WSAVAguidelines for the control of reproduction in dogs and cats

• DOI: 10.1111/jsap.13724
• Publication Date: 2024-05-28T08:18:31Z
• Authors: S. Romagnoli; N. Krekeler; K. de Cramer; M. Kutzler; R. McCarthy; S. Schaefer‐Somi
• Keywords: Neutering

1. Introduction 5 1.1. Use of this document 6 2. Surgical sterilisation in dogs and cats 7 2.1. methods associated with loss gonadal hormones 2.1.1. Female 2.1.1.1. Ovariectomy, subtotal ovariohysterectomy 2.1.1.1.1. Ventral midline laparotomy for ovariectomy 9 2.1.1.1.2. 14 2.1.1.1.3. 2.1.1.1.4. Flank 17 2.1.1.1.5. Laparoscopic ovariectomy, 2.1.1.1.6. surgical sterilization the periparturient female dog21 2.1.1.1.6.1. Hysterotomy concurrent 22 2.1.1.1.6.2. En-bloc 25 2.1.1.1.7. Prevention treatment complications ovariohysterectomy. 26 2.1.2. 30 2.1.2.1. 2.1.2.1.1. 31 2.1.2.1.2. 33 2.1.2.1.3. 2.1.2.1.4. cats33 2.1.3. Male 2.1.3.1. Orchiectomy descended testes 2.1.3.1.1. Prescrotal orchiectomy 2.1.3.1.2. prescrotal 37 2.1.3.1.3. Scrotal 2.1.3.1.4. scrotal ablation 2.1.3.2. cryptorchid 2.1.3.2.1. Cryptorchidectomy an extra-inguinal testis 40 2.1.3.2.2. inguinal 2.1.3.2.3. cryptorchidectomy intra-abdominal 2.1.3.2.4. 41 2.1.4. 2.1.4.1. 2.1.4.1.1. 2.1.4.2. 43 2.1.4.2.1. 2.1.4.2.2. 2.1.4.2.3. 45 2.2. preservation 2.2.1. 2.2.1.1. Hysterectomy 2.2.1.1.1. hysterectomy 46 2.2.1.1.2. 48 2.2.1.1.3. 2.2.1.2. Salpingectomy 2.2.1.3. Ovarian tissue implant50 2.2.2. 51 2.2.2.1. 2.2.2.1.1. 2.2.3. 2.2.3.1. Vasectomy 2.2.3.1.1. vasectomy 52 2.2.3.1.2. 2.2.4. 54 2.2.4.1. 2.2.4.1.1. Bilateral 2.2.4.1.2. 2.2.4.1.3. 55 2.2.4.1.4. male 2.2.4.2. Epididymectomy 2.3. Antimicrobial use 2.4. pain control 59 3. Non-surgical 3.1. Hormonal downregulation 3.1.1. GnRH agonists antagonists 3.1.1.1. agonist: Deslorelin 60 3.1.1.1.1. 3.1.1.1.2. 3.1.1.1.3. 61 3.1.1.1.4. 3.1.1.2. antagonists: acyline antide 3.1.1.2.1. 3.1.1.2.2. Cats 3.1.2. Progestogens 62 3.1.2.1. Megestrol acetate 3.1.2.1.1. 3.1.2.1.2. 3.1.2.1.3. 3.1.2.2. Medroxyprogesterone 63 3.1.2.2.1. 3.1.2.2.2. 3.1.2.2.3. 3.1.3. Androgens 3.1.3.1. Mibolerone 3.1.3.1.1. 3.1.3.1.2. 64 3.1.3.2. Other androgens 3.1.4. Melatonin 3.1.4.1. 3.1.4.2. 3.2. Immunocontraceptives 3.2.1. Immunisation against gonadotropin-releasing hormone 3.2.1.1. GnRH-conjugated to keyhole limpet haemocyanin 65 3.2.1.1.1. 3.2.1.1.2. 3.2.1.1.3. 3.2.1.1.4. 3.2.1.2. diphtheria toxin 3.2.2. zona pellucida 3.2.2.1. 66 3.2.2.2. 3.2.3. ZP 3.3. Chemical castration 3.3.1. Intratesticular injection 3.3.1.1. Calcium chloride 3.3.1.1.1. 3.3.1.1.2. 67 3.3.1.2. Zinc gluconate 3.3.1.2.1. 68 3.3.1.2.2. 3.3.1.3. Glycerol 3.3.1.3.1. 3.3.1.3.2. 3.3.2. Intra-epididymal injections 3.3.2.1. 3.3.2.2. 69 3.4. Mechanical 3.4.1. Intrauterine devices 3.4.2. Therapeutic ultrasonography 3.5. Gene therapy 3.5.1. silencing 3.5.2. overexpression 70 4. Health benefits steroid 4.1. 4.1.1. Reproductive tract diseases 4.1.1.1. 4.1.1.2. Uterine unwanted pregnancies 72 4.1.1.3. tubular neoplasia 4.1.1.4. Mammary tumours 73 4.1.1.5. Transmissible venereal tumour 75 4.1.1.6. Vaginal hyperplasia vaginal prolapse 76 4.1.1.7. Disorders sexual development 77 4.1.2. Progestogen dependent diabetes mellitus 4.1.3. Behavioural issues 78 4.1.4. Life expectancy 4.2. 81 4.2.1. 4.2.1.1. Testicular 4.2.1.2. Prostate gland 82 4.2.1.2.1. Benign prostatic 4.2.1.2.2. Prostatitis 83 4.2.1.2.3. Prostatic 84 4.2.2. Perianal 4.2.3. tumour. 4.2.4. Urethral 85 4.2.5. Perineal hernia 86 4.2.6. concerns 4.2.7. 88 4.3. 4.3.1. 4.3.1.1. Inflammatory mammary 90 4.3.1.2. Proliferative 4.3.1.2.1. fibroadenomatosis 4.3.1.2.2. 91 4.3.2. Infections immune system 92 4.3.3. 4.3.4. 5. detriments reproductive 5.1. 93 5.1.1. Tumours 5.1.1.1. Mast cell 5.1.1.2. Transitional carcinomas 94 5.1.1.3. Osteosarcoma 5.1.1.4. Lymphomas 95 5.1.1.5. Haemangiosarcomas 96 5.1.2. sphincter mechanism incompetence 5.1.3. Orthopaedic 98 5.1.4. Metabolic endocrine disorders 99 5.1.5. Immune 100 5.1.6. 101 5.1.7. Paediatric gonadectomy 102 5.2. 5.2.1. 5.2.1.1. 5.2.1.2. 105 5.2.1.3. 5.2.1.4. Osteosarcomas 5.2.1.5. 5.2.1.6. 5.2.2. (USMI) 106 5.2.3. 5.2.4. 107 5.2.5. 5.2.6. 108 5.2.7. 109 5.3. 5.3.1. Effects on metabolism 5.3.2. 110 5.3.3. 5.3.4. Lower urinary 5.3.5. 6. Ethics Reproduction Control 111 6.1. 6.2. Overpopulation shelter intake 6.3. Trap, neuter, return programmes 6.4. Responsible pet ownership 112 6.5. Variation spaying neutering rates 113 6.6. Early age 6.7. Ethical implications 6.8. Mandatory spay neuter laws 114 6.9. Recommendations reproduction different settings 6.10. Position Committee prosthetic testicular implants 117 7. References 118 During second half last century, have gained important place many households their numbers increased remarkably countries. While there are anecdotal estimates by country provided websites lay literature, is a lack peer-reviewed data actual world population cats, both owned unowned. These animals may easily reproduce once they achieve puberty if not constantly under control. Therefore, veterinarians continuously presented requests contain or eliminate behaviour fertility as whole cats. The presence small our homes has been paralleled increase dog cat populations suburban areas where free-roaming stray unsupervised uncontrolled, causing public health concerns. Animal shelters overcrowded Proactive rehoming, adoption policies being promoted parts world. However, seem remained stable have, despite all these efforts, some countries/areas/municipalities (Crawford et al., 2019). controlling always key issue working animal welfare organisations practitioners alike. historical approach through gonadectomy. For males, multiple methods, approaches means haemostasis utilised success precise technique generally based surgeon experience preference. females, removal (ovariohysterectomy, OHE) part (subtotal ovariohysterectomy; SOHE) uterus be performed concomitantly gonads. veterinary textbooks describe OHE procedure ligatures placed subsequent transection made at level uterine body, it recognise that anatomically physiologically incorrect. Some portion will inevitably remain patient therefore what performed, SOHE (Mejia 2020). should avoided exposes risk developing stump condition ovarian remnant present, progestogen administered later date. Ovariectomy (OE) alone quicker, uses smaller incision less potential (Okkens 1997). Consequently, absence pathology, predicted desired, guidelines recommend OE preferred painful provides better visualisation pertinent structures, especially breed dogs. Owner familiarity minimally invasive surgery humans producing large demand its pets (Buote, 2022). techniques maintain such also proposed effective safe inhibiting (Kutzler, 2020b; McCarthy, 2019; Zink 2023). Alternatives gonads existed since century. first drugs commercially available were synthetic analogues progesterone (progestogens) block action hypothalamic–pituitary–gonadal (HPG) axis. Unfortunately, improper led several case reports side effects from overdosing (Romagnoli & Ferre-Dolcet, 2022; Romagnoli Lopate, 2017). After careful selection, appropriate dose duration can method Earlier century new category active principles, long-acting preparations (GnRH) became countries allowing prolonged (Fontaine Fontbonne, 2011; Goericke-Pesch 2013; 2009; Trigg 2006). effect single administration agonist implant varies 12 months (depending dosage) much longer Repeated appears limited (Brändli 2021; bitches which option considered. Long-acting approved prepuberal bitches; off-label proving queens while more needed warrant postpubertal bitches. rendered sterile local chemical agents (Oliveira 2013). Approaches vaccination or, recently, gene Mullerian substance promising, particularly females (Levy 2005, Ochoa 2023; Vansandt Vargas-Pino remarkable extent current knowledge topic makes increasingly challenging advise clients stakeholders best animals. This true given emotional value usually pets. presenting request gone very simple "I would like my spayed/neutered" elaborate set questions most intriguing "how done" recently importantly "should we do not"? As consequence role playing lives, conditions receiving attention social media. Once shelter, rescued captured invariably gonadectomised, practice continues around using standard approach. needs blocked permanently prevents further increases chances adopted. remains valid solution certain situations because ease cost-effectiveness. evidence accumulating favour efficacy newer which, spite maintaining behaviour, offer adopting healthier Small need acquaint themselves regarding offering host novel replacing potentially harmful routine young options ones least long-term pronounced giant (Benka pets, decision case-by-case basis consultation owner due consideration species, sex, breed, purpose lifestyle well financial constraints. Albeit ideal individual pet, environment differ Effective strategies curb lacking, cost- labour-intensive often regarded controversial (Read 2020; Wolf Shelter policy makers only agree selection permanent affordable oppose alternative lessen probability abandonment. Veterinarians position educate pet-adopting about Their time lead acceptance align assist apply medical foremost priority. concept, requires sound scientific applying common sense amidst diverse practice. no acceptable acknowledged. continued gonadectomised traditional ages. Conversely, ovary-sparing offered following proper prospective owners risk. There one never used. Every advantages disadvantages depending practical/financial situation owner, genetics animal, age, health, kept. Over few decades orthopaedic, behavioural, neoplastic continuing emerge. consequence, ensued. becomes risk, choice improve. Although sexes medium-sized dogs, make considered client- shelter-owned body complex, sometimes conflicting differs breed. Arriving possible wide intensive owner. Considering complex nature decision-making process multitude factors consider, intended provide tool reach informed, consensual decisions meeting interest animals, expectations avoiding litigation. Whilst general expectation concise consistent, achievable guidelines. network variables circumstances impact of, I so, use. recommendations suited "best practice" cannot made. What become clear, however, routinely breeding supported categories Harmonising risk/benefit assessment client preferences, requirements importantly, ultimate thorough understanding confounding elements involved. include gonadectomy, lifestyle, whether responsible ownership. In cases ownership, leave unaltered unless necessity intervene. had advocated sterility non-negotiable, suggested option. Routine reserved those lower elimination necessitated. Sterilisation worldwide (Greenfield 2004). Numerous employed successfully divided into remove source preserve them. long term debated, discussed detail document. Gonadectomy ovaries (OE), concomitant partial (SOHE) complete (OHE) (Fig 1). Preventing cystic-endometrial-hyperplasia-pyometra touted reason performing but occur without exogenous (DeTora Noakes 2001). prevented entire uterus, incidence quite low benign (Brodey, 1970; Saba Lawrence, addition, reported before 2 years 2011). after unknown warrants investigation. Advantages over alternate procedures possibly pain, shorter times, fewer sites haemorrhage, likely inadvertent ureter ligation easier access pedicles Okkens 1997; Van Goethem reasons, pathology pregnancy, desired. OE, each either laparoscopy. With exception OHE, ventral flank. Potential regional anatomy surgeons ability simultaneously explore abdomen other reasons necessary. flank damage glands enlarged feral (McGrath No significant difference procedure, rate consistently demonstrated between approaches, so personal preference training (Griffin 2016; Looney 2008). than improved safety, (Culp Devitt 2005; Fransson Mayhew, 2015; Hancock 2005). Wound frequent laparoscopic (Charlesworth Sanchez, produced Hsueh 2018). Each paediatric (6- 16-week-old) patients, precautions taken (Faggella Aronsohn, 1994; Kustritz, 2002; 2008; Oliveira-Martins Olson 2001; Porters 2002). Patients healthy, properly immunised normal hydration status. A pre-anaesthetic physical exam warm preoperative postoperative provided. recommendation avoid fasting greater 4 hours hypoglycaemia, recent suggests hypoglycaemia does puppies ≥0.9 kg fasted durations (Fudge Puppies food soon able stand 2016). Tissue dissection must meticulous delicate vital structures. All surgically sterilised identified tattoo, external reoperation date (Looney Mielo Microchips gaining popularity identification, inaccuracy data, added expense required microchip reader limit usefulness identification status (Brent, green linear tattoo applied aspect immediately lateral recommended If used patient, been. Tattoo ink paste directly intradermal closure, separate cutaneous injected intradermally (Bushby, Griffin Welborn survey-based study including USA Canadian schools indicated curricula included discussion identifiers 31% lecture-based training, 75% spay/neuter laboratory 38% clinical practice-based training. same found 80% 72% clinics tattooed 84% 70% unowned private practices 5% patients (Mielo Enhanced implementation throughout industry Location initial skin calculated dividing distance umbilicus pubis thirds making length cranial third. depends dog's size, amount abdominal fat operator. allow adequate exposure safely perform procedure. Inadequate haemorrhage arteries, incomplete [ovarian syndrome (ORS)]. cold instrument scalpel blade frequently used, electroincision electrosurgery device reduces blood loss, redness wound discharge affecting healing (Meakin sharp blunt subcutaneous along Metzenbaum scissors, respectively. linea alba clearly elevated thumb forceps punctured facing up. extended towards ends cutting scissor grooved director guide 2). located dorsal bladder descending colon advancing hand internal wall (towards palm hand) viscera hand). Spay hooks 3) commonly helpful locating horn; great care, inadvertently damaging structures increased. Either left right horn hook positioned points swept down inside fold ipsilateral rear leg. point then rotated 180° slightly incision. engaged, tension felt hook. Too indicates engaged. disengaged, another attempt engage (Valdez, repeated attempts fail isolate enlarged, method, direct palpation caudal kidney utilised. gently retracted followed cranially until ovary located. Application anaesthetic improves intraoperative analgesia (Cicirelli Forceps ligament retraction suspensory broken stretched digital pressure. Performing manoeuvre close diaphragm avoids vessels. Sharp faster cause (Shivley Releasing who previously birth laxity window mesovarium th