Monday, February 29, 2016

Getting Tutored

In a straw poll veterinarians stated that their favorite The Far Side cartoon was the one where a dog being driven to the vet brags to his friend, "I'm going to the vets to get tutored!".
This is funny several ways, but the way that is relevant to this post is that it highlights the confusion around the terminology. Even well educated clients will approach the subject cautiously, "I guess it's time to get Fred... is it spayed, or neutered?".

For my lay readers, neuters are for males and spays are for females. At the risk of sounding unprofessional, a handy mnemonic is that the word neuters contains the word "nuts". Which brings me to the next area of confusion: the widespread misunderstanding of what this procedure actually entails. I'll focus on neutering and leaving spaying for another post lest I blather on too long.

So, the technical term neuter is actually orchidectomy. "So doc, you're taking out his... orchids???" Yeah, so that's why we don't use that term at all. A more descriptive term is castration. Large animal veterinarians routinely and happily call it that. The companion animal world is different however. Picture a sweet little old lady with her tiny fluffy white poodle sitting primly on her lap. He has a blue bow at the base of each ear and smells faintly of peaches. Now picture me saying, "Yes, Mrs. Butterworth, it's time to castrate Baby." Moreover, there are people who think that castration means cutting the penis off. Yikes! Yes, there are such people who believe such things. And no, we never do that (except in very special circumstances in cats who have frequent urinary obstructions, but I digress).

What do we do then? We do this: we surgically remove the testicles (remember? neuters contains nuts?). Sometimes I'm asked why we don't just perform a vasectomy instead. This is because reproductive control is only one of the reasons to neuter. In many cases we would also like to remove the ability to produce testosterone in order to eliminate the risk of testicular cancers and chronic prostate infections later in life, as well as to help curb marking behaviour, roaming and male-on-male aggression. You'll note that I wrote "help curb". Too often people use neutering as a substitute for training. It is not. 

Now I'm going to wade into a controversial area. Virtually all cats are neutered. The exceptions involve people who have had their own olfactory nerves removed. However, not all dogs are neutered, at least not at the traditional six months of age, and - here is the controversial bit - this might be ok. There is evidence now that breeds of dogs that are prone to cruciate knee ligament ruptures (typically large breeds) may be at increased risk if they are neutered before their bodies are fully mature. This might mean waiting until 18 or 24 months for some breeds. There may be other risks associated with early neutering in some dogs as well. This is a complex area of ongoing research, so please (please please) speak to your veterinarian first before making any decisions based on what you have read here or elsewhere on the internet. A lot of what we do has evolved from boilerplate "one size fits all" recommendations to a discussion of options tailored to the risk/benefit ratio specific to your pet. And this is a good thing. A confusing thing, but a good thing.
I guess that was more like toe-dipping rather than wading...

Finally, I'm going to leave you with this:
This 100% for real. And endorsed, it seems, by Kim Kardashian. Yes, finally there is help for the owner who wants to neuter their dog, but has an unhealthy attachment to the appearance of his scrotum. Unfortunately it's not the help these people actually need.

Comes with a nifty bumper sticker though!



  1. My whole family really enjoys your blog, Philipp. The "tutoring" post was funny and informative, and I'd love to see a similar post on spaying. There seems to be a lot of variation on the timing: from as early as 8 weeks to just before/after the 1st heat cycle. Why such a range?

    1. Thank you! I'm glad you're enjoying it! There will certainly be a post on spaying in the future and in it I will do my best to address the variation in timing, because there is definitely some confusion out there. In brief though, there is no medical advantage to the really early spaying, say under four months of age. This is almost entirely done by the shelters and humane societies simply to guarantee that the dog or cat is spayed by doing so before adoption because apparently a certain percentage of adopters do not return to have it done after the adoption at "the regular time". If you have the choice, I wouldn't do it so young because it is a little bit riskier. And what is "the regular time"? It's around six months of age, before the first heat cycle. This is in part because each heat cycle increases the risk of mammary cancer later in life. However, much as with neutering, there is some evidence that some large breed dogs may have an increased risk of knee ligament issues if they are spayed before being fully mature. That then leads to a discussion about balancing the competing risks. The next couple of years will be interesting as more studies come in and give us better hard data to make those decisions with.

  2. I'm not sure why I'm so fascinated by some of this stuff but I am! I really like reading about these newer studies and links and wonder how to really know which is the better way to go with this type of stuff....dealing with hormonal adolescent dogs or risking possible ligament tears...I look forward to reading more about this whole topic in the future!

    1. I graduated into a far more black-and-white medical world, so it's both challenging and interesting to navigate the increasing shades of grey.