Canine well-being: considerations about desexing and sterilisation

Canine well-being is a series of articles sharing the experience I have gathered while living with and caring for dogs. They address common canine health concerns. I am not a veterinarian. The contents of these articles are intended to inspire looking beyond conventional ideas and practices. Be responsible and do your own research and seek appropriate veterinarian advice (from a holistic vet such as Dr Pearson from Paws to Heal).

I’ve been wanting to write on the subject of dog neutering for a while. It can be an emotionally charged topic and I didn’t want to end up in the hot seat. But Brené Brown inspired me.

Courage originally meant
‘To speak one’s mind by telling all one’s heart.’

Brené Brown

Initially, I only had in mind to speak about the medical implications of (early) neutering that have become apparent in recent years through published research. When I began to look into the subject I realised that it is much broader than I had considered it so far. As no issue ever stands alone but arises in a context, so it is with this topic. Branching into different perspectives brings more nuances which, of course, mean greater complexity. What follows is me speaking my mind by telling all my heart.

Adverse effects

Research into connections between desexing and the increased risk of joint disorders, urinary incontinence, hypothyroidism as well as cancer is catching the attention of more and more dog parents and vets. The orthopaedic problems we are talking about here are elbow and hip dysplasia, and cruciate ligament tears and ruptures, the oncological ones are lymphoma/lymphosarcoma, hemangiosarcoma, mast cell tumors and osteosarcoma. A breed specific as well as a mixed breed (with five weight categories) study found significant increase of the above mentioned health problems for some breeds and some weight categories if desexed early. In most cases ‘early’ means under one year old but for some under two years old. Removing the gonads (testes in males, ovaries in females) means messing with the endocrine system as the sex hormones are not only tied to reproduction but also affect the immune system, the musculoskeletal system, the cardiovascular system, as well as cognitive functions.

A study called ‘Long-term risks and benefits of early-age gonadectomy in dogs’ (Spain CV, Scarlett JM, Houpt KA) found that early neutering was associated with an increased incidence of noise phobias and undesirable sexual behaviours. There are also reports on adverse reactions to vaccines, fearful behaviour and aggression.

The number one reason to desex dogs is to prevent unwanted litters. It all started in the 1970s in the US as animal shelters were bursting at the seams with stray or unwanted dogs which meant a high killing rate. Seeing healthy dogs euthanised in great numbers day in and day out took a heavy toll on the mental health of people working there. Spay and neuter surgeries were enthusiastically welcomed as a means to control overpopulation and help decrease euthanasia rates.

Many countries adopted this practice and today their shelters and rescue organisations only re-home dogs after desexing them. RSPCA Australia has been practicing early-age desexing (EAD) for many years. EAD refers to desexing dogs as young as eight weeks old. In private vet clinics the traditional desexing age has been, and continues to be, six months though the above mentioned health risks are becoming more widely known and acknowledged by vets who update their previous views and practices. It takes humility and courage for someone bound by the hippocratic principle of ‘do no harm’ to admit that what one has advocated for strongly and practiced diligently earlier has, in fact, caused damage. Veterinarian Dr Karen Becker shows such integrity in this video that went viral.

Debating the topic of desexing can elicit strong feelings – people might feel vulnerable, regretful, bewildered, exasperated, or a combination of these or other responses. It is a complex topic and no matter how much we’d like it, there is no one answer that fits all.

Other points of view

The investigations into adverse health effects of spaying and neutering leads to different possible answers. Research so far has concerned itself mostly with the timing of the desexing procedure but generally doesn’t seem to question at all its necessity in the first place. Whereas in many parts of Europe keeping dogs entire is the norm. Some countries even consider desexing inhumane. Under Norway’s animal welfare act neutering a dog without valid medical or animal welfare reason is illegal. It is deemed unethical to surgically alter a dog for human whim or convenience, the same as ear cropping and tail docking. Norwegians and other Scandinavians put the responsibility on the humans to prevent unwanted litters, it’s their duty to train and contain their canine companions appropriately. If that sounds crazy to you, please note that Scandinavian countries to not have pet overpopulation problems.

I grew up in an apartment in Vienna, Austria. When I was twelve years old, my mum brought home a puppy. He was a Spaniel mixed breed we called Cherry. He was trained and socialised from the moment we got him. My best friend had an Old English Sheepdog named Putney. We would walk our dogs together, they played off-lead with other dogs (all entire), they could come on public transportation and were allowed in cafes, restaurants and shops. Cherry never marked inside or humped cushions, legs, etc. Neither did any of the other males I knew. When your female dog was in heat, you would keep her on lead and only walk around the block, staying away from off-lead areas. This was four decades ago but it’s still much the same today. There is a requirement now for dogs to be muzzled when travelling on public transportation and while in the past they got on for free, you now need to purchase a child’s ticket for your pooch. There are declared on-lead and off-lead areas in parks today and there are fines for not complying, just like for not picking up your dog’s poop.

When Putney was about seven years old he became quite ill. It was something involving his prostrate and after medication didn’t make a difference the vet suggested neutering him. That was a rare case. The decision was a medical one.

Alternative neutering methods

You could dismiss the idea of keeping dogs entire as a rule, thinking other countries, other customs. If you’ve made up your mind to neuter your dog and just are unsure of the timing because of the physical and mental health ramifications then let me bring up another consideration: Desexing or sterilisation?

The current neuter methods remove the gonads – males get castrated, females receive the equivalent of a full hysterectomy (removing both ovaries and the uterus, creating ‘instant menopause’). It means shutting off the main source of the sex hormones testosterone, estrogen, and progesterone and depriving the body from their important other functions. There are, however, alternatives – vasectomy for males, tubal ligation (‘tube tying’), or just removal of the uterus for females (‘ovary-sparing spay’). It means the animal is sterile (can’t reproduce) but keeps the hormonal benefits. For females there is also the option of ovariectomy, that is the removal of just the ovaries (but not the uterus) which is done laparoscopically (keyhole surgery) which is less invasive than the classic spay surgery, however, the source of hormone production is lost.

The traditional desexing for females is often cited to make mammary cancer – the most common malignant tumours in female dogs – less likely when done before two to two and a half years of age. However, the published research results ‘are judged to be weak and are not a sound basis for firm recommendations.‘ This is a direct quote from a systematic review of the presented evidence. Also mentioned in support of traditional desexing is the elimination of pyometra (infection of the uterus) since the organ is absent. But this is also achieved when choosing the ovary-sparing spay. The tubal ligation is often viewed inconvenient because of continued breeding behaviours, menstrual spotting, and the attraction of male dogs.

It’s a bit more straight forward for males. No testicular cancer in the absence of testis if dogs are castrated (traditional desexing). However, according to veterinarian Dr Chris Zink testicular tumours are almost always benign. Examining your dog’s testicles regularly will detect any anomalies and if indicated at that point have them removed. Intact males are more likely to have benign swelling of the prostrate, but neutered are more likely to develop cancer of the prostate.

I wondered why only so very few vets offer alternative neutering procedures and found a plausible reason in the client information sheet I requested from a vet clinic that does. This is what it says, ‘Firstly, this method is not taught as part of a Veterinary curriculum. Universities only teach traditional desexing methods. Vets who want to perform this procedure [vasectomy] actively choose to learn the method so they can offer it to their clients. This is why you’ll be hard pushed to find a vet who performs vasectomies in dogs. Other than that – there is no surgical reason why this procedure is not routinely offered and performed in practice. It’s a quicker and less invasive method than traditional castration.’ The same applies to the alternative surgeries for females. Here is another vet clinic in Victoria that also offers alternative neutering procedures and charges more reasonably for it than the above mentioned one.

Behavioural considerations

Many believe that entire males are more prone to aggression than neutered ones. Several studies say otherwise. When sexually mature, the hormonal signature of intact dogs can be perceived as a threat and might elicit aggression from neutered males. This has certainly been the case for a friend’s English Staffy named Duke. If it wasn’t for the dangling proof between his hind legs I bet many people wouldn’t believe how good-natured, gentle and well-behaved he is. His human devoted himself to training and socialising Duke from the moment he got him. Unfortunately, none of that protected Duke from being attacked repeatedly, ending up with some severe injuries. He never retaliated, he never got aggressive himself. Now that he is eight years old, however, he is showing some anxieties after the last incident. Duke’s human always has been going out of his way to avoid these situations. It seems a well-behaved dog is like a magnet for dog owners to let their (not well-behaved) dog come over to say hello.

This comprehensive study on dog aggression says about similar studies so far, ‘It is worth noting that every prospective, controlled study that examined the effects of gonadectomy [traditional desexing] on the aggressive behavior of dogs demonstrated either no change in aggressive behavior or an increase in aggressive behavior after gonadectomy.‘ Its own research brought the same results just in a much larger study population than had been sampled previously. In the discussion part of its findings it states that research literature shows that aggressive behaviour is influenced by multiple factors. Owner-dependent factors were found to be more significant than dog-dependent factors in influencing the aggressive behaviour of dogs. In their discussion we can read that, ‘studies showed more aggressive behavior from dogs owned by first-time dog owners, dogs with less obedience training, and dogs acquired as a gift or to guard. McMillan et al. found more aggressive behavior toward familiar people, strangers, and other dogs in puppies acquired from pet stores than from noncommercial breeders. Guy et al. found yet other environmental factors correlated with aggression, including dogs in homes with one or more teenagers and dogs that had a history of skin disorders. Roll and Unshelm studied dog interactions and found differences between the owners of dog aggressors and those of dog victims regarding gender, profession, and the purpose for which the owner acquired the dog. They also found that obedience training and the owner’s attitude toward training were significant factors. Hsu and Sun found that dogs that had received physical punishment displayed higher levels of aggressive behavior. More owner-directed aggression was found (a) toward female owners than toward male owners and (b) when dogs were kept outside. In view of these findings, and the findings of the current study, it is essential to look beyond reproductive status to identify the causes and discover solutions for aggressive behavior exhibited by dogs.‘

Before coming across all these studies about dog aggression, my own findings, stemming from my work as a dog trainer, have brought me similar insights.

In this group of seven male and one female dogs (photo above) there are three entire males – aged eight months, thirteen months and two and a half years. Watching them play, you are unable to pick which ones they are because everyone is well-socialised. There is no mounting or other pestering behaviour nor are there any aggressive interactions. Click this link to watch them on video. They all know my daycare to be a happy place where fun things happen. I know each of them well and supervise to help and guide if necessary.

What is life like with an entire dog?

I spoke with three people who chose to leave their dogs entire beyond the 6 months mark about their reasons and experiences.

Yara opted to wait until her American Akita named Mika was done growing so that her dog would be protected from the adverse health effects connected with early desexing even though Yara found Mika hard to manage through her three heat cycles. On walks, Mika was anxious and over-excited, she pulled liked a freight train and barked a lot. At home, her nesting behaviours included ripping up the couch. Yara tells me that she felt conflicted because she finds neutering dogs is a bit of an unnatural thing to do, however, Mika’s massive behavioural changes were difficult to deal with, so the convenience factor played a big role in her decision. Yara was also concerned that her dog’s personality might change after desexing. She loved her goofiness and excited craziness and was worried that the good aspects of that (not the destructive ones!) might disappear. Luckily that didn’t happen, Mika is still a big goofball but in a lovely way.

Jonathan kept his Swiss Shepherd called Elsa entire for the same reason as Yara. His dog also went through three heat cycles, however, her behaviour didn’t change at all except during the last one when Elsa, usually friendly with other dogs, acted aggressively towards any dogs they met on their walk. Once her season was over she return to her normal, amicable self. Even with Jonathan’s high level of diligence, he feels the only way to be 100 % sure that Elsa won’t get pregnant is to neuter her which will happen later this year.

Zac’s decision to keep his now 2.5-year old Dachshund named Jak entire for life is based on his professional experience of what happens to people whose hormones go awry. He doesn’t want his dog to miss a fundamental physiological element. Jak has never tried to mount anyone or anything, however, he will mark inside when he gets the chance, when no one is looking. He obviously knows he is not supposed to but takes liberties when he sees the opportunity. I look after Jak when his family is away, he has never cocked his leg in my house.

The Ovary Sparing Spay and Vasectomy Info Group offers information units as well as the opportunity for discussion with people who have chosen to keep their dogs entire or elected one of the alternative neutering or contraceptive options.

What about contraception?

Contraceptive implants are available for male and female dogs, rendering them infertile temporarily. There is also the option of birth control pills. The information literature from the manufacturers (that gets repeated by vets) is a lot about the wonders and advantages of the drugs. Side effects, if at all, are stated briefly and rather vaguely: Permanent hormonal changes, changes in coat can occur, adverse side effects possible.

My personal experience – having exposed my own body to both forms of contraception, oral and implanted – has been eye-opening. Especially the latter greatly impacted my moods, digestion and weight. I felt like a different person. Not in a good way. When I started to research the side effects it was very difficult to find anything online that wasn’t directly or indirectly linked with the manufacturer’s website and only full of praise. I finally found a forum where hundreds of women who encountered adverse reactions too talked about their experiences, some of them dire and irreversible.

Psychoneuroimmunoendocrinology is the study of the interactions between the psyche, neural and endocrine functions and immune responses. Dabbling with one component has a ripple effect throughout the entire super-system. Even though this combined field of study was first described in 1936, only in the last two to three decades has there been a greater interest in the idea that bodies are not made up of independent parts but are finely tuned, interdependent systems.

Wildlife and zoo animals

To manage overpopulation in wildlife (such as horses and elephants) or zoo animals (as well as prevent inbreeding), neutering is rarely the first choice. The brumbies (wild horses in Australia) are culled every year whereas in the USA they use what they call ‘humane birth control’, darting the mares with PZP (Porcine Zona Pelucida) which renders them infertile for about a year. USA zoo animals’ fertility is controlled similarly but European zoos prefer to euthanise unwanted animals. Why am I bringing this up in a discussion about neutering dogs? To make the point that animal welfare is not one universal set of rules. What is considered ethical or humane differs widely. What is your personal understanding?

Paradigm shift

‘Emphasising the concept of personal choice, the idea inherent in the paradigm shift is to take each puppy as a separate case and consider all the relevant factors of the living context when deciding upon the age for neutering. As we learn more about some aspects of neutering such as age-related cognitive decline, there may be some additional considerations that may impact some breeds. The idea of a paradigm shift is that additional relevant information may come about and influence decisions made by puppy owners and their veterinarians,’ concludes a study by the School of Veterinary Medicine of the University of California in Davis.

Replacing a rigid across the board attitude about neutering with an individualised approach might be more appropriate in this day and age where there is not only a rising awareness of health repercussions in connection with neutering, but also a shift in our understanding of our role as animal carer from being ‘an owner’ to being ‘a guardian’. The relationship we have with our dogs nowadays has largely transcended that of property, they are our family members, beings with feelings, needs and individual personalities.