Welcome to the Animal Welfare Junction. This is your host, Dr. G. And our music is written and produced by Mike Sullivan. Today's special guest is Phil Busby, a surgeon that actually was, uh, one of the first individuals that I met when I started in this journey towards high volume sterilization. And even though he doesn't remember me, he left, uh, a very impactful memory in me. So thank you, Dr. Bushby for, for being here

today. Well, thank you. It's a pleasure to be here. Uh, I'll give you a little bit of my background. Uh, I graduated veterinary school in the early seventies, 1972. I remember going to veterinary school. I don't necessarily remember a whole lot that they taught us that, you know, 50 years ago. But I absolutely remember that in four years of veterinary school, we never talked about pet overpopulation. We never talked about the fact that in, in the early seventies, the estimates are between 15 and 22 million dogs and cats were being euthanized in the United States each year. We never walked into an animal shelter, and so I graduated with no perception of the issues that animal shelters face have certainly faced then. No perception of pet over population. I took an internship at the Henry Burg Memorial Hospital of the A S P C A in New York City. upper East Side Manhattan. at that time, the A S P C A was animal control for all five boroughs of New York City. And in the year of my internship they euthanized over 136,000 dogs and cats in that one facility. I don't remember if they euthanized on weekends, but let's pretend they didn't. so that equated to five, over 500 animals a day, five days a week, week after week, year after year. so welcome to the world of pet overpopulation and the urgency of spay neuter, my interest or surgery. I went on and did. Uh, surgical residencies. I went into private practice for a short period of time and ended up at Mississippi State University, college of Veterinary Medicine, very early in the history of that school. They took their first students in 19, uh, 77, and I joined their faculty in 1978, and I've been there ever since. Been there 45 years. I'm a board certified surgeon that did all of the referral stuff and this type of thing. And then that draw kept pulling me back to, the shelter world and spay neuter. And so since the early nineties, really that has been my focus for the last. Literally the last 30 years, my focus has been on high volume spay neuter, teaching students high volume spay neuter techniques, getting students into animal shelters to recognize even today we still have problems with pet overpopulation. It's really interesting because, should you spay neuter and at what age you should spay, neuter, used to be simple. for decades we were taught, and everybody basically assumed that the appropriate age to spay and neuter an animal was between six and nine months of age. And that's what everybody did. And the world was fine. And, we had no clue what we were doing. And that. Magic number of six months of age was just arbitrary. It was not supported by any research. In fact, until the, I would say the last 20 years, maybe 30 years, there had been very little research on the impact of spay neuter and on what ages you should spay neuter. Now there is a ton of literature out there, dealing with that issue. I'll start by saying everyone has a bias. I have a bias. I was impacted by, the numbers of euthanasias at the Henry Bird back in the early seventies. And that led me to a bias towards spay neuter, and I still have that bias. sadly bias influences the research people do, and so there are also people out there that have the exact opposite bias, that are either opposed to spay neuter or certainly opposed to spay neuter at a young age. Right. I have a stack on my desk right now. I have a stack, at least six inches high of articles, on the impact of spay neuter and the age of spay neuter. And I guarantee anybody can find an article which supports their position regardless of what their position is. The research is all over the place. one study contradicts the last study, and so thumb through the literature and find what you find something that supports your opinion, and run for it seems to be, the motto for, today. So, what I wanna do is start out by talking a little bit about the quality of the research that's out there. you know, basically, basically what, what we should do in with any medical decision is analyze the risk, benefit relationship. Alright? Is there a risk of performing spay neuter. Is there a benefit of performing spay neuter? and which outweighs the other? Is the benefit greater than the risk? We can do that with the overall issue of should an animal be spayed or dog or cat be spayed or should a dog or cat be castrated? We can do that risk benefit analysis related to should they be spayed at three months of age? Should they be spayed at two years of age? You know, we can look at do we wanna do spay neuter? Should it, we, should we perform spay neuter? And at what age should we perform spay neuter on? Alright. Sadly, sadly, mark, let me let. I'll, I'll get to sadly in a minute. The ideal research would be randomized clinical trials with an absolutely unbiased, selection of subjects with a large numbers of animals, with accurate and precise measurements of all of the variables and all of the possible parameters. And then with cautious and critical assessment of results in an unbiased manner. That's the perfect research project. Those almost never exist in veterinary medicine. Right. Most of what we have in veterinary medicine are retrospective studies where we go back into case records and try to analyze the data in those case records, to reach some conclusion. And there are, and, and, and why, why is that the majority of the research in veterinary medicine, it's quick, it's inexpensive. we have data. We already have data by pulling out medical records. so it's, it's relatively easy. Sadly, it's poor research. It cannot possibly determine cause and effect. There's no way to control variables. If I simply go to the case records, you know, Mississippi's Veterinary School has been around now for 46 years. I could go and pull case records from all 46 years and try to reach some conclusions about age of spay neuter. but the data would be all over the place. we would have no control over the environments that the animals were in no control over the, the diet. No control over the veterinary, medical care history of those animals. It's just data on a piece of paper with no control of variables. And we try to reach some conclusions from it, right? And that's what the majority of research that kind of opposes spay neuter, or at least wants us to delay spay neuter, older age is retrospective studies. The majority of spay neuter, of research that says spay neuter is appropriate and it's appropriate, to spay neuter, before six months of age, most of that is retrospective studies with no control of variables. Again, we can find whatever we want to support our own bias. So, so we have, you know, and, and in the last 10 years, we've fallen into the trend of publishing, in public access journals. So it's not just veterinarians now that read all of the studies out of uc, Davis, or the other studies from other places that support spay neuter. It's the public that's reading them too. All right? And so we've created this confusion because the data is, you know, the, the data is all over the map and it's no longer confined to a journal that comes to your mailbox once a month or every couple of weeks. It's out on the internet at anybody can access it in an at any time. It seems like we don't know what we're doing. Right. So, what I wanna do is, I'm, I'm, I'm gonna dissect a series of articles that I'm gonna start with a series of articles that basically say either don't spay, neuter, or wait. And I'm gonna analyze those articles and I'm going to, uh, kind of tear some holes in them. And most of these articles have come out of UC Davis in the last 10 years and have, all had kind of the same group of authorship.

And have these articles. They have the same authors, do they also use the same records, like the same population for all of these articles?

Yes. They're going back into the, clinical record system from uc, Davis, and it's, they have an extensive clinical record system. They have all this data and, and they're simply trying to analyze the data as they see it and publish that data. And I don't fault them for that. I just think people should understand that, uh, the research is not perfect. And we're gonna try to explain a little bit why. Alright, so the first we saw out of this group was entitled Neutering Dogs Effects on Joint Disorders and Cancers in Golden Retrievers. It was published in 2013. Uh, it reported on 759 client owned Golden Retrievers, and they concluded from analysis of their records that for males neutered under one year of age, which I think back 10 years, almost all males were neutered under one year of age, the incidence of hip dysplasia was doubled that of hip dysplasia in intact dogs. Okay. Uh, the cranial cruset rupture was increased in dogs neutered, uh, under one year of age. the incidence of lymphoma in, dogs neutered under one year of age was three times that of intact males. And the incidence of of Hemangiosarcoma, interestingly, in females spayed after one year of age was four times that of intact females. Ooh, shockwaves. Go through the, the profession. Clients are now saying, wait a minute, should we even spay and neuter our animals? Because of this article published now, 10 years ago, that was followed a year later with an article, long-term health effects of neutering dogs, comparison of lab, Labrador, retrievers, and golden retrievers. So go back into the same record systems. Pull out data from Labradors and compare it with golden retrievers. And in that article, they looked at, just over, well, 1,015 goldens golden retrievers, and 1500 Labradors. And they found increases in certain orthopedic conditions and certain cancers in sterilized Labradors. But there were differences between the findings in the Labrador and the golden retrievers. All right. So yes, increases, but they were different than the, the goldens. Follow that a year later, neutering of German shepherds, dogs associated joint disorder, cancers and urinary incontinence, 1,170 German Shepherds. Incidence of having one joint disorder in dogs neutered less than six months of age, they said was two to three times out of intact dogs. Incidents of one joint disorder in dogs neutered between six and 11 months of age was also two to three times that of intact dogs. And neutering in German Shepherds was not associated with any increase in cancer compared to intact dogs. All right, again, another large breed dog, basically large breed dog with increased orthopedic issues apparently, and no increase in cancers. Differences now between Goldens, Labrador and German Shepherds. Alright, let's really get confused. And in 2016, one article, one article a year, let's just hit bam bam, bam, bam. One article a year, gonadectomy effects on the risk of immune disorders in the dog, a retrospective study. and it looked at the incidence of several immune disorders in neutered dogs comparing them to intact dogs. And then we get 35 breeds of dogs assisted decision making on age of neutering for 35 breeds of dogs associated joint disorders, cancers, and urinary incontinence. If you, if, if you start to think, okay, I don't wanna, I don't wanna be real serious here. This article was actually, um, somewhat humorous. The results were all over the map. All over the map for male dogs, out of 35 breeds for 21 of those breeds, the author said that they lack any noticeable occurrence of increased joint disorders or cancers. And therefore, quoting from the article, those wishing to neuter should decide on the appropriate age, you know, on 21 of 35, 2 thirds of the breeds, they simply say, if you wanna neuter them, you decide on the appropriate age because we don't have any data. Female dogs, on 24 of the 35 breeds, there was no noticeable increase in joint disorders or cancers. And they said, quote, those wishing to neuter should decide on the appropriate age. Right. And when, when you read that article, the numbers were teeny. the, the most egregious one that they made a comment in St. Bernard's, in which they stated that the incidence of having at least one joint disorder occurred in 100% of the St. Bernard's in their study that was spayed under six months of age. All of them, all four. They had four St. Bernards in that category, right? And, and they're publishing that data as if it has any significance whatsoever. And then they come up. Then the next one was mixed breeds, five weight categories. Okay, let's get away from the, from the pure, pure breds. Now let's just look at the mixed breeds. And they divided into, uh, under 10 kilograms between 10 and 19, between 20 and 29, 30 and 39 and greater than 40. All right. Under 10 kilograms, no increase in joint disorders or cancers with neutering under one year of age. All right. 10 to 20. No increase in joint disorders or cancers with neutering under one year of age, 20 to 30 kilograms. Ooh, an increase in joint disorders if neutered. Under one year of age, no increase in cancers. 30 to 39. Uh, kilograms, again, increase in joint disorders if neutered under one year of age. and increase in cancers if they were not neutered. Okay, now I'm getting confused. Over 40 kilograms and males increase in joint disorders if neutered under one year of age. No increase in females, no increase in cancers with spay neutered regardless of age. All right, so plug all this data into your computer and when an animal walks through the door, hit the keys on the computer and let the computer tell you, oh, gee, this falls into this category. We'd better not spay it. We better not neuter it. No, it's gotten crazy. It's gotten totally insane. All those six articles all looked at the incidence of joint problems, either cranial cruciate rupture, or hip dysplasia and and various cancers. And they were looking at lymphoma, hemangiosarcoma, osteosarcoma, and mast cell tumors and immune disorders, and showed all over the map, some degrees of increase in incidents of certain orthopedic conditions and neoplastic conditions, and immune disorders. And it was all over the map. But now here's the but. These were all retrospective studies. In the best research we've already made the comment that all variables should be controlled except the ones you're measuring. And retrospective studies can't do that. Can you take a population of, you know, a thousand go and you'll it will, it'll become real clear why we don't do this research. Take a population of a thousand golden retrievers. Put them all in an identical environment. Uh, Put them all on the exact same diet, put them all, uh, on the exact same level of veterinary care, follow them for 10 years and determine, you know, and some of them were spayed at under six months of age. Some of them were spayed over six months of age, and some of them were left intact. And now compare incidents of orthopedic disease and incidents of various cancers. And you might actually have some valid data. But when you don't control any of the variables, you really can't make any solid conclusions from the data. Now, here are the flaws that I see in, in all six of those articles. These were cases managed, at a referral institution, right off the start, you have a biased selection of cases, cases managed by primary care. Veterinary clinics are not represented in these studies. And so why is this a concern? The, the local PR practitioner, the primary care clinic, might very well managed the dog with mammary neoplasia or the dog with pyometra, but refer the case of osteosarcoma. So now you're looking at the records from a referral institution, and you're not seeing incidents of mammary neoplasia in those intact dogs because those dogs don't show up at your institution. But you are seeing the cases of osteosarcoma in sterilized dogs, right? So there's a bias, it's, it's not intentional, but there's a bias built into studies that are restricted simply to the records of referral institutions. And this is a little bit of an overgeneralization, but in the United States, there are two reasons why people don't spay and neuter their dogs. The most common is they can't afford the surgery, and the second one is they intend to breed the dogs in order to sell puppies. So if people can't afford to spay and neuter their dog, what are their chances of ending up at a specialty clinic or a, university teaching hospital? Because the dog is limping. I can't afford to spay my dog. It's been limping for the last three months. My local veterinarian says it is a, cruciate rupture. But I can't afford $6,000 to take it to a referral institution to have a A T P L O performed. So my dog, my intact dog, doesn't appear in the record system that is used to generate these articles that we've been talking about. Carry that one step a little bit further. People who raise dogs to breed and sell puppies are much more inclined to keep those dogs confined to kennels or whatever. They're not running around the neighborhood. and so there's a potential that just their environment is helping protect them from cruciate ruptures or whatever, whereas the intact dogs are running around the neighborhood. Retrospective studies can point out associations. They cannot po they cannot show cause and effect. Right? And, and the ridiculous example I use, is in the past 15 years in human medicine, the incidence of diabetes, has increased. And so is the incidence of people, doing yoga. So does diabetes cause people to want to do yoga or does yoga create diabetes? No. You, you can't make those assumptions. Uc, Davis studies are reporting on relatively small numbers of cases and just random variation. If everything, if everything about the uc, Davis studies was perfect except numbers of cases, random variation. If the, the, the smaller the number of cases you have, the greater the impact of random variation. So my opinion, it's just my opinion is that what the uc Davis studies do for us is point to the need for much better research to look at these issues, but should not have any impact on the de the decisions that we make today.

So, yeah, you know what we do, right? So we're a mobile sterilization clinic and we take care of those individuals that cannot afford sterilization at larger practices. And our clients are the ones that are very unlikely to follow up with referral. And given the fact that everything that we see is unsterilized we could say, we could do our own research and say that all animals with cruciate disease or arthritis are unsterilized, right? Because everything that we see is unsterilized. So a hundred percent of our cases are unsterilized animals of all ages, whether it be younger dog for adult dogs. And the other thing is that from how I see it, is we're ignoring the genetic component because I know since the beginning of time you see a German Shepherd that's walking stiff, gated or, or really low in the back. And the first thing that you think of is hip dysplasia because the German Shepherd has been the poster child for hip dysplasia. So yeah, we are going to expect German Shepherds to be a higher incidence of hip dysplasia. And to your point, like a lot of the people that are going to be bringing these animals to a referral practice, you're gonna think of them as responsible pet owners that thus would've had their animals sterilized at an earlier age. So that also is something that kind of has to be taken into consideration that I don't feel that, that it is in some of these studies.

So, so if you are, if you are breeding German Shepherds and you know to sell German Shepherd puppies and you have a. Dog with hip dysplasia, if you're a responsible breeder, you are going to have that animal spayed. You're not going to breed it. Mm-hmm. All right, so now that animal's data is entered into a system that says this animal was spayed and it has hip dysplasia. Well, it's spayed because it has hip dysplasia. It doesn't have hip dysplasia because it was spayed and retrospective studies don't figure that out. They can't, differentiate between those cases where the surgery was done because of a problem as opposed to the problem occurring because of the surgery. They can't do that. So we have the need for those articles have a value, and the value is simply they point to the need for more research. But there's a ton of literature out there that supports spay neuter and early age spay neuter, and, and we're gonna talk briefly about those, but, hey, those are also retrospective studies. All right. Almost all of them. There's a study out of the University of Georgia. Reproductive capability is associated with lifespan and cause of death and companion animals was published in 2013. The same year the, the, the, uh, Davis study, the, the golden Retriever study was published. They looked at the data from 80,958 dogs. It's a little more than. You know, 150 or 600. They looked at age of death and categorized the cause of death. They compared age of death with gender and sterilization status. They compared cause of death with sterilization status. The article could not, did not look at age, which the animal was sterilized, but this is what they found. Sterilization was associated with increased longevity in both males and females. Male and female dogs that are sterilized live longer than those that are in intact. No control over variables. Maybe they live longer just because the sterilized ones get more veterinary care. We don't know. We don't know. We cannot say that sterilization caused them to live longer. We just know that the sterilized dogs do live longer. Life expectancy was greater by 13.8% in males and by 26.3% In females, we don't claim. Huh? Sterilization causes them to live longer. We just recognize that they do live longer. They looked at cause of death. Intact animals. The causes of death, the main causes of death, uh, death were infectious disease, trauma, uh, vascular disease and degenerative disease. And the, and sterilized the main causes of death were neoplasia and immune mediated disease. Alright. Ooh gee. That seems to support some of Davis's comments that, of increased cancer in animals that have been spayed or neutered. Right. But it really shouldn't surprise us that sterilized dogs that live longer might have a greater increase in certain cancers because cancers seem to be associated more with age. Right. And, and, and interestingly in the Davis German Shepherd study, they actually, that study was published in 2015, two years after this Georgia study. And so, uh, they actually referenced the Georgia Longevity Study and the author said, and this is a quote, a study utilizing the US National veterinary medical database, found that neutered males and females were more likely to die of cancer than intact dogs. But curiously, they failed to mention the sterilized dogs live longer than intact dogs, Grandmothers have a much higher incidence of cancer than teenagers. That doesn't mean being a grandmother causes cancer, it just means they're at an age where cancer is, uh, prevalent and teenagers aren't. I, I'm, I'm sorry. It's as simple as that. In that Georgia study, Increased transitional cell carcinomas, carcinomas, ost, osteosarcomas lymphomas, mass cell tumors significantly decreased, significantly decreased mammary neoplasia. When we read any one of these articles and they, the article says, the incidence of condition X was two times greater, in the spayed animals or the neutered animals than in the intact animals. We need to be willing to look at what is the overall incidence. in the incidence of osteosarcoma, transitional cell carcinoma, lymphomas, and mass cell tumors is relatively small. Doubling or tripling the incidence of a tumor that occurs in a very small percentage of animals still leaves it occurring in a very small percentage of animals. 2014, there was a study, it was a report from Banfield on the status of pet health, where they looked at longevity, and reproductive status. Again, it was a retrospective study, huge numbers of cases. it reported on, they analyzed data from 2.2 million dogs and 460,000 cats. And showed that sterilized female dogs, live longer than, intact females. Sterilized male dogs live longer than intact dogs sterilized females live longer than intact. Female cats and sterilized males. Sterilized male cats lived, uh, life expectancy was 62% greater than intact. We, we can kind of see why, but again, longevity and longevity is going to influence. Can the cause of death, what's the, probably the most common cause of death in, Male cats, under two years of age, it's probably being hit by cars because they're out there roaming, looking for females. and the 12 years of age, it's probably cancer, So, all of a study you've looked at so far basically show sterilized dogs and cats live longer. Sterilized. Dogs and cats have a higher incidence of certain cancers. Sterilized dogs and cats, uh, have a lower incidence of other cancers. Uh, some sterilized dogs may have higher incidents of some immune disease diseases and intact dogs are more likely to die of infection and trauma In 2007, Margaret Gor published an article looking at, the incidence of conditions, in dogs. and osteosarcoma was low. transitional carcinoma, was low hemangiosarcoma, frequency was very low. mammary neoplasia, the frequency was extremely high. Uh, pyometra frequency was very high, she didn't know it at the time, but what she was doing was kind of preparing a case for the fact that not only do we have to look at, All conditions that that can impact health, we can't make any judgements unless we know what the overall incidence is in the population and therefore can determine the significance of an increase or decrease. So what, how do what? What do I mean by all that? If we could look into the future for any particular animal and determine which animals were gonna develop o osteosarcoma, if they were sterilized and which we're gonna develop mammary neoplasia or pyometra, if they were not, we could make the best decision for each individual animal. Since we can't do that, we really need to be base our recommendations on population dynamics. In the United States right now, approximately 80% of adult female dogs are spayed. The incidence of mammary neoplasia in adult female dogs is approximately 4%, but that is almost exclusively in the intact dogs or the dogs, that were spayed later in life. So that makes the incidence of mammary neoplasia in, in tact dogs nearly 20%. The incidence of osteosarcoma is 0.2%, and some of the articles say that sterilization doubles the risk of osteosarcoma. But since 80% of the dogs are sterilized, that doubling effect is already represented in the 0.2%. So we can't treat mammary neoplasia and osteosarcoma as the same because the difference in incidents overall in the categories we're looking at are 0.2% to 20%. Mammary neoplasia is all over the place in intact animals and osteosarcoma is rare, even with 80% of the animals being sterilized. In Sweden, 7% of the female dogs are spayed, and yet the in the incidence of pyometra in dogs. By 10 years of age is 24 to 25%. When we make decisions, we have to use population dynamics. We have to be willing to, look at all conditions, not just handpicked a few. Oh gee, we find that cranial cruciate rupture seems to be increased. Let's write an article supporting, uh, delay of spay neuter, or not spay neuter because of that one condition. Okay, so let's make sure that none of the animals get lame, but they all get pyometra or, or mammary, neoplasia. We can't do that, So we cannot make spay new dec decisions based on, on the incidence of a small handful of diseases, we have to look at the entire health of the animal and say, what's the impact on the health of the animal? I'm not saying ignore cranial cruciate, R ruptures and ignore osteosarcoma. I'm saying, look at everything. And you make, you make your decisions based upon the impact on the overall health and longevity of the animal, not just on a few things. And we cannot focus on an increase in decrease of the incidence of a condition if we ignore what the incidence of the condition is to start with. It sounds so scary to say the incidence of O osteosarcoma is doubled or tripled. And, I'm sorry, two to three times, almost nothing is still almost nothing. So we could go on and on and on and on and on. I've come so far, I've completely ignored cats, and I'm gonna jump into cats here for a few minutes, but we've, we have seen a significant decrease over the decades in pet overpopulation of dogs. Most of that, but not all of that associated with spay neuter. A lot of it has been, some of it's been associated with the fact that since I, you know, when, when I graduated from veterinary school, the typical dog lived in the backyard, and now the typical dog lives in the roams in the house and joins up, joins the Zoom meeting. Uh, cats are slightly different situation because we still see kitten season. We still see shelters filled with kittens in the early to late spring. As the days get longer and the weather gets warmer, kittens seem to explode. There's nowhere near the number of articles on cats as there is on dogs nowhere near, And a lot of people are trying to assume, well, if it's true in dogs, it's gotta be true in cats. So they try to extrapolate from, you know, the scare of the, some of the Davis articles to cats. When the Davis articles prove that you can't even extrapolate from one breed of dog to another breed of dog. We certainly can't extrapolate from, from dogs to cats. Alright, so what should we do in cats? We know cats female cats can come into heat by four to five months of age. We know that kittens can give birth to kittens, basically, uh, there are zero, and again, there's not been much research, but there are zero articles out there that document. Increase in orthopedic conditions or increased cancers in early age, sterilized cats. Cats should be spayed or neutered prior to five months of age. Pure and simple, it all boils down to we should spay and neuter cats. There are no adverse to the best of our knowledge. We've not found any adverse effects of spay neuter of cats under five months of age. No adverse health effects. No adverse behavioral effects, nothing. So there's no reason not to, and there's every reason to spay ne to prior to five months of age in cats. And there several, several articles, uh, Lisa Howe out of Texas a and m uh, Victor, Spain and Janet Scarlet out of Cornell, uh, looked at, uh, health impact on cats, and followed those cats for periods of times, all retrospective studies. But whatever, there's a myth out there that's sterilizing a male cat, prior to sexual maturity can increase, incidents of urinary obstruction, and, feline lower urinary tract disease. There is no evidence to that whatsoever. In fact, there's been a couple articles that kind of disproved that, that occurs. and I, I did a, uh, did a, a review of. Every article that I could find that dealt with the incidents of urinary obstruction and what, the factors that caused urinary obstruction, obstruction, or were associated with urinary obstruction in cats. And not a single one of those articles mentions, age of Castration as an impacting urinary obstruction. Everybody believes it that you castrate them prior to sexual maturity. The urethra is smaller. Yes, it is smaller, uh, and it predisposes to urinary obstruction. There is zero evidence in literature that that occurs. Zero. So how do we, um, when we try to summarize, all right, cats spay new to prior to five months of age. Small breed female dogs spay new to prior to five, uh, prior to six months of age. I still say prior to five months of age, large breed female dogs spay prior to five months of age. The one exception I might make in my personal recommendation, so one exception I might make is that I might suggest that in large breed male dogs that are house pets, you might delay castration until growth is stopped. You might. But you watch those dogs very carefully and you see what the behaviors are, right? For that free roaming the dog, you know, I live in, out in the country. I'm five miles from town. I live on five acres. everybody who has dogs, the dogs just roam the neighborhood. The large breed male dogs that are roaming the neighborhood castrate prior to five months of age. now I've said all that because I'm biased. Okay? Uh, there is nothing that's been published in the literature that changes that bias because the literature is so poor, the research is so weak. We may reach a stage where we actually have valid information. You know, we do an, we do a risk benefit analysis, and we make our decisions the best decision we can can, based upon the data we have and the value of that data. Someone may put together a very, very good solid prospective research study that looks at these issues and, publishes new data, which is very valid. We should be open to changing our mind. We should be willing to change our recommendations on spay neuter and the age of spay neuter if we get good, solid data from good solid research. We don't have that yet. And so I think the the confusion caused by the, by the Davis studies is extremely unfortunate. we should either keep that six months, if you're comfortable at six months, that's okay. I like to go even earlier. but there is nothing that the Davis studies have have shown that should argue that we should wait on spay neuter for either dogs or cats, nothing. So how we get the public to understand that, how we get veterinarians to understand that that's what you're trying to do.

With the, with the cats, I worked in emergency for a period of 10 years and that that whole thing about intact male cats do not get blocked as often as neutered male cats. How many people want an intact male cat inside of their home? The answer is very few to none. Right? Because they spray, they smell horribly. They're constantly wanting to chase after girls. So if a male cat is going to obstruct, unfortunately it's gonna be an outdoor cat, we're never gonna know. It's probably going to to die outside. In emergency though, because we did low cost emergency, we did see a significant number compared to what I saw in previous private practice of intact cats that were presenting because they were obstructed. The other thing too is that a lot of these sterilized cats, we are not taken into consideration all the other compounding factors of obstruction, whether it be obesity, the fact that they're not stimulated behaviorally, they have an increased risk of stress. Their diet is not the same as what is outside. So as you mentioned, we are not controlling all of the variables involved. And then we're just saying, okay, this is what we're seeing in practice is all these sterilized cats and the majority of cats that come blocked are sterilized. So clearly that must be causation, whereas in reality, it's just correlation.

Right, right. Yeah, and again, the, the sterilized cats are the ones that are more likely to show up at the veterinary clinics in the veterinary clinic. Mm-hmm. Intact cats are. Are not in people's homes, they're roaming outside and they're not gonna get the veterinary care that the sterilized ones do. So again, that's a, that's a perfect example of biased patient selection, not intentional bias. It's just biased because one category of cat doesn't show up in the veterinary clinic. Just like there's categories of dogs that don't show up at uc, Davis Teaching Hospital.

anyway. Good point. Yeah. And then for dogs, uh, I've had two great Danes that were sterilized early in age. They were sterilized, uh, before six months of age, and both dogs died of cancer. Now the one dog had developed an osteosarcoma of her right elbow at almost 11 years of age, and the other one developed an osteosarcoma on her left shoulder at 13 years of age. So, as you said, it's, you know, if they had not been spayed, perhaps they would've died younger and not gotten old enough to develop these cancers that were ultimately what took them. But a 13 year old Great Dane, I'll take that any day of the week, right, because it's, uh, it doesn't, it doesn't occur that, that frequently, and I can say, I mean she was, she was sterilized young, but also she always had a good body condition. She was on a good diet. Uh, she had preventive care, so she had a lot of different things that contributed to her extended life. Um, yeah. So she has to eventually die of something, and that's what eventually took her was cancer on her shoulder.

I had a, uh, female, I, I, I call it a, a do beddor half doberman, half Labrador, Doberman, Labrador, mixed dog female that I spayed at six weeks of age, that died at 14 and a half years of age. Was euthanized at 14 and a half years of age because of complete urinary tract obstruction with a transitional cell carcinoma. Now, I don't intend that the surgery I did, at six weeks of age caused that cancer. What caused that cancer was she was 14 and a half years of age. Yeah, it's, we have to be careful making changes in what we do based upon very weak data that at best shows an association. Maybe what we should do is just euthanize all people that practice yoga because they're gonna get diabetes so we can save them diabetes

from diabetes. Yeah. Statistics can be manipulated in any given number of ways, and you can take a chart that is not significant and expand it and make it look significant. And for somebody that doesn't understand the, the numbers behind it and are just looking at a graph and saying, oh, this column is a lot longer than the other column. They don't really understand what that means. And that's kind of the unfortunate side of statistics. I love statistics, I love research, but I very well know that you can take numbers and sadly, make a graph that represents that it means nothing, or make a graph that represents that it means everything. So we need to be really careful with how we share this information to the public so that they can make an educated decision for the wellbeing of their pets.

Yeah, I, I play pickleball. And, I'm, I'll be 74 at the end of this month. Uh, and I was playing with a guy that was also in his seventies, the other day, and we were playing, Two people in their thirties. Pickleball games go to 11. The first match, we lost 11 to nothing. They killed us. The second match we lost 11 to three, and at the end of that match, I turned to my partner in the game and I said, we significantly improved over the first match. Other team didn't. All right. They scored 11 both times. We went from zero to three. Look how good we were. We could, we could have written an article and have published in, in an online journal on our improvement, while the other team stayed static. And if you knew nothing about what the subject was, it would look like we, we, we were really doing good. We got killed both games,

and the one thing that, that we can, that we can agree is that sterilized animals are not reproducing. So sterilized animals are not adding to the overpopulation problem. Right. And sadly, euthanasia in shelters is killing more dogs than, more than most cancers and most other problems that we are seeing. Right. So I don't know it, as you say, I mean, I am biased as well because I am, I care about the animals that are ending up in shelters. The problem with the over population in shelters, the number of animals euthanized for space, and then the impact that that's causing on the profession, on the wellbeing of the individuals that have to see these animals day in and day out. And then they have to make the difficult decisions to euthanize them. So, It's, it's what I see every day. And then from a, from a high volume sterilization perspective, most of the animals that I'm sterilizing, a lot of them are actually over the, I would say three years and older. And I am seeing a high incidence of mammary tumors. Uh, we sterilize quite a few dogs and cats, both that have pyometras, that have had ovarian tumors, that have had uterine cysts and tumors. So I see the reality of what an intact pet is going to have, going on in age. So,

so, yeah. And none of the cases you ever see are ever going to show up at a referral center.

So, right. Exactly. Exactly. Yep. Um, and yeah, it's, yeah, it, it's by, it's, there are biases on, on both ways, as I said. Like my clients are not gonna end up there, so they're not gonna be part of any research, right. They're just gonna be part of our local knowledge of how many of these pets are presenting. I mean, we diagnose a lot of hip issues because we put 'em on the table and their legs are not stretching, right? They have decreased range of motions. So we know that there are issues and problems and clearly not sterilized animals. Another, another thing is how people say, well, if I spay my, my dog, she's gonna gain weight and she's gonna be obese. There are so many dogs that I sterilize that are overweight, and clearly they are not sterilized. So that had nothing to do with it. So there, there are a lot of different things that, that cause changes on our pets. And because sterilization is done at such an early age or has been. Done at such an early age, everything is kind of getting blamed on that. Um, I had somebody make a comment to me once about how there was an increased risk of cancers in people that drank regular water, tap water. Uh, it was somebody trying to sell me a filtration system for the water, and he tried to talk statistics with the wrong person because I said, do you know what's the most common thing in the people who don't have cancer? They drink water too, so it's, you know, and then he had nothing to say to that. I was like, just stick to your, to what you're going to do for my water end. Please try to keep your, your statistics, your flawed statistics out of it because you can, you can kinda show it one way or another. We, we find, we find the information to prove what we wanna believe, and then we can run with it. Right. Right.

And I mean, I do the same thing. Mm-hmm. I, I use the supporting articles, you know? There are articles on spay, neuter and ages, spay neuter over the last 10 years. I handpicked the ones that proved my point. Mm-hmm. When I'm speaking. And Benjamin Hart. Handpicks and ones that prove his point. And the bottom line is 99% of all of this is crap anyway. It should not change what we do. It should just focus our research. So we're really answering the questions rather than just supporting our biases. And oh, it'd be, it would be so powerful, to design a study that involved, all of the high volume spay neuter to clinics, and have them follow up their cases for 10 years. We don't have a system to do that. And you know, our shelter program at Mississippi State, we're now over 110,000 surgeries since 2007. our longest follow up on any of them is three to four weeks, because they go back into shelters and then they get adopted. And one, they, once they're adopted, we completely lose any fa ability to follow up. And I, I suspect that almost every high volume clinic has a similar situation. We don't have the money or the means to do the quality of research. We need to really answer these questions. So, in that absence we need to try to solve the pet of the population problem. That's still, in my opinion, that's still the number one issue, is stop 'em from having, you know, I've used this analogy, you, you've heard me speak, so you've probably heard me use this analogy before, but you, you wake up in the morning and you discover the basement of your house is flooded, and you go down in the basement and you discover someone left the faucet running all night. and what do you do first? You start bailing water, or do you turn the faucet off? When you turn the frigging faucet off and turning the faucet off? Spay neuter is turning the faucet off.

Anyway,

And that's an excellent analogy. So yeah, it's, you know, overall we gotta, we gotta understand what the information is telling us, and then we also have to look at the reality of what we're seeing. Um, yeah. And then make educated decisions based on, on what we see. So I think that, I mean, thank you so much for dissecting all the research. you know, it, it, hopefully both veterinarians and the public listening can, can better understand what the numbers mean, what the reality of it is, and then make better decisions that are in the best interest of their animals, and then in the best interest of the community, keeping in, in, in mind the overpopulation problem, the shelter, pets, and, and everything else. So I, I really wanna thank you for, for spending this time with us and for sharing your wealth of knowledge with us.

All right. You take care. I enjoyed it.