Of all the e-mails and phone calls the last five years of blogging has brought my way, the most commonly queried issue has to do with how to source a tubal ligation or vasectomy for dogs. Apparently, it’s near impossible to find veterinarians willing to take on these simple procedures in some parts of the country. Which is endlessly frustrating to pet owners who have read up on tubal ligation and vasectomies for canine sterilization and decide this approach might just be best for their pet. As in: My breeder/community/veterinarian suggests that I spay or neuter my dog. I’d rather not because a) I want him to compete athletically. b) I’m not convinced of the health benefits of removing her sex organs entirely. c) I’m concerned about the health risks of spaying and neutering (obesity, osteosarcoma, cruciate ligament disease, longevity studies in Rottweilers, etc.). d) He or she has no imminent health or behavior problems that require a zero-sex-hormones approach. All I want is to keep him from potentially adding to the pet overpopulation problem. I don’t know about you, but in light of this kind of well-reasoned argument, I’m not capable of standing in the way of two procedures that bring me more intelligent—if somewhat eccentric—clients, and are simpler and less traumatic to perform than their alternatives. At any rate, these owners are typically so adamantly opposed to a gonadectomy that a) I’d be unlikely to succeed in changing their hearts and minds even if I tried. b) They’re absolutely willing to take the socially responsible approach and sterilize their dogs anyway. Pros and Cons So what’s to complain about? After all, veterinary medicine is slowly but surely coming around to the notion that ovariohysterectomy (or ovariectomy) and castration are not one-size-fits-all procedures—not for our dogs, anyway. Though the spay and neuter mantra still holds extrafirm among most of us when it comes to population control, the jury is still out on whether it’s best for dogs to retain their gonads in the absence of disease or any another immediately compelling reason (aggression, marking, roaming, etc.). Vasectomies and tubal ligations then would seem a reasonable alternative to those who argue they’d rather take their chances. “At least let me vasectomize him so he won’t contribute to the pet overpopulation problem” has met with increasing success in macho-minded Miami, where intact males are all the rage and most bitches keep their parts, “just in case I want to breed her later.” What’s more, from a public policy standpoint, vasectomization and tubal ligation offer a less invasive, more rapid brand of sterilization. (Read: less expensive = more dogs sterilized = tempered overpopulation). And an owner can always choose to completely gonadectomize later. No harm, no foul. In terms of public health—human or canine—it’s only in the event of testosterone-related aggression that the public loses out. And it’s only in the event of once and future disease (whose risks and benefits are still being tabulated) that the individual pet misses a surgical opportunity for a gonadectomy. Finishing the Job Yet it’s our profession’s prevailing wisdom that a complete gonadectomy is the only way to treat our dogs. Indeed, if you ask U.S. veterinarians, the concept of a tubal ligation or vasectomy reeks of the unethical. “Why do something only halfway?” they’ve written. “I mean, you’re already in there, so you might as well take it out.” And, “How can you apply an approach that would replace a more appropriate one?” Or how about this objection I received in my e-mail inbox recently: “Who pays when they get testicular cancer or mammary masses?” (To which I responded cheekily by surmising that my correspondent had never been sued for contributing to hormone-related incontinence.) There’s an undercurrent of denial to so many of these objections that I don’t quite get. Even ear crops and declaws don’t seem to rake up so much irrational moral indignation—not from the vet set, anyway. Perhaps it’s that we assume the desire for these procedures comes down to mere human conceit (i.e., “I want my dog to keep his balls and I think it’s natural for him to continue to have sex.”). And yes, I’ll agree this self-identification and humanization is an all-too-prevalent attitude among a certain kind of client. But more than likely, I think any staunch negativity against these procedures has more to do with this simple point: We don’t do vasectomies and tubal ligations because we weren’t taught to do them in school. Starts in College By design, those at the forefront of clinical change in our profession have traditionally been those in university settings. They influence all of us through the papers they write and the students they teach. But I’d posit our tertiary care setting surgeons have little incentive to teach vasectomies or tubal ligations or even ponder their significance given that OVH is a three-letter acronym they seldom see on their surgery schedules. It’s just not on their radar screens. Even shelter medicine programs haven’t eyed this possibility seriously. Perhaps it’s that adding another method to the mix is perceived as too complicated and messy, public relations-wise. That the scales haven’t yet tipped precipitously enough on the ideal timing of gonadectomy to warrant anything less dramatic than sterilizing with extreme prejudice. Or maybe it’s held that a halfway approach offers a toehold for even greater overpopulation should the public perception of sterilization shift even slightly away from its current positive trajectory. Whatever the case, the lack of discussion on this subject in academia and its apparent hard sell among veterinarians in practice is enough to make me wonder whether the most likely answer to the question of veterinary disinterest in these procedures—as with any safe surgical procedures with legitimate applications––has much more to do with fashion than with anything else. This article first appeared in the June 2010 issue of Veterinary Practice News. Click here to become a subscriber. Patty Khuly, VMD, MBA, is a small-animal practitioner in Miami and a passionate blogger at PetMD.com/blogs/FullyVetted. She earned her veterinary degree in 1995 and her business degree from Wharton in 1997.
