27 November 2020

Benefits and risks of neutering pets – what is the evidence – Surgical options

spotlight topic: Benefits and risks of neutering pets – what is the evidence? Surgical options Published 27 November 2020 | Updated 9 May 2025

Carbonari, A. et al. (2025) Ovarian pedicle local analgesia in midline versus flank cat ovariectomy. Veterinary Medicine and Science, 11 (2). https://doi.org/10.1002/vms3.70095
Cuervo, B. et al.(2024) Comparative analysis of Acute-phase protein profiles in cats undergoing ovariectomy: laparoscopic vs. conventional surgery in short time after procedure. Animals, 14 (22), 3274. https://doi.org/10.3390/ani14223274
Dalmolin, F. et al. (2024) Changes in biomarkers of inflammation and oxidative status in dogs subjected to celiotomy or video-assisted ovariohysterectomy. Veterinary Sciences, 11 (110, 583. https://doi.org/10.3390/vetsci11110583
Faulkner, E.B. et al. (2024) Serious surgical complications of canine cryptorchid castration are associated with surgical approach. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.24.04.0257
Shivley, J.M. et al. (2024) A randomized trial to compare smooth monofilament suture vs. barbed suture using the three-layer continuous closure technique in canine ovariohysterectomy in a high-quality high-volume spay/neuter clinic. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1365213
Souza, A. et al. (2023) Dexmedetomidine alone or combined with morphine for epidural anesthesia in bitches undergoing elective ovariohysterectomy. Topics in Companion Animal Medicine, 53-54, 100775. https://doi.org/10.1016/j.tcam.2023.100775
Tavares, I.T. et al. (2023) Premedication with acetazolamide: Is its use for postoperative pain and stress control after laparoscopic ovariectomy in dogs ruled out? Veterinary Medicine and Science. https://doi.org/10.1002/vms3.1115
Kramer, B.M. et al. (2022) Anesthetic and analgesic techniques used for dogs undergoing ovariohysterectomies in general practice in the United States. Veterinary Anaesthesia and Analgesia. https://doi.org/10.1016/j.vaa.2022.07.010
Pecile, A. et al.(2021) Immunohistochemical insights into a hidden pathology: canine cryptorchidism. Theriogenology, 176, pp. 43-53. https://doi.org/10.1016/j.theriogenology.2021.09.011

Once the decision to neuter has been made there are still decisions to be taken regarding the most appropriate technique.

Tivers, M.S. (2005) Questionnaire study of canine neutering techniques taught in UK veterinary schools and those used in practice. Journal of Small Animal Practice, 46 (9), pp. 430-435 https://doi.org/10.1111/j.1748-5827.2005.tb00341.x
DeTora, M. and McCarthy, R.J. (2011) Ovariohysterectomy versus ovariectomy for elective sterilization of female dogs and cats: is removal of the uterus necessary? Journal of the American Veterinary Medical Association, 239 (11), pp. 1409-1412 https://doi.org/10.2460/javma.239.11.1409
Van Goethem, B., Schaefers‐Okkens, A. and Kirpensteijn, J. (2006) Making a rational choice between ovariectomy and ovariohysterectomy in the dog: a discussion of the benefits of either technique. Veterinary Surgery, 35 (2), pp. 136-143 https://doi.org/10.1111/j.1532-950X.2006.00124.x
Culp, W.T., Mayhew, P.D. and Brown, D.C. (2009) The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. Veterinary Surgery, 38 (7), pp. 811-817 https://doi.org/10.1111/j.1532-950X.2009.00572.x
Owen, M.A. et al. (2023) Canine laparoscopic-assisted ovary-sparing hysterectomy does not increase risk of stump pyometra. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.22.12.0539
Brunn, A. (2022) Surgical castration in dogs: does the incision approach influence postoperative recovery? Veterinary Evidence, 7 (4), no. 587. https://doi.org/10.18849/ve.v7i4.587

When deciding on a surgical technique, it is also important to consider the possible risks and complications, as these can have a significant effect on animal welfare, client satisfaction and the wellbeing of veterinary staff.

Adin, C.A. (2011) Complications of ovariohysterectomy and orchiectomy in companion animals. Veterinary Clinics of North America: Small Animal Practice, 41 (5), pp. 1023-1039 https://doi.org/10.1016/j.cvsm.2011.05.004
Hamilton, K.H. (2014) Comparison of postoperative complications in healthy dogs undergoing open and closed orchidectomy. Journal of Small Animal Practice, 55 (10), pp. 521-526 https://doi.org/10.1111/jsap.12266
Moxon, R. et al. (2022) A prospective cohort study investigating the peri- and postoperative outcomes following ovariohysterectomy in bitches neutered prepubertally or post-pubertally. Theriogenology, 197, pp. 283-294. https://doi.org/10.1016/j.theriogenology.2022.11.047
Peeters, M.E. and Kirpensteijn, J. (2011) Comparison of surgical variables and short-term postoperative complications in healthy dogs undergoing ovariohysterectomy or ovariectomy. Journal of the American Veterinary Medical Association, 238 (2), pp. 189-194 https://doi.org/10.2460/javma.238.2.189
Charlesworth, T.M. and Sanchez, F.T. (2019) A comparison of the rates of postoperative complications between dogs undergoing laparoscopic and open ovariectomy. Journal of Small Animal Practice, 60 (4), pp. 218-222. https://doi.org/10.1111/jsap.12993 This paper was also the subject of a review in InFOCUS which is available at: https://infocus.rcvsknowledge.org/a-comparison-of-the-rates-of-postoperative-complications-between-dogs-undergoing-laparoscopic-and-open-ovariectomy/
Zink, C., Delgado, M.M. and Stella, J. L. (2023) Vasectomy and ovary-sparing spay in dogs: comparison of health and behavior outcomes with gonadectomized and sexually intact dogs. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.22.08.0382
White, S.C. (2018) Veterinarians’ emotional reactions and coping strategies for adverse events in spay-neuter surgical practice. Anthrozoös, 31 (1), pp. 117-131 https://dx.doi.org/10.1080/08927936.2018.1406205
De Menezes, M.P. et al (2023) Intraoperative and early postoperative pain in cats that underwent ovariohysterectomy using a spay hook: a randomised, masked, experimental study. BMC Veterinary Research, 19, no. 154 https://doi.org/10.1186/s12917-023-03718-w

Alongside primary published evidence there are also a number of evidence reviews available relating different surgical options:

Pennington, C. (2020) In female dogs undergoing elective neutering is ovariectomy or ovariohysterectomy superior? Veterinary Evidence, 5 (2), 303 https://doi.org/10.18849/ve.v5i2.303
Phypers, C. (2017) In Cats and Dogs Does Laparoscopic Ovariectomy Offer Advantages Over Open Ovariectomy for Postoperative Recovery? Veterinary Evidence, 2 (2), 59 https://doi.org/10.18849/ve.v2i2.59
Candetoft, M.N. (2020) The incidence of uterine pathology in ovariectomised bitches. Veterinary Evidence, 5 (3), 331 https://doi.org/10.18849/ve.v5i3.331
Stavisky, J. and Brennan, M. (2020) Midline versus flank approach and wound complications in neutering of cats.
Doit, H. and Belshaw, Z. (2019) Laparoscopic vs conventional midline approach for dog spays and post-op activity.
Espadas‐González, L. et al. (2023) Using complete blood count‐derived inflammatory markers to compare postoperative inflammation in dogs undergoing open or laparoscopic ovariectomy. Veterinary Record, e2835. https://doi.org/10.1002/vetr.2835

As well as looking at complication rates in the published literature it may be helpful to carry out a clinical audit of complications following routine neutering in your own practice. You can benchmark your own practice by contributing to the National Audit for Small Animal Neutering https://vetaudit.rcvsk.org/nasan/