logging in or signing up Reichler Benchmarking Surgical 10.00 ACCandD Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 127 Category: Science & Tech.. License: All Rights Reserved Like it (1) Dislike it (0) Added: May 17, 2010 This Presentation is Public Favorites: 0 Presentation Description Presented by Dr. Iris Reichler at the Alliance for Contraception in Cats & Dogs’ 4th International Symposium on Non-Surgical Contraceptive Methods of Pet Population Control, April 8-10, 2010, in Dallas, Texas, U.S. Comments Posting comment... By: devdut (12 month(s) ago) pls. give ppt i need Saving..... Post Reply Close Saving..... Edit Comment Close By: devdut (12 month(s) ago) very good information presented Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Benchmarking Surgical Sterilization : Benchmarking Surgical Sterilization Iris M. Reichler Small Animal Reproduction Vetsuisse Faculty University of Zurich, Switzerland Myths and truthsBenefits and risks of gonadectomy (Gx) : Myths and truthsBenefits and risks of gonadectomy (Gx) Benefits of Gx Population control Prevention of diseases Disease incidence, clinical relevance Risks of Gx Increased disease frequency Disease incidence, clinical relevance Study design (control group, age, breed, body score?) Mammary cancer Common disease, high clinical relevance : Mammary cancer Common disease, high clinical relevance Most common tumor Life-time risk up to 20% 50% malignant, always surgery 3rd most common tumor 17% of all feline tumors > 85% malignant, poor long-time survival rate Aggressive surgery and chemotherapy Major benefit of GxRisk of malignant cancer development : Major benefit of GxRisk of malignant cancer development Gx < 1st heat 0,5% relative risk Gx 1st to 2nd heat 8% relative risk Gx > 2nd heat 26% relative risk Gx > 2,5 years no benefit (risk for benign tumors) Gx < 6months 9% relative risk compared to intact Gx 1/2 to 1year 14% relative risk Gx 1 to 2years 89% relative risk Gx > 2 years no benefit Gonadal diseases Diseases mediated by sexual steroids : Gonadal diseases Diseases mediated by sexual steroids Female Metropathy Ovarian disease Vaginal hyperplasia Genital tract neoplasia Male Orchitis/Epididymitis Testicular neoplasia Prostate hyperplasia (BPH) Prostatitis Perianal tumors Major benefit of GxRisk of metropathy : Major benefit of GxRisk of metropathy Life threatening disease Mortality rates despite treatment up to 8% Incidence 25% of all dogs up to 10 years Likely in cats above 5 years Ovariohysterectomy recommended Major benefit of GX:No BPH, prostatitis, cancer of testis : Major benefit of GX:No BPH, prostatitis, cancer of testis Benign prostate hyperplasia (BPH) 50% of all dogs by 5 years of age Predisposition for prostatitis Treatment: Neutering (after stabilization) Tumors of the testicles 2nd most common tumor, metastasis < 15% Treatment: Neutering Major benefit of Gx:Avoidance of veneral diseases : Major benefit of Gx:Avoidance of veneral diseases Uncontrolled sexual behavior Stray dog population Free running dogs Transmissible veneral tumor Canine brucellosis Public health considerations Major benefit of Gx:No pregnancy or delivery related problems : Major benefit of Gx:No pregnancy or delivery related problems Dystocia: 5% up to 80% 0.4% up to 18% Mostly cesarean section needed Uterus torsion, uterus rupture Pregnancy toxemia Gestational diabetes mellitus Major risk of Gx:Urinary incontinence : Incidence: Intact bitches 0.2% - 2% Spayed dogs 3% - 21% Body weight Breed Time of spaying Success of medical treatment 95% Major risk of Gx:Urinary incontinence Major risk of Gx:Obesity : Major risk of Gx:Obesity Alteration in feeding behavior Food intake Activity Predisposing factor for Diabetes mellitus Lower urinary tract disease Perivulvar dermatitis Orthopedic problems Cancer Questionable risk of Gx:Diabetes mellitus- a sequelae of obesity ? : Risk factors Male gender: 1.6 x Obesity: 2.2 x (obese males 3.1 x ) Gx: no significant increased risk of either gender! Risk factors Spayed females No defined association with obesity Insulin treatment required in most cases Questionable risk of Gx:Diabetes mellitus- a sequelae of obesity ? Minor risk of Gx:Perivulvar dermatitis – influence of obesity! : Minor risk of Gx:Perivulvar dermatitis – influence of obesity! Small infantile vulva in gx animals Perivulvar dermatitis Predisposing factors Obesity Spayed as puppy Treatment Restriction diet, antibiotics, local cleansing Plastic surgery Questionable risk of Gx:LUTD – influence of obesity! : Effect of Gx on the urinary tract Numerous studies No effect in all but one study Lekcharoensuk 2001: 22 908 out of 263 168 cats had LUTD (8%) Influence of GX: Neutered: 2.8 x Spayed: 1.4 x Influence of weight: 1.4 x Questionable risk of Gx:LUTD – influence of obesity! Minor risk of Gx:Vaginitis, urinary tract infections : Minor risk of Gx:Vaginitis, urinary tract infections Incidence Increased in Gx Especially in very early Gx Treatment of vaginitis Estrogen supplementation Antibiotics Treatment of UTI Antibiotics Questionable risk of Gx:Physeal fractures – influence of obesity! : Spontaneous femoral capital physeal fractures (McNicholas 2002) Risk factors Sex and Gx (96% neutered cats) Delayed physeal closure (early Gx) High body weight No association between age at GX and incidence of fractures (Spain 2004) Questionable risk of Gx:Physeal fractures – influence of obesity! Risk of Gx:Canine hip dysplasia (CHD) : 1 733 Boxers from 325 litters, 8-year period (Van Hagen 2005) Risk factor Gx (> 6 months prior to CHD) Obesity was not considered Gx increases the risk for CHD 1.5 x 1 842 dogs, population study (Spain 2004) CHD with Gx before 6 months of age (6.7% versus 4.7%) Treatment for CHD: NSAIDs, pain medicaments, surgery Risk of Gx:Canine hip dysplasia (CHD) Risk of Gx:Cranial cruciate ligament rupture : Progressive degenerative ligament failure Most common orthopedic injury Risk factors Body weight and Gx Breed predispositions Surgical stabilization Risk of Gx:Cranial cruciate ligament rupture 2.4x 1.7x Risk of Gx:Osteosarcoma : Risk of Gx:Osteosarcoma Highly malignant bone tumor Survival time after surgery 20 weeks Large or giant breeds Risk factor: body size but not body weight Gx: inverse relationship between gonadal hormone exposure and risk for osteosarcoma Males gx < 1 year 4x than in intact males Females gx < 1 year 3x than in bitches Risk of Gx:Different types of cancer : In humans: Obesity increases the risk of cancer Low grade chronic inflammation and insulin resistance Leptin Interleukin-6 Tumor necrosis factor Most veterinary studies did not investigate body score Many veterinary studies did not investigate age of controls Risk of Gx:Different types of cancer Risk of Gx:Prostate cancer : Risk factors In men: Family, obesity… In dogs: Breed, Gx Teske 2002 Male referrals n=15363, Gx 20.4% PCA n=56, Gx 46% Age similar Gx favors PCA progression Risk of Gx:Prostate cancer Risk of Gx:Other tumors : Heart tumors (0,19%) Breed predisposition, Gx Spayed dogs 4x , neutered dogs 1.6x Protective effect of estrogen? Splenic hemangiosarcoma : Gx (age?) Transitional cell carcinoma: Gx 4, obesity Anal sac gland carcinoma Breed predisposition, Gx Risk of Gx:Other tumors Effects of Gx:Behavior : Gx of males Intraspecies aggression Sexual behavior, spraying Gx of males Roaming Bite injuries Gx of females Aggressive behavior Effects of Gx:Behavior Terre sauvage 1993 Risk of Gx:Cognitive impairment : Risk of Gx:Cognitive impairment In women: Cognitive impairment related to duration of estrogen deficiency In dogs: Signs of cognitive impairment Disorientation in the home and yard Altered social interactions Loss of house training Disturbed sleep-wake cycle Intact dogs less likely progress from mild to severe impairment Risk or benfit of Gx? Life expectancy : Risk or benfit of Gx? Life expectancy Gx males: 4 years Gx females: 1 year Gx males: 1 year Gx females: 1 year Female Rottweilers with longest ovary exposure were 3.2x more likely to live >13 years than dogs with shortest ovary exposure Benchmarking surgical sterilization : Benchmarking surgical sterilization Wildt 1977: “There is no way to know how much severe the problem would be today, if spaying had not been widely practiced.” Spain 2006: “Any policy decision should consider the frequency and consequences of any condition.” Thank you for your attention! : Thank you for your attention! Surgical sterilization: Is it gold standard – certainly not. Is it good standard – absolutely yes! You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Reichler Benchmarking Surgical 10.00 ACCandD Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 127 Category: Science & Tech.. License: All Rights Reserved Like it (1) Dislike it (0) Added: May 17, 2010 This Presentation is Public Favorites: 0 Presentation Description Presented by Dr. Iris Reichler at the Alliance for Contraception in Cats & Dogs’ 4th International Symposium on Non-Surgical Contraceptive Methods of Pet Population Control, April 8-10, 2010, in Dallas, Texas, U.S. Comments Posting comment... By: devdut (12 month(s) ago) pls. give ppt i need Saving..... Post Reply Close Saving..... Edit Comment Close By: devdut (12 month(s) ago) very good information presented Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Benchmarking Surgical Sterilization : Benchmarking Surgical Sterilization Iris M. Reichler Small Animal Reproduction Vetsuisse Faculty University of Zurich, Switzerland Myths and truthsBenefits and risks of gonadectomy (Gx) : Myths and truthsBenefits and risks of gonadectomy (Gx) Benefits of Gx Population control Prevention of diseases Disease incidence, clinical relevance Risks of Gx Increased disease frequency Disease incidence, clinical relevance Study design (control group, age, breed, body score?) Mammary cancer Common disease, high clinical relevance : Mammary cancer Common disease, high clinical relevance Most common tumor Life-time risk up to 20% 50% malignant, always surgery 3rd most common tumor 17% of all feline tumors > 85% malignant, poor long-time survival rate Aggressive surgery and chemotherapy Major benefit of GxRisk of malignant cancer development : Major benefit of GxRisk of malignant cancer development Gx < 1st heat 0,5% relative risk Gx 1st to 2nd heat 8% relative risk Gx > 2nd heat 26% relative risk Gx > 2,5 years no benefit (risk for benign tumors) Gx < 6months 9% relative risk compared to intact Gx 1/2 to 1year 14% relative risk Gx 1 to 2years 89% relative risk Gx > 2 years no benefit Gonadal diseases Diseases mediated by sexual steroids : Gonadal diseases Diseases mediated by sexual steroids Female Metropathy Ovarian disease Vaginal hyperplasia Genital tract neoplasia Male Orchitis/Epididymitis Testicular neoplasia Prostate hyperplasia (BPH) Prostatitis Perianal tumors Major benefit of GxRisk of metropathy : Major benefit of GxRisk of metropathy Life threatening disease Mortality rates despite treatment up to 8% Incidence 25% of all dogs up to 10 years Likely in cats above 5 years Ovariohysterectomy recommended Major benefit of GX:No BPH, prostatitis, cancer of testis : Major benefit of GX:No BPH, prostatitis, cancer of testis Benign prostate hyperplasia (BPH) 50% of all dogs by 5 years of age Predisposition for prostatitis Treatment: Neutering (after stabilization) Tumors of the testicles 2nd most common tumor, metastasis < 15% Treatment: Neutering Major benefit of Gx:Avoidance of veneral diseases : Major benefit of Gx:Avoidance of veneral diseases Uncontrolled sexual behavior Stray dog population Free running dogs Transmissible veneral tumor Canine brucellosis Public health considerations Major benefit of Gx:No pregnancy or delivery related problems : Major benefit of Gx:No pregnancy or delivery related problems Dystocia: 5% up to 80% 0.4% up to 18% Mostly cesarean section needed Uterus torsion, uterus rupture Pregnancy toxemia Gestational diabetes mellitus Major risk of Gx:Urinary incontinence : Incidence: Intact bitches 0.2% - 2% Spayed dogs 3% - 21% Body weight Breed Time of spaying Success of medical treatment 95% Major risk of Gx:Urinary incontinence Major risk of Gx:Obesity : Major risk of Gx:Obesity Alteration in feeding behavior Food intake Activity Predisposing factor for Diabetes mellitus Lower urinary tract disease Perivulvar dermatitis Orthopedic problems Cancer Questionable risk of Gx:Diabetes mellitus- a sequelae of obesity ? : Risk factors Male gender: 1.6 x Obesity: 2.2 x (obese males 3.1 x ) Gx: no significant increased risk of either gender! Risk factors Spayed females No defined association with obesity Insulin treatment required in most cases Questionable risk of Gx:Diabetes mellitus- a sequelae of obesity ? Minor risk of Gx:Perivulvar dermatitis – influence of obesity! : Minor risk of Gx:Perivulvar dermatitis – influence of obesity! Small infantile vulva in gx animals Perivulvar dermatitis Predisposing factors Obesity Spayed as puppy Treatment Restriction diet, antibiotics, local cleansing Plastic surgery Questionable risk of Gx:LUTD – influence of obesity! : Effect of Gx on the urinary tract Numerous studies No effect in all but one study Lekcharoensuk 2001: 22 908 out of 263 168 cats had LUTD (8%) Influence of GX: Neutered: 2.8 x Spayed: 1.4 x Influence of weight: 1.4 x Questionable risk of Gx:LUTD – influence of obesity! Minor risk of Gx:Vaginitis, urinary tract infections : Minor risk of Gx:Vaginitis, urinary tract infections Incidence Increased in Gx Especially in very early Gx Treatment of vaginitis Estrogen supplementation Antibiotics Treatment of UTI Antibiotics Questionable risk of Gx:Physeal fractures – influence of obesity! : Spontaneous femoral capital physeal fractures (McNicholas 2002) Risk factors Sex and Gx (96% neutered cats) Delayed physeal closure (early Gx) High body weight No association between age at GX and incidence of fractures (Spain 2004) Questionable risk of Gx:Physeal fractures – influence of obesity! Risk of Gx:Canine hip dysplasia (CHD) : 1 733 Boxers from 325 litters, 8-year period (Van Hagen 2005) Risk factor Gx (> 6 months prior to CHD) Obesity was not considered Gx increases the risk for CHD 1.5 x 1 842 dogs, population study (Spain 2004) CHD with Gx before 6 months of age (6.7% versus 4.7%) Treatment for CHD: NSAIDs, pain medicaments, surgery Risk of Gx:Canine hip dysplasia (CHD) Risk of Gx:Cranial cruciate ligament rupture : Progressive degenerative ligament failure Most common orthopedic injury Risk factors Body weight and Gx Breed predispositions Surgical stabilization Risk of Gx:Cranial cruciate ligament rupture 2.4x 1.7x Risk of Gx:Osteosarcoma : Risk of Gx:Osteosarcoma Highly malignant bone tumor Survival time after surgery 20 weeks Large or giant breeds Risk factor: body size but not body weight Gx: inverse relationship between gonadal hormone exposure and risk for osteosarcoma Males gx < 1 year 4x than in intact males Females gx < 1 year 3x than in bitches Risk of Gx:Different types of cancer : In humans: Obesity increases the risk of cancer Low grade chronic inflammation and insulin resistance Leptin Interleukin-6 Tumor necrosis factor Most veterinary studies did not investigate body score Many veterinary studies did not investigate age of controls Risk of Gx:Different types of cancer Risk of Gx:Prostate cancer : Risk factors In men: Family, obesity… In dogs: Breed, Gx Teske 2002 Male referrals n=15363, Gx 20.4% PCA n=56, Gx 46% Age similar Gx favors PCA progression Risk of Gx:Prostate cancer Risk of Gx:Other tumors : Heart tumors (0,19%) Breed predisposition, Gx Spayed dogs 4x , neutered dogs 1.6x Protective effect of estrogen? Splenic hemangiosarcoma : Gx (age?) Transitional cell carcinoma: Gx 4, obesity Anal sac gland carcinoma Breed predisposition, Gx Risk of Gx:Other tumors Effects of Gx:Behavior : Gx of males Intraspecies aggression Sexual behavior, spraying Gx of males Roaming Bite injuries Gx of females Aggressive behavior Effects of Gx:Behavior Terre sauvage 1993 Risk of Gx:Cognitive impairment : Risk of Gx:Cognitive impairment In women: Cognitive impairment related to duration of estrogen deficiency In dogs: Signs of cognitive impairment Disorientation in the home and yard Altered social interactions Loss of house training Disturbed sleep-wake cycle Intact dogs less likely progress from mild to severe impairment Risk or benfit of Gx? Life expectancy : Risk or benfit of Gx? Life expectancy Gx males: 4 years Gx females: 1 year Gx males: 1 year Gx females: 1 year Female Rottweilers with longest ovary exposure were 3.2x more likely to live >13 years than dogs with shortest ovary exposure Benchmarking surgical sterilization : Benchmarking surgical sterilization Wildt 1977: “There is no way to know how much severe the problem would be today, if spaying had not been widely practiced.” Spain 2006: “Any policy decision should consider the frequency and consequences of any condition.” Thank you for your attention! : Thank you for your attention! Surgical sterilization: Is it gold standard – certainly not. Is it good standard – absolutely yes!