Early-age sterilization, already widely practiced, is on pace to win full AVMA compliance by the year 2100
SCHAUMBERG, Illinois––Having realized that a cat is not a dog, following the advice of an expert panel issued in July 2016, the American Veterinary Medical Association board of directors in July 2017 “endorsed a document recommending that cats not intended for breeding be gonadectomized prior to five months of age,” according to an AVMA media release.
Next will come convincing the AVMA membership. If AVMA member vets at large are persuaded at the same pace as the AVMA board, fixing felines by five months could become universal practice in as few as 20 years or as many as 92, depending on whether the timeline for persuasion is said to have begun when the AVMA board first rejected early-age cat sterilization or when an article favoring it first appeared in the Journal of the American Veterinary Medical Association, called JAVMA for short.
10% of vets may do 90% of s/n surgery
Though results vary depending on what search terms are used, ANIMALS 24-7 surveys of veterinary web sites indicate that from 10% to 25% of small animal vets now recommend spaying or neutering cats at between four and five months of age.
The remainder continue to advocate that cats be spayed or neutered at six months or older. However, the veterinarians recommending the cats be sterilized by five months appear to do so many more surgeries than the rest that the North Shore Animal League America subsidiary Spay/USA is probably correct in asserting “The average age at which pets are spayed or neutered is four months.”
The Spay/USA network includes more than 1,500 clinics, employing more than 5,000 individual veterinarians, among them most of the high-volume spay/neuter specialists in the U.S. and many abroad. The most accomplished surgeons among them, for example Planned Pethood Plus clinic founder Jeff Young DVM, of Denver, average more than 5,000 spay/neuter surgeries apiece per year, more than 10 times as many as the typical veterinary general practitioner.
Jeff Young, Alley Cat Allies, & Esther Mechler
Young has staunchly advocated, and taught throughout his 30-odd-year career, that both cats and dogs should be sterilized as early as practicable, at eight to 16 weeks of age, depending on the size of the animal.
Alley Cat Allies has from inception in 1991 advocated sterilizing feral cats at eight weeks of age, or as soon afterward as they can be brought into a neuter/return program. This has made early-age sterilization the default norm for neuter/return programs serving feral cats and street dogs worldwide.
Spay/USA founder Esther Mechler, now heading the organization Marian’s Dream in Brunswick, Maine, has made “Fix felines by five months” her focal campaign since 2014.
“Spay delay as bad as lack of resources”
“For over two decades now,” Mechler told ANIMALS 24-7 readers in February 2015, “we have worked on the creation of a national network of spay clinics and programs, public and private, with some success. It has been truly heartening to see the spread of the idea from coast to coast and the zeal with which many people have embraced the idea of prevention, the public health approach.”
However, Mechler cautioned, “After all that time, I have now come to see that spay delay has been as bad an influence, especially for cats, as lack of resources.”
Mechler was among the most prominent and influential members of the AVMA Veterinary Task Force on Feline Sterilization Recommendations for Age of Spay and Neuter Surgery, ratified by the AVMA board after already obtaining endorsements from the American Association of Feline Practitioners, Association of Shelter Veterinarians, American Animal Hospital Association, Winn Foundation, Catalyst Council, Cat Fancier’s Association, and The International Cat Association.
“Best professional judgement”
Opens the Veterinary Task Force on Feline Sterilization joint statement of conclusions, “This document supports veterinarians in using their best professional judgment based on current scientific literature in deciding at what age gonadectomy should be performed on individual animals.”
This somewhat ambiguous claim is apparently meant to ease decades of friction between “old guard” vets, mostly in private practice, who typically sterilize relatively few cats, usually at six months of age or later, and high-volume, low-cost practitioners, most of whom are associated with nonprofit organizations, who avidly embraced early-age sterilization long ago.
(Young and Planned Pethood Plus, however, operate on a for-profit basis.)
The Veterinary Task Force on Feline Sterilization joint statement also mentions that “it is consistent with the AVMA policy on Pediatric Spay/Neuter of Dogs and Cats, and its endorsement was recommended by the AVMA’s Animal Welfare Committee.”
Current science: cats are not dogs
Meeting on January 15, 2016 in Orlando, Florida, the Veterinary Task Force on Feline Sterilization agreed as first premise, “from a review of the currently available scientific literature and group discussion,” that “Recommendations for the optimal age to sterilize cats may differ from the age to sterilize dogs.”
That this required “a review of the currently available scientific literature and group discussion” may surprise people, including some veterinarians, who are aware that cats typically reach reproductive age at about two-thirds the age of dogs, and that cats under favorable conditions may bear two to three times as many kittens per year as a dog may bear pups.
With that much observed, the Veterinary Task Force on Feline Sterilization recognized that the arguments for spaying kittens before their first estrous cycle are much the same as the arguments for sterilizing dogs before their first heat.
The task force said nothing specific pertaining to castrating male cats, but agreed “Current evidence does not support an increased risk for cats of complications or long-term adverse health effects with pediatric (6-14 weeks) or juvenile (>16 weeks)6-7 sterilization.”
The bottom line: “Given the known benefits of sterilization and the lack of evidence for harm related to age at which the procedure is performed, the Veterinary Task Force on Feline Sterilization calls for veterinary practitioners and professional associations to recommend sterilization of cats by five months of age.”
The catnip mouse dangled for the “old guard”: “This provides veterinary practitioners with a consistent message that may increase veterinary visits and spay/neuter compliance while reducing the risk of pet relinquishment and unwanted offspring.”
Leo L. Lieberman, DVM
The late Leo L. Lieberman, 91, DVM, would have applauded the report of the Veterinary Task Force on Feline Sterilization, but he died on February 15, 2006, in Swampscott, Massachusetts, after promoting early-age sterilization for much of his life, including in endorsement and encouragement of pioneering neuter/return programs.
A 1935 graduate of the Ohio State University School of Veterinary Medicine, Lieberman joined the U.S. Army after graduation. Initially the youngest lieutenant in the Army Veterinary Corps., Lieberman helped Allied troops to fight the Nazis in Europe during World War II––an especially dangerous theater for a Jewish soldier who carried a medical kit instead of a gun.
Leaving the Army as a lieutenant colonel in 1948, after 13 years of service, Lieberman practiced veterinary medicine for more than 30 years in Waterford, Connecticut.
Fighting spay advice based on hand size
“In the 1940s and 1950s,” recalled 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 sterilization 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 J.C. Flynn of Kansas City. Flynn, on record as early as 1913 deploring that most veterinarians were “uninterested” in acquiring best practice dog and cat skills, developed the basic early-age sterilization technique in 1925. This was three years after Flynn developed the now almost universally recommended small-incision spay technique, which he called “Spaying without sutures.”
Flynn was professionally well-enough regarded to teach “Diseases and Surgery in Small Animals” for the Indiana Veterinary College in Indianapolis, but had little success during his lifetime in advancing either small incision or early-age sterilization.
Lieberman took up early-age in 1970
“I did a literature search and found nothing on why the ages were set at what they were,” Lieberman recalled.
Lieberman, already 35 years into his veterinary career, 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.
Studies & debate validated early-age s/n in 1993
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 a newsprint debate facilitated by ANIMALS 24-7 editor Merritt Clifton 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 at last won acceptance of early-age sterilization from the AVMA, though the recommendation to “fix felines by five months” was another 24 years in coming.
Lieberman in 1993 received the Alex Lewyt Veterinary Medical Center Award of Achievement from the North Shore Animal League America for exceptional innovation, and in 2001 received a Lifetime Achievement Award from Spay/USA.