pediatric AKA 'early' S/N - safety & risks / benefits

[leashedForLife]

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In this thread, i'd like to explain the history, currently-known risks, & the benefits of desex before puberty, & specifically before 12-WO / 3-MO - known as either pediatric or 'early' desex, as traditionally, S/N was performed around 6-MO, at puberty.

Pediatric desex is now SOP [Standard Operating Procedure] in virtually all municipal shelters in the USA & Aus; also, 90% of U-S breed rescues & all-breed rescues desex every puppy or kitten B4 they're available for adoption. The few exceptions are either very-rural county shelters or disastrously underfunded urban shelters, & small-time rescues.
The reason for this is simple: Adopters cannot be trusted to S/N their pets.

Even after signing an adoption contract that stipulates their pet can be confiscated, plus they may face a fine or other charges, the average compliance rate for S/N of adopted intact pets in the USA is only 40% - less than half. // Promises don't mean diddly; if the pup or kit is already desexed, it's a done deal - no progeny will be produced by that F, & no litters will be sired by that M, if s/he's desexed prior to adoption.

Early-adopting shelters were doing pediatric S/N in the early '70s, so there are plenty of studies on safety, outcomes, complications, risks specific to pediatric patients, etc - IOW, there's loads of data, as millions upon millions of pups & kittens have been desexed between 8 & 12-wks age over those 47 years.

this is a 5-page article that explains the risks, benefits, AND the procedure itself, in detail -

An overview of pediatric spay and neuter benefits and techniques

it's intended for vets, but i think if U have a basic understanding of anatomy, U can understand the surgical procedure, or skip that part & just read the risk / benefit section.

- terry

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[leashedForLife]

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In any surgery, the single biggest risk is anaesthesia - local numbing is less risky than total sedation AKA general anaesthesia, as the plane of consciousness where pain is not felt can be uncomfortably close to the point where breathing & pulse become too slow to support the brain & body.
Monitoring the patient's pulse, respiration, & O2 saturation, is part of ensuring their safety during any surgery.

Luckily for young pups & kittens, they're "under" for much-shorter times than their older kin, which is a distinct advantage - they're exposed to less anaesthetic, needn't metabolize as much of it, post-surgery, & thus they're up & bouncing about very quickly.
Pediatric patients are also fasted for much shorter times - a few hours only, not 12-hours without food & the last 3 without water, as in adult surgical-patients. // They're also allowed to eat sooner, as they're awake faster - so all in all, it's a brief blip in their lives.

Pediatric patients have less post-op pain, & rarely need pain-meds - another benefit of fewer blood-vessels & fewer nerves vs pubertal or adult desex-patients, with their greatly-increased vascularization & many-more sensory nerves.

It turns out the single largest risk to pediatric patients is chilling - the younger an animal is, the less skilled they are at maintaining their own core-temp. // Vets have a number of options to help pediatric patients stay internally warm - heated saline-bags used on each side to brace the patient belly-up, reflective Mylar sheets to keep the patient's own body-heat from radiating away, or body-temp electric mats between the patient & the surgical table.
Vets who do many pediatric S/N ops will be prepared to do one or more of these, or another variation.

Post-desex, pediatric patients heal faster, have fewer complications, & scar less - that last is not about cosmetics, but about internal scarring, such as bladder adhesions to the abdominal wall, & other post-op internal changes that can complicate day-to-day living for the individual patient, or make future surgeries more dangerous.
Complications includes everything - infection, suture failure, swelling, everything, up to & including death.
Death as an after-effect of S/N is extremely rare, but for pediatric patients, it's even rarer.

All in all, pediatric desex is actually the safest age for S/N. // Pre-pubertal, statistically, is next-best; pubertal is 3rd best; & adult S/N is the highest risk.
That's not to say that S/N is too dangerous for adult dogs & cats, & should not be done! - not at all. But it's surely true that adult dogs & cats are more likely to have complications of all kinds vs pubertal, pre-pubertal, or pediatric patients. // Statistically, for instance, S/N is safer than a full-term pregnancy & delivery of a litter, but if everyone opted to choose the safest option, there'd be no more pups or kittens born of planned breedings - which would hardly be an improvement, as unplanned matings with zero health tests on either sire or dam are not optimal for any breed, nor even for crossbred or random-bred progeny.

- terry

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[Mad Murphy]

I guess there are many arguments for and against young de-sexing of animals but when trying to explain why it is so popular in rescues these days I think you hit the nail on the head with one sentence
The reason for this is simple: Adopters cannot be trusted to S/N their pets.

Sad but true humans cant be trusted.

 

[JoanneF]

I don't disagree with neutering animals and it clearly prevents overpopulation and takes away the responsibility from adopters. However I also understand the choice not to do it so early.

Most of the article you cited describes the surgical procedure. But importantly it also says -

Removal of the hormonal influence actually results in delayed closure of growth plates.

And

Hip dysplasia. Some veterinarians have questioned if pediatric spay or neuter results in an increased incidence of hip dysplasia in dogs. Research on this subject has proved to be equivocal.

For balance, here is an article that describes some of the physical problems in early neutering for some dogs.

https://onlinelibrary.wiley.com/doi/full/10.1002/vms3.34

And psychologically -

Are There Behavior Changes When Dogs Are Spayed or Neutered?

 

[leashedForLife]

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More than half of pediatric S/N is still done on shelter or rescue pups & kittens, but breeders are beginning to S/N litters or individuals before they leave for their new homes; if animals have serious heritable problems, desex prevents them passing it on. If they have various degrees of faults, from minor to automatic disqualification, again, S/N prevents them from passing it along.
Since U really can't be sure an 8-WO pup or kitten will mature to a healthy, sociable, excellent specimen of their breed, as an adult, nor is the average pet-owner a competent breeder of high-quality purebreds, S/N of entire litters sold as pets, prevents those buyers from accidentally or deliberately breeding their pet.

Naturally enough, those who want to buy a future breeding candidate will buy the best they can find, & hopefully know enuf to choose from litters whose parents were both screened for dog-generic & breed-specific heritable problems.
It's also to be hoped that & if they're dog breeders, they know that they should wait till their prospective dam or sire is a minimum of 2-YO B4 mating them for the 1st time, as that accomplishes 2 things:
- 85% of heritable issues that will affect THAT animal show symptoms by 2-YO
- delaying the 1st breeding to 2-YO adds an average of 2-years to their litters' lifespans.

source of those 2 stats:
https://www.amazon.com/Control-Canine-Genetic-Diseases-Reference/dp/0876050046

Dr Padgett specialized in k9 heritable problems & dog breeding - he spent decades assembling research on all things involved in producing healthy, high-quality pups with excellent temperament.

- t

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[leashedForLife]

I don't disagree with neutering animals and it clearly prevents overpopulation and takes away the responsibility from adopters. However I also understand the choice not to do it so early.

Most of the article you cited describes the surgical procedure. But importantly it also says -

Removal of the hormonal influence actually results in delayed closure of growth plates.
...

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actually, the later closure of GROWTH PLATES doesn't make a marked difference -
studies done on full brothers, 1 desexed by or B4 6-MO & their sibling left intact, found that their variation in height at the withers did not vary any more than variance between unrelated dogs from the same breed.
Pediatric desex won't make a Labrador grow-up to look like a Great Dane.

Allegations that this will "damage joints" or "change angles" is not accurate - all 4 legs are growing normally, & their joints mature as they would otherwise. The difference is usually fractions of an inch in the long-bone's length at adulthood - which, let me note, skeletal-size in a dog's body is usually as big as it's gonna get by 6 to 9-mos, & growth from 5-MO on is much, much slower than that from birth to 6-WO, & slower than 3-MO to 5-MO, also.
THE EXCEPTIONS are giant breeds who will mature at 125# or more as adults, who - similarly - continue to grow but much, much slower till they're 12 to 15-MO, but that's *not* their long-bones. It's primarily muscle tissue; their frames are already solid bone.

Different parts of the skeleton cease growing & solidify at different ages; the pelvis is among the last bones to completely calcify in all breeds, even under-10# toy dogs, & in very-large to giant breeds or mixes, MALE dogs' skulls can continue to change in shape as well as size, thru their 2nd year - depending on their breed or mix. // But the long-bones of their legs are not growing when they're 2 to 2.5-YO; their backskulls, occipital protuberance, jaws, & forefaces getting more massy isn't going to make them "taller", & the extended growing period for male-dogs' skulls is a sexually dimorphic trait.
Skeletons are not passive, either - they continue to remodel thru-out our lives, & if we were formerly active & athletic & become sessile & sedentary, we LOSE skeletal strength, just as we lose muscle thru atrophy after that change in physical activity.

[Aside for post-20s women reading this thread:
What's the largest risk factor for osteoporosis in women 35-YO or older, besides being white / "Caucasian"?
Whether U regularly drink soda or seltzer, believe it or not. // Diet or corn-syrup or sugar-sweetened or stevia, makes no difference; high-caffeine or none, machs nichts.
CO2 dissolved in H2O = carbonic acid.
When U drink a Big-Gulp while driving to the beach on a warm day, U're drinking acid; to counterbalance it as the carbonic acid reaches the bloodstream, yer body reaches for a buffer. What's the easiest to grab & most-plentiful buffer in the body?... Skeletal calcium.
Do yer bones a favor - drink something OTHER than carbonated beverages.]

- terry

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[leashedForLife]

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JoanneF's brief excerpt from the article made the information seem very cut-&-dried, when in fact, most of the expected after-effects of pediatric desex did not manifest. // From the article, QUOTE,
"Historically, veterinarians have expressed concerns about pediatric neutering [focusing] on either anesthetic risk or potential long-term physiologic effects [including] obesity, stunted growth, musculoskeletal disorders, perivulvar dermatitis, puppy vaginitis, feline lower urinary tract disease, & urinary incontinence, and most fears appear to be unfounded."

quoting more extensively from that same page [page #2], & taking them in order -
________________________________________


"Obesity is a multi-factorial problem with a tendency to occur regardless of the age an animal is spayed. A long-term study conducted at Cornell found a decrease in obesity for both male & female dogs that had undergone pediatric desex [incorrectly called 'OHE' - male dogs have neither ovaries nor uterus to remove].

Initial concerns that pediatric neutering may result in stunted growth have proven to be false. Removal of the hormonal influence results in a delayed closure of growth plates. The long bones of animals that undergo pediatric neutering are actually a little longer than those of animals neutered after 6 months of age. There does not appear to be any clinical significance to the delayed physeal closure.

Some have questioned if early age S/N results in an increased incidence of hip dysplasia. Research on this has proven to be equivocal.
A study at Texas A&M showed no increase in hip dysplasia, while a study at Cornell showed a slight increase in incidence. Interestingly, the Cornell study also showed that dogs sterilized at a traditional age were 3 times more likely to be euthanized due to hip dysplasia than dogs sterilized at a pediatric age.

Perivulvar dermatitis has been documented in unspayed & spayed animals, regardless of the age at which surgery was performed. This condition is related to a recessed vulva, & is made worse by obesity. Age of neutering appears to have no significant influence on the incidence.

Suspicion that pediatric castration would result in decreased diameter of the penile urethra in [ETA: male] cats &, therefore, lead to urinary obstruction proved unfounded. The diameter of the penile urethra in the adult male cat does not vary between animals neutered at 7 weeks or 7 months, or from intact males.

Studies have shown differing conclusions with respect to estrogen responsive urinary incontinence. The Cornell study revealed a slightly greater risk of urinary incontinence in dogs spayed earlier than 12 weeks of age. The Texas A&M study showed no difference, while a study by Arnold et al in 1992 showed a higher incidence of urinary incontinence in dogs spayed after their first estrus cycle. Three studies, with conflicting results.
Obviously, more research needs to be done on this issue, but the key factor is that the incontinence is estrogen responsive. Even if the results eventually show a higher incidence in those dogs spayed at an early age, the condition is easily treated."
______________________________________________


So in sum, obesity, stunting, perivulvar dermatitis, & stenosis of the penile urethra in M cats, have all proven to be unfounded fears, while hip-dysplasia & urinary incontinence in early-spayed Fs have both provided, at best, equivocal data - there's no clear cause / effect relation between pediatric S/N & HD, or pediatric desex & urinary incontinence in Fs.

The only physiological after-effect unequivocally associated with pediatric desex is that MALE DOGS may grow slightly taller than they would have if left intact; not all male dogs neutered by 3-MO will get taller, nor is the difference sufficiently large to be visually striking, or a distinguishing trait of Ms desexed 'early' [B4 or during their 12th-week].
Male pups' long-bone epiphyses are shut-down by the early flush of testosterone at about 5-mos in most breeds, at the ramp-up to full puberty at 6-mos, when they produce viable sperm in sufficient numbers to sire a litter.
[Female pups have a different process for closing down their epiphyses.]

I will cheerfully address every one of these concerns individually with specific research & source-links, in later posts.

- terry

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[leashedForLife]

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this is a full-text, free-to-read study on mammary cancer, risks, & spayed vs intact, as well as age when spayed & risks.

Epidemiological Study of Mammary Tumors in Female Dogs Diagnosed during the Period 2002-2012: A Growing Animal Health Problem

Frustratingly, many journals are free-to-read only in a university library, & the library must subscribe - each journal can cost $60 to over $100 per year, so many journals are hard to obtain in hard copy. Online, just reading the study in electronic form can cost $25 to 30, & printing a copy generally costs $35 to 40.

The only "free" content is often the abstract, a summary of the hypothesis, their results, & the team's conclusion.
This study being FREE in toto, is a wonderful bonus.

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[leashedForLife]

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the RSPCA received an inquiry about pediatric desex AKA 'early neuter', as done in their own surgery.

QUOTE, bold & color added to emphasize significant details:

Thank you for your enquiry. Neutering at six-weeks only occurs at our Greater Manchester Animal Hospital, & only under exceptional circumstances.

David Yates, director of the RSPCA's Greater Manchester Animal Hospital, said:
"Neutering dogs at six-weeks-old may sound upsetting to people, but we can reassure them that it is only done in a limited number of cases, for absolutely genuine reasons, & with positive results - offering those animals a chance to be quickly rehomed, & given a loving home.

In Manchester in the 80s / 90s, we had a major overpopulation problem with cats and dogs - unplanned mating, large numbers being put down, animal centres saturated, high numbers of road traffic accidents, & high incidence of mammary tumours. While these are still problem issues, early neutering helps counter them, and must be judged against the alternatives.
Our policy is based fully on sound, peer-reviewed science. There are many benefits associated with early neutering. In fact, it can be better for the animals' welfare - for example, the surgery is quicker, there are fewer complications, & the experience is less traumatic when carried out on young dogs.

All RSPCA dogs [Note; he's referring to 'pups', not to *dogs*] are neutered before they are rehomed, with the exception of a few breeds which some evidence shows are more prone to incontinence after spaying. By carrying out the procedure as early as possible, we reduce the time the animal has to spend in a stressful kennel environment, & are able to get them settled into a loving new home more quickly.
The RSPCA re-homes thousands of unwanted dogs and puppies every year, and we recommend neutering as a good way to help reduce the problem of unwanted litters. If scientific evidence showed that this policy was wrong, then obviously - obviously - we would reconsider. But at the moment, we are dealing with a very real problem with a sympathetic, practical and scientifically-backed policy.
The RSPCA generally neuters 'owned' dogs at around 12-14 weeks of age. At the Greater Manchester Animal Hospital, up to 50 stray/ abandoned dogs a year are neutered at six weeks of age."

Thank you again for your concern.

Kind regards
RSPCA Enquiries Service
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Every one of the reasons given by director Yates lists are precisely those i've given in other threads.
That's why early-desex is SOP in virtually all shelters & rescues, in the U-S: pet-overpopn, unplanned litters, swamped shelters & rescues... but at the same time, U can't hold pups till they're 6-MO for desex at the "traditional" age, U want them out of the shelter runs & out of the foster homes, to make room for the next batch.

In the U-S, minimum-age to separate pups or kittens from their litter & dam is generally 8-wks or 56-DO, including Federal law & most states; Virginia's minimum legal age to separate is 7-WO or 49-DO. Ergo, in small-budget / high-kill shelters, pups & kits are desexed as soon as they have an approved adopter; in low-kill facilities, all are desexed at 8-WO, before being offered for adoption.
[Tight-budget, high-kill shelters wait for a qualified adopter - U don't want to waste money desexing an animal, then euthanize them post-surgery, when space becomes critical.]
Any healthy pup or kitten who weighs at least 2# is a safe candidate for S/N.

Mr Yates also notes the sharp increase in mammary tumors as another reason for 'early neuter', & lists the same advantages for younger pups that I have, elsewhere: safer, shorter procedure; fewer complications; & less trauma; all of which are documented by data.

I will direct the reader's attention to the last paragraph of Mr Yates' quote -
"The RSPCA generally neuters 'owned' dogs at around 12-14 weeks of age."

If it's acceptable practice by the RSPCA, why is it horrifying, when U-S shelters, rescues, & yes, breeders, desex pups before they leave for their owners' homes? Surely 3 to 5-million excess pets killed every year are valid reasons.
It's not as tho it only happens in the benighted, ignorant New World; RSPCA vets obviously believe that 3-MO is fine, or as Mr Yates said, "we would reconsider", & 'our policy is based fully on sound, peer-reviewed science.'

I've provided scientific references many times; now, I discover that the RSPCA uses pediatric desex, & uses the selfsame data to support it. Surprise!

- terry

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