can contain with-in certain cross checks to help validate the information.

The anonymous part as described might just well be, that the contributors were told that their contributions were anonymous.

To bring up the fact that this study can’t be necessarily attributed to the larger dog population because it was designed and directed to only one breed, well hey maybe yes maybe not, but the study was designed to look at Viszlas.

cancer is a big issue in dogs, and not just for the Viszla breed but for many breeds.

Now this study showed some surprising results on pyrometra and mammary tumours, but is also surprising to me, in not only this study, but in other recent studies , why is there not any reference to the “hallmark” studies, that of “course” must have been done, before the veterinary medical community decided that 6mths old across all breeds is the optimal time to spay or neuter for the “HEALTH”
G McLarnon says:
June 20, 2014 at 2:54 pm
I don’t know why the study designers and funders decided to only look at a few things that were negative, and not to what is the benefits.. but gosh hey here is a thought mayhap the rates of cancer;skin,and other problems in Viszlas was what they wanted to look at.

So it remains in this and many other studies conclusions including your analysis, that one as a dog owner need to truly discuss the risks and benefits for their dog of this breed and the timing of same for s/n. And it behooves the vet community to come up with and train for alternatives to OVE and Castration, to truly give pet owners a “choice” in this decision
G McLarnon says:
June 20, 2014 at 3:52 pm
And one other comment where is the learned discourse, on what studies can be attributed to the larger dog population as a whole? What is the criteria, how was it developed, based upon what assumptions?
skeptvet says:
June 20, 2014 at 4:44 pm
The problem with recall bias and with misclassification of different kinds in studies that use similar methods is a well-recognized source of error. It is not something unique to this study, nor does it automatically invalidate the results. However, it is an uncontrolled source of bias that potentially reduces the internal and external validity of the trial. Similarly, the limitation to one breed clearly does reduce the extent to which we can generalize the results to other breeds or mixed breeds. Again, that doesn’t mean the results aren’t worth considering, but it does mean we cannot reasonably use the results of this one trial to dramatically alter our understanding of the risks and benefits of neutering or our specific practices. It is one bit of evidence out of hundreds of studies with its own strengths and weaknesses, and it must be evaluated in that context.

Automatic neutering of all dogs of both sexes at 6 months of age is absolutely an arbitrary practice with little in the way of evidentiary support. The trick is that when we reject such an arbitrary, non-evidence-based practice we be careful not to replace it with another.
skeptvet says:
June 20, 2014 at 4:46 pm
I have this very kind of complex, nuanced discussion with owners every day, and I think more and more vets are doing so. Unfortunately, both vets and owners tend to want simply, broadly applicable general rules, and biology is just too complex for that to be a reliable strategy.
skeptvet says:
June 20, 2014 at 4:46 pm
I’m afraid I don’t understand your question.

[gemy]

Originally Posted by pstinard

From this table, the biggest pro's are reduction of pyometra (score of +100) and mammary neoplasias (breast cancer; +24). The biggest cons are urinary incontinence (-66), surgical complications (-20), obesity (-14), and CCL rupture (-11). Surprisingly, the biggest negative effect was the chance of urinary incontinence. Based on the numerical scores, overall, the pro's outweigh the cons. Note that this table is for female dogs overall, and is not broken down by size or breed.

From the same study, further on towards the summary.


For both species and genders, obesity is a significant detriment of gonadectomy.

Veterinarians can use this opportunity to talk to clients about proper nutrition and exercise

for maintenance of normal body weight. Setting aside obesity, the clear benefit

of ovariohysterectomy for bitches and queens is evident. For male dogs, the high incidence of BPH artificially increases this impact factor. Because castration at the time of clinical manifestation of BPH is curative and because dogs are unlikely to develop clinical manifestations of this disorder until 2 to 3 years of age, castration can safely be
deferred until that time in most dogs.40–42

Well I will say Benign is just that Benign and not Cancerous. A slight enlargement of the prostate gland will not have any effect on the male dogs health. And even this author says there is no overt health reason to neuter a male dog early.

Once again a study that does not show cause and effect. The assumption which may or may not be valid, that obesity after s/n is a direct owner mis-management fault is just that an assumption. It needs to be studied, because obesity has many health risks associated with it.

THe metabolic effect of s/n might just be a clue that could elucidate on what breeds and what sexes s/n at different ages is. Of course the study would have to be designed to measure metabolic rates before s/n, and for some years after s/n.

At this time, my thoughts are that there appears to be no definitive guidance on what studies can be attributed to all breeds/mutts/mixes/designer dogs, and what is the scientific basis on which you can safely determine this study (which ever one it is), can be applicable to all breeds.

It also appears that at this point we don't have any studies that even tries to look at "cause and effect".

Perhaps getting the full mapping of each dog breeds Genome might help in future design of studies.

[megansmomma]

I found this conversation very interesting in the BREEDER FORUM regarding how you need to handle unaltered pets in your home and feel that anyone considering not spaying or neutering their family pets take a look at it. This is real life with intact dogs and not abstract studies and to me there seems to be a lot of work involved with keeping intact animals and it is not for the casual pet owner. After reading this exchange between a couple of members it seems it might even be dangerous to leave your home without crating and rotating. Personally, all of mine for the most part live very peacefully together and I never have to worry about things like hormones setting off dog fight. http://www.yorkietalk.com/forums/bre...ml#post4457717

[gemy]

To Neuter or Not to Neuter - What You Should Know - Page 1




Here is the link. No really new research although he does quote the Viszla study, which is of rather recent vintage.


Read it through nothing really surprising, he states more research is needed yada, yada, yada; a fact most of us know. Especially broad research unequivocally across the dog genus.

[mindy10]

I believe everything happens for a reason in people and pets. My first dog came from a pet store and lived to be 16 with no health problems. He was neutered at 5 months and never had muscle problems even at 16 years old. Some dogs come from great breeders and have liver shuts, CT, kidney problems. I really don't think there is no rhyme or reason. I do believe we are all here for a limited amount of time and some people are real healthy to the end and some are not. Some exercise exercise and eat right and die young of cancer or heart disease. Some abuse there bodies and live to be 80. I think we put to much thought into everything. I had a dog with CT and he was misdiagnosed and was on no medicine for 6 years with it and fainted 3 times a years from it for 5 years and then I finally put him to sleep at 12. He was meant to live to 12.

[gemy]

Well Mindy, I don't take what seems to be a fatalistic view of health. I believe that science evidenced based research can truly help to inform our decisions. And it is necessary to do. Absolutely.


I do agree that despite the best knowledge we have at the time, dogs get sick, so do humans, but that doesn't mean we should not try to understand why, and hopefully find preventatives. There is no 100% guarantee on life, except that death will come to all of us, and if you are human Taxes too

[gemy]

It also provides references to research - some studies are new to me and not yet linked in this thread


https://www.doglistener.co.uk/neutering_definitive


What I found particularly interesting is that it is in Sweden *illegal* to s+n a dog unless for medical reasons. Also that breeders have to be licensed/certified and health warranties for 3 years. Also no pet shop sales allowed.

[107barney]

My coworker did not spay her pup. She's spent $5,000 on cancer so far to deal with the fall out. Dog is still hanging on. So preventable.

[gemy]

Many types of cancer (at this point) are not preventable, at least as far as our knowledge goes.


Lymphoma, bladder, liver, heart, brain, kidney etc as far as I am aware are not associated with either spay or neuter. or intact dogs.


Studies how-ever have shown that for certain types of cancer - the risk appears to be either reduced or increased by s+n.


Mammary cancer while rare in dogs is increased by leaving an un-bred female intact (the most risky) - next is an older female who has been bred.


Hemangiosarcoma and Osteosarcomas and Sarcomas very deadly are highly increased in s+n (spayed or neutered dogs). Hemangiosarcoma is, for more than a few breeds quite common.


Cancer overall appears to be the leading cause of death in dogs... Surely we should try to find out why this is so.


I neutered my cat, and he died around middle age of a Sarcoma. I did not spay my female dog and she died young of Lymphoma.


One cancer associated with neutering(sarcoma), one cancer not associated.... (lymphoma).


Informed and judicious weighing of the risks versus benefits for your particular breed of dog is always wise.

[dottiesyrky]

Gemy.
Thank you for the article. A long read, but well worth it. I do believe that on balance, waiting until maturity is a good idea. But of course one has to protect the dogs from procreating until then. :-(