Neutered Nicholai

Sitting in front of my computer, my eyes were starting to glaze over. Reading everything I could find on the effects of neutering dogs, pros and cons, benefits and risks, I was rapidly tiring of the lack of unbiased information on either side. Like so many issues, what we already think colors the "facts" we so often blithely tout as truths. As if to hammer this point home, a salesman knocked on the door (Do we need new vinyl windows?). Nicholai – a neutered male dog – charged the door in his typical "protect the homestead" mode. Lunging and barking, hackles up, he looked formidable. The salesman stepped off the porch. I laughed out loud.

Neutering male dogs supposedly cures them of roaming (90% success rate). Seems true, Nicholai doesn't roam. Aggression toward other dogs should be reduced (60% success); Nicholai will posture and face-off with other male dogs, the vast majority of whom are also neutered, but never fight – maybe that is due to lack of testosterone. One of the reasons we had him neutered, in addition to preventing unwanted pets, was to quell any tendency toward aggression, dominance, or fighting. But Nicholai sure is a guarder, protector, and a "don't step one more foot on my property, mister" kind of guy.

Preventing unwanted pregnancies is a good reason to spay and neuter, though I do have to wonder if as a society, we put puppy mills and irresponsible breeders out of business we might solve the pet overpopulation problem .

Here's the deal. Everything I read is conclusive that early spaying and neutering (before sexual maturity) increases the incidence of torn cruciate ligaments in the knees of dogs. Hip dysplasia – especially in large dogs – is dramatically increased. These are not inconsequential problems. Nicholai's knee surgeries cost over $6,000.00. In addition, there is evidence that cancer risk is increased by the metal implants used in many orthopedic surgeries. I shudder when I stop and think of the dramatic health problems that may have been iatrogenically introduced in Nicholai. We've had the resources to care for the issues; dogs whose owners can't afford these procedures either suffer or are euthanized. This is not cool.

I worry too that people will see neutering as a panacea for behavior problems, when it is not. A bored dog, a neglected dog, a fearful dog, an untrained dog, a dog whose people hoped to get it fixed and then resume their busy lives, these dogs' problems will not be resolved by a simple snip-snip. The people may be sorely disappointed when the dog still misbehaves.

Until quite recently, I was as big a proponent as anyone of spaying and neutering dogs before they reached maturity. If I saw an unneutered male dog on the street, I vocally questioned the manhood of his human counterpart. Now, quite honestly, I have to wonder if the reluctant human males may have been onto something more than their testosterone-driven egos all along. Is it so wrong to allow a dog to grow as nature and his or her physiology intended? Couldn't we alter them a touch later and allow them to grow up as healthy as they can be?

Early Spay and Neuter – Is It a Good Thing?

I'm in the midst of a palm-smacking-the-forehead moment of enlightenment. After two decades of blithely altering my companion animals with the theory that it's "good for them," I am questioning this practice, and with good reason.

Over the past few decades, the call to spay and neuter dogs and cats has become an imperative. Sanctioned by licensing agencies, approved by veterinarians, sanctified by humane organizations, and honored by trainers and behaviorists as the way to achieve a happy, well-adjusted pet, any owner choosing to keep a pet intact can be met with fines, lectures, blame, even outrage. Humans have decided nature made a great mistake creating animals with the ability to procreate, and we – in our infinite wisdom – have "fixed" it.

The paradigm of early spay and neuter is deep and wide. Imagine not altering your next dog and think of it as a good thing, and you'll see what I mean. You'll risk downright vilification from some quarters (until very recently me included) but let's look at the scientific evidence. (This is sounding eerily familiar to me, like the war on cancer, see Paradigm).

Dogs who are spayed and neutered before reaching maturity have a doubled risk of osteosarcoma, a common bone cancer with a poor prognosis. They have a two-and-a-half to five times higher risk of hemangiosarcoma, another common deadly malignancy. Altered dogs have increased rates of hypothyroidism, obesity, diabetes, urinary incontinence, and chronic urinary tract infections. In return, they are protected from the relatively small incidence of reproductive tumors, since these organs are removed.

Altering dogs during their growth phase, up to twenty-four months for some breeds, can have a profound effect on bones and joints. Bones normally close their growth plates at different times, allowing each bone to grow just the amount of time it needs for a perfectly proportioned animal. Spaying and neutering sends a hormonal message saying "this dog is still a pup – keep growing." At the time that message comes, the bones with closed growth plates can't grow any more, but the others now delay closing and continue to grow out of proportion, resulting in untenable stresses on cartilage and tendons. Lower leg bones (tibia) often outgrow upper leg bones (femurs) causing a too steep angle at the knee and resulting in an eventual tear of the cruciate ligament. The hip bone and the thigh bone often become disproportionate. Studies show that altered dogs are twice as likely to experience ruptured cruciate ligaments, and seven times more likely to develop age adjusted hip dysplasia. Both of these conditions cause pain and disability for the animals and cost thousands of dollars for their people to treat.

Nicholai was neutered when he was six months old. As he continued to grow, we noticed his back legs becoming lanky and his back end shot up higher than the front. By middle age, Nicholai had torn the cruciate ligaments in both knees, and evaluation showed that the angles of his knee joints were incorrect. Nicholai underwent surgery on both of his knees to rectify the instability caused by the torn ligaments.

When we adopted Izzy, we of course had her spayed right away. Indoctrinated in the compassionate thinking of humane organizations toward reduction of unwanted pets, we never gave a thought to the health repercussions of spaying and neutering a dog before it went through puberty and became an adult naturally. Meanwhile, I saw more and more dogs in my work with knee problems and soon, Izzy too came up with a torn ligament in her knee.

When Kelley was abandoned in a park, and I picked her up, she hadn't been spayed. Today, she has come into her first season, my first dog to be allowed this gift and blessing of nature. We're being careful about keeping her on leash, keeping her home from doggie daycare, cleaning up drops of blood that escape her flowered panty. I am hopeful that she will grow the way nature intended her to, strong and beautiful, powerful and fully female. When she is an adult, not a mere teen, when her skeleton has reached maturity, and her body has gone through the cycles nature meant it to have, we'll get her spayed.

It has become clear to me while studying human nutrition over the past two decades, that every time we humans decide to improve on nature (isolating one vitamin – oops it needs cofactors; eliminating saturated fats – oops, polyunsaturated fats increase cancer) we find that nature had it right all along. Perhaps this is one more instance where humans playing god just doesn't work out.

More on this later, meanwhile, I invite your comments and input.

 

 

Early Morning Outing

Another beautiful walk at the river, long shadows in the morning sun, shoots of green grass working through dry wheaten stalks and old brown leaves, and a late raccoon waddling across the field in search of a sip of water before bedding down for the day. Waterfowl are populating the wetland areas, choosing mates and nesting areas. Last spring and early summer, we watched ducklings and goslings as they grew from little fluff-balls to full-fledged flying creatures.

The sun cut across the trails and fields from its perch low in the sky and I had the sense that we were startling the area's residents by our extra early presence. The scent of deer hung heavily enough in the air for me to pick it up once or twice. Nicholai's nose was high as he probed the breeze for information, deigning once or twice to dash into the tall brush, in search of the elusive ruminants.

Though Nicholai's ribs are showing a bit these days and he's lost a tad of musculature – part age and part cancer – his coat shimmered in the morning sun and he danced with glee about the deer he chased, the one that got away. With a sudden burst of speed, he and Izzy gave momentary chase to the tardy raccoon. It jumped into the pond and hissed furiously at the two of them. They pulled up short, considered the masked mammal, and loped back to me – a good choice as a raccoon can make a worthy opponent for a dog. The morning's peace was maintained.

As we hiked away from the rivers and wetlands and toward our easy-going Sunday in the city, we met Labrador retrievers, Australian shepherds, Basset hounds, an Akita mix, a husky, and a Bernese mountain dog, all out with their humans for a Sunday morning stroll.

A-h-h-h, what a start to a day.

Spent a beautiful hour half snoozing on the deck, with my arm curled around a big old dog. What a simple delight – both the warm afternoon and the blessing of a still living buddy.

Common Weeds

Rene Caisse was a Canadian nurse. In 1922, while caring for an elderly patient, she noticed a mass of scar tissue on one of the patient's breasts. The old woman told her that doctors had diagnosed her with breast cancer years ago, but without money for surgery, she had gone home to die. There, she came in contact with an old Ojibwa medicine man who told her he could cure her condition with a tea. He showed the woman which herbs and plants to use. Consequently, thirty years later, she was alive to pass this story on to Nurse Caisse.

A short time later, Rene Caisse was walking with a retired doctor. He pointed out a common plant and said, "Nurse Caisse, if more people would use this weed, there would be little cancer in the world." The weed was sheep sorrel; one of the plants the old woman told her was in the medicine man's tea.

Over the next fifty years, Rene Caisse used this tea with a number of cancer patients who went on to live double digit numbers of years. She experimented on lab mice and human cancer patients and eventually developed her own herbal formula which has survived to today and is known as Essiac (her surname spelled backwards).

Over the years, patients and families petitioned the Ontario government to allow Nurse Caisse to officially treat cancer patients, and while this was denied, she was allowed to treat patients under the supervision and observation of a group of doctors. Impressed by what they saw, they petitioned the government for broader studies of the treatment. However, with heavy pharmaceutical influence, Nurse Caisse was continually threatened with arrest once the petition had been delivered to the government, and she finally withdrew from public view. As a result, Essiac tea has been marginalized, minimalized, and never thoroughly explored.

Nicholai takes a tincture of herbs which includes those used in Nurse Caisse's tea. I used them as well. Like Nurse Caisse's reported patients, we are still here to tell about it. Doesn't that at least deserve a little research?

Only Right Now

When it has been a long day, when events have conspired to drain me of energy or hope, when words fail to communicate emotions and desires, there is nothing like a good cuddle with a soft domestic brother to the wolf.

Nicholai is a dog who enjoys his personal space. He eschews hugs and tires quickly of too much handling. During the day, he loves to accompany me on our walks and hikes of course, and he loves to ride shotgun while I drive on errands. Lounging at home, he prefers his private spots – a bolster bed tucked into an out-of-the-way corner of the living room, or his mattress behind the washer in the basement. But late in the evening, after I've tucked our youngest into bed and am changing into my own pj's, Nicholai pads up the stairs and lumbers into the bedroom. He climbs onto the bed via a set of carpeted steps and plops down at the foot of the bed, rolling to his side, lifting his leg, offering his belly for a rub. If I don't respond immediately, he'll whine or grumble.

Tonight I pulled a pillow next to him and lay with my arm around his back, gently stroking his belly and chest. Dodging the inevitable speed bump on his male tummy, my hand came to the huge lymph tumors on his lower belly. I stopped for a moment, let my mind wander to worry, and then buried my nose in his soft black fur. He smelled sweet, and slightly musky. When I didn't continue to gently stroke him, he whined, pushed at my hand with his foot.

I chuckled. He brings my focus to the moment. Forget what if's, maybe's, second guessing. There is only right now – sweet, musky, soft black body, ribcage expanding and contracting with each breath, heart gently beating. Commanding me to stay focused on the present.

Still Here

March 1^st. I take another deep breath; knock on wood, pinch myself. He's still here. Daily, I watch for signs of deterioration, but other than a constant waxing and waning of lymph node size my pack-brother is enthusiastic to a fault about our walks, about his meals (and of course, bites of our meals), and about momentary snuggles.

Occasionally, I find myself second guessing the choices I've made about Nicholai's care. He's so strong entering his fourteenth month since diagnosis, I wonder if he could have weathered chemotherapy and if it might have bought him additional time. Then I think, wait a minute, I'm debating if he might have weathered the treatment, and I know it's possible he might not even have survived it. But, still … what if haunts me.

I've received emails from people wishing they hadn't elected to pursue courses of chemotherapy; in hindsight seeing that their canine companion didn't gain quality time. I've also heard from people heartbroken because they couldn't afford the treatment regimen and feel they let their beloved dog down. I remind myself that hindsight is always 20/20, it's making the best choice we can today, with the information and resources we have that's important.

No one should feel guilty about thoughtful choices they make to care for a cancer diagnosis in their canine companions. Treatment consisting of chemotherapy, radiation, and surgery is cost prohibitive for some families, and though sometimes it does, it's far from certain to succeed. In a situation where every choice has very real costs associated with it, no choice can be deemed better than another. Each conscientious owner is doing the best he or she can with the information and resources available at the time.

What concerns me is there seems a dearth of exploration of the road between "doing nothing," which many people feel is their only choice, or pursuing aggressive, potentially harmful, always expensive, frequently unsuccessful pharmaceutical approaches. I wish that alternative methods of treatment could get more serious scientific review. I wish that inexpensive, non-toxic approaches like vitamins and herbs could get their day of honest, detailed scrutiny.

When I was diagnosed with colorectal cancer, the doctors told me that I would need chemotherapy to survive, but the research showed me that the main drug they proposed to use – fluorouracil – had been proven to be ineffective two decades earlier; that was the reason the Mayo clinic doctors felt they could ethically experiment on colorectal cancer patients with vitamin C – their treatment was doomed to fail. The profound disconnect between the standard of care recommended, even pushed, at me and the scientific knowledge base shook me to the core. The experience was pivotal for me, and I can no longer take a prognosis from a medical authority on its face.

Nicholai's success so far points me to the fact that there are more options out there than we know. Too few of us – human or animal – feel that we can opt out of the standard of care, lest we lose the "battle" with cancer, but so often we lose anyway. For all our sakes, we must explore other paths and see where they will lead us.