Thoughts on mandatory spay/neuter programs

Regarding the AVMA's recently revised policy on mandatory spay/neuter regulations and laws,¹ we at the Humane Society Veterinary Medical Association would point out that the term mandatory is a misnomer that has been inaccurately applied to programs that incentivize pet sterilization. Such programs typically mandate only preferential licensing fee structures—ones that favor spayed and neutered pets with lower fees. However, such programs do leave room for responsible pet owners to choose not to sterilize their animals, simply by paying a fee.

The Humane Society Veterinary Medical Association agrees with the AVMA that dog and cat population control is a primary welfare concern of our society² and concurs that the application of scientific and veterinary medical judgment is essential to determining the timing of sterilization and to making decisions about sterilization in particular cases. A large body of research substantiates the many benefits of spaying and neutering that accrue to individual pets and to the companion animal population as a whole. There is more than enough evidence to conclude that pet sterilization provides benefits for individual animals, as well as a meaningful solution to the overpopulation of unwanted dogs and cats.

Every year, 3 million healthy and treatable dogs and cats are euthanized in animal shelters nationwide. Incentivized spay/neuter programs acknowledge, through rational public policies, the great financial burden placed on public institutions and private organizations by the pet overpopulation crisis. Our communities shoulder the financial burden for animal care and control associated with dog and cat overpopulation, so it is only reasonable that people with sexually intact pets should pay more toward those municipal costs than people who choose to spay or neuter their pets.

Myths surrounding mandatory spay/neuter programs have long obscured a critical animal health and welfare issue. This imprecise language has fostered misunderstandings about how such programs are structured. This inaccuracy should be clarified and corrected once and for all—within our own veterinary profession and within the broader public arena. The term incentivized spay/neuter more accurately depicts the mechanism by which such programs attempt to influence human behavior and effect positive change. An incentivized spay/neuter approach is truly a win-win situation for pets, pet owners, veterinarians, and society at large.

Barbara Hodges, DVM, MBA

Veterinary Consultant, Humane Society Veterinary Medical Association, Davis, Calif

I am writing in response to a JAVMA blurb so small that I almost missed it, yet so shocking that I have decided to write for the first time. As a veterinarian, I truly cannot imagine why an organization of, by, and for veterinarians has chosen to oppose mandatory spay/neuter legislation as a matter of policy.¹ Veterinarians are the first line of defense for the welfare of animals in general, and I know of no other single action on the part of veterinarians that benefits the welfare of all companion animals more than widespread sterilization. The decreased risk of life-threatening diseases and objectionable behaviors almost always outweighs the risk of surgical complications.

I understand the AVMA's hesitation to condone legislation regarding procedures that fall within the realm of veterinary services. Decisions about veterinary services should rightfully be made within the owner-veterinarian partnership. Many veterinarians already suggest sterilization for most pets. However, a lack of education, funds, or pathos among owners can frequently interfere with optimal care recommendations. In the population realm, the ultimate burden for lack of sterilization falls on taxpayers, including tax-paying veterinarians. Municipalities have tried many solutions to curb pet overpopulation, but the most successful has been spay/neuter legislation, especially when accompanied by low-cost programs that target at-risk owners and adequate staffing for enforcement.

Fears of pushing violators underground or away from veterinary care have never been confirmed. Veterinarians frequently see unlicensed animals, sexually intact animals from unlicensed breeders, animals from pet shops violating laws of various sorts (such as animals not old enough to be weaned), animal victims of abuse and neglect, and even animals involved in fighting operations. Rabies vaccination clinics are commonly held in conjunction with licensing clinics, and owners who choose to bypass the licensing staff still choose to vaccinate.

Spay/neuter legislation must be carefully crafted. It must allow sensible exceptions, such as for show, working, and high-risk animals and licensed breeding facilities, and should perhaps even contain a “conscientious objector” category. The legislation must allow veterinarians to determine whether individual pets would benefit from a delay in sterilization. It must provide assistance for owners who cannot, for any variety of reasons, have their pets sterilized. We all want to usher in a day when we would not need such legislation because all litters are planned and wanted, but the reality is that such a day is not getting any closer on its own.

The AVMA ought to be on the leading edge of calls for better government policies to address conditions of detriment to the animal community. If a certain disease claimed several million animal lives in the United States every year, we would be striving for a cure. Mandatory spay/neuter laws are the cure for the disease of unwanted litters. By ensuring that animals are harder to acquire and more valued, we help ensure better treatment for them, better health for them and their owners, and better compliance with all veterinary care recommendations. Thus, the AVMA ought to be helping write good legislation, not opposing all such legislation.

Katy Byrd, DVM

Dos Palos, Calif

Dr. Golab responds:

We appreciate Drs. Hodges and Byrd's interest in the AVMA's revised policy on Dog and Cat Population Control¹ and thank the editor for the opportunity to clarify why the AVMA developed its current perspective on mandatory spay/neuter (MSN). Multiple states and municipalities have considered, or are currently considering, MSN proposals, and state and local veterinary medical associations have requested input from the AVMA. We agree with Dr. Hodges that there is a difference between programs that mandate spay/neuter of animals by a certain age and those that invoke differential licensing fees. It is not uncommon, however, for such approaches to be comingled in legislative and regulatory proposals. For this reason, and as indicated by Dr. Byrd, it is critical that these proposals be carefully evaluated to ensure the consequences of their implementation are completely understood.

In addressing MSN, the AVMA Animal Welfare Committee (AWC) chose to recommend incorporation of verbiage into the existing policy on Dog and Cat Population Control, rather than establish a separate policy on MSN, because research suggests multiple causes for high intake and euthanasia rates in shelters.² A variety of animal health and behavioral issues contribute, as do owner lifestyle, cultural attitudes, economics, and, of course, unowned animals (eg, strays and feral cats). The result is that the success of spay/neuter programs is intimately tied to other animal control programs (eg, identification and licensing, behavioral modification, trap-neuter-return, and trap-andremove) designed to reduce failures in reuniting animals and owners, provide alternatives to relinquishment, and address unowned animal populations. The members of the AWC recognized that single-pronged approaches, such as MSN, do not provide effective solutions to multifactorial problems.

As evidence of the latter, there are conflicting reports regarding euthanasia rates and animal control costs achieved in communities that have enacted MSN, and in some communities, animal control costs and euthanasia rates have actually increased. To our knowledge, the only approach to population control with documented long-term efficacy is voluntary sterilization of owned pets.^a

In addition, although spay/neuter is an important part of effective population control programs and may benefit individual dogs and cats if performed at the appropriate time, whether and when to spay/neuter dogs and cats requires the application of science and professional judgment to ensure the best outcome for veterinary patients and their owners. The AWC agrees with Drs. Hodges and Byrd that there are documented³ benefits to spaying/neutering dogs and cats, including prevention of unexpected litters, reduced incidences of some cancers and reproductive diseases, and prevention and amelioration of certain undesirable behaviors. However, potential health problems associated with spaying and neutering include an increased risk of prostatic cancer in males, increased risks of bone cancer and hip dysplasia in large-breed dogs neutered before maturity, and increased incidences of obesity, diabetes mellitus, urinary tract infections, urinary incontinence, and hypothyroidism.³ Although the assessed risks of many of these latter concerns are low, both benefits and risks need to be considered by veterinarians when making recommendations on whether and when to spay/neuter. Unfortunately, most MSN proposals require veterinarians to invoke exemption clauses to implement their professional judgment. In the opinion of the AVMA, veterinarians should not have to “opt out” to provide appropriate patient care.

Gail C. Golab, PhD, DVM

Director, Animal Welfare Division, AVMA, Schaumburg, Ill

Optimism for the future of large animal practice

Dr. Cobb's dismal assessment of the future of large animal practice¹ compels me to write. I have been practicing since 1985, with the last 17 years in exclusively large animal practice. Product sales have never figured in my business model (the margins are too slim). Where I practice, most of my clients have fewer than 30 cows. I concentrate on diagnostics and prevention to build my client base. Somehow, I manage to enjoy a rewarding and comfortable living.

I regularly have young people who ask to ride with me on my calls. I always tell them they are welcome. They see that this is not a job for everyone; the physical challenges can be too much for some. I personally cannot see myself in a clinic with the pervasive smell of wet dog in the air. Yes, I am often bespattered and sometimes bruised, but I would never tell a young person not to pursue this career. I enjoy it too much.

Elizabeth D. Mitchell, DVM

Brush Creek, Tenn