Pediatric Spay/Neuter

Spay/Neuter of Shelter Animals
Pediatric Spay/Neuter
Facts About this Safe and Effective Procedure
Pediatric spay/neuter is the subject of ongoing debates among veterinarians
that is fraught with misinformation, misconceptions and high emotions.
Although millions of domesticated animals have been surgically sterilized,
many veterinarians believe sufficient conclusive research has not been
conducted to determine the best age or reproductive stage of life to spay
and neuter dogs and cats.
However, studies have been conducted that show that pediatric spay/neuter is
safe and effective in both the short and long term. This information can
help allay many of the veterinarian's fears so they may embrace the concept
as readily as they embrace neutering at 6 months of age.

Early Age Spay/Neuter Defined
The harshest criticism by veterinarians of early age neutering is usually
reserved for surgeries performed on animals as young as 6-8 weeks of age or
under 2 pounds of body weight. But early age spay/neuter should be broadly
defined as surgical sterilization procedures performed on animals who are
6-16 weeks of age or under the traditional age of 6 months. Using that
definition, surgery performed on a 4-month old female animal would be
considered a pediatric spay.
Because the term "early" implies that the procedure is being performed
prematurely, some veterinarians proposed that alternative language might be
more acceptable. Some alternative terms for early age spay/neuter include:
* Juvenile spay/neuter
* Pediatric spay/neuter
* Prepuberal spay/neuter
* Prepubertal spay/neuter
* Prepubescent spay/neuter
History of Spaying and Neutering
Many veterinarians are not aware of the different theories that have been
advanced regarding the timing of spaying a female cat or dog. Both
veterinarians and the general public might be surprised to know that in the
early 1900s, veterinarians advocated spaying bitches between 3 and 6 months
of age, or even prior to weaning, and castration was done as early as 4
weeks of age. At one time it was believed that it was beneficial for animals
to have a litter before being spayed, while another prevailing school of
thought, until fairly recently, was that animals should go through one heat
before being spayed.
Many veterinary colleges are currently teaching that spaying and neutering,
also known as gonadectomy, can be done safely at any age, but believe that
pediatric spay/neuter is a tool mainly for population control for shelter
animals only. However, pediatric spay/neuter should be considered for
animals belonging to the general public as well.
Revisiting the Six-Month Recommendation
Six months of age is generally considered to be the standard recommendation
for spaying and neutering puppies and kittens. It is unclear from the
scientific literature how that conclusion was reached.
It is now known that spaying an animal before the first heat prevents the
development of mammary gland tumors later in life. Since kittens may go into
heat at 4 months of age, waiting until 6 months risks accidental pregnancy
and loses the protection against mammary gland cancer.
It would appear that decisions about when to spay and neuter are based more
on the individual practitioner's comfort level and familiarity with the
surgical technique and anesthesia rather than on any sound scientific or
medical evidence.
The six month age requirement for surgery came into question in the late
1970s when shelters encountered difficulty getting adopters to comply with
contractual agreements to neuter their newly adopted pets. Despite various
incentives, many adopters simply refused to abide by the agreements once
they had acquired the animals.
Some shelters found that litters from animals they had adopted out were
being brought back to them, and that they were thus actually contributing to
the overpopulation problem. They decided the best solution would be to
neuter the animals before they were adopted, but the six month age
restriction meant that puppies and kittens could not be altered.
Once it was determined that no compelling medical reason could be found in
the veterinary literature to wait until the animals were six months of age,
pediatric surgeries began to be performed. Dr. Leo Lieberman is the
acknowledged pioneer of pediatric spay/neuter. He began performing the
surgeries in the late 1970s, and they have been performed by shelters ever
since.
A Growing Body of Evidence
In 1993 Faggella and Aronsohn published surgical and anesthetic protocols in
the Journal of the American Veterinary Medical Association (JAVMA) for
safely neutering animals as young as 6 weeks of age. Although the surgeries
had already been performed safely on thousands of shelter animals, these
articles provided the much-needed research data to prove that the procedures
were indeed safe to perform.
On July 18, 1993, the American Veterinary Medical Association (AVMA) House
of Delegates approved a resolution on early age spay/neuter which stated:
"Resolved that the AVMA supports the concept of early (8-16 weeks of age)
ovariohysterectomies/ gonadectomies in dogs and cats, in an effort to stem
the overpopulation problem in these species."
Aware of the controversy surrounding this statement they also added:
"The concept is for the benefit of animal shelter and humane society
spay/neuter programs. Individual veterinarians have the right/responsibility
to decide at what age they will perform the procedure."
In 2004, the policy was revised and the "concept" portion of the statement
was removed.
Throughout the 1990s, groups such as the American Animal Hospital
Association (AAHA), American Society for the Prevention of Cruelty to
Animals (ASPCA), American Humane Association (AHA), Cat Fanciers Association
(CFA), American Kennel Club (AKC), Humane Society of the United States
(HSUS), and the California Veterinary Medical Association (CVMA) endorsed
pediatric spay/neuter.
Despite these endorsements and the body of evidence already gathered through
research and anecdotal information from over 25 years of performing
pediatric procedures, the debate still goes on. This information should help
resolve some of the problems and concerns.
Concerns about Pediatric Spay/Neuter
An often-cited concern regarding pediatric spay/neuter is a lack of
sufficient scientific data regarding long-term consequences. The following
are commonly discussed issues:
* Obesity
* Stunted growth
* Cranial cruciate ligament rupture
* Hip dysplasia
* Behavioral problems
* Lower urinary tract disease
* Secondary sex characteristics
* Urinary incontinence
* Infectious disease
* Hypothyroidism
* Diabetes mellitus
* Neoplasia
General Concerns about the Long-Term Effects
The results of studies of the long-term outcome of gonadectomies performed
at an early age or traditional age in cats and dogs were published in JAVMA
in the December 1, 2000 and January 15, 2001 issues, respectively. The
studies were performed at the Texas A&M Veterinary College by Dr. Lisa Howe
on 269 dogs and 263 cats from animal shelters.
The conclusion for dogs was that "with the exception of infectious diseases,
prepubertal gonadectomy may be safely performed in dogs without concern for
increased incidence of physical or behavioral problems during at least a
4-year period after gonadectomy."
Shelters that held puppies long-term encountered problems with parvovirus.
However, the authors of this paper did not conclude that prepubertal
gonadectomy caused parvovirus. The puppies in the study were at an age where
they were susceptible to parvovirus and housed in a shelter environment
where parvovirus can be common; they developed parvovirus for these reasons,
and not because they were sterilized as pediatric patients. (Studies have
also shown that, unrelated to surgery, the longer animals are held in
shelters, the more likely they are to become ill. Shelters that held puppies
short-term did not encounter similar disease problems.)
The conclusion for cats was that "prepubertal gonadectomy may be performed
safely in cats without concern for increased incidence of physical or
behavioral problems for at least a 3-year period after gonadectomy."
Another study addressing the long-term effects of pediatric spay/neuter was
published in JAVMA in the February 1, 2004 issue. This study was performed
at the Cornell University College of Veterinary Medicine by Dr. Vic Spain,
who looked at the records of shelter animals (1,842 dogs and 1,660 cats) who
were sterilized as pediatric patients. This study provided follow-up for as
long as 11 years.
The conclusion for dogs was that "because early-age gonadectomy appears to
offer more benefits than risks for male dogs, animal shelters can safely
gonadectomize male dogs at a young age and veterinary practitioners should
consider recommending routine gonadectomy for client-owned male dogs before
the traditional age of 6 to 8 months. For female dogs, however, increased
urinary incontinence suggests that delaying gonadectomy until at least 3
months of age may be beneficial." It is important to note that the female
dogs with reported urinary incontinence remained in their homes and were not
relinquished to the shelter. The long-term Texas A&M study did not find
similar results about urinary incontinence, and another study from 1992
showed a higher incidence of urinary incontinence in female dogs spayed
AFTER the first estrus cycle.
The conclusion for cats from the Cornell study was that "Gonadectomy before
5.5 months of age was not associated with increased rates of death or
relinquishment or occurrence of any serious medical or behavioral condition
and may provide certain important long-term benefits, especially for male
cats. Animal shelters can safely gonadectomize cats at a young age and
veterinarians should consider recommending routine gonadectomy for
client-owned cats before the traditional age of 6 to 8 months."
It should be noted that similar focused studies have not been conducted to
establish the long-term safety of gonadectomies performed at 6 months of
age.
Obesity
Obesity is influenced by a number of factors, and while neutered animals do
have a tendency to weigh more than intact animals, it occurs regardless of
whether the surgery was performed prepubertally or at the conventional age
of six months. A published study in 1991 indicated that dogs did not develop
obesity when they were sterilized at either pre or post puberty. Another
study from 1996 showed that cats can gain weight after gonadectomy, but this
is for both gonadectomy at the traditional age as well as prepubertal.
It should be stressed again that obesity is a multi-factorial problem. Even
an intact animal can become obese if a proper diet and exercise regimen is
not followed. Just as in humans, dietary indiscretions and lack of activity
are the real culprits in this case.
Growth
Many veterinarians erroneously believe that pediatric spay/neuter will stunt
the growth of animals. In fact, the exact opposite is true. This concern
about stunted growth following prepubertal gonadectomy has been refuted by
multiple studies.
In contrast to intact dogs, pups spayed or neutered at 7 weeks of age and
male pups neutered at 7 months of age had greater final radius and ulna
lengths. The removal of hormonal influences on the growth plates of the long
bones results in delayed closure, resulting in bones that are actually a
little longer. However, no clinical significance to this difference in size
has been found.
In cats, although prepubertal gonadectomy had a similar effect of delayed
closure of the growth plates, this did not lead to clinically significant
differences in the final length of the long bones.
Cranial Cruciate Ligament Rupture
In humans, cranial cruciate rupture (CCL) is more common in women than men
and may be more likely to occur during certain phases of the menstrual
cycle, which may be due to a hormonal effect on joint stability (Root
Kustritz). Reported incidence of rupture of the CCL in dogs is 1.8%, and
this is reportedly more common in sterilized female and male dogs than in
intact dogs (Root Kustritz).
The exact cause and effect relationship has not yet been defined, but in
addition to the suspected hormonal influence, heredity, body weight, and
body condition score may all play a role in CCL rupture (Root Kustritz).
There have not been any studies that have shown that delayed closure of the
growth plates of the long bones results in asynchrony and/or abnormalities
in joint formation as a cause of CCL rupture in dogs.
Hip Dysplasia
Long term studies have looked at the incidence of hip dysplasia in dogs and
the association of hip dysplasia with pediatric spay/neuter (Howe, personal
communication). The reported incidence of hip dysplasia is 1.7% with an
increased incidence in large and giant-breed dogs (Root Kustritz). In the
long term Cornell study, puppies that underwent pediatric spay/neuter before
5.5 months of age had an increased incidence of hip dysplasia. However, an
additional finding of this study was that dogs that were gonadectomized at
the traditional age were three times more likely to be euthanized for the
hip dysplasia as compared to the early gonadectomized group. The authors
suggest that early age gonadectomy may be associated with a less severe form
of hip dysplasia (Howe, personal communication).
Behavior
The effects of pediatric spaying and neutering on behavior remain largely
unknown. Sterilization and the subsequent decrease in related hormones have
been correlated with a decrease in gender-specific behaviors. Neutering at
any age reduces the urge of male animals to spray urine to mark territory,
roam and fight with other male animals. The demonstration of sexual
behaviors in male cats can make them undesirable house pets, and a decrease
in such behaviors is a powerful benefit of having them neutered. Also, the
trainability of working dogs is not altered by gonadectomy and does not vary
with age of the dog at time of surgery (Root Kustritz).
The large Cornell study of dogs sterilized before 5.5 months of age
indicates an increase in noise phobias and sexual behaviors and a decrease
in escaping, separation anxiety, and urination in the house when frightened
(Spain, Scarlett, Houpt, 2004). However, a different study showed no
difference in the incidence of overall or specific behavioral problems
between early-age and traditional-age sterilization (Howe, 2001).
There is some early evidence that animals that are gonadectomized at 7 weeks
or 7 months of age are more active and excitable, and that male and female
cats may be more affectionate than those left intact, but this is a fairly
subjective observation that requires more research to substantiate. There
does not appear to be any clinical significance to any observed behavioral
differences.
Lower Urinary Tract Disease
Pediatric spay/neuter has not been found to contribute to a higher rate of
urinary tract obstructions in male cats. Studies have been conducted on male
cats to determine the incidence of urinary tract obstructions in all
populations. It was found that the diameter of the penile urethra did not
vary between animals neutered at 7 weeks or 7 months of age or from intact
male cats.
It was originally believed that castrated cats had a higher incidence of
urinary tract blockages, but this is not the case. The penis in male dogs
castrated at 7 weeks of age is smaller as is the os penis, and preputial
development is juvenile in comparison with dogs castrated at 7 months of age
or left intact, but there has been no clinical significance attached to
those differences.
Secondary Sexual Characteristics
The vulva of spayed females is smaller than that of intact bitches, but
there is no evidence that there is any clinical significance to this size
difference. Perivulvular dermatitis occurs in intact as well as spayed
females, and is related to obesity rather than sexual status. Mammary glands
and nipples are also smaller.
The penis and prepuce of male animals will retain a juvenile appearance, but
again, there is no evidence of any clinical significance in animals that are
not sexually active. There is a reduction in the male cat's ability to
extrude the penis from the prepuce, but there is no knowledge of any
clinical problems associated with this. It can occur whether the surgery is
performed at 7 weeks or 7 months of age.
Urinary Incontinence
Urinary incontinence, or the inability to control urination, may be observed
in female dogs whether they are spayed or intact, and regardless of the age
when spayed. Older, intact female dogs may experience incontinence naturally
as a result of the decrease in circulating estrogen, which has an effect on
the external urethral sphincter. In spayed dogs, incontinence may be seen
soon after the surgery has been performed, years later, or not at all.
The long-term Cornell study showed a slight increased risk of urinary
incontinence for female dogs spayed before 12 weeks of age (12.9% vs. 5.0%).
However, it is important to note that there was no incidence of
relinquishing these dogs to the shelter; they remained in their homes. Also,
the long-term study from Texas A&M that followed dogs out 4 years post
surgery did not show an increased risk of urinary incontinence. Finally,
another study from 1992 showed a higher incidence of urinary incontinence in
female dogs spayed AFTER the first estrus cycle (20.1%).
It would appear that there is a need for more research, but practitioners
who are concerned about this slightly increased risk of incontinence may
still safely perform prepubertal puppy spays at 3-4 months of age. Many
shelters continue to perform the procedures on puppies under 3 months of age
because the study did not show an increased risk of relinquishment because
of incontinence, which can be treated, and because of the high rate of
failure to return for spaying when adopters are allowed to take intact
female puppies home.
Infectious Disease
It is true that some shelters find an increased incidence of infectious
disease (in particular, upper respiratory infections (URI) in cats and
parvovirus in dogs) in animals that are neutered prepubertally, but the
stress of anesthesia and surgery affects adult animals as well, not just
kittens and puppies. One study showed that surgery and anesthesia have
little effect on the dog's ability to mount a humoral antibody response to
distemper vaccination. Many of these shelter animals might have developed
disease anyway because of the presence of these infectious agents in
shelters.
Good screening of surgical candidates, a comprehensive veterinary health
care program that includes deworming, good nutrition, stress reduction, good
sanitation, appropriately timed vaccinations, etc., and good post-operative
care can minimize the impact of this problem.
Shelters that neuter animals only after they have been selected for adoption
and send them home after the surgery to recuperate seem to have fewer
problems with upper respiratory infections. Infectious disease should not be
a problem in the private-practice clinical setting.
Hypothyroidism
Hypothyroidism occurs more commonly in sterilized dogs than in intact dogs,
but while there is an association, a direct cause and effect has not been
established. The overall incidence of hypothyroidism in dogs is 0.2 to 0.3%.
Certain breeds, such as Doberman Pinschers, Golden Retrievers, and
Dachshunds, have a predilection for this disease.
In performing a risk-benefit analysis of pediatric neutering, it should be
pointed out that the incidence of hypothyroidism is low, the condition is
readily treatable, and most dogs have a good response to medical treatment.
In addition, other diseases which can be prevented by gonadectomy (such as
mammary neoplasia, pyometra, and prostatic hyperplasia) have much higher
incidences and may not have as favorable an outcome as hypothyroidism.
Diabetes Mellitus
Sterilized male and female cats have been shown to have an increased risk of
developing diabetes mellitus than intact male and female cats (Root
Kustritz). Other risk factors for cats in developing diabetes mellitus
include breed (Burmese have a higher incidence), sex (males have a higher
incidence), obesity, and increasing age (Root Kustritz). Recent new theories
suggest a high-carbohydrate, dry-food diet may also be a contributing factor
to the development of diabetes in cats.
Neoplasia
There has been concern that pediatric spay/neuter may increase the risk for
certain types of cancer. But, pediatric spay/neuter will also decrease the
risk for other types of cancer. For example, mammary gland tumors are the
most common type of tumor of female dogs, with a reported incidence of 3.4%.
Mammary gland tumors are the third most common tumor of cats, with a
reported incidence of 2.5% (Root Kustritz). Sexually intact dogs and cats
have a much greater risk of developing mammary gland tumors than
gonadectomized animals (Root Kustritz). The literature also shows that the
risk of developing mammary gland tumors in dogs spayed prior to the first
estrus is 0.5%, while the risk after the first estrus is 8.0%, and the risk
after the second estrus increases to 26%.
Another type of neoplasia that may be affected by gonadectomy is prostatic
neoplasia. While some studies show an increased risk of prostatic neoplasia
in castrated dogs (Root Kustritz), the reported incidence of prostatic
tumors in dogs is only 0.2% to 0.6% (Root Kustritz), and it occurs in both
intact and castrated male dogs. So while castration does not protect against
prostatic neoplasia, it does protect against other prostatic diseases seen
more commonly in intact male dogs. These include benign prostatic
hyperplasia (BPH), cystic hyperplasia, squamous metaplasia, paraprostatic
cysts, prostatitis, and prostatic abscesses.
Another tumor associated with gonadectomy is hemangiosarcoma. Spayed females
have 5 times the risk of developing cardiac hemangiosarcoma compared to
intact females (Root Kustritz). However, the overall incidence of cardiac
tumors in one study was only 0.19%, making them very uncommon compared to
other tumor types.
Gonadectomy can increase the risk of development of osteosarcoma (OSA) by
1.3 to 2.0 times (Root Kustritz). In one study, there was a significant
increase in OSA in sterilized dogs that had undergone gonadectomy at less
than 1 year of age, but the overall incidence of OSA in this population of
dogs (Rottweilers) was much higher than that in the general population,
which suggests a hereditary component (Root Kustritz). Also, in this study,
the life span of sexually intact and castrated male dogs did not differ, and
the life span was actually increased in spayed female dogs compared to
intact female dogs (Root Kustritz). This study also looked at dogs that
underwent gonadectomy before 1 year of age, and this cannot be defined as
pediatric spay/neuter (Howe, personal communication).
Transitional Cell Carcinoma (TCC) is the most common tumor of the urinary
tract of dogs. Gonadectomized animals have an increased risk of developing
TCC compared to sexually intact animals (Root Kustritz). However, a cause
and effect relationship has not been defined, and TCC in dogs is reported to
be at most 1.0% of all malignant tumors (Root Kustritz).
Testicular tumors are the second most common tumor type in dogs. Although
malignancy is considered low for these types of tumors, castration is
usually curative (Root Kustritz). Ovarian and uterine tumors are not common
in dogs and cats, and although malignant tumors of the female reproductive
tract have been reported, sterilization is usually curative (Root Kustritz).

Special Pointers for Pediatric Surgical Patients
The following pointers highlight the main considerations when performing a
pediatric surgical procedure.
Pre-Surgical and Anesthetic Considerations
The handling of pediatric patients before surgery should be minimized to
prevent excitement before sedation for surgery. The staff should be urged to
resist the temptation to play with the puppies or kittens. Excited animals
will resist being restrained, and they become more difficult to sedate.
Littermates should be housed together to reduce stress.
Intramuscular or subcutaneous injections for initial sedation or
pre-medication are recommended as less restraint is needed.
Animals should not be fasted for more than 3-4 hours before the procedure to
avoid hypoglycemia.
Hypothermia can be a problem for these patients. A small area of hair at the
surgical site should be clipped and a warm surgical scrub used. The use of
alcohol should be avoided or minimized because of its cooling effects on the
skin. Supplemental heating sources should be used as needed, such as
circulating hot-water heating pads or carefully monitored warm-water
bottles. (Avoid placing them directly on the skin, and remove them
immediately when they become cool.)
There are many different protocols in the literature for pediatric
anesthesia. The most successful protocols are usually already in use by the
veterinarian with adjustments for the weight difference. The use of
isoflurane inhalation anesthesia eliminates many of the concerns about
biotransformation of anesthetic drugs in the liver and kidneys of pediatric
patients. (Halothane should not be used on the pediatric patient.) The
current recommendation is to use multimodal analgesia, such as nonsteroidal
anti-inflammatory drugs (NSAIDS) in combination with opioids.
Good monitoring of the patient for safety is no different from the protocols
used for any other patient. These include observing the heart and
respiratory rates, depth of anesthesia, color of the patient's mucus
membranes, etc.
Surgical Considerations
A supplemental source of heat should be used to prevent hypothermia during
the surgical procedure. Circulating warm water heating pads covered by a
blanket or towel on the surgical table work well.
Some surgeons recommend that the surgical incision for spaying female
puppies should be more caudal than the incision for female adult dogs. The
location of the incision for spaying kittens remains the same as it is for
adult cats, in the caudal third of the ventrum. Male puppies may be neutered
through a scrotal incision, the same as male cats.
Tissues must be handled gently and close attention paid to hemostasis, but
this is true in any surgical procedure. The truth is, in most cases,
bleeding in these animals is minimal. Usually only single ligatures are
indicated and hemoclips can also be used, compared to the adult patient
where double ligation is often indicated.
Pediatric animals can have a significant amount of clear abdominal fluid,
but this is normal.
The animals should be tattooed in the inguinal region, on the ventral
abdomen or have tattoo ink applied to the incision to identify them as
having already been neutered. Tattooing is as important for males as it is
for females, as it might spare male animals from exploratory surgery if it
was assumed the animal had bilaterally retained testicles.
Post-Surgical Considerations
Puppies and kittens should be kept warm in the post-operative period.
Heating lamps can be used to prevent hypothermia as long as the patient is
closely monitored while under the lamp. If there are problems with the
recovery, their temperature and blood glucose should be checked.
A small meal should be offered within an hour after anesthetic recovery to
minimize the chance of developing hypoglycemia. If there are signs of
hypoglycemia, treat quickly and accordingly. Many practitioners recommend
routinely applying a small amount of Nutrical on the gums of the recovering
pediatric patient.
Some surgeons recommend avoiding the use of PDS suture material in the
subcutaneous and subcuticular (intradermal) tissue, as there have been
reports in the literature of PDS in these tissue layers being associated
with the post-op complication of calcinosis circumscripta.
Additional Advantages to Pediatric Spay/Neuter
One of the main reasons why many veterinarians do not perform pediatric
spay/neuter is that they are most comfortable performing surgery on animals
that are 6 months of age or older, and they believe there are no compelling
reasons to change the current protocols in their private practices. However,
there are actually many advantages to pediatric spay/neuter. Although some
have been mentioned before, they are summarized here:
* Veterinarians who are familiar with the surgery and anesthesia concur that
pediatric spay/neuter is much less physiologically stressful on younger
patients.
* Animals should be fasted for only 2-4 hours in order to prevent them from
developing hypoglycemia. This can be an advantage for clients who often
forget to withhold food for several hours from adult animals prior to
surgery and then object to rescheduling their appointment. (Many surgeons
still recommend an overnight fast for adult dogs, although this practice is
also falling out of favor.)
* Animals are awake and ambulatory usually within an hour of completion of
the surgery, so they can be fed a small meal and then sent home the same
day, avoiding a stay in hospitals that frequently do not have staff
available to monitor them overnight.
* Once the veterinarian has gained experience, the surgery is much faster
and easier, so it is less stressful on both the patient and the surgeon.
* There are fewer perioperative complications associated with pediatric
spay/neuter than with spay/neuter performed at an older age.
* Pyometra is a potentially life-threatening condition whose incidence
approaches 66% in older unspayed females. It can be very expensive to treat,
and it occurs with much greater frequency than some of the other concerns
mentioned in this article, such as CCL rupture or cardiac tumors. This major
health concern is easily prevented by prepubertal spaying.
* Veterinarians often cite a fear of losing money by performing pediatric
procedures. However, many veterinarians also admit that they subsidize the
cost of surgically neutering adult animals with other procedures or simply
lower the cost and absorb the financial loss. Pediatric surgery is less
expensive because of the use of fewer materials, and because less staff time
is needed for surgery and pre and postoperative preparation and monitoring.
* Private practitioners are strongly urged to comply with the recommendation
in the Cornell study to perform the procedures before the traditional age of
6 to 8 months. Doing so prevents accidental pregnancies and the development
of mammary gland tumors in females later in life. If the procedure is
performed or scheduled when the last vaccination is given at 3 to 4 months
of age, the veterinarian does not have to worry about the client forgetting
to return, or shopping around and going elsewhere for the surgery. It can be
included as part of a kitten/puppy care package of vaccinations, deworming
and neutering. The delay in neutering pets is often responsible for the
production of accidental litters that end up at shelters.
* Embracing the concept of "one health" that promotes the link between
animal and human health and welfare requires veterinary participation in
solving community problems. Studies have shown that intact animals are much
more likely to be relinquished to shelters than sterilized ones. Pediatric
spay/neuter is an essential component of a comprehensive community strategy
to end the euthanasia of unwanted companion animals in the United States.
* Pediatric spay/neuter should not be considered a tool just for humane
societies because shelter animals actually represent a small source for
acquisition of pets. Simply neutering that population will not have
sufficient impact on reducing the overall pet overpopulation problem. The
best strategy includes education about responsible pet ownership, increased
efforts to improve adoptions, counseling to keep animals with behavior
problems in their homes, and the prevention of births of unwanted animals.
Surgical sterilization is one part of the solution that only veterinarians
can provide.
Conclusion
As with all veterinary procedures, there are potential complications and
both advantages and disadvantages to any spay/neuter procedure. Each patient
should be evaluated on an individual basis and the veterinarian should
discuss both the benefits and risks for spay/neuter surgery with the client.
Pediatric spay/neuter is important for humane societies and shelters because
with these procedures, almost every animal can be sterilized prior to
adoption, which helps prevent the birth of unwanted litters that often end
up at the shelter. Private practitioners should also consider performing
pediatric spay/neuter on their patients because of the many medical
advantages as well.
Lila Miller, DVM, is Vice President of ASPCA Veterinary Outreach.