The association between gonadectomy and timing of gonadectomy, and the risk of canine cranial cruciate ligament disease: A systematic review and meta-analysis
The association between gonadectomy and timing of gonadectomy, and the risk of canine cranial cruciate ligament disease: A systematic review and meta-analysis
Open access
In our edition of: Feb 2025
In our categories of: small animals
our summary:
Low, D. et al. (2024) The association between gonadectomy and timing of gonadectomy, and the risk of canine cranial cruciate ligament disease: A systematic review and meta-analysis. Veterinary Surgery, 54 (2), pp. 254-267.
The aim of this systematic review and meta-analysis was to investigate the association between gonadectomy and the risk of cranial cruciate ligament disease (CrCLD) in dogs. The null hypotheses were that dogs undergoing gonadectomy do not have a different risk of CrCLD from entire dogs, and that dogs undergoing early gonadectomy do not have a different risk of CrCLD from dogs undergoing late gonadectomy.
Published papers were identified following literature searches carried out in May 2024 on three databases. A search for gray literature was also carried out. Inclusion criteria were clinical studies comparing gonadectomised and entire groups of dogs, with an outcome measure of dogs having the diagnosis of CrCLD.
There were 51 articles eligible for full-text screening, of which 27 were excluded, leaving 24 for meta-analysis. All were observational studies (six cohort and 18 case-control) and with the majority (19) from North America. The meta-analysis was conducted in accordance with the PRISMA 2020 statement and the GRADE framework. A total of more than 1.8 million dogs were available for aggregate analysis, which included nearly 37,000 CrCLD cases and over 770,000 gonadectomy procedures.
Meta-analysis of the aggregated data showed an increased risk of CrCLD associated with gonadectomy in both male and female dogs compared to entire dogs.
Subgroup analysis by age at gonadectomy showed that gonadectomy at one year or less was associated with increased odds of developing CrCLD in both male and female dogs.
Subgroup analysis by breed, which was only available for the Labrador retriever, found female gonadectomised Labrador retrievers did not show increased odds of CrCLD risk compared to entire female Labrador retrievers.
The authors rated the body of evidence overall as moderate, and the risk of bias was assessed as moderate to high.
Limitations of the study include that all the eligible studies were observational studies, providing a moderate strength of evidence and a moderate to high risk of bias. Most of the studies were conducted in North America, and mainly in referral hospital populations, and therefore the results may not be applicable to the generalised canine population. The analysis on the age of neutering was influenced by three studies from the same research group, and were based on age, rather than accumulative gonadal exposure which may be a more relevant measure.
This systematic review/meta-analysis provides additional evidence of the influence of age at neutering on the risk of developing CrCLD. This information will be helpful when practitioners are discussing the risks and benefits of gonadectomy with clients.
The following may also be of interest:
Moxon, R. et al. (2024) Effect of neutering timing in relation to puberty on health in the female dog–a scoping review. PLOS ONE, 19 (10), e0311779. https://doi.org/10.1371/journal.pone.0311779
An inFOCUS summary is available
Benefits and risks of neutering pets – what is the evidence? [inFOCUS] [online]. Available from: https://infocus.rcvsknowledge.org/brnp_benefits-and-risks-of-neutering-pets-what-is-the-evidence/ [Accessed 20 February 2025]
Canine Cruciate Registry. [RCVS Knowledge] [online]. Available from: https://knowledge.rcvs.org.uk/quality-improvement/canine-cruciate-registry/ [Accessed 20 February 2025]
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