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Friday, October 25, 2013

Ovary Sparing Spay Promoting choice for optimal animal health!

OVARY SPARING SPAY REDUCES RISK OF CANCER
Check out this interview with Dr. Kutzler by Dr. Karen Becker of Healthy Pets

Ovary-Sparing Spay

Promoting choice for optimal animal health

A way to have one’s cake and eat it too: a way to spay female dogs (thus addressing population concerns), without the increased cancer risk and health impacts from hormone loss (particularly in large and giant breeds) that are only recently beginning to be understood.
In 2007 a respected veterinarian published a review of the the pros and cons of spaying and neutering at different ages (Determining the optimal age for gonadectomy of dogs and cats, Margaret Root Kustritz.) This generated a lot of discussion, and thought leaders are beginning to accept that spay and neuter have both positive and negative health consequences which vary by age, gender, and breed.
In particular, mounting evidence indicates that in at least large dogs, the health benefits of keeping the ovaries may outweigh the health risks (the risks being mammary tumors and pyometra, which is infection of the uterus).  For example, one study of exceptionally long-lived Rottweilers linked length of ovarian exposure in their first 8 years to total longevity (Exploring mechanisms of sex differences in longevity: lifetime ovary exposure and exceptional longevity in dogs, Waters DJ et al 2009).  This study has some serious design flaws that make it hard to rely on. However, it fits with data in humans; for example, in the Nurses’ Study, women who kept their ovaries when having hysterectomy lived longer than women who had both the uterus and ovaries taken out (Parker WH et al 2009). A more recent publication from U.C. Davis (de la Riva, Hart et al, 2013) looked at two joint disorders and three cancers– hip dysplasia, cranial cruciate ligament tear, lymphosarcoma, hemangiosarcoma and mast cell tumor– and showed that, for all five diseases analyzed, the disease rates were significantly higher in both males and females that were neutered either early or late compared with intact (non-neutered) dogs.
As a result, a set of highly-motivated and informed potential adopters is beginning to question or resist the mandatory spays required to adopt from a shelter.  In particular, those thinking of adopting breeds known to have greater risk of certain problems after spay may be in this category (for example, Boxers nearly always get incontinence, and Rottweilers and giant breeds are prone to bone cancers).  But this is a highly distressing development to shelters, which fear going backwards on the progress on euthanasia rates and overpopulation that has been made thanks to widespread spay/neuter.
Parsemus Foundation is proposing that we all think more creatively about individualizing spay.  In these situations, veterinarians should be prepared to remove the uterus and leave the ovaries, sometimes called “partial spay.” This removes the nuisance of bleeding during heats, along with the risk of infection of the uterus (pyometra), as long as ALL of the uterus is removed. (In traditional spay, there is no need to remove every bit of the uterus, since it will no longer be under stimulation by the ovaries. But in partial spay, the veterinarian must make a large enough incision to pull the uterus up to the surface, see what he/she is doing, and be able to tie off and cut precisely at the cervix rather than just anywhere on the uterus; otherwise it is still possible to have an infection develop in the remaining uterine stump, “stump pyometra.”)
If the whole uterus is removed, mammary tumors are the only significant health risk from keeping ovaries (ovarian cancer is rare enough that the ovaries should not be removed just to try to prevent it).  Adopters of dogs who believe that their dog is likely to live longer or be healthier by keeping its ovaries can then be informed of the pros and cons and to keep alert to the possibility of mammary tumors as their dogs age.  Owners with the economic means may even wish to have a mammary-gland ultrasound as part of their dog’s annual exam once it reaches middle age; vets who are skilled with ultrasound should be pleased at the opportunity to offer this new service using existing equipment. Meanwhile, the shelter’s population goals are achieved too, because the dog will not be fertile without a uterus.
Parsemus Foundation has funded a demonstration of ovary-sparing spay by Dr. Michelle Kutzler, a professor of veterinary medicine at Oregon State University and an acknowledged expert and speaker on dog and cat contraceptive advances and reproduction. (Check out this interview with Dr. Kutzler by Dr. Karen Becker of Healthy Pets). In the video above, she demonstrates ovary-sparing spay in a giant breed, a 6-year-old Mastiff who was finished breeding but whose owner was concerned about increased risk of bone cancer and cruciate ligament rupture from traditional ovariohysterectomy spay.
Again, the cervix must be ligated precisely– one cannot ligate just anywhere on the uterus as is normally done– to prevent the risk of stump pyometra.  Not realizing this fine point has been what has made veterinarians resistant to the idea (“But you’ll get stump pyometra!”); we thank Dr. Kutzler for pointing out that the solution lies in taking extra care with ligation placement. Her slightly larger incision allows her to visualize the area and take this extra care.
The procedure takes slightly longer than high-volume spay, because the cervix must be cut and tied off precisely and a larger incision must be made to see what one is doing.  More suture time is involved.  In compensation, shelters offering this option will have an answer for potential adoptees who would otherwise be turned off from shelter adoption because of mandatory traditional spay; and veterinarians offering the option are likely to be in great demand as it becomes better known (and to be able to command a substantial premium, with dedicated owners willing to travel a significant distance to one of the few veterinarians in the country currently offering it). As an added health measure, in deep-chested breeds highly susceptible to stomach torsion (gastric dilatation volvulus) such as Great Danes, Weimaraners, Saint Bernards, and Setters, it may make sense for veterinarians in private practice and owners with the economic means to consider the pros and cons of stomach-tacking, a procedure which might not justify the risks of elective preventive surgery on its own, at the same time– along with discussing behavioral preventative measures.
Since this information doesn’t appear to be available anywhere else, we are beginning a list of veterinarians open to performing hysterectomy/ ovary-sparing spay.  Please feel free to call us (see Contact page) if you are a veterinarian who wishes to be included on this list. If you’re a dog owner/guardian and have an open-minded veterinarian who might like to offer this service, you could pass the information along, as there are large parts of the country that are not covered. And please let us know if you have any experience to share, whether especially positive or negative, with contacting one of these vets!

Additional Resources

Download our flyer for a brief overview of the topic.
“A Healthier Respect for Ovaries”, Waters D.J. (the author of the Rottweiler study mentioned above)
“Neutering Dogs: Effects on Joint Disorders and Cancers in Golden Retrievers”, Hart et al. 2013
“Golden Retriever study suggests neutering affects dog health” (UC Davis press release on above study)
“Pukka’s Promise: The Quest for Longer-Lived Dogs”, A thought-provoking book by Ted Karasote with a chapter on spay-neuter and health.
More resources and links on this issue, from Dr. Marty Greer, DVM, Veterinary Village, WI

Veterinarians Open to Offering Ovary-Sparing Spay

California, Northern
Dr. Mack L. Barney
(ask for Dr. Barney specifically and mention this website; staff may not be aware that he offers this service)
Barney & Russum Animal Clinic

2255 Boynton Ave.
Fairfield, CA 94533
(707) 426-1761
Yelp
Dr. Susan Parry
Toro Park Animal Hospital
22720 Portola Dr.
Salinas, CA 93908
(831) 484-9744
please ask to schedule with Dr. Parry
Dr. Kimberly Carlson, DACVS
Bay Area Veterinary Specialists
14790 Washington Blvd.
San Leandro, CA  94578
(510) 483-8500
California, Southern
Dr. Robert E. Woods, DVM, CVA
11561 Salinaz Ave.
Garden Grove, CA 92843
(714) 539-0755
John Lupo, DVM
Malibu Veterinary Clinic
28990 Pacific Coast Hwy.
Malibu CA, 90265
(310) 457-6453
Florida
Haydee Perez-Tirse, DVM, CVA
Panda Animal Clinic
329 E. 9th Street
Hialeah, FL 33010
(305) 887-1018
Email: pandaclinic [at] aol [dot] com
Georgia
Dr. Gwyn Mathis, Dr. Greg Mathis, and Dr. Mike Kelly
Brookwood Animal Clinic and Laser Surgery Center

118 Brookwood Ave.
Jackson, Georgia 30233
Email: BrookwoodAnimalClinic [at] gmail [dot] com
(770) 504-0853
Illinois
Jim D. Carlson, DVM CVA CVT and Stacey Sutter, DVM
Grove Animal Hospital & Holistic Center
600 N. McHenry Road
Buffalo Grove, IL 60089
(847) 541-4005
and
Riverside Animal Clinic & Holistic Center
2904 West Illinois Route 120
McHenry, IL 60051
(815) 344-7716
Maryland
Dr. Susan Maturo (practice owner)
Animal Medical Center of Watkins Park

60 Watkins Park Dr.
Upper Marlboro, Maryland 20774
(301) 249-3030
New Mexico
William C. Thompson III, DVM, PhD
New Mexico Repro at Los Lunas Animal Clinic
575 Hwy 314 NW
Los Lunas, NM 87031
(15 mins South of Albuquerque)
(505) 865-4604
Email: Loslunasanimalclinic [at] gmail [dot] com
Oklahoma
Brad Roach, DVM
Best Friends Animal Clinic
1607 N. Harrison Ave.
Shawnee, OK 74804
Email: Bradroachdvm [at] gmail [dot] com
Oregon
Prof. Michelle Kutzler, DVM
(pioneer of ovary-sparing spay technique)
Department of Animal Science
Oregon State University
Corvallis, OR
Cell: (541) 740-1434
Office: (541) 737-1401
Email: Michelle.Kutzler [at] OregonState [dot] edu
Dr. Hernan Montilla
Oregon State University
College of Veterinary Medicine
209 Magruder Hall
Corvallis, OR 97331
Office: (541) 207-4822
“This is a procedure we would offer given the owner is requesting it, is aware of all the pros and cons, and is comfortable with the decision. They can contact me directly or ask for me when contacting the front desk. We’d be more than glad to help, and it would be a great experience for our students.”
Wisconsin
Marty Greer DVM, NAIA Board Member
Veterinary Village
N11591 Columbia Drive
Lomira WI 53048
Canada
Dr. Moira Drosdovech
Pawsitive Veterinary Care
#6 1551 Sutherland Ave Kelowna, BC, V1Y 9M9
(250) 862-2727
Email: drmoira [at] gmail [dot] com

Veterinarians Offering Mammary Ultrasound

California, Northern
Dr. Lauren Knobel
Seven Hllls Veterinary Hospital

5264 Diamond Heights Boulevard
San Francisco, CA 94131
(415) 642-7200
Ask Dr. Knobel for an appointment with their ultrasound specialist from Sausalito. Appointments with Dr. Knobel are also available in the East Bay, at Codornices Veterinary Clinic in Albany (near Berkeley).
Sam Silverman, DVM and associates
10 Liberty Ship Way
Sausalito, CA 94965
(415) 331-5212
Does ultrasound for veterinary clinics throughout the San Francisco Bay Area. You will need to make an appointment with them through a vet in the area who uses their services (such as Seven Hills Veterinary Hospital, abo

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