Reprod Dom Anim 44 (Suppl. 2), 29–35 (2009); doi: 10.1111/j.1439-0531.2009.01437.
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ISSN 0936-6768
Gonadectomy in Cats and Dogs: A Review of Risks and Benefits
IM Reichler
Section of Small Animal Reproduction, Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
Contents
The necessity, and in particular the timing, of gonadectomy
in dogs and cats is still controversial. This is mainly because
gonadectomy confers a mixture of benefits and adverse
effects that depend upon the age at neutering, sex, species
and breed. In this paper, the long-term risks and benefits of
gonadectomy, at various ages, in dogs and cats are reviewed
using data describing the effects of desexing on the urogen-
ital tract and on other medical conditions, such as ortho-
paedic diseases, immune-mediated diseases, tumour
development and behaviour.
Introduction
Contraception through surgical sterilization or
gonadectomy (GX) is usually an irreversible
intervention that results in a permanent cessation of
reproductive function. Surgical methods where the
gonads are removed, are ovariectomy (OVE) or
ovariohysterectomy (OVH), through the linea alba or
via the flank or laparoscopy (Davidson et al. 2004;
Devitt et al. 2005). In contrast to the removal of the
gonads, sterilization by means of a vasectomy and
salpingectomy also results in the elimination of
reproductive function, but the sexual behaviour and
the incidence of diseases caused by sexual hormones are
not influenced.
GX to Control Pet Overpopulation
Until now, GX is the contraceptive technique of choice.
As GX is irreversible, spay programmes are widely
accepted for population control. In spite of worldwide
efforts to reduce pet overpopulation, the number of
unwanted dogs and cats is still increasing (New 2006).
Researchers worldwide are searching for a single and
simple contraceptive method that results in the
permanent elimination of reproduction, but at signifi-
cantly less cost than neutering. In male dogs, for
instance, this can be achieved by the intratesticular
injection of zinc gluconate (Levy et al. 2008). Spaying of
female dogs and cats is still recommended to avoid high
population densities, animal suffering and the spread of
zoonoses. The castration of tomcats is also
recommended, because castrated cats have on average
better health and a reduced mortality rate than intact
cats (Kalz 2001).
The necessity, and in particular the timing, of GX
in dogs and cats kept as pets is still controversial. This
is mainly because GX confers a mixture of benefits
and adverse affects depending on age at neutering,
sex, species and breed and it has been proposed that
‘Any policy decision should consider the frequency
and consequences of any condition’ (Spain 2006).
 2009 The Author. Journal compilation  2009 Blackwell Verlag GmbH
Effect of Spaying on the Reproductive Tract
In some countries, OVH is the preferred technique for
spaying of bitches. This preference was most likely based
on the presumption that future uterine pathology is
prevented by removing the uterus. However, historical
reviews of the short-term and long-term complications
after OVH and OVE lead to the conclusion that there is
no benefit and thus no indication for removing the
uterus during routine neutering in healthy bitches
(Okkens et al. 1997; Van Goethem et al. 2006). At our
clinic, OVH is only performed in older females or
females previously treated with gonadal steroids.
With the removal of the gonads, diseases such as
ovarian tumours and cysts no longer occur. Further-
more, spayed dogs and cats are no longer susceptible to
disorders mediated by ovarian hormones, such as
vaginal hyperplasia or uterine disease. In spayed dogs
and cats, uterine pathology is virtually non-existent,
whereas it is common in intact or progestagen-treated
animals. In Sweden, only approximately 7% of all
bitches are spayed and a study showed that almost 25%
of all registered dogs up to 10 years of age developed a
pyometra (Hagman 2004). Other researchers also found
that in 5-year-old queens, there was a significant
likelihood of clinical evidence for uterine disease (Potter
et al. 1991).
Effect of GX on the Development of Tumours of
the Reproductive Tract
Sparing effect of spaying on the development of mammary
tumours (MT)
Mammary tumours are the most common tumours
found in female dogs, with estimates of a lifetime risk
for developing malignant MT ranging from 2% to more
than 20% (Dorn et al. 1968; Moulton et al. 1986). In
cats, the incidence is less than half that of dogs.
However, these tumours account for 17% of neoplasms
in female cats, (Schmidt and Langham 1967; Dorn et al.
1968; Patnaik et al. 1975; Hayes et al. 1981) and at least
85% of feline MT are malignant (Schmidt and Langham
1967; Hayes et al. 1981; Bostock 1986). There is some
evidence supporting a breed-associated predisposition:
Siamese cats, Domestic shorthair cats, several Spaniel
and Poodle breeds and the Dachshund seem to be
predisposed. Apart from the genetic predisposition,
gonadal hormones appear to mainly influence the
pathogenesis of MT. Spayed dogs and cats are signif-
icantly less affected by MT than intact animals, but the
timing of spaying also plays a critical role. The risk of
developing malignant MT in dogs spayed prior to the
first oestrus is reduced by 99.5% as compared to intact
dogs. Dogs spayed after the first and before the second
30
oestrus had a 92% reduction in the risk of malignant
MT development as compared to intact dogs. The
sparing effect of GX on the development of malignant
MT appears to be lost after females have cycled more
than twice or are older than 2.5 years of age (Schneider
et al. 1969). However, the risk for benign MT
development appears to be reduced by GX even at a
later age (Phillips 2002). Similar effects are seen in cats:
those spayed prior to 6 months of age had a 91%
reduction in the risk of malignant MT development as
compared to intact cats. Those spayed prior to 1 year of
age had an 86% reduction in risk, those spayed between
12 and 24 months of age had an 11% risk reduction, but
after 24 months of age there was no benefit (Overley
et al. 2005).
GX and survival rate after MT removal
According to several studies, performing an OVE or
OVH at the time of or after MT excision does not
significantly affect the survival time (Schneider et al.
1969; Yamagami et al. 1996; Morris et al. 1998; Phili-
bert et al. 2003). In contrast, other authors suggest that
OVH may be an effective adjunct to MT removal in
dogs with mammary gland carcinoma and that the
timing of the OVH plays a critical role in survival time.
Dogs spayed within 2 years of the development of their
malignant tumours had a survival advantage over intact
dogs or those spayed more than 2 years prior to MT
development and mastectomy (Sorenmo et al. 2000).
Effect of spaying on tumours of the genital tract
In general, tumours of the genital tract are rare in
spayed dogs and cats. Most canine uterine, canine and
feline vaginal and vulvar tumours are leiomyomas.
Because the occurrence of leiomyomas is mainly
reported in intact female dogs and cats (Wolke 1963;
Stein 1981; Thacher and Bradley 1983; Kydd and Burnie
1986) and these tumours were not seen in bitches
ovarectomized before 2 years of age (Brodey and Roszel
1967), a hormonal influence is strongly suspected.
Furthermore, OVH at the time of tumour removal
may be beneficial. In a review, no bitches undergoing
concurrent OVH had recurrence of vaginal or vulvar
neoplasia (Thacher and Bradley 1983).
Effect of spaying on external genitalia
Gonadal hormones are responsible for the normal devel-
opment of the external genitalia. The effect of GX, and
especially the time of GX, on the size of the vulva was
examined in three groups of bitches and female cats. In
cats and dogs, gonadectomized at 7 weeks or 7 months,
the vulva was small and infantile compared to that of
intact females (Salmeri et al. 1991; Root et al. 1997). In
these studies, no clinical problems were evident. However,
in dogs, perivulvar dermatitis is thought to develop more
commonly in obese bitches that have an infantile vulva.
The incidence of recessed vulva, perivulvar dermatitis and
vaginitis are higher in spayed than in intact dogs and the
incidence may even be higher in females spayed as puppies
(Verstegen-Onclin 2006).
 2009 The Author. Journal compilation  2009 Blackwell Verlag GmbH
IM Reichler
Vaginitis may occur as so-called juvenile vaginitis, or
subsequent to vaginal atrophy following GX. Whether
the spaying of bitches with juvenile vaginitis will cause
chronic vaginitis persisting to adulthood or even lifelong
is controversial. In a review of 37 dogs with juvenile
vaginitis, 84% of the cases resolved with or without
treatment (Johnson 1991). Allowing bitches with juve-
nile vaginitis to go through an oestrous cycle may hasten
resolution. However, it is unknown what effect increas-
ing age and maturation of the immune system will have
on the resolution of juvenile vaginitis.
Effects of Testicular Removal on the Genital
Tract
Apart from the permanent suppression of reproductive
function, bilateral orchiectomy has a prophylactic and
therapeutic effect on androgen-dependent diseases, such
as benign prostate hyperplasia (BPH), chronic prosta-
titis, perineal adenomas and perineal hernias. In fact,
50% of intact dogs exhibit histological evidence of BPH
by 5 years of age (Berry et al. 1986). In addition, BPH
predisposes dogs to prostatitis, and thus for both
conditions castration is a suitable treatment. Castration
also prevents testicular and epididymal disorders, such
as neoplasia, torsion of the spermatic cord, orchitis and
epididymitis. This is especially important in male dogs
as the testicles are the second most common anatomical
sites for cancer development (Hayes and Pendergrass
1976). These diseases are very rare in tomcats.
Prostate cancer (PC)
Prostate cancer is rare in dogs (less than 0.6% in
necropsy studies) and very rare in cats, but is almost
always malignant (Weaver 1981). Castration has been
evaluated as a treatment in human cases. The traditional
contention was that GX reduces testosterone concen-
trations, which should in turn reduce the risk of PC.
However, although PC begins as an androgen-depen-
dent tumour, the beneficial effects of androgen depriva-
tion are often temporary and the development of an
essentially incurable therapy-resistant PC seems to be
almost inevitable during the later stages. In 1987, a
study showed that castration at any age had no sparing
effect on the risk of developing PC in dogs (Obradovich
et al. 1987). Furthermore, eight cases of PC were
described in cats: all but one had been castrated (Hawe
1983; Carpenter et al. 1987; Hubbard et al. 1990; Caney
et al. 1998; LeRoy and Lech 2004).
Over the last 5 years, several studies in dogs have
identified an increased risk of neutered dogs to develop
PC (with an odds ratio of 2.84 for all prostate tumours)
(Teske et al. 2002; Sorenmo et al. 2003; Bryan et al.
2007). Compared to intact dogs with PC, neutered dogs
with PC were more likely to fall into an older-age
category (Bryan et al. 2007). Apart from the reproduc-
tive status, the breed also affects the risk of developing
prostate tumours. Risk varies with breed, suggesting
that genetics play a role in the development of prostate
tumours (Bryan et al. 2007). Neutered mix-breed dogs,
Shetland sheepdogs, Scottish terriers, Beagles, English
Springer Spaniels, German shorthaired pointers and
Surgical Contraception: Pros and Cons in Cats and Dogs
West Highland white terriers had significantly higher
odds than the background population of neutered dogs
to have PC (Bryan et al. 2007).
Effects of the timing of testicular removal on the genital
tract
These effects were investigated in male cats and dogs
neutered at 7 weeks, 7 months and compared with
intact males (Salmeri et al. 1991; Root et al. 1997).
The most striking differences in the development of
secondary sex characteristics were the immaturity of the
prepuce, penis and os penis of male dogs neutered as
puppies and the missing penile spikes in neutered cats.
Effects of GX on the Lower Urinary Tract
Urinary incontinence (UI)
The risk of UI is low in intact bitches. The incidence of
UI due to spaying varies between 3% and 21%, in
different studies (Joshua 1965; B.S.A.V.A. 1975; Ruck-
stuhl 1978; Osborne et al. 1980; Okkens et al. 1981,
1997; Holt 1985; Thrusfield 1985; Arnold et al. 1989;
Blendinger et al. 1995b; Stöcklin-Gautschi 2000; Stock-
lin-Gautschi et al. 2001; Angioletti et al. 2004; Reichler
et al. 2005). Urinary incontinence after spaying can
occur immediately or up to 10 years after surgery;
approximately 75% of the bitches become incontinent
within 3 years after GX (Arnold et al. 1989). In most
cases, the cause for UI after spaying is a reduction in the
urethral closure pressure (Arnold 1997).
The risk for UI is influenced by various factors such
as body weight or breed and time of spaying. Dogs
weighing less than 20 kg have a risk below 10% of
becoming incontinent after spaying, whereas in dogs
weighing more than 20 kg, the risk is up to 30% (Arnold
et al. 1989; Reichler et al. 2005). Boxers, Dobermans,
Old English Sheepdogs, Giant Schnauzers and Rottwe-
ilers all have a known predisposition for UI. Spaying
shortly before puberty seems to reduce the risk by 50%
(Arnold et al. 1989; Stöcklin-Gautschi 2000; Reichler
et al. 2005). In another study, bitches were significantly
more likely to develop UI when spayed at less than
3 months of age than bitches spayed between 3 months
and 1 year of age (Spain et al. 2004b).
The pathophysiology of UI remains unclear. Altered
GnRH, FSH and LH secretion after GX (Reichler et al.
2003, 2004, 2005, 2006a,b, 2007; Ponglowhapan et al.
2007) may be involved. In most cases, UI due to spaying
is easily controlled with the treatment of alpha-adren-
ergic substances (Awad et al. 1978; Blendinger et al.
1995a).
Feline lower urinary tract disease (FLUTD)
A recent survey of veterinary surgeons in practice, found
that the most common medical concern raised was the
possibility of increased risk of FLUTD with early
neutering (Spain et al. 2002). Numerous studies have
been performed to examine the effect of GX on urinary
health in cats, most failing to detect a correlation
between GX of cats at any age and an increase in
incidence of FLUTD or other problems associated with
 2009 The Author. Journal compilation  2009 Blackwell Verlag GmbH
31
this condition. GX had no effect on urethral function in
cats, as determined by urethral pressure profiles (Stubbs
et al. 1996). Furthermore, similar urethral diameters, as
well as no difference in pre-prostatic and penile urethra,
were found in cats neutered at 7 weeks, 7 months or
those remaining intact (Root et al. 1997). A long-term
study performed to compare effects of pre-pubertal and
traditional-age GX found no increased risk of FLUTD
in early-neutered cats up to 3 years after surgery (Howe
et al. 2000).
However, in one large study of male and female cats,
both GX and obesity were found to be risk factors for the
development of FLUTD (Lekcharoensuk et al. 2001).
Transitional cell carcinoma (TCC)
Transitional cell carcinoma rarely occurs; however,
there is considerable variation in the risk of canine
TCC. Epidemiological studies of TCC in dogs have
revealed a number of risk factors, including breed,
female gender, reproductive status and obesity, as well
as environmental factors, such as insecticide exposure
(Knapp et al. 2000). Scottish terriers have an 18-fold
increased risk when compared with mixed breeds.
Females have a twofold increased risk as compared to
males; GX increases the risk more than four times in
females and in male dogs (Knapp et al. 2000). The
increased risk for developing TCC in neutered dogs of
both sexes is not explained at this time.
Effect of GX on Metabolism
Body weight
Although obesity can occur in both neutered and intact
animals and is influenced by a number of factors such as
diet, breed and activity level, there is data indicating that
neutered animals may gain significantly more weight as
compared to intact animals. While results of several
studies indicate that neutering is a risk factor for obesity
in cats (neutered cats are 3.4 times more likely to become
obese than sexually intact cats) (Fettman et al. 1997;
Kanchuk et al. 2002; Nguyen et al. 2004), there is
conflicting information on whether dogs are more likely
to experience weight gain after neutering (Houpt et al.
1979; Le Roux 1983; Edney and Smith 1986; Jeusette
et al. 2004). The time of GX is also controversial: In a
15 months’ prospective study performed to compare the
effect of early and traditional age neutering of intact
animals, no differences in food intake, weight gain or
back-fat depth among neutered and intact animals were
found (Salmeri et al. 1991). However, the results of a
recent population study indicate that neutering of dogs
before 6 months of age is associated with lower prev-
alence of obesity as compared to neutering after
6 months of age (Spain et al. 2004b). These results raise
the question if early spaying reduces the increased risk
of obesity after neutering (Spain et al. 2004b).
Obesity is not necessarily a consequence of GX, but it is
important to control the body weight in neutered animals
because of its association with increased risk of other
medical problems (Lekcharoensuk et al. 2001) and the
negative effects on the life expectancy (Greer et al. 2007).
Obesity can be prevented by simple measures. There is
32
evidence that cats on high dietary fat, in exchange for
carbohydrate, gain weight and that GX increases
sensitivity to weight gain induced dietary fat (Backus
et al. 2007). A low-fat diet alone is, however, insufficient
to prevent obesity after GX, as it requires the feeding of
carefully controlled meals and not ad libitum (Nguyen
et al. 2004).
Diabetes mellitus (DM)
Neutered cats are not only at a higher risk of becoming
obese, but also have a two- to ninefold increased risk of
developing DM than sexually intact cats (Panciera et al.
1990; McCann et al. 2007; Prahl et al. 2007). The
increased probability that cats will develop obesity and
DM after GX may be due to decreased insulin sensitivity
(Hoenig and Ferguson 2002; Kanchuk et al. 2002).
A possible increase in the risk of developing DM was
detected in castrated dogs. The possible association with
obesity was not defined (Marmor et al. 1982). In intact
bitches, an altered glucose metabolism, induced by
progesterone, occurs during pregnancy, metoestrus and
after progestin administration. Spaying is an integral
part of the treatment of DM in these females.
Hypothyroidism
Two studies showed that neutering was the most
significant gender-associated risk factor for the devel-
opment of hypothyroidism in dogs and cats (Milne and
Hayes 1981; Panciera 1994). However, in another study,
using age-matched controls and TSH response test
results, neutering had no apparent effect on the likeli-
hood of a dog being hypothyroid (Dixon and Mooney
1999; Dixon et al. 1999).
Effects of GX on the Musculoskeletal System
Growth
The effect of GX on skeletal growth was already well
known from historical information on eunuchoid
growth. Studies examining the effects of GX and timing
of GX, showed that the growth rate is unaffected, but
physeal closure is delayed (Salmeri et al. 1991; Root
et al. 1997). This is most obvious in male cats, who when
neutered at 7 weeks or 7 months, have on an average
final radial lengths of 13% greater than intact females
(Root et al. 1997). It is controversial if this altered
growth rate has an effect on soundness.
Fractures
In cats, spontaneous femoral capital physeal fractures
have been suggested to be a result of delayed physeal
closure related to early neutering. In retrospective
studies, 39 cats with 47 fractures were examined (Craig
2001; McNicholas et al. 2002; Fischer et al. 2004). Four
risk factors for spontaneous femoral capital physeal
fractures in cats older than 1 year were suggested:
gender and reproductive status, delayed physeal closure
and abnormally high body weight. Obese neutered male
cats may be predisposed to femoral capital physeal
fractures, which in turn emphasize the importance of
 2009 The Author. Journal compilation  2009 Blackwell Verlag GmbH
IM Reichler
controlled feeding in early-neutered cats. Population
studies provide no association between age at GX and
incidence of fractures in either cats or dogs (Spain et al.
2004a,b).
Canine hip dysplasia (CHD)
There is a possible influence of GX on the development
of CHD. Neutered Boxers, with a mean age of 3 years at
neutering, were 1.5 times as likely to develop CHD as
sexually intact dogs (Van Hagen et al. 2005). However,
body weight was not included in this analysis, and there
are no data on the influence of the timing of GX (Van
Hagen et al. 2005). In a recent population study, the
influence of age at GX on development of CHD was
also examined. Puppies that underwent GX before
5.5 months of age had a 6.7% incidence of CHD, while
those neutered between 5.5 months and 1 year of age
had an incidence of 4.7%. The authors speculated that
this increased incidence may have resulted from altered
hip joint conformation secondary to increased bone
length (Spain et al. 2004b). However, considering the
lower rate of euthanasia among early-age gonadecto-
mized dogs with CHD in comparison to those that
underwent later GX, the author suggested that early-age
GX may be associated with a less severe form (Spain
et al. 2004b).
Cranial cruciate ligament rupture (CCLR)
GX has an influence on the prevalence of CCLR. The
prevalence of CCLR is most common in neutered males,
followed by spayed females, while intact animals have
only half of the risk (Slauterbeck et al. 2004). No data is
provided on the body weight.
Osteosarcoma
Osteosarcoma is a rare but highly malignant tumour,
occurring mainly in large dogs (Tjalma 1966; Ru et al.
1998). Risk factors, such as increasing age, body weight,
body size and GX, were established (Priester and
McKay 1980; Ru et al. 1998; Cooley et al. 2002).
A study comparing 3062 pure-bred dogs with osteosar-
coma and 3959 pure-bred dogs without osteosarcoma,
revealed a twofold increased risk of osteosarcoma
among neutered dogs when compared to intact dogs
(Ru et al. 1998). As the data did not include the age at
GX, this study could not evaluate bone sarcoma risk in
terms of duration of gonadal hormone exposure. To test
the hypothesis that endogenous sex hormones signifi-
cantly influence bone sarcomagenesis, a study of Rott-
weiler dogs, a breed known to be at high risk for bone
sarcoma, was performed (Cooley et al. 2002). Bone
sarcoma was diagnosed in 12.6% of dogs in this cohort
overall, with neutered dogs having a twofold increased
risk. However, gonadectomized female and male dogs
lived longer than sexually intact dogs. The longer life
expectancy may contribute to a higher overall cancer
incidence in neutered animals. A significant association
between gonadal hormone exposure and risk of bone
sarcoma was found. In males castrated before 1 year of
age (lowest gonadal exposure), the risk for bone
Surgical Contraception: Pros and Cons in Cats and Dogs
sarcoma was almost four times greater than in sexually
intact males. In females spayed before 1 year of age,
bone sarcoma incidence was more than three times
greater than the rate in sexually intact females. The risk
factor of early GX was found to be independent of adult
height or body weight.
Effects of GX on Various Conditions
Cardiac tumours
Cardiac tumours have an overall incidence of 0.19% in
dogs and 0.0275% in cats. Cardiac tumours occurred
with similar frequency in male and female dogs, but the
relative risk of developing a heart tumour for spayed
females was greater than four times that of intact
females (Ware and Hopper 1999). Castrated males had
only a slightly greater risk (1.6 times) of developing a
heart tumour than intact males. No data are provided
on the age at GX. However, as most dogs with cardiac
tumour were older than 10 years and data on the age of
the control population are missing, a possible effect of
the extended life expectancy of neutered dogs, compared
to intact dogs, on the incidence of tumours cannot be
excluded.
Diseases that are transmitted by mating or copulation,
such as Sticker Sarcoma or brucellosis, are rarely
observed in neutered dogs. FeLV and FIV are transmitted
by mating, along with other direct social contacts. It is
well known that castration reduces the territorial area and
behaviour (Kalz 2001), but these diseases can also be
transmitted by using the same feeding places. The time of
GX does not seem to have an effect on the incidence of
these diseases (Howe et al. 2000).
Life expectancy
It is well documented that neutered animals live longer
than intact animals (Kraft 1998; Greer et al. 2007). The
increased life expectancy in gonadectomized animals
may be due to the preventive effect on diseases of the
reproductive tract and ⁄ or the reduced risk-associated
behaviour. However, the increased life expectancy may
also reflect to some extent the enhanced care of neutered
animals by their owners.
It is clear that surgical contraception offers both
significant health and welfare benefits; however, the
risks and adverse effects should always be considered in
each animal and should be subject to careful debate with
the animal’s owner.
Conflicts of interest
The authors have declared no conflicts of interest.
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Submitted: 30 June 2008
Author’s address (for correspondence): IM Reichler, Section of Small
Animal Reproduction, Clinic of Reproductive Medicine, Vetsuisse
Faculty, University of Zurich, Zurich, Switzerland.
E-mail: ireichler@vetclinics.uzh.ch