Early Spay/Neuter ***

[KingstonTodd]

I did sone research and found a published study concerning the risks in ESN, thought I would pass he info along:

J Am Vet Med Assoc. 1997 Jul 1;211(1):57-62.

Short-term results and complications of prepubertal gonadectomy in cats and dogs.Howe LM.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station 77843-4474, USA.

OBJECTIVE: To determine short-term results and complications of prepubertal gonadectomy in cats and dogs.

DESIGN: Prospective randomized study.

ANIMALS: 775 cats and 1,213 dogs. PROCEDURE: Animals undergoing gonadectomy were allotted into 3 groups on the basis of estimated age (group 1, < 12 weeks old; group 2, 12 to 23 weeks old; group 3, > or = 24 weeks old). Complications during anesthesia, surgery, and the immediate postoperative period (7 days) were recorded. Complications were classified as major (required treatment and resulted in an increase in morbidity or mortality) or minor (required little or no treatment and caused a minimal increase in morbidity). An ANOVA was used to detect differences among groups in age, weight, body temperature, and duration of surgery. To detect differences in complication rates among groups, chi 2 analysis was used.

RESULTS: Group 1 consisted of 723 animals, group 2 consisted of 532, and group 3 consisted of 733. Group-3 animals had a significantly higher overall complication rate (10.8%) than group-1 animals (6.5%), but did not differ from group-2 animals (8.8%). Differences were not detected among the 3 groups regarding major complications (2.9, 3.2, and 3.0% for groups 1, 2, and 3, respectively), but group-3 animals had significantly more minor complications (7.8%) than group-1 animals (3.6%), but not group-2 animals (5.6%).

CLINICAL IMPLICATIONS: In this study, prepubertal gonadectomy did not increase morbidity or mortality on a short-term basis, compared with gonadectomy performed on animals at the traditional age. These procedures may be performed safely in prepubertal animals, provided that appropriate attention is given to anesthetic and surgical techniques.

[kirama]

That's good information. When we had Beck neutered the vet said that he likes to do it at 16-20 weeks on large dogs- something about their bone development if it's done too early, and complications if its done too late..but I don't remember what the deal with the bones was I guess I should have paid closer attention lol

[KingstonTodd]

Apparently the bone development arguement is a myth, I'll post that article too.

J Am Vet Med Assoc. 1991 Apr 1;198(7):1193-203.

Gonadectomy in immature dogs: effects on skeletal, physical, and behavioral development.Salmeri KR, Bloomberg MS, Scruggs SL, Shille V.

Department of Small Animal Clinical Sciences, University of Florida, Gainesville 32610-0126.

In a 15-month study, the effects of prepubertal gonadectomy on skeletal growth, weight gain, food intake, body fat, secondary sex characteristics, and behavioral development were investigated in 32 mixed-breed dogs. Male and female pups from 5 litters were randomly allotted to 3 groups: group I, neuter at 7 weeks (n = 14); group II, neuter at 7 months (n = ; and group III, sexually intact dogs (n = 10). Growth plate closure was delayed (group I vs group III; P less than 0.000001; group II vs group III, P less than 0.000001) in all neutered dogs, as compared with sexually intact dogs. Growth plate closure was delayed longer (group I vs group II, P less than 0.000045) in dogs neutered at 7 weeks old, compared with dogs neutered at 7 months old. The rate of growth was unaffected by gonadectomy, but the extended growth period resulted in greater final radial/ulnar length in all male dogs and bitches neutered at 7 weeks. Gonadectomy did not influence food intake, weight gain, or back-fat depth. Penile development was immature in the adult group-I males (mean +/- SEM diameter of pars glandis = 11.1 +/- 1.0 mm), compared with adult group-II (16.3 +/- 0.5 mm) and group-III (21.0 +/- 2.2 mm) males. Subjectively, the prepuce and os penis of the group-I males were immature, compared with those of group-II and group-III males. Vulvar development in group-I and group-II bitches was less mature than vulvar development in the sexually intact bitches. Of 7 behavioral characteristics assessed, only general activity and excitability rated differently among treatment groups. All neutered dogs were judged to be more active (group I, P less than 0.004) than sexually intact dogs. Group-I males were judged to be more excitable (P less than 0.02) than group-III males. It was concluded that with respect to skeletal, physical, and behavioral development, the effect of neutering pups at 7 weeks old was similar to that of neutering pups at 7 months old.

[Jac]

Wow, Todd...this is excellent research! Thank you for posting it!

[kirama]

It is..I'm going print that out and take it to the vet next time I go & show him that the bone thing is a myth

[KingstonTodd]

I guess it depends on what part you focus on:

"Growth plate closure was delayed longer in dogs neutered at 7 weeks old, compared with dogs neutered at 7 months old. The rate of growth was unaffected by gonadectomy, but the extended growth period resulted in greater final radial/ulnar length in all male dogs and bitches neutered at 7 weeks."

But:

"It was concluded that with respect to skeletal, physical, and behavioral development, the effect of neutering pups at 7 weeks old was similar to that of neutering pups at 7 months old."

So I take that the ESN may make the pup slightly taller, but it doesnt matter as they are equally healthy in regards to their skeleton.

Also note the first study on short term health had over 1200 puppies in it which is very significant, and the latter was a small study and likely needs to be repeated on a larger scale before it will change any vets mind. But considering the minor difference of ESN in the small study and he major impact on pet overpopulation, I wouldnt be surprised to see vets jumping on the bandwagon of ESN in teh future. Also, I think it is important to have a vet qualified/experienced to do ESN and be up to date on current anesthetic dosages for young pups before I would trust them with one of mine.

[MaxandMe]

great articles TODD.....for me and my vets, we prefer to wait till 5mos or older due to anesthesia risks
BUT if a young puppy were to have to undergo immediate surgery to save the puppy's life and you aren't breeding the puppy
then at that point they do the spay/neuter at the same time.

i ran into this situation with peanut at 15wks old but luckily she didn't need surgery.

this will alway probably be an ongoing debate early or later spay/neuter.

[KingstonTodd]

Not to try and stir anything up but, What anesthetic risk? I still ahve to read the full paper article, but from the abstract, the first study of over 1200 puppies demonstrated no difference in shrot term outcome from surgery, and this included complications from anesthesia. They say in the conclusion special attention must be paid to anesthetic and surgical technique, but this is true of any surgery at any age. A botched procedure will have a bad result if it is ESN or done at an earlier age. My main concern would be the TYPE of anesthetic used. If they use an injectable, then a small overdose cannot be undone, you can't suck it back out! But if the vet uses an inhaled anesthetic, it is breathed off with every breath and if a puppy starts to be too deeply anesthatized, you just reduce the flow and increase the ratio of oxygen for a minute and bring them back to the correct anesthetic plane.

[SamsonsMom]

What great research! Thank you for sharing Todd!

From a breeder standpoint - I can't comment. I'd say from a rescue organizations standpoint this is GREAT research to know about. Frankly, there is a HUGE pet overpopulation problem, and the animal shelter here do ESN's to prevent an unaltered pet going to a new home and the new owner not following through on the surgery. The shelters here do use inhaled anesthesia.

[Jac]

I agree on the anesthesia issue...I think that the anesthesia can be very safe...so long as the vet is experienced and knows what he/she is doing. Of course, all vets need to practice, but if I were a vet, I would ask (hire) an experienced vet (one who has done many juvenile spay/neuter operations) to stand by and mentor me...then, the experience comes but someone is there to help in an emergency.

[MaxandMe]

I did have one doodle that had a bad reaction to anesthsia thus we learned what NOT to use on Beau in the future whereas max and peanut were fine

so that is what i meant by risk and also experience with young puppies.

i guess i am oldfashioned and still wonder if females have a problem with UTI's more when spayed very young or not
(good one for Todd to research now and i know you will Todd )

i am just one that perfers to wait till 5 or 6mos old.

1200 dogs may sound like a lot but in reality that is a tiny fraction compared to how many early spays vs later ones imo

[kirama]

There is a far greater anesthesia risk with 'low cost' spay/neuters. When I had Beck neutered I was a bit shocked at the expense, she explained that what I was paying for was intubation, IV administered anesthesia and electronic monitoring. She said that when you get a 'bargain' spay/neuter the vet uses gas or guesses at the amount of injected anesthesia and does not intubate or monitor, and that is fine 'unless' the dog runs into a problem during the procedure, and if it does the vet will most likely not be able to keep it alive.

[KingstonTodd]

I agree that there are a lot of measures you can do to make it safer (heat, fluids, heart rate and blood pressure monitoring), and all those things cost money. Good point about "low cost" clinics vs a more comprehensive operation.

I do wonder about different routes of administering anesthetic, injectable, IV and Gas, for the case of overdose. With a gas, if you notice the breathing getting too deep, which is the first sign, you cut back the flow of anesthetic and increase the oxygen. If you cut it of completely the animal would wake up in a minute, very fast, and so the risk of overdose is only there is somebody in not monitoring the animal closely. With injectable, you can't suck it back out, and once they are down they take 10 minutes of more to come out, which may be too long. This method is very old fashioned and I think where the "risky" aspect of anesthetic comes from historically. Now, with IV, since it is not a single large dose at the begining like injectable, but rather a smaller continuous dose, I think it would be much safer than injectable. I would like to ask a vet how fast it wears off, i.e. how fast can you revive if you notice slowed breathing and cut the flow in the IV? So, I do prefer a gas at the moment. (side note, we use gas over injectable in lab when we do surgery on mice, they recover much better and we have found it to be safer, and have lesss complications like overdose).

[SamsonsMom]

OK I don't want to stir the pot or anything, but not ALL low cost spay/neuter clinics are like that. Only speaking for our area, but the low cost spay/neuter clinics here actually ask local Vets to volunteer for the clinic. The clinic staff ensures that the Vet has a good reputation, and is experienced. Same vet who does the procedure in his office and charges 3xs what the clinic does, is handling the actual procedure in the clinic.

We have one major clinic in our area. It has a 3 month waiting list and is known for its reputation of being great before/during/after the procedure. They not only used skilled vet techs to assist the volunteering vet, but do monitor your pet throughout the operation. The Vet techs call before your appointment to help you prep your animal for the operation, and to tell you what to expect, give you more instruction while you're there dropping off your pet, and than have an emergency vet on standby just in case something happens once you get home that you need to take your pet too (free of charge if its an post-op problem).

Not only that but your pet must be fully awake and alert for 2 hours at least before you can pick up your pet. This is done for continued monitoring post-op.

Typical neuter in our area about $150, clinic charges $35. Main reason they're able to do it so cheaply - Vet is volunteering (no charge), Vet techs are volunteering (no charge), the clinic staff who handles the administration side are volunteering (no charge) and the building they operate in was donated to them, and the equipment was bought by doing MANY MANY fundraisers over a span of 3 years.

I personally think low cost spay/neuter clinics are a terrific service to the community, because lets face it, not everyone who gets a pet thinks about the expense of vetting the pet and they're not able to afford it, this way communities can cut down on unwanted litters of puppies/kittens. The clinic above that I was talking about tells you, if you can pay a traditional vet fee, please do so, so they can help as many people who can't afford the higher cost of the vet's office.

---Getting off soap box now---

[Jac]

Great info all around...for me, the most important thing about this discussion is that we should all learn the right questions to ask our vets.

I have been one to just "assume" that the vet is smart and knows what he/she is doing...and that they are prepared for all emergencies and that they all do things the same way...obviously, I have been very wrong!

I learned the hard way.

Todd, the information you have given is excellent. When I go to the vet again, for any surgery, I plan to ask a lot of questions and find out why they do what they do...and I also plan to ask what they have lined up for an emergency.

Liz, that is very good information too...you are so lucky to have an excellent vet service. It really is excellent too!

In our area there is a low cost spay/neuter clinic and one of my puppy owners took their pup to them for neutering...during the visit before the surgery...one of the women at the clinic SLAPPED the puppy! The owner confronted her, very angrily, and asked why she did that...as she was pulling her dog back to her...and the woman said "Because he was getting ready to lift his leg and pee on something." !!! First of all, my friend said that he was NOT going to pee...she was watching him all the time...and then we found out that the woman is actually the OWNER of the clinic property, not an employee, and that she OFTEN smacks male dogs...she is a cat person and hates dogs and she especially hates male dogs because they mark in her building and cause her to have to clean it up!

If that would have been me...or even if I had lived here at the time (it was before we moved here) I would have gone to visit that woman...and my eyes would have been flashing fire! I also would have followed up with a letter from my (attorney) husband! I was so furious...and this was posted on a forum where others wrote in to say that they had similar experiences!

Sooooo, the point I am making is, be sure to find out EVERYTHING you can about the vet, the clinic, the care and the procedure before you take your dog in.