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If your dog has a cancerous tumor on his spleen and will die unless it is surgically removed, the operation is clearly a medical necessity. But there are a couple of surgeries we commonly perform at Tufts to prevent disease and other problems rather than treat them. Thus, they are considered elective procedures. Here’s a close look.
Nose surgery. No, it’s not a cosmetic procedure. Some flat-nosed (brachycephalic) dogs like English and French bulldogs and pugs struggle to breathe. Their breathing passages are so distorted they’re constantly gasping for breath. For instance, a dog may have stenotic nares — nostrils that are too small to permit sufficient air to get through. Or he may have an elongated soft palate, meaning the tissue at the back of the throat is too long and is obstructing the airway passage. Either issue can be fixed with a surgical procedure that removes excess tissue and opens up the airways.
Facial surgery. It’s not to improve appearance or make a dog look younger. The characteristic skin folds on a shar pei’s face can dip into the eyes, making it impossible for the dog to see. The excess skin can also cover the ears, making a dog prone to developing ear canal infections. Such a dog stands to benefit greatly from a literal “face lift” to remove the extra wrinkly folds.
Breast surgery. Again, it’s not what it seems. Dogs who have been bred repeatedly may have mammary tissue so stretched as to cause debilitating soreness. A surgery can reduce the stretching.
Prophylactic Gastropexy. Large, deep-chested dogs have about a one-in-four chance of falling prey to a life-threatening disease called gastric dilatation-volvulus (GDV). For Great Danes, the chance is 40 percent. The disease often kills within hours. Out of nowhere, the stomach twists, cutting off its own blood supply and compromising the blood supply to other vital organs. Even just at our own facility at Tufts, we see two to three cases a month. We can perform emergency surgery to flip the stomach back over, but about one in six dogs succumbs, anyway. Too much stomach tissue is already dead by the time the dog arrives at the hospital, or the effects on organs like the kidneys and heart are too severe and cannot be reversed.
But a simple surgery that secures the stomach to the abdominal wall before GDV develops can prevent the illness’s agonizing pain and potential death. Called prophylactic gastropexy, it can be performed laparoscopically rather than with a large incision in the abdomen. True, it costs about $2,000. But that’s a lot less than the $5,000 or more it can cost to try to fix GDV once it has developed.
“Prophylactic gastropexy makes a lot of sense,” says Your Dog editor-in-chief John Berg, DVM. “GDV is one of the worst diseases we see in terms of pain and suffering. It’s horrible, in addition to being one of the leading causes of death in large- and giant-breed dogs.”
Spaying/Neutering. Some people don’t consider the spaying and neutering of dogs elective at all. Millions of homeless dogs are put down because shelters don’t have the money to take care of them. If all dogs other than those kept by professional breeders were sterilized, the canine overpopulation problem would disappear. Still, because spaying and neutering don’t treat or cure illnesses, they technically go in the “elective” column. Furthermore, there’s some evidence that sterilization comes with health risks down the line, making the term “elective” all the more relevant. Here’s our take on whether to consider holding off, even if you don’t want to breed your pet.
Spaying. Since the early 2000s, evidence has been emerging that spaying can potentially predispose a dog to cancers such as mast cell tumors, lymphoma, osteosarcoma (bone cancer) and transitional cell carcinoma, or cancer of the bladder. The evidence is equivocal, to be sure, but taken together it suggests there may be a two- to three-fold increased risk with spaying. Then, too, spayed dogs are more prone to obesity and also develop a small risk for urinary incontinence.
On the other hand, the advantages of spaying are clear and have stood the test of time. If you spay a dog before her first heat, which commonly occurs by the time she’s 6 months old, you virtually eliminate her risk for mammary cancer, which is often ultimately fatal. Moreover, spaying prevents a severe infection of the uterus later in a dog’s life. Called pyometra, it often requires emergency surgery. Finally, osteosarcoma affects large-breed dogs almost exclusively. If you own a small breed of dog, osteosarcoma is extremely unlikely, whether you have her spayed or not.
Because there are so many pros and cons, the decision whether or not to spay your female dog is not simple. For that reason it is definitely one to discuss with your veterinarian.
Neutering. As with females, castration in young male dogs may come with an increased risk of the cancers mentioned above. Male dogs neutered young may also be more predisposed to canine cognitive dysfunction, which plays out like Alzheimer’s disease in people. And they may also be more prone to cruciate ligament ruptures — serious, painful problems in the hind legs that are expensive to treat. The word “may” cannot be overemphasized. Research is suggestive but by no means nailed down.
On the other hand, neutering a dog most definitely decreases his risk for prostate infections, prostatic abscesses, and an enlarged prostate, which creates difficulty urinating (just as in men). It also helps prevent perianal adenomas — benign tumors around the anal area. The risk goes down as well for a perianal hernia, a herniation in the pelvic area that can make it difficult to defecate.
Then, too, neutered male dogs are three times less likely to bite as intact ones. In fact, the American Veterinary Medical Association’s Task Force on Canine Aggression and Human-Canine Interactions has said that intact male dogs are “involved in 70 to 76% of reported dog bite incidents.” (And there are close to 5 million dog bites a year in the U.S.)
We think an approach worth considering is neutering a male dog after he turns one year of age. According to the research, that ratchets down his risk for various diseases — particularly bone cancer — but does not diminish all the benefits that neutering confers. If you do choose to wait until his first birthday, it is important that you keep your male pal on leash outdoors so he does not seek females in heat — or act aggressively toward people or other dogs, if he is expressing those tendencies.
