If you have questions about canine hormone replacement therapy (HRT) and hormone-sparing sterilization, you’ve come to the right place.

Recently, I hosted a webinar with Dr. Michelle Kutzler, a board certified canine hormone expert, to discuss this vitally important topic with our community.

Below are Dr. Kutzler’s answers to many of the most frequently asked questions about canine hormone replacement therapy (HRT) and hormone-sparing sterilization. 

FAQ

Q: When is the best time to check LH (luteinizing hormone) levels? 

A: It is advisable to check LH levels in dogs suspected of having an inflammatory condition, regardless of whether they are spayed/neutered or intact.

For older intact dogs, checking LH levels may be beneficial if they show health issues.

Q: Is Suprelorin always necessary, and is testosterone always required? 

A: Using Suprelorin in addition to testosterone and estrogens is the preferred method of treatment of spayed and neutered dogs. 

Q: Are there any natural ways to increase testosterone or estrogen in dogs?

A: I don’t have any concerns about administering testosterone or estrogen to dogs as medication, as it helps replace missing hormones and can have significant positive effects. When a dog’s ability to produce these hormones is impaired, providing appropriately formulated hormones at the correct dosage is the preferred option. While some glandular supplements may contain hormones, dosing them accurately would be challenging, so I would not recommend using these at this time.

Q: Can glandular powdered support supplements provide similar benefits to hormone replacement therapy? 

A: While these supplements do not lower LH concentrations, they may offer some benefits in supporting glandular health in dogs with hormone imbalances linked to high LH levels, particularly concerning adrenal gland health.  However, I generally prefer pharmaceutical-grade preparations when it comes to hormones. They can be dosed more accurately.

Q: Is it advisable to allow female dogs to undergo a few heat cycles before undergoing hormone-sparing surgery? 

A: Theoretically, there is no necessity to wait for hormone-sparing sterilization surgeries in female dogs. However, I recommend that, even with hormone-sparing procedures, it is best to wait until the dog is at least 6 to 12 months old.

Q: Do female dogs continue to produce hormones through the uterus alone if ovaries are removed?

A: In female dogs that have had their ovaries removed but still have a uterus, hormone production is minimal. Generally, ovariectomy, or the removal of the ovaries, is not recommended because it can lead to a significant hormone deficiency.

Q: What should you do if a dog is intact and experiencing false pregnancies?

A: You can consider an ovary-sparing spay (hysterectomy). If this issue persists, you may choose to remove the ovaries later, preferably using laparoscopic techniques. However, it is advisable to be cautious about removing the ovaries. I recommend providing your female dog with small furry toys, which may help calm her down. Additionally, consult a homeopathic practitioner to address your dog’s specific situation.

Q: Is an ovary-sparing spay (OSS) a more complex surgery compared to a traditional spay?

A: An ovary-sparing spay (OSS) is not a more complex surgery; it simply involves a different approach. In some ways, it can even be simpler because there is no need to remove and ligate the ovaries, which have a heavy blood supply. However, for the removal of the cervix, the surgeon must go deeper into the pelvis to ensure that all uterine tissue is completely excised. This procedure is technically a different technique; it is not more invasive or traumatic than a traditional spay. In fact, it may be less so since there is no sudden drop in hormone levels.

Q: What about pyometra, which is the inflammation and infection of the uterus? 

A: Pyometra cannot occur if a complete hysterectomy is performed since there is no uterus remaining. However, if an ovariectomy is performed, there is still a risk of pyometra because it can develop with the presence of progesterone and a uterus.

For intact females, there is a risk of developing pyometra regardless of their age. Some studies indicate that the lifetime incidence of pyometra is about 25%, though this can vary depending on the breed.

Q: What is the relationship between mammary cancer and estrogen? 

A: Estrogen may contribute to some mammary cancers; however, progestins are more commonly associated with mammary tumors in dogs. Regular breast exams are essential for early detection. Keep an eye out for anything unusual during routine belly rubs. Most mammary tumors in dogs are actually benign.

Q: For a dog that has been bred, is it better to have an ovary-sparing spay or to keep her intact?

A: There is a 25% chance that an intact dog will develop pyometra. Based on discussions with Dr. Kutzler, opting for an ovary-sparing spay is a reasonable choice to prevent pyometra in aging female dogs, especially if you want to avoid the risk of emergency surgery. Ultimately, the decision is personal. Some people believe it’s better not to interfere with the body as a whole system, while others prefer a preventive ovary-sparing spay to reduce the risk of pyometra.

Q: Is there a possibility of a spike in LH after a dog has puppies at the age of six years?

A: A natural spike in LH occurs just before ovulation.

Q: Is there a difference in the protocol for dogs that are spayed or neutered later in their senior years?

A: There is no difference in the protocol for dogs that are spayed or neutered later in their senior years; the protocol remains the same.

Q: Have you noticed any changes in food sensitivities after hormone replacement is added?

A: Research indicates that luteinizing hormone (LH) can cause inflammation in the gastrointestinal tract. Therefore, it is possible that dogs with inflammatory bowel disease or leaky gut may experience a reduction in food sensitivities when hormone replacement is introduced. While research supports this possibility, it’s important to note that each dog is unique, and individual responses may vary.

Q: What would you recommend for a three-year-old Maltese with a portosystemic shunt and a small heart murmur?

A: While this situation may not be directly related to hormone replacement therapy, if this dog has high luteinizing hormone levels and shows symptoms of inflammation, I would still recommend hormone replacement therapy. It’s important to monitor the liver regularly, ideally at least once every three months. As for the heart murmur, its significance is uncertain without a full medical report, making it difficult to provide further comments.
 

Q: Is it safe to use hormone therapy alongside immunotherapy or chemotherapy when treating multiple cancers?

A: Currently, there is insufficient evidence regarding combined treatments for animals suffering from cancer and metastatic disease. Given that this condition is terminal, if I had a dog with cancer, I would seriously consider using Suprelorin to suppress the luteinizing hormone and potentially administer hormone replacement therapy. This approach may help reduce symptoms and improve the animal’s overall health, but we still lack enough information to confirm its effectiveness in cancer treatment.

Q: Where in the U.S. is hormone-sparing sterilization surgery performed on cats? Is hormone replacement therapy possible? 

A: Currently, there isn’t enough information available to determine how cats respond to hormone-sparing sterilization or HRT. Unlike dogs, cats do not seem to be affected as significantly by spaying and neutering, based on what is known so far. Cats are also induced ovulators, which further complicates the issue. I recommend consulting a feline medicine expert who may be able to provide more insight on this topic. Our website focuses exclusively on canine medicine and health.