Monday, March 02, 2015

Spay-Neuter Debate Obscures a Simple Truth

Over at the Scientific American blog they note that all the "research" purporting to show that spay-neuter is bad for dogs is underwhelming in methodology and frequently poorly reported on to boot.

The "research" in question is, simply put, overburdened with selection bias.

If folks are really interested in avoiding cancer and other diseases in dogs, we know how to do that, it is not that hard, it is a great deal more obvious, and it yields far more impressive results than anything that might be done in the spay-neuter arena:

[T]wo papers were published, in 2013 and 2014, suggesting that [spay/neuter] may lead to increased long-term risk of certain kinds of cancers. These studies ignited a debate which had been smouldering for years: are there unwanted health consequences associated with altering a dog’s levels of estrogen or testosterone?

The 2013 paper looked at Golden Retrievers. The authors reviewed data from veterinary hospitals, comparing Goldens who were diagnosed with various diseases, those who were not, and the spay/neuter status of each group; they found a correlation between spaying or neutering and cancers such as osteosarcoma, hemangiosarcoma, and mast cell cancer. The 2014 paper used a voluntary Internet-based survey to perform a similar investigation in the Vizsla breed. They also found correlations between spay/neuter status and mast cell cancer, hemangiosarcoma, and lymphoma.

These are scary results, but I caution that studying the causes of multi-factorial diseases like cancer is incredibly challenging. Take the Golden Retriever study, a retrospective study using data from a veterinary referral hospital. This study was limited to dogs whose owners chose to bring them to a relatively expensive referral hospital. This is the kind of place where you take your pet when he has cancer and you are willing to spend a fair amount of money to help him. As a result, this hospital’s records probably provide a great source of data on companion animals living with concerned owners, particularly owners who have provided excellent medical care for much or all of the animal’s life. However, this hospital’s records are less likely to provide data on animals whose owners have provided sub-optimal care. This kind of bias in sample selection can have a significant effect on the findings drawn from the data.

The Vizsla study used an Internet-based survey instead of hospital records. Like the Golden Retriever study, this study could have found itself with a biased sample of very committed dog owners, in this case owners who engaged in dog-focused communities online and who had enough concern about the health of the breed to fill out a survey. This study additionally suffered from a lack of verified data; owners were asked to give medical details about their dogs and may have misremembered or misinterpreted a past diagnosis.

Don’t get me wrong – these were both important studies, and they did their best with the available resources. I applaud both sets of authors for putting this information out there. But the studies both have their limitations, which makes their findings difficult to trust or generalize to other populations of dogs.

Meanwhile, another 2013 study presented some other interesting results. This study drew data from multiple referral hospitals to determine the causes of death in spayed or neutered versus intact dogs – and they found that spayed and neutered dogs, on average, lived longer than intact dogs. Intact dogs were more likely to die of infectious disease or trauma, while spayed or neutered dogs were more likely to die of immune-mediated diseases or (again) cancer. In other words, while spayed or neutered dogs did get cancer, it didn’t seem to shorten their lifespans.

This study shed a new light on the cancer question. It suggested that perhaps spayed or neutered animals might be more likely to get cancer simply because they were living long enough to get it. Intact animals were more likely to die younger, perhaps simply not aging into the time of life when the risk of cancer rises.

So where does that leave us? Is there a causal link between spaying/neutering and cancer? I think the question is still wide open. What we really need is a study that follows animals forward throughout their lifetimes instead of using retrospective records or surveys to get the data – and, thanks to Morris Animal Foundation’s groundbreaking Golden Retriever Lifetime Study, we are getting just that. This study is enrolling Goldens as puppies and following their health over the course of their lives. It will be years before the study gives us answers, but it provides hope for more solid data. (Of course, it still can’t address the issue of bias, in that owners who enroll their puppies in this study could be highly responsible dog owners who provide excellent medical care!)

We can, however, do something about cancer in dogs without waiting for the results of that study. It is no coincidence that two of the studies discussed here investigated Golden Retrievers. Sixty percent of Golden Retrievers will die of cancer. That is indisputably a problem with the genetics of the breed, and other breeds suffer from similar problems. We should be attacking cancer on all fronts, and this is a front we don’t have to study first. Golden Retriever breeders are between a rock and a hard place, trying to breed for health in a gene pool which doesn’t have enough genetic diversity to support it. The solution is to bring in new blood from gene pools with much lower risk of cancer, breeding dogs who don’t look like purebred Goldens for a few generations to revitalize the breed as a whole. Genetics contribute far more to risk of cancer than whether an animal is spayed or neutered. We clearly have a strong desire as a society to reduce the incidence of cancer in Golden Retrievers and other breeds. While we’re studying risk from spaying and neutering, let’s address the genetics question that we know we can fix.


Genevieve said...

The science may not be in regarding the relationship between spay / neuter and late stage cancers. But if we can accomplish the same population control effect with less intrusive means (vasectomy, tubal ligation) why not do it? They're becoming more common for dogs and have a faster recovery time.

PBurns said...

Neutering can now be done with a single shot, as I have reported in the past. See The cost here is just $4-$10 per dog and requires no surgery.

Stacey said...

It's posts like this one where I feel most keenly your talent for making people think. Whether one agrees with you or not on any given topic is beside the point; learning how to read and think with a more critical lens, with an eye for what is actually being said and an ear for what is being left out, for robust inquiry rather than rote acceptance--these things make such a huge difference no matter a person's walk in life.