This post is in response to Dr. Craig Woloshyn’s article “Cheap spays, neuters won't fix the animal overpopulation,” published in the November 15, 2010 issue of Veterinary Economics. Dr. Woloshyn makes a number of assertions about the effectiveness, financial viability, and quality of spay and neuter programs that require rebuttal:
1. We've had very little effect on the dog and cat population in this county, nor will we with this approach. Dog and cat populations are affected by factors we haven't learned to control.
The simplest factor controlling a population is its fecundity. This is something that we, as veterinary surgeons, have learned to control on an individual basis by spaying and neutering. While we may not yet have mastered the intricacies of human behavior and animal survival rates based on neutering prevalence in a community that in turn affect the population size, we do understand the basis for population growth in companion animals.
And in fact, the past several decades have witnessed a decline in shelter euthanasias nationally, from an estimated 13.5 million cats and dogs in 1973, to 4-5 million in 1991, (Scarlett 2004) to 3-4 million currently (HSUS 2010).
2. This isn't the place for an exposition on procreation, but you won't find a single well-documented study that shows significant decrease in animal populations anywhere in this country. Those few studies that exist show essentially flat shelter fill and euthanasia rates.
Some studies have already shown effects from spay and neuter programs on shelter intake and euthanasia. White (2010) studied the impact of the Animal Population Control Program in New Hampshire and demonstrated a significant decrease in cat intake and euthanasia in shelters during the years after program onset. Austin-based EmanciPET Free Spay/Neuter Program produced a significantly lower rate of increase for dog and cat intake and euthanasia in the municipal shelter for animals from the program areas. Shelter intake and euthanasias in Asheville, N.C have decreased by 75% since Humane Alliance established their low-cost high-volume spay neuter program.
Indeed, more studies are needed to prove the effects of high volume spay and neuter programs on animal populations. Several such studies are in the process of being completed and await publication. In addition, spay and neuter programs and animal shelters have come to understand the necessity of accurate and thorough data collection. Geographic Information Systems (GIS) are being studied for use as tools to track risk for animals coming into shelters and to focus spay and neuter resources on highest risk neighborhoods (Patronek, 2010; Weiss, 2010). Studies such as these will help us better understand the effectiveness of spay and neuter programs and how we can use our resources most effectively.
It would be a mistake to view inconclusive evidence as proof of failure. Evidence-based medicine is, by its nature, based on evaluation of the results of experimentation. If we, as scientists, are not allowed room to form hypotheses and test them, then we can have no evidence-based medicine.
3. If what we said would work were working, we'd see it by now.
In Joshua Frank’s 2004 mathematical model of neutering for animal population control, neutering programs were found to be effective at reducing shelter euthanasia. However, the model also predicted that the full impact of a one-time permanent increase in the neutering rate may not be felt for as much as 40 years (Frank, 2004). In addition, many of the spay and neuter clinics now in existence have been opened within the past five years (Humane Alliance, 2010). Thus, we are only now beginning to see the effects of a movement that began several decades ago.
4. Approximately 40 percent of pets in this country are sexually intact. Apparently we can't sway this population of owners with cost.
Cost is the reason most often cited by owners for not having their cats neutered (Patronek, 1997 and New, 2004). With unowned, feral cats, the percent of caretakers attempting to have feral cats neutered (Levy 2003) or taking feral cats to a veterinarian for any reason (Lord 2008) is small, ranging from 11% to 22%. Cost is likely to be even more of a factor with these cats than with owned cats. Thus, providing reduced cost or free spay and neuter services addresses one of the most common reasons for failure to spay and neuter cats.
Low-cost or free subsidized spay and neuter surgery is the only way to reach certain segments of our country’s companion animal population. In the United States, 14.3% of people live below the poverty line (Bishaw, 2010). People with low incomes are nearly as likely to own pets as are people with high incomes (AVMA, 2007), indicating that large numbers of animals live in households that simply cannot afford full-service veterinary care.
5. Feral cats are so fecund that even if we leave one pair unneutered, we'll soon see the population restocked naturally.
One population model of feral cat populations show that population control can be achieved by ongoing spaying of at least 75% of the fertile female population. (Anderson 2004). While this approach does take ongoing effort and monitoring, the number of surgeries required to maintain a greater than 75% spay and neuter rate is low after the initial, first-year trapping and neutering. Indeed, removal-and-euthanasia strategies, sometimes touted as an alternative to Trap Neuter Return (TNR) programs, also require ongoing monitoring and euthanasia, making them no less effort than TNR. In addition, euthanasia of ferals is often unsupported by the general public and by colony caretakers, and may be morally untenable for the humane agents or veterinarians who would be asked to perform the procedure.
Several studies have demonstrated the success of ongoing TNR programs for free-roaming and feral animal management. A TNR program in Jaipur, India sterilized and rabies vaccinated 24,986 dogs between 1994 and 2002. Direct observational surveys of the local dog population indicated that 65 per cent of the females were sterilized and vaccinated, and that the population declined by 28 per cent (Reece, 2006). A study of a cat colony on a university campus in Florida saw a 66% decrease in the resident cat population after the onset of a TNR program, and concluded that a comprehensive long-term program of neutering followed by adoption or return to the resident colony can result in a sustained reduction of free-roaming cat populations in urban areas (Levy, 2003).
6. We've cheapened the entire profession with bargain-basement spays. We've taught the public that we don't consider ourselves worth much.
Human medicine offers many examples of professionals providing care at low or no cost to individuals who cannot or will not otherwise seek care. Rather than cheapening the medical profession, these services demonstrate compassion while enhancing human welfare and public health. Similarly, veterinary medical services provided to enhance animal welfare and public health by providing services to those who could not, or would not, otherwise afford them demonstrate compassion and enhance the value of the veterinary profession.
7. We've set the standards of care at the level of herd medicine, not something most small animal practitioners want.
Indeed, many small animal practitioners are not accustomed to or comfortable with approaching animal health on a population basis. However, veterinary epidemiology and population medicine is a central part of the veterinary curriculum in our veterinary schools. While private practitioners may not, in day to day practice, think about veterinary epidemiology and animal populations, much of the medicine that veterinarians practice today is based on epidemiological evidence. Evidence-based clinical veterinary medicine relies heavily on the results of epidemiological analyses (Thrusfield, 2007), and veterinarians in clinical practice must use probability-based information to make decisions about individual patients in day-to-day practice. (Pfeiffer, 2010).
Standards of care in high volume surgical settings need not compromise animal health and welfare. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs, published in JAVMA on July 1, 2008 (Looney et al 2008), provides practical standards for high-quality, humane, and efficient care of veterinary patients in high-volume spay and neuter programs.
8. And we've exercised our seemingly unbounded ability to take blame for situations that are not of our making.
Taking action does not equate to taking blame. Veterinarians are in a unique position to take action, not because we are at fault, but because we have the skills that can actually change the population dynamics of our cat and dog populations.
9. We've also wasted a lot of time and money sending people to school for four years to perform a simple procedure that takes three months to master.
While a spay or neuter surgery is, in itself, a simple procedure, it is of course false to assume that “cutting and sewing” is all that is involved in spay and neuter practice. Spay and neuter surgeons must know current anesthesia and analgesia protocols that maximize patient comfort and welfare, while being attentive to cost. They must be familiar with patient monitoring techniques and emergency procedures. They must be able to perform efficient physical examinations in order to aid in patient selection and in the modification of treatment protocols. They must know common and uncommon reproductive anatomical anomalies and understand how to address them surgically. They must learn to practice efficient surgical techniques that minimize tissue trauma.
10. Many practices are now feeling the effects of these misguided efforts. Clients who don't understand why real surgery costs 10 to 20 times the price of a spay bristle at the idea of paying us a living wage. Young doctors whine about their student debt yet gladly debase the very profession that should be supporting them.
Efficient, high quality spay and neuter programs need not underpay their veterinary staff. Spay and neuter clinics can and should offer competitive salaries and benefits (Weedon, 2007).
Furthermore, the advent of spay and neuter programs need not imply a decrease in procedures performed by private practitioners. In an analysis of five communities with targeted spay and neuter programs, Frank (2007) demonstrates that low-cost neutering programs are effective at increasing the total number of neuters in the program community, including in private practices, rather than simply causing a substitution of sources for neutering services as some practitioners might fear.
In conclusion, I, as a member of the Association of Shelter Veterinarians Veterinary Task Force to Advance Spay Neuter, feel that High-Quality, High-Volume Spay and Neuter programs have a vital place in our profession and are an essential component to decreasing cat and dog overpopulation and shelter euthanasia. While more data needs to be collected, preliminary research does show a reduction in shelter intake and euthanasias associated with high-volume spay neuter programs. And, finally, compassionate activities directed towards animal welfare and public health enhances the value of the veterinary profession as opposed to cheapening the profession.
Editor's note: Click here to join the cheap-spay discussion online right now on the dvm360 Community message board.
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