Promoting choice for optimal animal health
A way to have one’s cake and eat it too: a way to spay female dogs (thus addressing population concerns), without the increased cancer risk and health impacts from hormone loss (particularly in large and giant breeds) that are only recently beginning to be understood.
News 2014: Ovary-sparing spay option now approved by the AVMA!
For an informative overview of ovary-sparing spay Powerpoint lecture: Hysterectomy by Dr. Michelle Kutzler.
In 2007 a respected veterinarian published a review of the pros and cons of spaying and neutering at different ages (Determining the optimal age for gonadectomy of dogs and cats, Margaret Root Kustritz.) This generated a lot of discussion, and thought leaders are beginning to accept that spay and neuter have both positive and negative health consequences which vary by age, gender, and breed.
In particular, mounting evidence indicates that in at least large dogs, the health benefits of keeping the ovaries may outweigh the health risks (the risks being mammary tumors and pyometra, which is infection of the uterus). For example, one study of exceptionally long-lived Rottweilers linked length of ovarian exposure in their first 8 years to total longevity (Exploring mechanisms of sex differences in longevity: lifetime ovary exposure and exceptional longevity in dogs, Waters DJ et al 2009). This study has some serious design flaws that make it hard to rely on. However, it fits with data in humans; for example, in the Nurses’ Study, women who kept their ovaries when having hysterectomy lived longer than women who had both the uterus and ovaries taken out (Parker WH et al 2009). A more recent publication from U.C. Davis (de la Riva, Hart et al, 2013) looked at two joint disorders and three cancers– hip dysplasia, cranial cruciate ligament tear, lymphosarcoma, hemangiosarcoma and mast cell tumor– and showed that, for all five diseases analyzed, the disease rates were significantly higher in both males and females that were neutered either early or late compared with intact (non-neutered) dogs.
As a result, a set of highly-motivated and informed potential adopters is beginning to question or resist the mandatory spays required to adopt from a shelter. In particular, those thinking of adopting breeds known to have greater risk of certain problems after spay may be in this category (for example, Boxers nearly always get incontinence, and Rottweilers and giant breeds are prone to bone cancers). But this is a highly distressing development to shelters, which fear going backwards on the progress on euthanasia rates and overpopulation that has been made thanks to widespread spay/neuter.
Parsemus Foundation is proposing that we all think more creatively about individualizing spay. In these situations, veterinarians should be prepared to remove the uterus and leave the ovaries, sometimes called “partial spay.” This removes the nuisance of bleeding during heats, along with the risk of infection of the uterus (pyometra), as long as ALL of the uterus is removed. (In traditional spay, there is no need to remove every bit of the uterus, since it will no longer be under stimulation by the ovaries. But in partial spay, the veterinarian must make a large enough incision to pull the uterus up to the surface, see what he/she is doing, and be able to tie off and cut precisely at the cervix rather than just anywhere on the uterus; otherwise it is still possible to have an infection develop in the remaining uterine stump, “stump pyometra.”)
If the whole uterus is removed, very few long-term health issues remain. Ovarian cancer is rare enough that the ovaries should not be removed just to try to prevent it. That makes mammary tumors the remaining concern. Although a recent review article indicates that the limited research on the effect of neutering on mammary tumors is inconclusive (Beauvais et al., 2012), decades of real-world experience indicate that mammary tumors occur more often in dogs with ovaries. Adopters of dogs who believe that their dog is likely to live longer or be healthier by keeping its ovaries can then be informed of the pros and cons and to keep alert to the possibility of mammary tumors as their dog ages. Owners with the economic means may even wish to have a mammary-gland ultrasound as part of their dog’s annual exam once it reaches middle age; vets who are skilled with ultrasound should be pleased at the opportunity to offer this new service using existing equipment. Meanwhile, the shelter’s population goals are achieved too, because the dog will not be fertile without a uterus.
Parsemus Foundation has funded a demonstration of ovary-sparing spay by Dr. Michelle Kutzler, a professor of veterinary medicine at Oregon State University and an acknowledged expert and speaker on dog and cat contraceptive advances and reproduction. (Check out this interview with Dr. Kutzler by Dr. Karen Becker of Healthy Pets). In the video above, she demonstrates ovary-sparing spay in a giant breed, a 6-year-old Mastiff who was finished breeding but whose owner was concerned about increased risk of bone cancer and cruciate ligament rupture from traditional ovariohysterectomy spay.
The concept is by no means new; it was first published in 1972 in a groundbreaking publication that is startling in its frankness about the effects of hormone loss. (“The conventional method of unsexing a female dog is by ovariohysterectomy (surgical removal of the uterine horns, ovaries and the body of the uterus). During the many years I have used this procedure, I have often encountered cases of extreme obesity, cardiac stress and urinary incontinence in the middle-aged spayed female…) We are just adding specifics for how to eliminate the risk of pyometra, plus a video demonstration of the procedure in action, to help this option gain more acceptance in the quest for improved dog health.
Again, the cervix must be ligated precisely– one cannot ligate just anywhere on the uterus as is normally done– to prevent the risk of stump pyometra. Not realizing this fine point has been what has made veterinarians resistant to the idea (“But you’ll get stump pyometra!”); we thank Dr. Kutzler for pointing out that the solution lies in taking extra care with ligation placement. Her slightly larger incision allows her to visualize the area and take this extra care.
The procedure may take slightly longer than high-volume spay, because the cervix must be cut and tied off precisely and a larger incision must be made to see what one is doing. More suture time is involved due to the slightly longer incision. In practice, it takes about 5 minutes longer because of the extra suture time, according to Dr. Kutzler. She reports that some veterinarians say it is actually quicker than an ovariohysterectomy because the need to double ligate around each ovarian stump is eliminated.
Shelters offering this option will have an answer for potential adoptees who would otherwise be turned off from shelter adoption because of mandatory traditional spay; and veterinarians offering the option are likely to be in great demand as it becomes better known (and to be able to command a substantial premium, with dedicated owners willing to travel a significant distance to one of the few veterinarians in the country currently offering it). As an added health measure, in deep-chested breeds highly susceptible to stomach torsion (gastric dilatation volvulus) such as Great Danes, Weimaraners, Saint Bernards, and Setters, it may make sense for veterinarians in private practice and owners with the economic means to consider the pros and cons of stomach-tacking, a procedure which might not justify the risks of elective preventive surgery on its own, at the same time as spay—along with discussing behavioral preventative measures.
Since this information is not available anywhere else, we are beginning a list of veterinarians open to performing hysterectomy/ ovary-sparing spay. Please call or email us (see Contact page) if you are a veterinarian who wishes to be included on this list. If you’re a dog owner/guardian and have an open-minded veterinarian who might like to offer this service, you could pass the information along, as there are large parts of the country that are not covered. And please let us know if you have any experience to share, whether especially positive or negative, with contacting one of these vets!
Download our flyer for a brief overview of the topic.
The original 1972 publication about ovary-sparing spay, Wendell O. Belfield
“The Pros of Partial Spay”, ovary-sparing spay summary by Elaine Lissner in the Integrative Veterinary Care Journal
“Hysterectomy powerpoint lecture” by Dr. Michelle Kutzler.
“A Healthier Respect for Ovaries”, Waters D.J. (the author of the Rottweiler study mentioned above)
“Neutering Dogs: Effects on Joint Disorders and Cancers in Golden Retrievers”, Hart et al. 2013
“Golden Retriever study suggests neutering affects dog health” (UC Davis press release on above study)
“Pukka’s Promise: The Quest for Longer-Lived Dogs”, A thought-provoking book by Ted Karasote with a chapter on spay-neuter and health.
More resources and links on this issue, from Dr. Marty Greer, DVM, Veterinary Village, WI
Veterinarians Open to Offering Ovary-Sparing Spay
Dr. Mack L. Barney
(ask for Dr. Barney specifically and mention this website; staff may not be aware that he offers this service)
Barney & Russum Animal Clinic
2255 Boynton Ave.
Fairfield, CA 94533
Dr. Kimberly Carlson, DACVS
Bay Area Veterinary Specialists
14790 Washington Blvd.
San Leandro, CA 94578
Dana Bleifer, DVM
Rose City Veterinary Hospital
2695 East Foothill Blvd
Pasadena, CA 91107
Email: rosecityvets [at] yahoo [dot] com
John Lupo, DVM
Malibu Veterinary Clinic
28990 Pacific Coast Hwy.
Malibu CA, 90265
Angelina Piccoli, DVM
Spay Today, Neuter Now!
1864 S Wadsworth Blvd #2
Lakewood, CO 80232
Also offering vasectomy and tubal ligation
Haydee Perez-Tirse, DVM, CVA
Panda Animal Clinic
329 E. 9th Street
Hialeah, FL 33010
Email: pandaclinic [at] aol [dot] com
Dr. Gwyn Mathis, Dr. Greg Mathis, and Dr. Mike Kelly
Brookwood Animal Clinic and Laser Surgery Center
118 Brookwood Ave.
Jackson, Georgia 30233
Email: BrookwoodAnimalClinic [at] gmail [dot] com
Kimberly Parker, DVM
Atlanta Center for Animal Osteopathy
615 Hembree Parkway Suite 100
Roswell, Georgia 30076
Jim D. Carlson, DVM CVA CVT
Grove Animal Hospital & Holistic Center
600 N. McHenry Road
Buffalo Grove, IL 60089
Riverside Animal Clinic & Holistic Center
2904 West Illinois Route 120
McHenry, IL 60051
Dr. Jared Settle, Dr. Sarah Webb, Dr. Lisa Woodside
Midwest Animal Hospital
11205 W 183rd Place
Orland Park, IL 60467
Phone (708) 478-7788
Dr. Stacey Sutter
Countryside Veterinary Center
9823 W 55th St.
Countryside, IL 60525
Phone: (708) 469-6050
Dr. Susan Maturo (practice owner)
Animal Medical Center of Watkins Park
60 Watkins Park Dr.
Upper Marlboro, Maryland 20774
William C. Thompson III, DVM, PhD
New Mexico Repro at Los Lunas Animal Clinic
575 Hwy 314 NW
Los Lunas, NM 87031
(15 mins South of Albuquerque)
Email: Loslunasanimalclinic [at] gmail [dot] com
Brad Roach, DVM
Best Friends Animal Clinic
1607 N. Harrison Ave.
Shawnee, OK 74804
Email: Bradroachdvm [at] gmail [dot] com
Prof. Michelle Kutzler, DVM
(modern champion of ovary-sparing spay technique)
Department of Animal Science
Oregon State University
Cell: (541) 740-1434
Office: (541) 737-1401
Email: Michelle.Kutzler [at] OregonState [dot] edu
Dr. Hernan Montilla
Oregon State University
College of Veterinary Medicine
209 Magruder Hall
Corvallis, OR 97331
Office: (541) 207-4822
“This is a procedure we would offer given the owner is requesting it, is aware of all the pros and cons, and is comfortable with the decision. They can contact me directly or ask for me when contacting the front desk. We’d be more than glad to help, and it would be a great experience for our students.”
Jennifer Rouse, DVM CCRP
212 North Eagle Road
Havertown. PA 19083
homesteadvetrehab [at] gmail [dot] com
Additional offerings include vasectomy, medical evaluations and rehabilitation medicine, in house laboratory testing, DHP titers and modalities such as therapeutic laser.
Marty Greer DVM, NAIA Board Member
N11591 Columbia Drive
Lomira WI 53048
Dr. Moira Drosdovech
Pawsitive Veterinary Care
#6 1551 Sutherland Ave Kelowna, BC, V1Y 9M9
Email: drmoira [at] gmail [dot] com
Dr. Bob Perry
Dunnville Veterinary Clinic
110 Ramsey Drive
Dunnville, ON, Canada
Email: DrBob [at] dunnvillevetclinic [dot] com
Book with Dr. Bob Perry
Veterinarians Offering Mammary Ultrasound
Dr. Lauren Knobel
Seven Hllls Veterinary Hospital
5264 Diamond Heights Boulevard
San Francisco, CA 94131
Ask Dr. Knobel for an appointment with their ultrasound specialist from Sausalito. Appointments with Dr. Knobel are also available in the East Bay, at Codornices Veterinary Clinic in Albany (near Berkeley).
Sam Silverman, DVM and associates
10 Liberty Ship Way
Sausalito, CA 94965
Does ultrasound for veterinary clinics throughout the San Francisco Bay Area. You will need to make an appointment with them through a vet in the area who uses their services (such as Seven Hills Veterinary Hospital, above).
Above: Loie, a perfect example of the dilemma. Abandoned at the rural shelter with her litter of puppies, she was just starting her second heat when the rescue organization saved her. Remove her ovaries now? Since she has had two heats, this Lab/Rottweiler mix has already lost a fair part of the mammary cancer prevention of early spay. Furthermore, removing her ovaries could quadruple her risk of bone cancer (spayed Rottweilers have a frighteningly high 1 in 4 risk of osteosarcoma) and raise her risk of hemangiosarcoma (also a death sentence) to 10-20%. That’s not to mention the increased risk of CCL tears (which Labs are famous for and which are expensive and/or disabling), incontinence (to which both Labs and Rottweilers are very prone), and an obsession with food which can lead to weight gain unless the new adoptees are careful. But what if she could have a hysterectomy and keep her ovaries (but still be sterilized– no more abandoned puppies) instead?