How Many "Oops" Litters Do You Know About?

I’m trained as a demographer, which means I have some familiarity with maternal and infant mortality rates.

The bottom line is that pregnancy is dangerous for both women and children, and that danger is factored into the acceptable risks associated with human birth control.

Some years back there was an intrauterine device (IUD) called the Dalkon Shield.  Analysis showed that for every 1,000 Dalkon Shields placed, 5 women were hospitalized for excessive bleeding and/or infection, and there was an IUD-related fatality rate of 3 per million users per year of use. 

Though the Dalkon Shield was safer than pregnancy, the product was nonetheless pulled as other contraceptive products were just as effective and had a longer track record of accepted use. If other alternatives with quantifiably worse outcomes had been all that were available, the Dalkon Shield would still be in use today.

Weighted risk analysis underpins all FDA approval. The bottom line is that the chance and relative severity of the side effects of a drug, device, or procedure has to be deemed to be less than the chance and severity of the disease or issue being treated. There is no blanket FDA approval — it is approved for a specific condition, even if the drug is also (and often) used off-label to treat other issues.

Even when FDA approval is granted, it may be based on non-representative data and therefore suspect. For example, a larger than normal percentage of Phase III trials are done on populations in Iceland, Sweden, and Scotland.  Why?  The answer is simple: to reduce the percentage of people in the trial who may have some real world race-based health issues.  Test a glaucoma drug on a 55-year old 200-pound New York City black woman with hypertension and sickle cell anemia?  Not if they can get better trial results from a 35-year old 145-pound white man in Sweden with no other known health issues!

What does any of this have to do with dogs?

Quite a lot.

You see, when it comes to early spay-neuter health research, not only is the risk of maternal mortality from pregnancy never factored in when it comes to canine family planning, but neither is neonatal mortality associated with canine litters.

And what about the cohort being looked at?  The summary statements about early spay-neuter typically brush over breed, sex, and size differences and generally look at pure bred dogs already presenting with a jaw-dropping host of health issues. Please do not tell me you care about a slight increase in X or Y health issue when you have acquired a dog with 40 percent chance of getting cancer or dysplasia no matter what is done in the spay-neuter arena!

And what about the well-known, predictable, and quantifiable outcome of delayed spay-neuter — unplanned pregnancies that result in the deaths of millions of dogs abandoned to the pound?  This data is universally and studiously ignored, and yet the historical US data on this issue is nothing less than astounding.

  

At DVM 360, two veterinarians discuss the issues: Read the whole thing at the link paying attention to the lack of baseline data given by Michael Petty.  Setting aside the lack of baseline data, read the points made by Veterinarian Mark Goldstein -- points routinely and deliberately left out by most early spay-neuter presentations:

I don't believe there is conclusive evidence to suggest that prepubertal spays and neuters result in more harm than good. In fact, I would argue that the benefit of early sterilization to control overpopulation and the subsequent risk of having to euthanize dogs outweighs the increased chance of potential orthopedic, developmental or neoplastic problems 

 

These studies also have to compare the incidence of health and behavioral problems associated with prepubertal spay/neuter against the incidence in intact dogs; such concerns may include pyometra, dealing with a dog in heat in a household, and the desire of intact males to roam. The answer, of course, is not as simple as sterilizing them when they are older because in many regions of the country post-adoption sterilization of shelter animals simply does not occur. That is why various jurisdictions in the United States have laws that require sterilization before dogs are adopted from shelters. 

Just a few decades ago, 13 to 15 million healthy and treatable dogs and cats were euthanized each year in shelters nationwide. Today, that number is much closer to 1.5 to 2 million-still a tragic number but one that shows great strides. Proactive sterilization of shelter animals before they are adopted is considered the single greatest reason for this achievement. Shelter programs that incentivize people to sterilize their pet after adoption, including contracts with local veterinarians and deposits for later spay/neuter surgery, have been proven largely ineffective nationwide.

If one accepts that the best chance for a dog to be sterilized is before it leaves the shelter, then a study from the University of Georgia demonstrates why completing the procedure before adoption — regardless of age — is critical. After analyzing the records of over 80,000 male and female canine patients, the investigators demonstrated that sterilized dogs have a longer life expectancy that nonsterilized dogs:

• Mean age of death of intact dogs: 7.9 years
• Mean age of death of sterilized dogs: 9.4 years
• Increased life expectancy in sterilized male dogs: 13.8%
• Increased life expectancy in sterilized female dogs: 26.3%

Literature reports that suggest health or behavioral issues from prepubertal spay/neuter surgery should be interpreted cautiously, as several issues may cast doubt on the conclusions:

• Many variables, such as diet, weight, lifestyle and the economic ability of the owner to seek out medical intervention, cannot be controlled in retrospective studies.
• Research from referral hospitals or universities may include population bias because the study populations are already filtered.
• Association does not prove cause and effect.
• Many studies use relatively small patient numbers compared with the general population.

Results from one breed study cannot be extrapolated to all breeds or to mixed breeds.

Bingo! 

People actively research tradeoffs and risks with various forms of human contraception but ignore the most important determinant they consider for themselves -- contraceptive failure rates that result in pregnancy.  

I'm reminded of the old demographer's joke:  You know what you call someone who practices abstinence as birth control?  A parent.

What about folks in other countries that manage to keep intact dogs without massive accidental pregnancies?  

What about them?  

Other countries have different cultures where people may be less likely to be complete and total idiots. 

In other countries 40 percent of the population may not be obese. Other countries may have national service and national health care. Other countries may have a 60 percent tax rate and may not have 390 million guns in the private hands of paranoid people eager to demonstrate their fragile manhood.  

Guess what?  You live in America, and we know what kind of culture we have, and we also know that dogs get out all the time, no matter how good your fencing system is.  

Only once in 10 years, you say?  Right.  But once is all it takes.

When it comes to dogs and personal responsibility, we need only look at the statistics and the regular "oops" litters that occur all the time.

You may think you are a special person with terrific discipline and a well-trained dog, and maybe that's true.  We all know that's what Sarah Palin thought about her daughter... and looked what happened there.  Twice.

As always, do what you want, but don't tell me you're perfect, or your dog is either, and that several million dead dogs a year is not a predictable and quantifiable outcome of delayed spay-neuter.  

And for Dog’s Sake, don’t tell me that you count that pound death number as ZERO -- the one number we ALL know is wrong.