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Hormone replacement therapy in neutered and spayed dogs

By knowing this, your dog may be very lucky

In the last email about Pax, I explained why many dogs end up with health issues after they lose their sex hormone-producing glands and that we must change the way we prevent dog overpopulation and homelessness.

I mentioned the invaluable work of Dr. Michelle Kutzler, Dr. Linda Brent, Dr. Karen Becker, and Dr. Ruth….  who have been trying to change the status quo through research, petitions, and education about hormone-sparing birth control.

The argument makes sense: humans don’t get neutered and spayed to prevent unwanted pregnancies, so why should dogs be allowed when hormone-sparing birth control is available?!

Vasectomy and hysterectomy allow puppies to develop into healthy and strong adults without increasing the number of homeless canines. 

Last time, I also mentioned that for some time, my dog Pax was affected by the absence of testosterone. About six months after him being neutered, he started to get injured. I began to question why, and to be honest, seeing my dog’s decline was very upsetting, not just personally and emotionally but also on a professional level.

So, I embarked on the search for answers, knowing that this was not an issue of nutrition, a balanced diet, lack of exercise, or the absence of chiropractic and rehabilitation.  I did all that but;

Something else was missing... 

I feel very lucky to have stumbled on the research by Dr. Kutzler and Brent and after conducting a few interviews and studying the available research, I took the route of least regret and started Pax on a hormone replacement therapy protocol.

My account of the experience so far

Phase one of the treatment:

I put Pax on Suprelorin, an under the skin implant that reduces the pro-inflammatory levels of LH (luteinizing hormone) about a month ago (second half of March 2024)

The evening after the implant, Pax looked like he just ran a marathon. He slept and slept and I was almost worried something was wrong.

The next day, he got up and was fine and in the following couple of weeks, friends repeatedly commented on how much happier he seemed. He was no longer limping and I was honestly shocked at how quickly the change happened.

The only side-effect I saw was increased itching and a change in Pax’s coat texture. It was courser and he pulled out some hair which initially concerned me.

Phase two of the treatment:

Pax received his first dose of testosterone a month after his Suprelorin implant. I separated the treatments to have a clear idea of their individual effects.

Just to clarify, giving a physiological dose of testosterone to a male dog that has been neutered is very different from bodybuilders using and abusing this hormone in much higher doses.

I have used a dose of 0.5 mg/kg (approximately 0.25 mg/lb), a total of 14 mg of testosterone subcutaneously with an insulin syringe, a 30-gauge needle, which is almost as fine as an acupuncture needle. Pax almost didn’t notice.  Personally, I feel that 25G needle is better, as the liquid is quite thick. 

The veterinary literature suggests an intramuscular injection, however, there are studies done in humans confirming that subcutaneous injections are as effective and clearly not as painful,  so I went for this route of administration with the plan to give it once a week.[1] 

My observations so far

It took about three days after the injection, Pax became bouncier, happier, and much more of what I would expect from a 5 year old dog. He has not displayed any negative change in his behaviour, has not tried to “hump” other dogs, and he also stopped itching, which was clearly related to reducing LH.

I will be frank, not having a clear explanation to why he was getting injured was very hard. I questioned what I was missing and why my dog, who was getting the best nutrition was declining and NOW I KNOW. 

I suspect that there are many dogs out there suffering from this spay and neuter syndrome, and that sex hormone deficit is at the core of many chronic medical conditions some of which have been confirmed by research.

There are studies of neutered and spayed dogs being affected by higher rates of cruciate ligament tears, hypothyroidism and cancer.

    So where do we go from here?

    I will continue sharing my experience with treating Pax and be grateful tohave found this important piece of knowledge.  

    But the work is just starting

    because we need to change the status quo.

    We will do our best to connect with rescue organizations and veterinarians to bring this issue to their awareness and do all we can to move towards hormone-sparing birth control of dogs.

    If you have a male dog that has been neutered, I suggest the following:

    1. Ask your vet to measure your dog’s luteinizing hormone levels to see if they are elevated. They most likely will be elevated. 

    2. If your male dog is suffering from any inflammatory conditions - from skin, allergies, digestive issues, hormonal or organ disease or joint and mobility issues, ask your veterinarian to start Suprelorin treatment combined with testosterone.

    3. If you have a female dog, it is possible that they do not suffer from hormone deficiencies as severely as male dogs do. This is because the reproductive cycle of female dogs naturally fluctuates. However, research on this topic is still ongoing and I will keep you updated on any new findings. In the meantime, it's worth noting that estrogen replacement therapy has been used in female dogs to treat urinary incontinence. If your dog has chronic unresolved symptoms mentioned in this article, this may be an option worth considering.

    In the next article, I will write on intact male dog behaviour and whether are they more aggressive or not.

    Make sure you don't miss this and other updates


    (1) Gagliano-Jucá T, Basaria S. Testosterone Therapy With Subcutaneous Injections: A Safe, Practical, and Reasonable Option. J Clin Endocrinol Metab. 2022Nov1;107(11):30893098.

    (2) Animals (Basel). 2020 Apr 1;10(4):599. doi: 10.3390/ani10040599. Possible Relationship between Long-Term Adverse Health Effects of Gonad-Removing Surgical Sterilization and Luteinizing Hormone in Dogs. Michelle A Kutzler

    (3) Volume 261: Issue 3. Vasectomy and ovary-sparing spay in dogs: comparison of health and behavior outcomes with gonadectomized and sexually intact dogsDVM, PhD, DACVSMR, PhD and Judith L. Stella PhD

    (4) Top Companion Anim Med2021 Nov:45:100565. doi:10.1016/j.tcam.2021. 100565. Epub 2021 Jul 28. Restoration of Reproductive Hormone Concentrations in a Male Neutered Dog Improves Health: A Case Study Linda BrentElaine A LissnerMichelle A Kutzler 


    About the author

    Dr. Peter Dobias, DVM is an Integrative veterinarian, nutritionist and creator of natural supplements for dogs and people. Helping you and your dog prevent disease, treat nutritional deficiencies, and enjoy happier, healthier, and longer lives together.

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