The debate below, published in the March 1993 edition of ANIMAL PEOPLE, immediately preceded the acceptance of early-age sterilization of both puppies and kittens by practically every major organization in the veterinary and humane fields.
Cruel! by Leslie N. Johnston, DVM
There is a trend now to establish what are called spay/neuter clinics at all of the city and county animal pounds and at the various so-called humane animal shelters all across our country. The term spay/neuter is incorrect use of the English language. The simple term neuter is enough.
The people running these clinics are also ignorant about neutering dogs and cats. The trend now is to neuter the dog or cat before he or she leaves the facility, regardless of age (as early as six weeks of age). To neuter a dog or cat this early is cruel, inhumane, deceptive, and the most sadistic vivisection that could be done to a poor little animal.
Remember, dogs and cats are not hogs and cattle. We neuter calves as soon as we can catch them, and pigs at about six weeks of age. But these animals will be slaughtered at six to 18 months of age. We will keep our cats and dogs with us for 10 to 20 years. The minimum ages for neutering dogs and cats are six months for female cats, nine to 12 months for male cats, eight months for female dogs, and 10 months for male dogs. Add time to these figures and the better for the animal.
I am all in favor of neutering, but this must be done properly and at the proper time by proper people. Early neutering leads to:
1) Extreme overweight. With obesity, all kinds of other health problems will develop.
2) Poor bone formation. The bones in early neuters tend to elongate and be spindly in character, much more subject to fracture.
3) The genitalia will just about stop development at the time of neuter. The penis of the dog or cat will not grow as large as it should. This is why we see so many blockages of urethras and urine flow. Death from urine flow blockage has to be one of the most painful and pitiful deaths that any animal could suffer. I am not saying we don’t have blocked urine flow problems in the intact or properly neutered animals, but the incidence rate is greatly reduced relative to early neuters. We have surgical procedures to correct blocked urethras in male cats and dogs, but if the urethra is infantile, there is very little to work with. In the female dog, the vulva will remain infantile and very small. This results in the vulva being covered and left in a pocket of folds of fatty skin. The dog urinates in this pocket, creating a place for infection which is hard to deal with using the very best antibiotics and sanitation. We also see ascending vaginitis. There is a surgical procedure to correct this condition, but why should the dog have to be put through such surgery due to deception and malpractice?
4) There is increased incidence of diabetes with early neuter. Any time you have excess fat, you increase the possibility of diabetes.
5) There is increased incidence of cataracts. Cataracts go with diabetes.
6) Increased skin problems.
7) Increased heart problems.
8) When the animal becomes so obese that he or she will not play, the owner begins to neglect the pet.
9) Urinary incontinence in the female dog neutered at an early age is greatly increased.
10) Increased thyroid problems.
11) Improper development of the sheath in the male cat, so that it will actually grow onto the penis in some cases.
“Authorities” will tell you that based on studies of 32 dogs in one place and 200 dogs in another place, no ill effects have been seen from early neuter. They don’t tell you that there was no follow-up done on these animals for long enough to see what is going on. When these animals leave a neuter clinic, they are dumped on veterinarians in private practice to deal with.
I have done well over 20,000 neuters during a 36-year practice, and I know what early neutering will do to a dog or cat. I have lived with many of these animals through their lifespans and I have seen my problems from my own early neutering of dogs and cats.
To do surgery to an animal that will make the animal suffer health problems and a shorter life, and cause the owner frustration, heartache, and extra expense, is veterinary malpractice.
[Dr. Johnston, a veterinarian since 1959, practices in Tulsa, Oklahoma.]
Kind! by Leo L. Lieberman, DVM
Recognition of the problem of pet overpopulation with the euthanasia of millions of dogs and cats each year generated the concept of neuter-before-adoption. Thus shelters can avoid becoming a source of the problem they are trying to solve.
Puppies and kittens are the most attractive prospects for adoption from shelters. But veterinarians in the past have refused to do surgery at less than six or seven months of age. Some have even required the animal to pass one “heat” cycle. This has been traditional, and was taught at all schools of veterinary medicine despite the fact that until 1991 no scientific reports or evidence existed to indicate any age as preferable for this surgery.
In 1975 the Humane Society of the U.S. printed their policy statement holding that, “No animal should be adopted from any shelter without being spayed/castrated.” In 1992, after weighing the available information as presented by a panel of experts, the American Humane Association issued a policy statement on early neuter surgery, “supporting this practice as a feasible solution to decreasing pet overpopulation.”
The world’s first controlled study of neutering was undertaken at the University of Florida and reported in the April 1, 1991 issue of the Journal of the American Veterinary Medical Association. Here is proven that the changes in the bitch spayed at seven months of age, the conventional time, are insignificantly different from the changes found in the littermate bitch pup spayed at seven weeks of age. Studies on cats and related issues are underway now.
Many shelters and colleges of veterinary medicine are now doing early-age surgery, some as early as six weeks. It was never intended to direct any practioner to undertake surgery at a time other than of his or her own choice, but many veterinarians have found it advantageous to do neutering at younger ages.
Dr. Johnston fails to mention the many advantages of early neutering to the patient: there is no mammary cancer and no pyometra; there is markedly reduced prostate disease; there are no perineal hernias nor perianal adenomas; and these animals have a longer life expectancy because they have a tendency to stay at home, avoiding the most common cause of companion animal death the automobile.
Dr. Johnston claims early-age neutering is cruel, inhumane, and sadistic, but it should be noted that many forms of major surgery including organ transposition are now routinely performed on one-to-five-day-old people.
Modern livestock practice dictates that pigs be castrated at two or three days of age, rather than the six weeks of 40 years ago, as suggested by Dr. Johnston. The same with calves. Yes, they are slaughtered young. But horses are also castrated as early as two to 10 days of age, and both horses and steers raised as oxen may live for 20 years or more.
Contrary to Dr. Johnston’s allegations, fatness in animals is in proportion to the quantity and quality of the food consumed. Some breeds have a propensity for obesity and must be carefully monitored whether neutered or intact. Available knowledge and special diets can accomplish obesity control if the owner is willing to make the effort. Neutering is not the principal cause of obesity; excess food is.
Abnormal thyroid function can contribute to excess weight and should be treated. This is caused by dysfunction of the hyothalmus-pituitary-thyroid axis and destruction of the thyroid itself from thyroiditis or degeneration. This has no relationship to neutering at any age.
With regard to bone formation in early-age neutered animals, the slight elongation of the radius, ulna, and femur usually goes unnoticed, as there is no abnormal appearance, function, or fragility. (See the report by Salmari and Bloomberg in JAVMA, 4/1/91.)
It can be agreed that the genitalia of early-age neutered animals are reduced in size. This should be of no significance as long as there is adequate passage of urine. In very obese bitches, the globs of exhuberant fat in the posterior aspect of the thigh misaligns the urine stream so that the patient soils herself. Combine that with the excoriating effect of alkaline urine from cystitis, and a very uncomfortable, smelly, miserable patient is presented with a reddened ulcerated perineum. Yes, sometimes surgery is indicated. If the cysititis were controlled and the excessive obesity were not allowed, the plight of these patients could be avoided. This is basically a case of irresponsible or neglected care of a bitch spayed at any age. This condition does not occur in cats.
In 1972, JAVMA pages 208-211, M.A. Herron of Texas A&M reported that castration before puberty had relatively little effect on the diameter of the penile urethra of cats. Some practictioners continue to attribute the occurrence of plugged urethrae of cats to castration at an extremely early age. However, this condition also occurs in uncastrated males, and to a lesser extent, in females. Veterinary urologist Carl Osbourne and veterinary nutritionist Lon Lewis in many publications have reported the plugged urethrae to be precipitated by excess magnesium and phosphate in the diet. Readily available prepared foods with reduced levels of magnesium and phosphate plus the capacity to acidify urine have reduced the incidence of plugged urethrae.
Ascending urinary infections of the females of any species (including humans) occurs more frequently than we like. Why it occurs in one patient and not in another is not clearly understood. It has nothing to do with neutering at any age. It is suspected that nature’s arrangement of the female body orifices increases this propensity.
Urinary incontinence has been reported by Thrustfield (Vet Record, 1985, p. 116, 695) to occur in the spayed female more frequently than in the intact. But the condition does occur in the unspayed female fairly often, and also in humans. There are many recent reports on this subject. One “estrogen-sensitive” incontinence responds well to tiny doses of hormones administered by mouth or by injection. This has been incorrectly interpreted to indicate that the condition is due to the absence of estrogen in the spayed bitch. Experts agree that this is not true.
Early-age neutered animals have not been around in sufficient numbers for long enough for anyone to have adequate valid data on urinary incontinence, which is primarily a disease of the elderly. Our preliminary retrospective studies of the older early-age neutered animals we have been able to locate show no significant increase in this disease. There is a need for additional clinical research.
Diabetes mellitus is most often caused by relapsing pancreatitis. Cataracts of the eyes are a common and important complication of diabetes. Obese animals are often the victims. But this has no relationship to neutering at any age.
The penile sheath of some castrated male cats adheres to the penis. Usually the penis can be easily exteriorized. Unless there is interferance with urination, it is of little consequence, if the penis is retained. Lack of urination demands immediate surgery.
Dr. Johnston’s comments on the relatively small (32) number of animals involved in the reported studies of early neutering are not valid. In the design of the study, statisticians were consulted. How many animals is an appropriate number? Should there be one of each sex and breed? Should there be 10, or perhaps 100 or 1,000? What is the cost of the procedures, tests, and maintenance? How much money is available? How long should the animals be confined? Each of these questions requires compromise. The study as performed has cost $75,000, and continues with no funds available. Yes, it is expected that practitioners will eventually contribute data to an essential larger study. First, however, practioners have to be convinced to do early neutering, as many are doing, both in shelters and in private practice. These animals should be watched and compared to other animals for a number of years. In time, the answers to all our questions will become self-evident.
[Dr. Lieberman, a veterinarian since 1935, heads the Association of Veterinarians for Animal Welfare in Port St. Lucie, Florida.]
Leo L. Lieberman, 91, DVM, died on February 15, 2006, in Swampscott, Massachusetts. A 1935 graduate of the Ohio State University School of Veterinary Medicine, Lieberman joined the U.S. Army after graduation, became the youngest lieutentant in the Veterinary Corps., and served in Europe during World War II. Leaving the Army as a lieutenant colonel, after 13 years of service, Lieberman practiced veterinary medicine for more than 30 years in Waterford, Connecticut. “In the 1940s and 1950s,” recalls Marcia Hess in The History of Spay/Neuter Surgery, “anesthetics were not terribly safe, especially for young animals. Surgical instruments now used to find a tiny uterus did not exist. Vets were mainly men. They had big hands, and had to find that uterus with their fingers. Since a uterus is bigger and much easier to find after an estrus, or after having a litter, the advice of waiting until after the first estrus or after a litter began and persists.” Lieberman began to question the conventional wisdom after noting that early-age sterilizing prevents mammary tumors in dogs, and that the few vets who did early-age sterilizing had gotten good results for as long as 20 years–including a Dr. Flynn of Chicago, who developed the basic technique in 1925, but could not convince other vets to try it. “I did a literature search and found nothing on why the ages were set at what they were,” Lieberman recalled. He began doing early-age sterilization in 1970. As then-president of the Connecticut Veterinary Medical Association, Lieberman set an influential example. The American SPCA in 1972 became the first major humane society to endorse early-age sterilization. Lieberman’s 1987 Journal of the American Veterinary Medical Association article “A case for neutering pups and kittens at two months of age” turned veterinary opinion in favor of early-age sterilization by explaining that guardians of dogs and cats who were spayed or castrated young reported less aggressive behavior, less obesity, and fewer medical problems. Lieberman followed up in JAVMA in 1988 and 1991. Research funded by the Winn Feline Foundation, conducted by Thomas J. Lane, DVM, of the College of Veterinary Medicine at the University of Florida, Gainesville, in 1991 and 1992 supported Lieberman, as did a major study of early-age sterilization done by the Massachusetts SPCA at Angell Memorial Hospital in Boston. In March 1993 Lieberman faced off in ANIMAL PEOPLE against early-age sterilization critic Leslie N. Johnston, DVM, of Tulsa, Oklahoma; defended early-age sterilization before a gallery of critics at the World Veterinary Congress in Berlin, Germany; and in July 1993 won endorsement of early-age sterilization from the AVMA. Lieberman in 1993 received the Alex Lewyt Veterinary Medical Center Award of Achievement for exceptional innovation, and in 2001 received a Lifetime Achievement Award from Spay/USA.