who lives longer intact or neutered animals?

Re: who lives longer intact or neutered animals?

The SkepVet — Wed, 10 Jun 2009 12:50:59 GMT

I though you believed in evidence based decision making! >>>>

I preach evidence based medicine ( the discipline that insist on proof traditional medical practices really work). I post about once a week on quackwatch.org, a list run by a md psychiatrist.

art malernee dvm

definition quoted from Alternative Health Measures published by AMA p 5: Fraud: the FDA has defined health fraud as promotion of an unproven remedy for profit.

art malernee dvm

The SkepVet

Re: who lives longer intact or neutered animals?

Peter Ding — Tue, 09 Jun 2009 19:09:23 GMT

Somewhat misleading and in danger of being grossly anthropomorphic on a veterinary forum, skepvet!

I doubt many entire dogs, or cats will ever live to be 60 plus years old.

Far be it for me to point out that animals and people are considerably different and live very different lives.

I though you believed in evidence based decision making!

Had the study shown the opposite would you seriously be considering becoming a eunach?

Re: who lives longer intact or neutered animals?

Ella Massy-Greene — Fri, 05 Jun 2009 23:51:14 GMT

You know, I think there is a study. But I can't for the life of me remember when I heard it (or what the result was).

The interesting thing is, our primary aim is to remove the ovaries- really the uterus is incidental (if you look at the research looking at long term complications of OVE vs OVH- they are the same).

I would ignore this human study- it seems irrelevant on so many levels (species first and foremost, age and health status of patient at time of procedure, indications for procedure, actual procedure done etc etc).

Re: who lives longer intact or neutered animals?

vs0u — Thu, 21 May 2009 16:04:33 GMT

Neutered male cats roam less, fight less and have smaller territories...this is what I meant by 'calming down'. (I'm fairly sure this has been shown in research)

Weight gain may be more subjective...

Re: who lives longer intact or neutered animals?

Evelyn Barbour-Hill — Wed, 20 May 2009 13:47:37 GMT

It's right to keep thinking about these things. But in my experience they don't calm down and gain weight.

Re: who lives longer intact or neutered animals?

vs0u — Wed, 20 May 2009 13:13:48 GMT

On a separate but related issue:

I was reading up on testosterone deficiency in (human) males recently, it said the symptoms are lethargy, depression and aching joints/muscles.

I wondered, is this what we are condemning neutered male dogs/cats to? Is this why they are said to calm down and gain weight - becaue they feel tired and fed up?

Re: who lives longer intact or neutered animals?

Andrew Kent — Sun, 17 May 2009 15:06:06 GMT

Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4

Hi Art,

We seemed to have switched to male dogs now which is fine. There are indeed documented benefits to castration, not necessarily regarding tumours of the prostate but reducing the risk of the more common benign prostatic hyperplasia.

Krawiec, D. R. (1994). Canine prostate disease. Journal of the American Veterinary Medical Association, 204(10): 1561-1564.

Krawiec, D. R., & Heflin, D. (1992). Study of prostatic disease in dogs: 177 cases (1981-1986). Journal of the American Veterinary Medical Association, 200(8): 1119-1122.

There is also some links between older entire dogs and perineal hernias, see:

Dorn, A., Bone, D., & Bellah, J. (1985). Sex hormone-related diseases treated surgically in male dogs. Modern Veterinary Practice, 66: 727-733.

Regarding females I think the link between spaying and reduction in risk of mammary tumours is fairly conclusive:

Schneinder, R., Dorn, C.R., & Taylor, D. (1969). Factors influencing canine mammary cancer development and post-surgical survival rates. Journal of the National Institutes of Cancer, 45: 1249-1251.

Schneinder, R. (1970). Comparison of age, sex and incidence rates in humans and canine breast cancer. Cancer, 26: 419-426.

Hope that helps,

Andy

Re: who lives longer intact or neutered animals?

The SkepVet — Sun, 17 May 2009 13:36:58 GMT

It's not particularly the difference in DNA but the difference in situation that makes this study less relevant.

We generally perform ovariohysterectomy as a prophylactic procedure>>>>

when you promote ovariohysterectomy as a prophylactic procedure at your place do you have any prospective study data to give the client to support your promotion about what you are trying to prevent? I am looking for prospective study data that addresses the question of using castration as a treatment used to try and get patients to live longer. I had a old client about thirty years ago who was castrated for testicle cancer when he was young as a "proplylactic proceedure". After looking at lance armstrong in the bike race yesterday who only had his testicle with the cancer removed and then thinking back what the client looked like after castration, i can understand why my client did not think neuter was the great prophylactice proceedure his doctors promoted it to be. I promoted to my castrated client that castrating his dog would prevent prostate cancer but the data now shows castration is a risk factor for prostate cancer at least in the dog. So much for my common sense.
art malernee dvm

Re: who lives longer intact or neutered animals?

Andrew Kent — Sat, 16 May 2009 18:45:12 GMT

It's not particularly the difference in DNA but the difference in situation that makes this study less relevant.

We generally perform ovariohysterectomy as a prophylactic procedure at a young age whereas in human medicine it is generally done at a later age to treat some kind of pathology so I find it difficult to apply this study to the veterinary situation.

Andy

Re: who lives longer intact or neutered animals?

Holly Lee — Sat, 16 May 2009 16:09:41 GMT

[quote user="The SkepVet"]One can always argue that the dna of study patients does not match the dna of the doctors patients. [/quote]

I suspect there is a little more variation - genetic and lifestyle/diet/lifespan - between people and dogs/cats than between 2 different people.

Re: who lives longer intact or neutered animals?

The SkepVet — Sat, 16 May 2009 14:42:43 GMT

How is this a clinically important question for the veterinary field when the study is irrelevant for our profession.?>>>

One can always argue that the dna of study patients does not match the dna of the doctors patients.

Eventually we will learn enough about genome to

predict which patient will respond to which treatment, but until then there

is no rational way to select one over the other. It is also problematic

because individuals frequently become convinced that something has "worked"

for them when it really hasn't. The only rational way to verify that an

individual treatment works for an individual patient is to do a double blind

N=1 trial, which the promoters of alternative treatments almost never do.

And even this method is not foolproof.

art malernee dvm

Re: who lives longer intact or neutered animals?

Stephen Ashman — Fri, 15 May 2009 18:23:37 GMT

[quote user="The SkepVet"]However, the new study shows that while women receiving bilateral oophorectomy do have a decreased risk of contracting ovarian cancer and breast cancer, they face a higher risk of death overall[/quote]

I found it difficult to get past this bit; how much more than 100% is the risk of death if you have ovaries removed?

Re: who lives longer intact or neutered animals?

The SkepVet — Fri, 15 May 2009 16:54:15 GMT

Incidentally, the reason why the question mark appeared in the wrong place is because that's where you put it!>>>

No, I was not me, i checked and it was a software malfunction of mine that I call little Arnold. I will keep him alive on my computer so I can send him back in time to fight for "evidence based medicine. "

I would do it for you, but I'm scared you'll accuse me of doing something underhand >>>

You can "believe" any thing you want but here is what we know about scientific peer review which I think should be called "competitive review."

BMJ 2003;326:241 ( 1 February )

News

Little evidence for effectiveness of scientific peer review

Caroline White, London Despite its widespread use and costs, little hard evidence exists that peer review improves the quality of published biomedical research, concludes a systematic review from the international Cochrane Collaboration. Yet the system, which has been used for at least 200 years, has only recently come under scrutiny, with its assumptions about fairness and objectivity rarely tested, say the review authors. With few exceptions, journal editorsand cliniciansaround the world continue to see it as the hallmark of serious scientific endeavour. Published last week, the review is the third in a series from the Cochrane Collaboration Methods Group. The other reviews look at the grant application process and technical editing. Only the latter escapes a drubbing, with the reviewers concluding that technical editing does improve the readability, accuracy, and overall quality of published research. The Cochrane reviewers based their findings on 21 studies of the peer review process from an original trawl of only 135. These were drawn from a comprehensive search of biomedical print and online databases, and information received from bodies such as the World Association of Medical Editors. Almost half of the available research focused on the effects of concealing the identity of reviewers and/or authors, which, the Cochrane authors conclude, has little impact on quality. Few studies assessed the impact of peer review on the importance, usefulness, relevance, or quality of research. Only one small study tested the validity of the peer review procedure itself. On the basis of the current evidence, "the practice of peer review is based on faith in its effects, rather than on facts," state the authors, who call for large, government funded research programmes to test the effectiveness of the system and investigate possible alternatives. "As the information revolution gathers pace, an empirically proven method of quality assurance is of paramount importance," they contend. Professor Tom Jefferson, who led the Cochrane review, suggested that further research might prove that peer review, or an evolved form of it, worked. At the very least, it needed to be more open and accountable. But he said that there had never even been any consensus on its aims and that it would be more appropriate to refer to it as "competitive review." Not only did peer review pander to egos and give researchers licence to knife each other in the back with impunity, he said, but it was also "completely useless at detecting research fraud" and let editors off the hook for publishing poor quality studies. In the latest report from the Committee on Publication Ethics, Professor Peter Lachmann, until recently president of the UK Academy of Medical Sciences, comments: "Peer review is to science what democracy is to politics. It's not the most efficient mechanism, but it's the least corruptible."

art malernee dvm

Re: who lives longer intact or neutered animals?

beldather — Fri, 15 May 2009 16:38:16 GMT

Art,

How is this a clinically important question for the veterinary field when the study is irrelevant for our profession.?
Relax about the filter, paranoia is only justified if people are out to get you

Regards

Blair

Re: who lives longer intact or neutered animals?

Holly Lee — Fri, 15 May 2009 15:55:29 GMT

I take it there is no comparable study in dogs/cats then? Since the indications and timing of ovariohysterectomy in animals are very different compared to people perhaps it is a bit soon to assume the cost/benefit evaluation is the same for every species? Since the main risks described in your human study apply to strokes, heart disease and lung cancer which have strong lifestyle/dietary associations in people then I can't see the application to veterinary medicine at the moment. If I'm missing something I apologise and please fill me in...

Re: who lives longer intact or neutered animals?

Arlo Guthrie — Fri, 15 May 2009 13:11:52 GMT

Incidentally, the reason why the question mark appeared in the wrong place is because that's where you put it!

However, you can edit your posts retrospectively, correct mistakes, and in this case, put the word 'breast' back in, now that the filter doesn't exclude it.

I would do it for you, but I'm scared you'll accuse me of doing something underhand

Re: who lives longer intact or neutered animals?

Arlo Guthrie — Fri, 15 May 2009 13:06:28 GMT

Sounds like you're crediting the system with being more sophisticated than it actually is!

It's just a simple word filter than was preconfigured to delete certain words in the English vocabulary that are used as swear words, or which can be very offensive.

Anyway, I am not blaming the machine. It's my fault. I forgot to remove words that are OK in a veterinary context from the filter. I have now done that. All anatomical words are OK, but things like 'the c word' remain filtered.

Re: who lives longer intact or neutered animals?

The SkepVet — Fri, 15 May 2009 12:57:20 GMT

so much for the common sense promotion that a OHE will keep your patients from dying of cancer.

art malernee dvm

see
Removal of ovaries during hysterectomy increases risk of death, outweighs benefits

Published: Tuesday, 21-Apr-2009
Printer Friendly

Women's Health News

Results of a landmark study led by a doctor at John Wayne Cancer Institute at Saint John's Health Center raises serious questions about the long-term survival benefits of removing a woman's ovaries during routine hysterectomy.

The study, appearing in the May 2009 issue of Obstetrics and Gynecology , compared women with benign (noncancerous) reproductive disease who were given a hysterectomy, with either bilateral oophorectomy (removing both ovaries) or ovarian conservation (leaving the ovaries intact).
For decades, bilateral oophorectomy has been a common practice to eliminate the possible risk of developing ovarian cancer. However, the new study shows that while women receiving bilateral oophorectomy do have a decreased risk of contracting ovarian cancer and breast cancer, they face a higher risk of death overall, a higher risk of fatal and nonfatal coronary heart disease, and a higher risk of lung cancer. In addition, removing the ovaries does not appear to provide any overall increased survival benefit.
The investigation, titled "Ovarian Conservation at the Time of Hysterectomy and Long-Term Health Outcomes in the Nurses' Health Study," pulled together an international team under the direction of William H. Parker, M.D. of John Wayne Cancer Institute and researchers from Harvard Medical School. In 2004, Dr. Parker, a practicing gynecological surgeon and researcher, began to question the value of removing a woman's ovaries for prophylactic reasons, since the average risk of ovarian cancer is relatively low. Ovarian cancer accounts for about 3% of all cancers in women, and is responsible for less than 1% of all causes of death in women.
Dr. Parker turned to the Nurses' Health Study, one of several large-scale studies that provide researchers with decades of reliable health data on older women. Started in the mid-1970s, the first Nurses' Health study has continuously tracked 121,700 female registered nurses to assess risk factors for cancer and cardiovascular disease.
The team focused on a set of 29,380 women from the study: 16,345 had hysterectomy with bilateral oophorectomy, and 13,035 had hysterectomy with ovarian conservation. They evaluated incident events and death from coronary heart disease (CHD), stroke, breast cancer, ovarian cancer, lung cancer, colorectal cancer, total cancers, hip fracture, pulmonary embolus, and death from all causes. Women were divided into age groups to reflect pre- and post-menopausal status at the time of hysterectomy, as well as whether or not they had received estrogen replacement therapy.
After adjusting for multiple independent risk factors, the researchers found several striking trends: Removing both ovaries was indeed associated with a markedly lower risk of ovarian cancer, as well as a reduced risk of breast cancer and cancer overall. However, women with oophorectomy had a significantly higher risk of CHD, stroke and lung cancer.
Looking at survival rates, women with oophorectomy had a higher risk of death from CHD, lung cancer and all cancers. The risk of death from all causes was significantly greater for women who were younger than age 50 at the time of surgery. The studyconcluded that for every 24 women having bilateral oophorectomy, at least one woman will die prematurely from any cause as a result of the procedure.
While the risk of dying from ovarian cancer did decrease dramatically after oophorectomy, the risk to women whose ovaries had been conserved was also extremely low (34 deaths out of 13,305 women, or 0.26%).
Importantly, no analysis or age group showed an increased survival associated with oophorectomy.
"For the last 35 years, most doctors have been routinely advising women undergoing hysterectomy to have their ovaries removed to prevent ovarian cancer," said Dr. Parker. "We believe that such an automatic recommendation is no longer warranted."
Dr. Parker asserted that women who are at high risk of ovarian cancer should indeed consider oophorectomy as part of hysterectomy: this includes women with a family history of ovarian cancer, and women who carry BRCA1 or BRCA2 gene mutations that increase the risk of ovarian cancer.
"Certainly, some women do have a high risk of ovarian cancer, but this is relatively rare in the general population," Dr. Parker explained. "For the majority of women, the risk of ovarian cancer is very low. While taking out the ovaries will effectively prevent ovarian cancer, this study shows that it significantly increases the risk of other diseases that are much more likely to kill you, such as heart disease, stroke and lung cancer, which are far more common causes of death."
The study report notes that ovarian cancer kills 14,700 women in the U.S. each year, while CHD accounts for 326,000 deaths, and stroke accounts for approximately 86,900 deaths annually.
"We believe these results highlight the need for a new conversation between the patient and doctor, framed by the patient's specific risk factors and personal concerns," Dr. Parker said.
"Before menopause, the ovaries make a lot of estrogen, plus androgens including testosterone and androstenedione. These hormones keep the heart, bones and blood vessels healthy," Dr. Parker explained. "After menopause, the ovaries make less estrogen, but continue to produce androstenedione and testosterone, which are converted by fat and muscle cells into estrogen. So there is a continued source of estrogen from these hormones that continues to protect the blood vessels. If you remove the ovaries, you lose the estrogen and the androgens, and the benefits to the blood vessels."
Interestingly, although the protective effects of estrogen have been known for decades, no researchers had investigated the oophorectomy connection until now.
"Nobody to date had thought to look at the big picture," Dr. Parker said. "That is, how does the survival data actually inform the decision about whether to take out the ovariesor not?"
Reflecting on his motivation to develop the study, Dr. Parker explained, "I have been in private practice for many years, and this is something my patients and I have to deal with on a regular basis. After a while, the common knowledge appeared to be wrong. It didn't make sense to me to advise women to have their healthy ovaries removed when there might be benefits that we hadn't accounted for."
"We need to tell our patients that they should consider the benefits of keeping their ovaries over the long term," Dr. Parker concluded. "And in my experience, most women intuitively think this is the right answer."
Ovarian Conservation at the Time of Hysterectomy and Long-Term Health Outcomes in the Nurses' Health Study. William H. Parker, Michael S. Broder, Eunice Chang, Diane Feskanich, Cindy Farquhar, Zhimae Liu, Donna Shoupe, Jonathan S. Berek, Susan Hankinson, JoAnn E. Manson. Obstetrics & Gynecology, Vol. 113, No. 5, May 2009

Re: who lives longer intact or neutered animals?

The SkepVet — Fri, 15 May 2009 12:23:27 GMT

Do I have this right? When you post on this web site about clinically important controversial topics and find what you post has been edited without your OK, apparently its not the fault of humans but the fault of machines. Is there anyway we can turn off this machine ( I will call him Arnold) before he comes back again to edit what we write or at least let people who sign up to post know about Arnold?

art malernee dvm

Re: who lives longer intact or neutered animals?

ms1083 — Fri, 15 May 2009 07:56:20 GMT

Please can you supply reference to the new paper you are talking about? I have found, quite often, that the method and case selection of vet papers is so awful the whole study is flawed. As vets we are very good at reading the abstract, and possibily the conclusion, and believing.

Re: who lives longer intact or neutered animals?

beldather — Thu, 14 May 2009 20:58:30 GMT

Filtering a veterinary forum must be a bit of a bitch hey Arlo

Re: who lives longer intact or neutered animals?

Arlo Guthrie — Thu, 14 May 2009 18:53:13 GMT

No, you are not being edited by anyone. I'm the only one with the ability to edit posts, and I haven't touched yours!

There is a bit of software that removes preset rude words. I think you set it off on the last post with 'breast', which I have now removed from the list of disallowed words, along with a couple of others like bitch and penis.

If I were ever to edit someone else's posts, I would always be transparent and explain publicly what had been edited and why.

Re: who lives longer intact or neutered animals?

The SkepVet — Thu, 14 May 2009 13:10:41 GMT

Am I being edited by someone on this internet site without my approval? Evidence based study's show except for "technical editing" peer review does not work. I think peer review editing needs to be a open process or abandoned all together. art malernee dvm

Re: who lives longer intact or neutered animals?

The SkepVet — Wed, 13 May 2009 13:40:23 GMT

should read "*** cancer" not ***cancer . I could use mammary in case the bad language cops are trying to prevent a wardrobe malfunction. I have no idea why the ? mark occured in the first sentence and not the second.

art malernee dvm