Want to pick the best option for my dog out of a bunch of bad options.
July 5, 2010 4:37 PM   Subscribe

Are there alternatives to neutering for my 14 year old dog? What would you do in this situation? Have asked the vet, need more information.

This week, the vet has diagnosed my 14 year old dog with a testicular tumor; we don't know if it's cancerous or not.

The vet told me that we MUST neuter. The vet is extremely gung ho about neutering and thinks he should have been neutered a long time ago. (This is a new vet; I just moved recently.) I think it is a really bad idea for a 14 year old dog to have major surgery if there are other good alternatives, or if the risks of the surgery outweigh the risks of the alternatives.

So I have questions. My vet basically refused to give me a straight answer to any of my questions because she wants me to just agree to the neutering. So, I am wondering if anyone here has ever dealt with this issue before and might have thoughts on my questions. (I could go to another vet for another opinion, but I worry that I would just be spending another $200 for the next vet to say/do exactly the same thing. I do not want to waste money like that since I might have a gigantic bill coming up for this treatment and I want to have enough money for it. If you think I should only ask vets questions like these, I respect your right to think that, but please don't derail this thread into a debate about it.)

- If we do a biopsy and the tumor is not cancerous, could it become cancerous in the future if we just leave it and don't take it out?

- I was able to find information on the rates of complication/death as a result of neuter surgery for dogs in general, but not specifically for extremely senior dogs. Have you seen this information anywhere online?

- Aside from the risks of the surgery itself, will there be health consequences for my dog to be neutered? We hear a lot about the health benefit of neutering so I'm familiar with what they are, but never anything about the drawbacks. I think that there must be drawbacks, just like there would be for a human man if he were castrated. I was able to find information on the drawbacks of neutering a dog before sexual maturity, but are there any that would affect my dog, at his age?

- Would it be worse for my dog, if his tumor is cancerous, to only take out the affected testicle? Would the surgery be just as risky as taking both, would the health drawbacks be the same to him as taking both? I am also worried about the other one developing a problem later, because I do not want to put him through two surgeries.
posted by Ashley801 to Pets & Animals (23 answers total)
This seems like a pretty good page about spay/neuter. Notice they list specifically that SPAYING, which is the surgery for female dogs, as a major surgery. Neutering is not really a major surgery event for dogs or cats. Country vets will - and I know, everyone, you're going to freak out, but country vets will more or less neuter a male cat or dog on-site for practically free, and as long as the dog/cat is cooperative and easily caught, the whole thing takes about ten minutes.

Your dog has cancer. I don't necessarily understand why you feel it is important for him to remain intact, but dude: Cancer. The best thing to do is get rid of it. Neuter your dog. He probably will never know the difference.
posted by Medieval Maven at 4:53 PM on July 5, 2010

Response by poster: Your dog has cancer. I don't necessarily understand why you feel it is important for him to remain intact, but dude: Cancer.

I don't want to overly interfere with this thread, but I just want to note- we actually do not know yet if the tumor is cancerous or not. We haven't done the biopsy yet. If it's not cancerous, I'm much much more worried about neutering him than if it is.
posted by Ashley801 at 4:56 PM on July 5, 2010

I had a dog that HAD a cancerous tumor in his balls. His last days were fuckin' brutal.

Cut the dog's balls off. Will save him a ton of pain. Sounds like he had a good run, anyways.

If you need a different slant - what if you had a tumor in your breast, would you just, "Wait and see? Or, would you get it treated?

Same with the dog.
posted by alex_skazat at 4:58 PM on July 5, 2010 [1 favorite]

What are the bad points to neutering? I know you worried about complications to the surgery (read that too), but that is really minor compared to what the pup is facing.

IANAV, but this is a fairly simple 'operation', barely deserving of the name (much less intrusive than spaying say), and almost all dogs go through this with problems being rare. Any other options is going to take more from you, financially and in time and in emotion than doing this thing. Perhaps (and some deny even this, but I'm not among them) you will have to watch his weight more, but that isn't a bad thing, pups (especially older ones) get more from walks and attention than just exercise.

The worst thing you have to worry about, is that an orchiectomy won't be enough, not that it will do any harm.
posted by Some1 at 4:59 PM on July 5, 2010 [1 favorite]

Neutering is not major surgery, and the risk should be minimal assuming your vet has a decent anesthetic protocol.

Although many vets ignore it, being intact does have some health benefits to male dogs up until middle age (age 6-7 or so, depending on breed), after that, hormones are not their friends, and being intact carries health risks. Your dog is well past middle age, and is experiencing one of the major health risks of being intact in old age.

If you don't trust your vet, get a second opinion, but generally, a testicular tumor definitely warrants neutering.
posted by biscotti at 5:02 PM on July 5, 2010 [3 favorites]

The ASPCA offers a run-down of the drawbacks, namely:
  • A small percentage of male dogs become attractive to intact male dogs after being neutered. Other male dogs may become sexually aroused and try to mount your neutered dog.
  • Dogs neutered before they’ve stopped growing may grow slightly taller than they would have had they not been neutered.
  • There is a very slight increased risk for neutered dogs to develop osteosarcoma and hemangiosarcoma (two kinds of cancer), particularly those breeds that are already predisposed to these diseases.
  • Dogs neutered prior to five months of age may be slightly more likely to develop hip dysplasia and cranial cruciate ligament (CCL) rupture, particularly those breeds that are already predisposed to these diseases.
  • Neutered dogs are at increased risk of developing hypothyroidism.
  • Physiological changes after neutering may affect your dog’s metabolism and appetite, making him prone to weight gain. There’s some evidence to suggest that puppies neutered before five months of age are at greater risk of becoming obese than puppies neutered later. This potential drawback is easily controlled with appropriate diet and exercise. If you notice that your dog looks overweight, you can decrease the amount of food you give him and increase his exercise. If you’re not sure if your dog’s weight is appropriate, please consult your veterinarian.
Honestly? All of these sound preposterously minor to me compared to the health benefits of a dog who possibly has cancer having his testicles removed. If you're really that reluctant, you should seriously pursue a second opinion--but not doing so (and entertaining options like keeping one testicle, which suggests to me like you might frankly be a bit over-invested in not having your dog neutered) because you're afraid the second vet will confirm the feelings of the first is . . . strange.
posted by PhoBWanKenobi at 5:03 PM on July 5, 2010 [1 favorite]

Your vet's approach is incredibly common when professionals see testicular growths in older animals.

I think it is a really bad idea for a 14 year old dog to have major surgery if there are other good alternatives, or if the risks of the surgery outweigh the risks of the alternatives.

I'm confused as to why you assume neutering will be traumatic or painful when the alternatives for treatment in the case of a hypothetically malignant tumor (chemo? radiation?) would be more drawn-out and quite likely more costly. If he had a growth on his leg, I'd understand wanting to know more about the cancer before chipping away his limb, but he's losing a body part that's simply not essential to a high quality of life.

Again, neutering is hardly invasive and it doesn't require much recuperation time. It's not a radical medical event, and obviously thousands of dogs (often puppies, yes, but often older dogs that are neutered through catch-and-release programs) go through this procedure every day with extremely little risk involved.

I'd advise you to go through with this very low-risk surgery and neuter him completely, because even if this growth isn't malignant, he's likely predisposed to tumor growth in that area and could develop a malignant tumor in the future.
posted by zoomorphic at 5:04 PM on July 5, 2010 [4 favorites]

Has the vet done a needle aspiration of the tumor to determine its pathology? If not, do that -- it may show the tumor is not malignant. BUT even if the tumor is not malignant, a tumor in your dog's testicles is not a good thing -- it could grow quite large, affecting his quality of life tremendously and it could (as you would imagine in a human person) cause hormonal problems.

I.e., even if it's not OMG CANCER, it's a tumor and should be removed.

As for the surgery, any time an older dog is placed under anesthesia, there's a risk. But weigh that risk against the consequences of not having the surgery. You may need more information about the tumor to make that sort of determination -- is it fast growing? is it likely to spread to other areas of your dog's body? (Again, a biopsy can provide some of that information in most cases.)

FYI, I say all of this as someone who had her 11 year old dog put under earlier this year so the vet could remove a neural sheath tumor of indeterminate malignancy from under his eye. Had it not been on his face, I might not have made the same decision, but because of its location, it posed a serious risk of affecting his vision and his ability to eat. For what it's worth, he came out of the surgery just fine and is doing great. I don't regret having the tumor removed.
posted by devinemissk at 5:08 PM on July 5, 2010 [1 favorite]

I have made the mistake, really, of paying for fairly major surgery on a dog with abdominal cancer, only to have him die shortly thereafter. The right thing would have been to spare him those miserable last days.

But in this case, you have the chance — chance — to give this dog some quality extra time and spare him the pain and trauma of having this cancer spread. I'm not sure what you're waiting for. Your vet knows what she's talking about; take her advice.
posted by beagle at 5:15 PM on July 5, 2010

Let's assume that the OP is going to remove any cancerous parts. The question is really about what to do in the case of a benign tumor and/or the dog's neighboring testicle.

The OP has probably already read the risks of neutering dogs too early (as she stated), so this is more about the risks of neutering dogs later in life, or at all.
posted by amtho at 5:17 PM on July 5, 2010

Response by poster: Thank you very, very much, everyone. Last peep from me, just want to answer two things:

zoomorphic: I'm confused as to why you assume neutering will be traumatic or painful when the alternatives for treatment in the case of a hypothetically malignant tumor (chemo? radiation?) would be more drawn-out and quite likely more costly.

There is no question that if the tumor is cancerous, the tumor is coming out; the biopsy is happening in a few days. If it's between neutering and chemo/radiation, neutering is obviously better.

As amtho said, my biggest concern is about what to do if the tumor is NOT cancerous. I didn't know what the consequences to my dog would be to leave a benign non-cancerous tumor untreated. devinemissk addressed some possible consequences, which I appreciate very very much.

A few people have asked why I'm so resistant to neutering, regardless of whether the tumor is benign or not. The biggest reason right now that I would be resistant to neutering for a benign tumor is because of his age, not because I have any personal attachment to him being intact. I would not be nearly as resistant if he were younger. Even if most younger dogs have no problems, I'm worried about putting him under anaesthesia and undergoing any kind of surgery.

Okay, shutting up now. Thank you guys again, I appreciate all of your answers extremely much.
posted by Ashley801 at 5:32 PM on July 5, 2010

Neutering is by far cheaper than biopsies etc, plus millions of people have dogs that are neutered and they are fine. Your dog is pretty old too, he lived most of his life as a full male - this lets him live out the rest comfortably. If you leave the lump you will have to keep re-checking it at intervals, and take him to the vet for that and pay more bills.
posted by meepmeow at 5:42 PM on July 5, 2010

To assuage your fears about the putting him under, any vet worth their license will do pre-anesthesia bloodwork before any operation regardless of the animal's age and regardless of the procedure. That doesn't guarantee that there won't be complications, of course, but most neuters are done in the matter of 20 or so minutes and the dogs are awake again shortly thereafter.

However, if you don't like this new vet or don't feel comfortable entrusting his care to them, please find a clinic where you do. It'll benefit everyone.
posted by Ufez Jones at 5:44 PM on July 5, 2010 [1 favorite]

Just anecdotally: Both of my elderly cats (yeah, feline, but the risks are still there, etc) were put under with anesthesia so the vet could remove some rotten teeth. One cat had all but one fang pulled; the other had just a fang and a long upper molar removed. These 'surgeries' were about as invasive as a neutering is for males.

The vet told me that there was a risk of putting them under, but both of them pulled through just fine. Granted, the 16 year old took about five days to recover from the anesthesia, but she was okay then. She's the one who lost all but one fang. Afterwards, she started eating again and was much, much happier.

Having an older animal put under is scary and risky, but it's often in the best interests of the animal to take that risk.
posted by LOLAttorney2009 at 6:10 PM on July 5, 2010 [1 favorite]

Just chiming in to say that the risks of anesthesia are also dependent on your dog's health in general, namely his weight. It's harder to maintain obese animals at the proper level of sedation, and they may have a longer recovery (in terms of waking up) time.
posted by alygator at 6:29 PM on July 5, 2010

Does the type of biopsy being done require anesthesia? If so, I would definitely recommend having the neuter done and sending out the biopsy at the same time. Because , if you are truly worried about risk, it would be better to have him go under once. If the biopsy comes back looking like neutering is recommended, you are going to be anticipating two rounds of anesthesia for an elderly pet instead of one. And, as you mentioned cost, you are also going to be paying for two procedures instead of one as well. I can understand your reluctance if surgery is financially or emotionally not an option for you, but if you are going to pursue a biopsy anyway, it's worth considering that his recovery, your financial investment, and probably your stress level will all be minimized by having everything settled with one relatively easy procedure.
posted by troublewithwolves at 6:40 PM on July 5, 2010 [6 favorites]


Find a vet you trust, job #1. You should feel well informed about your options and the pros and cons of any procedure.

That said, it is very likely that you will want to proceed with the castration, even if the tumor is found to be benign. When the benign tumors get to be of a certain size, they begin to change the dog's range of motion. They also burst into a stinky awful mess that is very prone to infection. In a way it is fortunate that the tumor is on the testicle, as removing the testes is often easier than a tumor that is inside the body wall. Less mess and fuss. It is easier to get good margins on a testicular tumor, so from the surgeon's perspective, the location is great!

Anesthesia does carry a risk, but it isn't the perilous danger that it was 15 years ago. We now have training and access to similar drugs that they use human side on pediatric patients. With constant monitoring and advanced pharmaceuticals, risks to geriatric patients have decreased a great deal. There is risk in anything, and only your vet can advise you about your specific dog and his possible surgery.

All that said, in most cases I've seen, it is easiest on the patient to castrate.
posted by Nickel Pickle at 6:44 PM on July 5, 2010 [3 favorites]

Want to add my voice to the others who are saying that neutering a male is NOT major surgery. In fact, it's a fairly simple process.

But also ----

My vet basically refused to give me a straight answer to any of my questions because she wants me to just agree to the neutering.>>

If you truly believe this, this is not a person I'd wish to trust with my pet's health and life. Get a new vet immediately. One that comes recommended.
posted by FlyByDay at 8:37 PM on July 5, 2010

I had a dog who had a leg amputated because of osteosarcoma - I am truly astounded that you think one of the simplest and most basic procedures is fraught with peril. If it were my 14-year old dog I wouldn't give it a second thought.
posted by O9scar at 11:20 PM on July 5, 2010

Neutering a male dog is a really simple procedure, it seriously takes about ten minutes barring any complications. He'll be fine.
posted by InsanePenguin at 4:49 AM on July 6, 2010

I don't know where you are, but it might not cost $200 to get a second opinion. If your vet did any bloodwork or needle aspirate, etc, at that appointment, you should be able to take the results of those with you to the 2nd opinion vet. You wouldn't need to have those re-done.

I am not remotely comfortable trusting my dogs to someone who brushes off my questions, even if I don't have any problems with their diagnosis. For a senior dog who will need particular attention while under sedation, I'd want to be absolutely sure I trusted the vet and the staff.

My elderly dog with a dickey heart developed a tumor last year and had to have it removed under sedation, so I definitely know where you're coming from; I was really worried for her. They knew I was worried and they were extra careful, gave her the lightest sedation possible, and they called me as soon as it was over to let me know she was fine. I wouldn't have wanted to leave her for something like that, with a vet who didn't seem to care that I was worried about sedating an older dog, or who brushed off my concerns about it. Hope this works out for you.
posted by galadriel at 5:59 AM on July 6, 2010

Response by poster: Just posting an update in case anyone in the same situation in the future does a search and finds this question, and is curious to know my/my dog's experience ...

We skipped the biopsy and just did the neuter. My dog came through the surgery with no problems, and seemed to be mostly back to his old self within a week.

It appears that you all were right with your answers to my second question, that undergoing neutering/anesthesia, itself, shouldn't cause him problems even at his age.

The tumor turned out to be benign.

The total bill for the neutering amounted to over $1200. This included blood work to determine suitability for anesthesia due to his age, chest radiology to check for hypothetical spread cancer, the anesthesia itself, "extra" anesthesia for the same full price, the fee for the actual neutering itself, staff fees, etc and so forth.

After the surgery, after doing more research on my own on my third question, health consequences as a result of neutering, I found that not are most testicular tumors benign, and that even malignant testicular tumors rarely metastasize, but neutering significantly increases a dog's risk for several types of cancer, including prostate and bladder cancer.

If I were to go back and do this again, I'd have done the biopsy first to check whether the tumor was benign or not, and, upon finding that it was benign, just kept an eye on it.

This is partly because of the increased risk of cancer, partly because the extreme expense to neuter such an old dog depleted my savings in case something else happens to him that I need to pay for.
posted by Ashley801 at 1:44 PM on October 7, 2010

Thanks for posting the update! And I hope you enjoy your dog for long while to come!
posted by beagle at 4:10 PM on October 7, 2010

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