Saturday, July 25, 2020

The Pros and Cons of Ovary Sparing Spay (OSS) for Your Dachshund

For the first time, I brought home a dog that wasn’t spayed.

I knew that getting her “fixed” was the right thing to do for us but, now that I was bestowed the responsibility myself, I wanted to do some research first.

I started to hear mumbling that perhaps spaying a dog at a young age wasn’t as beneficial as once thought.

It seemed that waiting until a dog was older to spay, or opting for an Ovary Sparing Spay (OSS) might be a better way to go.

So, like I do, I went into research mode and spent months learning about all of the details, benefits, and potential negative consequences.

So that others don’t have to dig through all of the same information, I compiled the common, and what I think are the important, talking points into this article.

Two months of research about Ovary Sparing Spay (OSS) condensed into one article. Two months of research about Ovary Sparing Spay (OSS) condensed into one article. Two months of research about Ovary Sparing Spay (OSS) condensed into one article.

WARNING: It’s Huge. I put the most stand-out points up front but included all of the important details. It’s so huge, I’m not even going to make you scroll more by putting photos in it. #SorryNotSorry

If you’re here, I’m guessing want ALL THE INFORMATION, easily, and could care less about generic pretty pictures.

What is an Ovary-Sparing Spay?

A traditional spay (the term used for neutering a female dog) surgery can be done two ways – by removing a dog’s ovaries (ovariectomy) or removing the ovaries and uterus (ovariohysterectomy).

Due to veterinary medicine advances, a traditional spay is not the only choice you have anymore when it comes to making sure your dog can’t get pregnant.

Another option is what is called an Ovary Sparing Spay (OSS),  which involves removal of the uterus and cervix while leaving one or both ovaries.

All three of these procedures will make sure your dog cannot reproduce, resulting in an unplanned litter.

The first two – ovariohysterectomy and ovariectomy – remove the female dog’s reproductive, and some growth, hormones.

The third – OSS – leaves the dog’s hormones in their “natural” state.

Why Do OSS Instead of a Traditional Spay?

 A female dog’s ovaries are the primary way the body produces the hormone estrogen and progesterone.

When the primary way for a dog to produce estrogen is stopped, a dog essentially goes into menopause.

There can be several negative consequences to a dog growing up from an early age without these hormones.

Below are all of the pros and cons of removing a female dog’s reproductive hormones that I considered.

First, a couple caveats.

It’s important to note that most studies on the pros and cons of OSS involve larger dogs. However, that doesn’t mean that the findings don’t apply to smaller dogs too.

I did find some studies that cited that the differences – with or without reproductive hormones – were less pronounced in smaller breeds (which may have to do with them maturing sooner).

Also, most of the studies measured the negative effects if a spay was done “too early”, which was defined as anything done before 12-18 months (the lower range applies to smaller dogs since they develop faster than larger dogs) and especially before 6 months.

While I didn’t read any evidence that the below issues are not factors if a dog’s ovaries are removed after the 18 month mark, it was definitely my impression that the extremes of the pros and cons are diminished (ie. not as big of a difference) if a dog is spayed after 18 months.

Still, I believe it’s possible the benefits and negative factors could be at play even if a dog’s ovaries are removed later in life.

Summary of the Pros and Cons of OSS vs Traditional Spay for Dachshunds

For those that don’t want to read my ginormous article – I condensed probably 100 articles and social media conversation threads below – here are the cliff notes.

But seriously, you should read the whole thing (especially the part where I say what I decided to do and why) because there is so much important info to consider in your decision.

Here is what stood out to me and what I think the pros and cons of OSS vs traditional spay are:

Pros of Ovary Sparing Spay:

  • A dog can’t get pregnant
  • A dog gets to keep their natural hormones
  • It may help prevent injuries to ligaments and joint structures such as CCL tears and disk herniations due to IVDD/IVDH
  • There is little or no behavior change (besides normal hormonal changes during heat cycles – see cons below)
  • None of the behavior changes associated with traditional spay – becoming more aggressive, fearful, anxious, and be more difficult to train (see the behavioral changes section below)
  • There is a significantly reduced risk of incontinence at a later age (spay incontinence)
  • There is potentially less risks for bone cancer (I didn’t discuss this below because it primarily affects larger, male dogs but you can read about it HERE)
  • Effectively reduces the nuisance of bleeding during heats (although some discharge may still occur)
  • Removes the risk of infection of the uterus (pyometra), as long as ALL of the uterus is removed. (see cons below)
  • An owner has the option to have a traditional spay performed later
  • There is a significantly decreased chance of becoming overweight (Up to 50% of spayed/neutered dogs are obese)

Cons of Ovary Sparing Spay:

  • A female still has heat cycle so experiences hormonal changes that affect behavior and attractiveness to males (ie. can still cause fighting among males and male dogs will still try to mount)
  • Many dog daycares and sitters don’t accept female dogs while they are in heat
  • Some businesses and organizations don’t recognize OSS so it may not meet the requirements of a rescue or dog daycare
  • There may still be some discharge associated with heat cycles
  • There is an increased risk of mammary tumors
  • There is a risk of stump pyometra if the cervix isn’t completely removed
  • There is potential for a longer recovery time because of the longer incision typically required (may be negligible)
  • There is potential of a higher cost because of longer time in surgery (may be negligible)
  • The need for ongoing monitoring (manually at home and/or ultrasounds), and potential treatment, of mammary tumors
  • It may be difficult to find a vet in your area that is knowledgeable about this procedure and that will be sure to do it properly

Of course, the only way to make sure a dog never gets pregnant is through spay and I fully believe in doing that if there are not specific reasons for not doing it (breeding, sports competitions, etc.).

To me, ovary-sparing spay is a good option for helping to control pet overpopulation, and unplanned litters, while avoiding the negative effects associated with removing a dog’s ovaries and hormones.

Continue reading below for more details about the pros and cons that I listed.

The Link Between Neutering/Spaying a Dachshund and Intervertebral Disk Herniation (IVDH)

Dachshunds are prone to back problems, primarily caused by a genetic disease called Intervertebral Disk Disease (IVDD).

IVDD can cause the spine to prematurely degenerate and become brittle.

Compromised disks are susceptible to Intervertebral Disk Herniation (IVDH) and can result in back injuries or paralysis.

Among the many of the articles I reviewed, it seemed these terms were sometimes used interchangeably to reference back injuries in Dachshunds.

To get right to my point, I found this article that stated, the frequency of “Intervertebral Disc Disease increased in gonadectomized (spayed/neutered) dogs.”

A 2015 UK study (Packer, et al.) also revealed increased incidence of IVDD in neutered [and spayed] Dachshunds.

The study authors did point out that there are many factors at play besides just reproductive hormones.

For example, they found that dogs that were highly or moderately active for more than 1 hour per day showed a decrease incidence of IVDD-related injuries (dogs that exercised for less than 30 minutes per day were found to be more at risk).

A study in 2018 reexamined the data from the surveys collected during the previous 2015 study.

This examination was more specifically aimed at making a connection between the removal of hormones, and at what age the hormones were removed, and the incidence of IVDH in Dachshunds.

The new study (Canine Genet Epidemiol) confirmed that “neutered females were at significantly higher risk of IVDH than entire females.”

In regard to age, they found if a female Dachshund was neutered before 12 months old, they were around twice as likely to develop IVDH as unneutered females.

In their study conclusion, although they said that the decision to spay or not to spay is personal and should consider many different factors,  “the… increased IVDH risk associated with neutering is a key factor to consider in deciding whether and when to neuter.”

The bottom line:

There is a clear link between hormones – specifically, the lack of hormones in a female dog that has had their ovaries removed – and back issues in Dachshunds.

While there are certainly other factors involved, the effect of removing a female dog’s ovaries is very likely to have a negative impact on spinal health.

Cranial Cruciate Ligament (CCL) Injuries in Small Dogs

One of the biggest cases for OSS is the decreased incidence of Cranial Cruciate Ligament Rupture (or CCL – the human equivalent of an ACL injury) in active dogs.

In short, the Cranial Cruciate Ligament stabilizes the knee joint. When a dog experiences a CCL injury, they may become lame or not be able to walk using that leg.

The CCL injury can be acute – occurring from a forceful, sudden trauma – or occur as a result of weakening of the ligament over time.

A ruptured CCL is the most common orthopedic injury in dog, especially in large breed dogs. (source)

Some studies have shown that 8% of females neutered before 12 months of age developed CCL injuries later in life. (source)

But how common are these types of injuries in small dogs and Dachshunds in particular?

According to the American College of Veterinary Surgeons, “Certain dog breeds are known to have a higher incidence of CrCLD (cranial cruciate ligament disease)… while others are less often affected (Greyhound, Dachshund, Basset Hound, and Old English Sheepdog)”

However, it was found that obese pets may be more likely to develop CCL injuries (source) and, in my experience, it’s more common for a Dachshund to weigh more than they should than not.

Other contributing factors to CCL injuries include inactivity with occasional strenuous activity (weekend warrior syndrome), straight conformation in the hind limbs (source), and nutrition.

According to Dr. Karen Shaw Becker, a lack of dietary manganese can significantly affect the frequency of CCL injuries.

She also said that, “While nutrition plays a big role in protecting ligaments, desexed animals have more CCL damage than intact animals. Sex hormones appear to have a protective effect on the musculoskeletal system.”

The bottom line:

My research shows that it is certainly possible for a Dachshund to experience a CCL rupture, although it’s less common in this particular breed and small dogs in general.

My takeaway is, yes, spaying a female Dachshund can have an effect on the incidence of CCL injuries but it’s probably not the biggest factor.

Factors that likely have a larger influence are being inactive most of the time, being overweight, and nutrition.

Spay Incontinence

Urinary incontinence tends to be more common in female dogs who have had their ovaries removed.

One common cause of this “spay incontinence” is the weakening of the urinary tract muscles due to the lack of estrogen.

Lack of estrogen may cause the muscle used to control the exit of urine to become weak and release urine involuntarily.

Incontinence is most common during rest as these muscles are further relaxed.

Note: Gretel is 9 years old and spayed. This has actually happened to her a few times.

One study found that the average rate of incontinence in female dogs with their ovaries removed was 20.1%.

The onset of incontinence varied between immediately to 12 years with an average period of 2.9 years after surgery.

The study found that dogs with a smaller body weight (under 44 lbs) developed spay incontinence less frequently (only 9.3% on average).

Dachshunds, specifically, were found to have a spay incontinence rate of 11.1%.

This type of incontinence is typically and successfully treated with drugs. However, it is possible that a dog can experience negative side effects from these hormones and medications.

A female dog’s risk of incontinence later in life is significantly reduced if she retains her hormones, but it can still happen.

The bottom line:

Incontinence in middle aged dogs who have had their ovaries removed is common. However, it appears to occur at a lower than average rate in Dachshunds who have had their ovaries removed.

Spay incontinence is relatively treatable and incontinence can be managed with environmental (home) and lifestyle modifications.

Behavioral Changes

Years ago, and still somewhat today, spaying or neutering a dog was recommended to curb “undesirable behavioral issues”.

The unwanted behaviors that may be diminished weren’t always discussed with dog owners.

However, it’s assumed that the behaviors that would be eliminated were directly related to a dog no longer having reproductive hormones.

For example, spayed female dogs are less likely to roam when in heat, urinate frequently or “mark”, and be less irritable and aggressive during heat cycles.

Unfortunately, scientists are finding that removing a female dog’s hormones may create as many, or more, behavioral problems as it was supposed to help.

As Dr. Deborah Duffy puts it, In her presentation Non-reproductive Effects of Spaying and Neutering on Behavior in Dogs, “For most behaviors, spaying/neutering was associated with worse behavior, contrary to conventional wisdom”

Dr. Stanley Coren, in a Psychology Today article, discussed two valuable and reliable studies that show that removing a female dogs reproductive hormones can actually increases aggression, fearfulness, and anxiety in the dog, as well as make them more difficult to train.

Dr. Stanley Coren found:

  • Spayed and neutered dogs show considerably more aggression, varying from a 20% increase to more than double depending on the type of aggression measured (toward people, toward other dogs, etc.)
  • For females, early spaying (before the dog is one year of age) causes a considerably larger increase in aggression relative to later spaying [relative to male dogs]
  • There was a roughly 31% increase in fearfulness for both sexes.
  • There was a roughly 33% increase in touch sensitivity for both sexes
  • There was a roughly 8% increase in excitability (assumed that was excitability in the negative sense) for both sexes

These results have been confirmed in another, more recent, large scale study.

That study says, “Neutered dogs… showed many more fear-related behaviors. These included:

  • Responses to loud noises
  • When first exposed to unfamiliar situations
  • When approached directly by an unfamiliar child
  • When barked at, or growled at, by an unfamiliar dog
  • When approached by another dog of similar or larger size
  • When encountering strange or unfamiliar objects on or near the sidewalk
  • When encountering windblown objects
  • When examined by a veterinarian; or when having their nails clipped.”

Once again, the younger the dog was when neutered, the greater these fear-related effects appear to be.

Behaviors Lost: Ending the Heat Cycle

All of those potential “gained” behaviors due to the removal of ovaries and hormones sound pretty undesirable to me.

However, there are definitely behaviors associated with the female dog heat cycle that may also be undesirable (ie. These go away if you go with a traditional spay).

Dealing with a dog that goes into a month-long heat cycle twice a year isn’t for everyone. Especially in a culture, unlike Europe, where the majority of dog owners aren’t used of managing unaltered dogs.

A female dog in heat will likely display all or many of these behaviors:

  • She may be jumpy or on edge
  • She may become more clingy during the heat cycle
  • Male dogs may become obsessively interested in her, and potentially fight over her, and she will sometimes solicit the behavior because she is “feeling frisky”
  • Other female dogs may be aggressive toward her and she may be aggressive back
  • She may exhibit mounting behavior (yes, females)
  • Excessive licking may occur (primarily the vulva)
  • She may exhibit increased urination or “marking”
  • About a month or two after her heat cycle is over, and lasting approximately a month, she may have a “false pregnancy” and exhibit undesirable behavior like restlessness, depression, mammary gland secretions, etc.

The Bottom Line:

There is no doubt that traditional spay, where the ovaries and hormones are removed, results in behavior changes.

It turns out, especially in female dogs, the negative behavior changes may likely outweigh any positive behavior changes.

What stands out to me here – almost shockingly so – is that a lot of “negative traits” of Dachshunds, and small dogs in general, are the same behaviors Dr. Stanley Coren attributed to a female dog having their reproductive hormones removed.

It makes me question how much of these behaviors (separation anxiety, reactivity/defensiveness toward other dogs, fear of children, etc.) are just natural Dachshund traits and how many we THINK are just because most of us in the US only meet Dachshunds who have had their ovaries removed.

However, some of the behaviors associated with the heat cycle can be annoying or troublesome and a dog who had OSS done still experiences those cycles.

I absolutely believe it’s important to carefully weigh the pros and cons and know the choice one is making between traditional spay and OSS when it comes to a dog’s potential behavior.

One must be prepared to deal with the potential consequences no matter which you choose.

Note: As stated above, you can perform a traditional spay after OSS (at an additional cost of course) if your dog does display more undesired behaviors associated with heat cycles than you would like.

Ovary Sparing Spay and Pyometra

This discussion is pretty quick.

Pyometra is a sometimes deadly infection of the uterus. Any dog who still has a uterus and ovaries (the estrogen influences it) is at risk of developing it.

A dog with no ovaries can’t get pyometra.

A dog with no uterus and cervix can’t get pyometra since that is where the infection occurs.

The catch with OSS comes when every bit of the cervix is not removed during the procedure.

To remove the risk of a dog developing pyometra, the cervix and uterus must be removed carefully and completely.

The bottom line:

As long as I can be confident that the veterinarian performing the OSS procedure will completely remove the uterus and cervix, the risk of a dog developing pyometra is very little to none.

Mammary Tumors in Dachshunds and OSS

Mammary tumors are just what they sound like – tumors that develop in the breasts of female dogs.

The development of these tumors is hormone-induced – affected by estrogen and progesterone.

Mammary tumors are more common in female dogs that are either not spayed or were spayed after 2 years of age.

Adult [intact] female dogs (9 to 12 years old) were most likely to get mammary tumors, followed by 5- to 8-year-old females. (source)

The risk of a dog developing a mammary tumor is 0.5% if spayed before their first heat (approximately 6 months of age), 8% after their first heat, and 26% after their second heat. (also source above).

The (same) study found that there are other significant factors at play though.

These factors include environmental pollution, chemical exposure, and being overweight (having a lot of fat on the body).

Only about half of mammary tumors are cancerous and surgery followed by chemotherapy is effective in some of the cases (but can be costly, especially if one doesn’t have pet insurance).

I did find a couple of articles that said the Dachshund is a breed more prone to mammary tumors. (source1 and source2)

While all of my research to this point suggested an INCREASED risk of negative “effects” if a dog was traditionally spayed too early, in the case of mammary tumors, removal of the ovaries before 6 months of age significantly decreases the risk for tumor development.

In a previous study at the Veterinary Hospital of the University of Pennsylvania, it was shown that dogs spayed, either at the same time of their tumor removal or within two years prior to the tumor surgery, lived significantly longer than dogs that remained unspayed after their tumors were removed.

The bottom line:

The risk of mammary tumors in female dogs that still have their ovaries – either intact or due to electing for an ovary-sparing spay – is high.

However, there are other significant factors that contribute to the occurrence of mammary tumors.

Mammary tumors may be more common in Dachshunds than in other breeds.

Around half of mammary tumors are not cancerous. However, they still need to be medically addressed and cancerous tumors are commonly fatal. 

How Much Does an Ovary Sparing Spay Cost?

The ovary sparing spay procedure is a bit more time consuming to perform than a traditional spay and may require a longer incision. Both of these things can increase the cost.

My research has revealed that OSS can cost anywhere from $250-$1,000, with the most common figures I’ve seen being in the $500-$800 range.

The cost of having a female dog spayed using the traditional procedure can be significantly less.

I’ve heard of some shelters, or low-cost spay/neuter clinics, charging well under $100 for the procedure.

According to PetCareRx, “[Traditional] spaying services can cost anywhere from $35 to $300 dollars. Certain factors, including the health or age of your pet, the region of the country you live in, the breed of dog, and where the procedure happens, can all influence the cost.”

Obesity or diabetes in a pet can add $25 to $50 to the cost, for example, as can bringing in an animal in heat (many veterinarians won’t even do it during a dog’s heat).

Blood work prior to the procedure, to check kidney and liver function, can add about $40. Pain medications might cost an additional $15.”

The bottom line:

While an ovary sparing spay is likely more costly than a traditional spay, that is not always the case and the difference may be negligible.

It’s worth calling around to local veterinarians and getting price quotes.

Long-Term Cost Considerations of OSS

While there may be many benefits of OSS, there are extra long-term care and costs that should be taken into consideration.

A dog with their ovaries, whether intact or one who had OSS performed, is susceptible to mammary tumors later in life.

If one opts for OSS, they must be prepared to regularly monitor their dog (ideally, through ultrasound), have any suspicious lumps biopsied, and to have surgery performed if their dog gets mammary tumors.

At the very least, if the tumors are not cancerous, this surgery involves removing part or all of the breast tissue and the ovaries (to reduce the risk of re-occurrence).

Under a worst-case-scenario, a dog may need expensive cancer treatment to save their life or the owner may need to opt for euthanasia.

One also needs to consider, especially if they are used to owning dogs that have been spayed or neutered, that an OSS dog may exhibit undesirable behaviors that make the owner want to go ahead and do a traditional spay later.

That means that an owner will have incurred costs from the initial OSS procedure and of a traditional spay, effectively doubling the cost or more.

The bottom line:

It’s important to know what choice one is making and be sure you can fully commit, lifestyle-wise and financially, to having a dog with ovaries monitored for mammary tumors throughout their life.

It would also be highly advised to have pet health insurance if opting for OSS.

While pet health insurance won’t cover a traditional spay down the road if that is desired, it can definitely help offset the bulk of costs associated with mammary-tumor surgery and treating cancers.

My Discussion with a Veterinarian About OSS

At a certain point, I felt like I had researched the benefits, and negatives, of ovary sparing spay to death. I felt like I was going in circles.

However, it still wasn’t enough for me to make a decision. I decided to talk directly with a veterinarian that regularly performs this procedure.

Going into the appointment, my main concerns were the mammary tumor potential, negative behavioral changes, and the possibility of injury from being really active (hiking) and/or IVDD.

The veterinarian generously sat down with me for an hour to discuss every little detail I had questions about.

In regard to mammary tumors, she said that the study that cites a 26% chance of mammary tumors after the second heat is from the 70’s.

She said in countries where it’s common to leave a dog intact, there is definitely a higher incidence of mammary tumors though.

Her point being that, yes, there is an elevated chance of mammary tumors with OSS but we can’t be sure it’s 26%. So many lifestyle factors can affect the chance of getting cancer.

What rose to the top of “pros” of OSS for me, was the orthopedic benefits.

She 100% believes, based on research and personal experience, that leaving the hormones allows a dog to maintain muscle/ligament tone and reduce injury.

Leaving the hormones also means that a dog’s metabolism is faster, making it easier for Dachshunds to not become overweight, which is a huge factor in the severity and occurrence of IVDD back injuries, cancers, etc.

What became the biggest “con” to OSS for me was the lifestyle modifications I need to consider. A female dog that still has at least one ovary needs to be treated like she is still in-tact.

That means always being vigilant when she is in heat and the restriction of some options always available to traditionally spayed dogs.

For example, if we have a trip planned, and there is a rare instance when we want to put the dogs in a local daycare so we can do something dog-free that day, we will have to cancel those plans if she goes into heat (I’m not aware of any dog daycare (and a lot of sitters) that allow you to bring a dog if she is in heat).

Also, we have to watch for Summit’s heat causing aggression or dog fights.

Where we live, it’s very common to have dogs spayed and neutered. Because those other dogs don’t have their hormones, they probably won’t react to Summit when she is in heat. At least not nearly as much.

We travel a lot too though.

It’s mostly in the US where spaying and neutering are more common but I would like to travel to a European country with Summit someday where it’s not.

Also we often travel to rural US areas where it may be less common to neuter a dog.

The vet also wanted to make sure that I fully understood the choice I was making when it comes to any change in behavior.

Regardless of reproductive status, a dog’s personality can change significantly when they are 2-3 years old due to maturity (other hormones).

I was more concerned with not removing Summit’s hormones and “forcing” a personality change. If she changed on her own, that was ok.

One final, and probably one of the most important, points she made was to wait at least one heat cycle (Summit has already had one) before deciding on OSS.

Since a dog with ovaries still experiences a heat, and displays associated behavior, it’s important to know what kind of cycle-related personality changes you will be living with.

What Did I Decide to Do?

Before I even talked with the vet, my gut said to go with OSS.

Although I knew only I could make the right decision for my Dachshund, I gave the veterinarian the chance to pitch me either way why OSS is best for us or might not be.

She didn’t try to advise me against it. She was 100% clear there would be an orthopedic, and weight-management, benefits and I was 100% on board with those benefits.

Her biggest advice against OSS was the warning that a dog with hormones does mean some lifestyle changes that could potentially impact our adventures. I was ok with that.

I keep going back to the analogy of cutting hair. Once you chop it all off, you can’t add any back. But it’s totally possible to take one step at a time until you’re satisfied with the results.

Although I don’t prefer to put Summit through a second surgery later, doing OSS now WOULD leave me the option of a full spay later if we found her having her hormones to be problematic for any reason (although the vet said no one had ever come back and asked that the last ovary be removed).

I’ve started the process for the ovary sparing spay for Summit. The soonest appointment we could get is the end of June.

I’ll keep everyone updated on our experience and my feelings about OSS.

Resources for Further Information on OSS

In addition to reading all of the articles I linked to above, check out these resources if you want to learn more about ovary sparing spay.

The Parsemus Foundation

The Ovary Sparing Spay and Vasectomy Info Group on Facebook

Speak with a local veterinarian knowledgeable about the procedure in your area (you can find them HERE or HERE).

A traditional spay might not be right for your dog. Learn about the pros and cons of a second option - an ovary sparing spay (OSS).A traditional spay might not be right for your dog. Learn about the pros and cons of a second option - an ovary sparing spay (OSS).A traditional spay might not be right for your dog. Learn about the pros and cons of a second option - an ovary sparing spay (OSS).
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source http://www.luckydogsolutions.com/the-pros-and-cons-of-ovary-sparing-spay-oss-for-your-dachshund/

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