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Rethinking Dog Sterilization: Pax’s Story and the Case for Hormone-Sparing Methods
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Rethinking Dog Sterilization: Pax’s Story and the Case for Hormone-Sparing Methods

Part One: I have heard this before 

People come to me and say, "I have given my dog the best food, the best supplements, go for regular walks, take them to chiro, physio, and acupuncture, and despite all this, my dog got sick!" What am I doing wrong?

It may surprise you, but even I sometimes ask the same question. But what if there is nothing we were doing wrong? What if it was more about what we were missing?!

Let me explain

When we adopted my dog Pax in 2019, I thought I knew what he needed to grow into a healthy and strong dog. In the first 1.5 years of his life, I was thrilled to see him growing into a happy dog, full of energy and enjoying his life. 

He got raw and cooked foods, FAB4 supplements, and regular detox, and all was well.

But then, I had to make a tough decision

Pax was in training to become a certified service dog for my sleepwalking. I have a history of sleepwalking and almost died walking through a glass door by cutting a branch of an artery on my leg.For Pax to receive his final certification, the rules were firm, and he had to be neutered.

I tried to delay the surgery, but then it had to be done. About six months later, I started to notice that Pax would occasionally limp, getting progressively worse. Lyme disease tests, X-rays, and other exams came back negative, and I used all my tools in the toolkit but repeated injuries and stiffness continued, and we could no longer enjoy the beach and swimming - our favourite.

My heart broke

Spay, Neuter, Pax Story, Hormone Sparing Sterilization


It was even worse because I am a vet, and I should know what the problem was, right?!  I was at my wits' end. But I also knew that dogs come into our lives to teach us and help us learn what we are missing, and Pax is no different.

His challenges prompted me to search for answers to his unexplained lameness and eventually, I came across the research of two of my colleagues. Dr. Michelle Kutzler and Dr. Linda Brent.

In their scientific studies [1][2][3] they confirmed what I was suspecting and what my friend, Dr. Becker has been pointing to. Spaying and neutering our dogs the old traditional way causes inflammation, lameness, organ disease and cancer!

The culprit in all this is a severe elevation of luteinizing hormone (LH) that regulates the production of testosterone and estrogen in intact dogs.  However when ovaries and testicles are removed, the luteinizing hormone production rises, and levels go through the roof which can cause severe inflammation in genetically predisposed dogs.

It took me some time to decide if I should put Pax on treatment with Suprelorin, which Dr. Kutzler and Dr. Brent confirmed reduces the LH levels, but I eventually started him on the treatment. Now a month later I am about to start Pax on a physiological dose of testosterone.

The change in Pax’s mobility after starting Suprelorin was almost immediate and striking!  The only side-effect I noticed is that he is a little itchy from time to time.

I have also started Pax on JointButter, my new joint and mobility formula that has supported the recovery. 

The question I am now asking is: How many dogs are suffering from this spay and neuter syndrome and how can we spread the word as fast as possible?! 

For dogs and puppies that are still intact, the solution is simple. To prevent dog homelessness, hormone-sparing vasectomy and hysterectomy without removing testicles and ovaries are the way to go. The other option is to leave dogs intact but most rescue organizations and shelters would not be willing to do so.

The solution for dogs who have already been spayed and neutered, for example Pax, is a little more complex and I will give you more details in the next blog.

Part 2: 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.[4] 

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 to have 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 they are more aggressive or not. 

    Part 3: Adventures and Healing with Pax in the Austrian Alps

    It is a weekend, my partner is travelling, and Pax and I have gone on a road trip. I don’t do this on my own very often but a few days ago, my dear team member Robyn and I were chatting dogs 😁🐾, and Robyn said something that really hit me:

    We have only a limited number of summers with our dogs, so we should make sure we do as many adventures as possible. 

    I just could not stop thinking about it and then I packed a few things, dog food, computer, supplements for Pax, supplements for me, protein powder, five-finger shoes, podcast library, audio books and here we are, the Austrian Tirol Alps.

    Dr Dobias and Pax Alps Austria


    Which brings me to the update on Pax, and his injury. You may remember that I have given Pax an implant to reduce the Luteinizing hormone, that gets super high in neutered and spayed dogs, causing inflammation, injuries, hormonal issues and even cancer. This has been confirmed by multiple research studies.

    For Pax, as a young dog, the problem showed up as a repeated injury of the psoas muscle, and neutralizing LH is not enough. Neutered dogs especially lose muscle mass and based on the studies, a physiological dose of testosterone helps to restore the lost muscle, prevent further injuries and boost mood.

    The decision was tough, despite the reassurance by the scientists - Dr. Kutzler and Dr. Brent but eventually, I did it and started Pax on a weekly dose of testosterone. 

    I attributed Pax’s moping and being kind of disinterested in fun to his maturing, but now I know that the traditional form of neutering was the cause.

    While newer forms of sterilization such as vasectomy and hysterectomy are only now starting to be used, if your dog has already been neutered or spayed, hormone replacement therapy based on research is the way to go especially if your dog has health issues. 

    Pax has been on the treatment for about 5 weeks now. The change has been gradual, but many of my friends have commented on his energy and how happy he seems. 

    His gait has still been a little uneven, but it gets better after a strenuous uphill hike so my assumption is, he just needs to start engaging his muscles to rebalance.

    Today, we hiked for 6 hours in one of the most beautiful areas I have been to. I ended up with a very muddy and very happy dog and things are looking up.

    Perhaps you are wondering why I didn’t mention Pax’s injury sooner. Frankly, I was really down about it and wanted to have an answer and a solution to the problem. 

    But now, seeing and experiencing what Dr. Brent and Dr. Kutzler studied and confirmed in their research, I am thrilled and determined to help and change the status quo. 

    It is very clear that in addition to healthy food, FAB4 supplementsJointButter mobility support, the right exercise, spinal and muscle work, and mitochondria boosting (such as NMN), we must not forget about hormonal health. It is coming to the forefront in dogs and people alike. 

    Make sure you don't miss this and other updates


    (1) 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

    (2) 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

    (3) 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 

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


    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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