The World Small Animal Veterinary Association (WSAVA) have recently published their first reproduction control guidelines for dogs and cats. These guidelines have been put together by the WSAVA Reproduction Control Committee and reflect the latest evidence in neutering practices. The guidelines recommend a move away from a blanket neutering policy, and a shift towards a more targeting approach to the neutering of pets.
Table of contents
- What did the WSAVA look at when producing these guidelines?
- What were their conclusions regarding surgical neutering practices?
- What was the advice around non-surgical methods of neutering?
- What were the WSAVA’s recommendations overall, about neutering dogs and cats?
- What ethical concerns did the WSAVA have around neutering?
- In summary:
- Links:
What did the WSAVA look at when producing these guidelines?
The WSAVA brought together world-renowned experts and international stakeholders to develop guidelines. They looked at surgical and non-surgical neutering, explored the health benefits and risks of these procedures, and examined the ethical aspects of reproductive control in dogs and cats.
What were their conclusions regarding surgical neutering practices?
The group found that there are several different surgical approaches to neutering that are practised worldwide. They noted that the main reason complications might occur, whatever the approach, was ‘inadequate exposure’. In other words, the surgeon might not have made a big enough incision to be able to clearly visualise the surgical field.
Recommendations for keyhole spays
The committee also found that when neutering (or spaying) a female dog, an ovariectomy (removal of the ovaries) is preferred to a full ovariohysterectomy (removal of the ovaries and uterus), unless the uterus is diseased. The reason for this is that without the ovaries, the uterus won’t usually cause a problem if left within the body, and the surgery can then be quicker and less invasive for the animal. The group recommended a keyhole or laparoscopic approach to neutering, when this is available and not cost-prohibitive. This marks a shift away from the traditional ovariohysterectomy approach.
Strong advise against over-use of antibiotics…
The group also looked at the need for antibiotics when a patient undergoes a neutering procedure. Although surgical site infections can be a concern in dogs and cats, it’s not recommended that antibiotics are routinely given as a preventative measure. Instead, the focus should be around keeping the procedure short, maintaining surgical sterility, and having a clean environment to perform the procedure.
…or under-use of painkillers
Neutering surgeries, as is the case with all surgical procedures, are painful. The WSAVA recommends pain relief is given for every surgical neutering procedure, and this must be sufficient for the individual circumstances of the patient and must cover the whole perioperative period. The recommendation is to give ‘multimodal’ anaesthesia, which means multiple types of pain relief, so that pain is controlled in the most effective way.
What was the advice around non-surgical methods of neutering?
Not all pet owners want their pet to be surgically neutered, and in some areas of the world, surgical neutering is not an available option. Non-surgical neutering can be achieved by:
Hormonal downregulation
This involves administering hormones like progestogens, androgens, or deslorelin implants to reversibly shut down the hormone-releasing centres in the brain. Sometimes, these can be administered as a long-acting implant. This treatment is not suitable for every animal.
Immunocontraception
This involves injecting a vaccine that binds to hormones and suppresses reproductive hormone production. The vaccine doesn’t last long though and requires multiple injections.
Intratesticular chemical castration
An injection is injected into the testicles to prevent sperm production, and in some cases, brings about a reduction in testosterone too. Adverse reactions can occur, and the procedure currently lacks long-term evidence for safety and efficacy.
Gene therapy
This is a relatively new treatment technique that makes use of the body’s natural processes, to control genes that are associated with the production of reproductive hormones. Currently, there is little research available to see how well this treatment works in the live animal.
What were the WSAVA’s recommendations overall, about neutering dogs and cats?
Removal of the gonads (organs that produce sex hormones; the ovaries in females, or testicles in males) can bring health benefits for some animals while causing problems for others. Vets must explain the pros and cons behind performing the procedure and take individual circumstances into account.
The WSAVA felt it advisable to leave both male and female dogs intact, where these animals are kept by responsible owners, unless there are specific reasons for neutering that individual dog
This was particularly advisable for certain breeds prone to developing health issues post-neuter. However, the owner would need to be watchful for the development of certain conditions such as mammary and vaginal tumours, pyometra and other reproductive diseases. For many owners there is inconvenience associated with leaving a female dog intact, due to risks of unwanted pregnancy and managing bloody vaginal discharge. The WSAVA recommends deslorelin implants or ovariectomy as an alternative. If surgical neutering is chosen for a female dog, this should generally be carried out after the first or second heat ideally.
In a canine shelter setting, the WSAVA suggests waiting for a potential owner to come forward before a decision is made on neutering options.
The situation is different for cats though
Currently, it’s recommended that female cats are neutered pre-pubertally, before they reach four months of age. Male cats can also be neutered at this age, without detrimental effects on life expectancy, health, and behaviour. Removing the testicles in cats is generally recommended because it eliminates unwanted behavioural traits. It’s known that neutered cats have an increased risk of weight gain; but this can be managed by feeding an appropriate diet and encouraging exercise. Any other health detriments associated with neutering before four months of age have not been definitively proven, and overall, the benefits of neutering at this time outweigh any potential concerns.
What ethical concerns did the WSAVA have around neutering?
Besides health concerns for individual animals, other factors, such as ethical considerations, practices at shelters and pet overpopulation also have to be considered.
The WSAVA noted that while pet overpopulation remains an important problem to be tackled, it’s not clear whether low-cost spay and neuter programs have led to a reduction in the numbers of animals coming into shelters. Similarly, Trap, Neuter, Return (TNR) programs to control feral animal populations might not deliver the desired long-term outcomes. Mandatory spaying and neutering laws in some countries may also not be as effective as hoped.
In summary:
The WSAVA summarises that there are still a lot of areas where data and evidence is lacking around neutering practices. And further work is needed if we are to fully understand the impact of neutering on the pet population. Many will see these recommendations as controversial, but given the weakness of much of the data, the committee seem to have come down on the side of caution for now. For the individual animal, neutering decisions should be made carefully; weighing up the risks, benefits, individual circumstances and the wider implications for the pet population.
As the WSAVA Committee say,
“Ultimately, the decision whether and how to spay, neuter or sterilise an animal should be based on a thorough assessment of the individual animal’s health and client preferences. Veterinarians play a crucial role in guiding these decisions, weighing the risks and benefits to ensure the best outcome for the animal, the client, and the broader community.”
Links:
- WSAVA Guidelines for the Control of Reproduction in Dogs and Cats
- Reproduction Control Guidelines – WSAVA
- Escaping Domestic Abuse – charities that can help protect your dog or cat
- Are Neutering Implants Worth Considering in Veterinary Medicine?
Discussion
Welcome to the land of naivety…and the belief that most owners can identify tumors early? And afford frequent screening?
There are owners who don’t believe their male dogs have nipples…
This is such a disappointing document. It was doomed for the start by lack of representation from all of the relevant expert specialties. Instead of seeking input from experts in animal welfare, population level animal health and welfare, One Health, and shelter medicine, the committee was narrowly comprised of theriogenologists and others who focus on one animal at a time, usually presented by owners with the wealth and motivation to seek out specialist-level care. One hopes that the large gaps in evidence ignored by the panel on the direct relationship between sterilization rates and euthanasia in animal shelters and cat and dog population control practices globally through CNR/TNR program we simply lack of knowledge of this topic rather than a deliberate attempt to exclude evidence contrary to the committee’s goals. It is so disheartening to work in the charity sector with an ever-increasing veterinary workforce shortage and to witness the crushing impact of pet overpopulation, pet owners not equipped to manage intact animals, pyometra, mammary cancer, and a host of other issues that could have been pre-empted by a timely neuter. No one ever thinks their clients are the “irresponsible” ones whose pets end up in animal shelters or who can’t afford an $8000 pyometra surgery in the ER, and yet we see them by the thousands. I hope the supporters of this terrible recommendation will step up to create a solution for the downfall that those in the charity sector know will follow. Maybe you can create a fund for low-cost mastectomy and pyo surgery to be performed in private practice so you don’t add to an already overburdened charity care system. Or take responsibility for creating good outcomes for the unintentional offspring from the whoops litters that will inevitably increase. Our safety net capacity for this care is breaking down, and it doesn’t feel like WSAVA has anything to contribute except denial. It’s disheartening from an organization that has traditionally been so much more inclusive and evidence-based.
Interestingly, if you read it, it does feel like there are several voices competing – some sections are almost incoherent as one sentence contradicts the one above.
The big issue I think is that there’s relatively little really robust data, so perhaps that’s where we should really be focussing. Most of the really big studies, for example, just look at neutered vs not-neutered, without considering all the confounders (especially, responsible owners being more likely to neuter in most jurisdictions)
If one of you would like to come and spend a week in the shelter with me, I am open to it.
Do you know how many unwanted pets are euthanized in this country?
Don’t blame us, we’re just reporting on the WSAVA’s findings…!