Abstract
Widespread support and scientific rationale begs the question as to why early neutering is not undertaken more routinely.
Even what appear to be simple and straightforward questions in veterinary science can reveal an interesting spectrum of clinical practice. Neutering of cats, primarily for population control, is a routine procedure and yet there are marked differences in how and when it is done, and even whether it is done at all. While a high proportion of owned pet cats are neutered in most countries, this is not true of all, with cultural differences meaning the practice is less common in some areas, or perhaps done at an older age.
This issue of JFMS contains several articles relevant to the clinical practice of neutering in cats. First there is an excellent and timely clinical review by Alison Joyce and David Yates (from the Royal Society for the Prevention of Cruelty to Animals) about early-age neutering. 1 This article sets out clearly the arguments for early neutering, the scientific evidence for its safety, and the practical techniques that are involved. It is a great example of the combination of scientific and practical information we try to achieve in review articles in the ‘Clinical Practice’ issues of JFMS — and should be of real benefit to all involved in practice.
As the authors point out, there is no ‘one size fits all’ when it comes to neutering, and individual circumstances need to be considered. They define ‘early’ as neutering that takes place up to the age of 4 months, and point out that, while for owned pet cats a neutering age of 12–16 weeks might be appropriate, in other situations (such as for rescue or feral cats), neutering earlier than this may be appropriate.
The authors have carefully reviewed the current literature, and conclude that there is no evidence of any clinically significant adverse effects associated with such early neutering, while the benefits (especially in ensuring the opportunity to neuter cats before they become sexually active) are clear. They provide evidence that the procedure may in fact be better tolerated in younger kittens. Yet, despite strong evidence to support early neutering, the authors point to a recent study which found that only 28% of veterinary surgeons in private practice in the UK agreed with the concept of neutering at 12–16 weeks. Traditional attitudes, it seems, are hard to change!
On page 58, we publish a position statement from the AAFP on early spay and castration. 2 Although defined slightly differently (neutering at 6–14 weeks of age), the AAFP also clearly comes out in favour of early neutering as a safe and effective means of population control, and as having long-term behavioural and medical benefits for the individual too. The statement highlights the safety of the procedure, the importance of neutering before the ‘traditional’ age of 6 months (to avoid unwanted litters of kittens), and that early neutering is also endorsed by the American Veterinary Medical Association, the American Humane Association, and the American Society for the Prevention of Cruelty to Animals, among others.
Such widespread support and scientific rationale begs the question as to why early neutering is not undertaken more routinely. This, and other questions related to cat neutering, were the subject of a recent round-table discussion organised by The Cat Group (www.thecatgroup.org.uk). This is a group of charities and other veterinary-related organisations in the UK that have an interest in feline welfare and collaborate to develop joint policies on important issues. The group met, along with invited experts and academics, to review various aspects of cat neutering in the UK, and the results of its deliberations are published on pages 56–57 of this issue. 3
Flank or midline? The former is the traditional approach to cat spays in the UK, but not in many other parts of the world. It now appears that there are some good reasons to challenge that convention
While it was recognised that the majority of veterinarians in the UK still undertake neutering of cats at 5–6 months of age, the group concluded that neutering of owned pets at 4 months (16 weeks) should be regarded as the normal convention (to avoid unwanted pregnancies) and that earlier neutering (at 8–12 weeks of age) should be regarded as safe and appropriate for rescue and feral cats. The group also considered what should be provided routinely for analgesia in neuter patients, whether ovariectomy or ovariohysterectomy should be regarded as the ideal, and whether a flank or midline approach to the surgery should be adopted.
Again, there are national and geographical influences on whether ovariectomy or ovariohysterectomy constitutes normal practice, as was pointed out by Professor Stefano Romagnoli in this journal last year. 4 There are, as yet, no substantial data available in the feline literature to guide a clinician's choice in this matter, and the findings of The Cat Group suggest that neither technique can currently be regarded as having a significant advantage over the other.
The Cat Group also noted that while a flank approach to cat spays is undertaken by the vast majority of veterinarians in the UK, in most other parts of the world a ventral midline approach is routine. It is reported that this tradition in the UK may have emerged for reasons that are no longer important or relevant, and that a ventral midline approach may have some appreciable advantages (including reduced pain and reduced risks of some complications). 5–7 The Cat Group suggests that a change in attitude is important, that veterinary students should be taught both techniques and that they should not be constrained by ‘convention’ when choosing a technique to use in practice.
Where we have the opportunity to make significant improvements to feline health and welfare (eg, by avoiding large numbers of unwanted pet, stray or feral cats), we should positively embrace change.
These are important discussions. It is vital that, as a profession, we continue to challenge perceived wisdom and traditions. On many occasions conventional or traditional approaches may have much to commend them, but where science has progressed and where clear evidence exists for an equally valuable or perhaps better way of approaching issues, we should not be afraid of change. Indeed where we have the opportunity to make significant improvements to feline health and welfare (for example, by avoiding large numbers of unwanted pet, stray or feral cats through better population control), we should positively embrace change. We have the ability to make a difference; the question is whether we will rise to that challenge.