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Pet Docs: Delayed neutering has benefits for health of dogs

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Q: I have a 14-month-old golden retriever who is in need of being spayed. I have read that there are some health benefits to waiting until a dog is over a year old before spaying. However, now the surgery seems like a much bigger deal than it would have been if she were only a 20- to 25-pound puppy. She has grown, is a little fat and now weighs close to 75 pounds. Now I’m reluctant to put her through it. What do you think?

A: It is true that the recent studies have made a compelling case for delaying neutering (spaying or castrating) dogs before they are mature. A commonly cited reason for spaying females before they are mature, meaning before their first heat cycle, is that this seems to greatly reduce the risk of mammary tumor formation later in life.

While this may be true, there are counterpoints to the practice. The risks of developing certain cancers can be elevated with early neutering. Likewise, the risk of certain developmental orthopedic diseases, such as hip and elbow dysplasia, as well as ligament injuries, are increased when neutering is performed prior to sexual maturity.

One downside to waiting is what you are experiencing. Neutering procedures, especially spays, in small puppies are technically much simpler to perform than they are on big, mature dogs. Not only are they simpler to perform but the risk of significant complications, such as hemorrhage, are higher in larger dogs. Minor complications, like swelling, bruising and pain, are also increased in mature animals.

As a surgical specialist, I (Henri Bianucci) am proficient in complicated orthopedic procedures, such as hip replacements, as well as more delicate things, like cardio-thoracic surgery. But when it comes to routine spays, there's a good chance your vet could outpace me. It is likely that they will perform the procedure faster and with a smaller incision than I would. That is particularly true with puppies.

With large adults, my incision is likely to be closer to that of a general practitioner, and our times may be closer together. Both of us will have larger incisions, compared to the same one on a small puppy. The larger, or fatter, the dog, the truer this becomes. Larger incisions mean more tissue damage and more pain. Deeper body cavities allow things to fall out of sight and the potential for an undetected bleeding vessel increases.

The recommendation for delaying neutering for the purposes of reduced risk of developmental orthopedic disease, and certain cancers, are derived from studies performed on large-breed dogs, including golden retrievers. But, an increasingly popular way to merge the benefits of delayed neutering with minimally invasive surgery is laparoscopy.

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Using specialized access ports, a small camera and surgical instruments can be passed into the abdomen through an incision of only a few inches long. The camera allows for excellent visualization, even in large dogs, which allows for a clear inspection of the surgical sites and verification that nothing is continuing to bleed.

In the end, the incision may not be a lot larger than the puppy version on the same dog. These dogs are then often administered a long-acting, local anesthetic/pain reliever. They recover quickly and are usually discharged a few hours later.

Some large-breed dogs are at an increased risk of developing a condition called gastric dilatation and volvulus (GDV). This is when the stomach bloats and then twists. This condition is an emergency and is rapidly fatal without surgery.

This condition can be prevented with a relatively simple procedure called a gastropexy. In this procedure, the stomach is sutured to the abdominal wall, which will prevent it from twisting in case it bloats later in life. An advantage to waiting to neuter these larger dogs is the ability to perform both procedures simultaneously while doing it laparoscopically. This procedure can be performed through the same port as the spay, meaning that there would still be only a single, small incision.

Many adult dogs are spayed at veterinary clinics around the world every day with relatively few complications. That procedure, in the hands of a skilled vet, is routine and very safe. So your veterinarian is likely an excellent option.

When the decision is made to wait to spay a dog until it has reached sexual maturity, and thus full size, laparoscopic procedures provide an opportunity to maintain the benefit of small incisions, faster healing and reduced pain while allowing the opportunity to perform a prophylactic gastropexy if it makes sense for the breed.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.

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