밑에 문단마다 번역을 간단하게 했는데 한번 보시고요 결정에 도움이 되셨음 합니다. 저도 이번에 셋째아가 키우면서 첫째 요키는 중성화 하지않앗고 14년 살다 갔고 둘째치와와는 두번 고민 안하고 수의사님 말씀듣고 7개월째에 시켯는데 수술은 잘되었지만 아이가 고통스렁워했던 기억이 생생하고 그이후로는 체중과의 싸움이 시작되었습니다. 중성화 이후에 백신을 맞고 한번 크게 알러지 리액션이 갑자기 생겨서 병원에 한밤중에 가고 고생한 기억이있는데 밑에 논문을 보니 중성화 이후 꽤높은 수치가 그런 백신에 리액션이 생긴다고 하는군요.
제가 이 글을 이렇게 공유하고 싶었던 이유는 흔히 알려진 바와는 다르게 수컷들이 크게 중성화로 건강상의 이득을 보는바는 없고 중성화가 이렇게 널리 퍼지게된 이유는 사람들과 함께 살아야하는 입장에서 좀 더 우리에게 함께 살기에 적합하도록 변형을 시키는 과정에서 이렇게 된것이 아닌가 하는 생각도 듭니다. 수컷의 경우 마킹이라던지 발정기라던지 하는 이유요. 여아의 경우는 밑에 보시는바와같이 모든 상황을 잘 고려하여 함께 할 가족이 결정해야하는것이 아닌가 합니다. 전 사실 중성화 완전 찬성맘이엿어요. 여아를 키우는 입장에서 다른 수컷들도 무섭고 ㅎㅎ(저의 무지를 용서해주세요) 생리뒤처리도 겁나고, 또 새끼 낳아서 누굴 줄 자신도 없기때문에 수의사님이 건강상의 이유로 좋다, 최대한 7개월 전에 하는것이 좋다 라고 했을때 아무것도 모르고 해버린 기억이납니다. 고통스러워하는 우리 치와와 두리를 보면서 제 결정이 옳앗었는지 많이 고민도 했어구요. 지금도 6살이 된 아이를 보면서 엄마가 과연 옳은 결정을 한것인지 궁금해질때가 많습니다. 이제 셋째 곰두리도 5개월이 다되가고 결정의 시간이 다가오면서 한국 미국내 자료들을 찾아보던중 몽실아버님말씀대로 중성화가 좋다는 이야기는 많지만 그를 뒤받침할 자료는 너무나 부족하다는것을 알게되엇습니다. 이 자료를 한번 보시고 참고 하시는것도 좋을듯하고요 일단은 믿을만한 출처, 이름있는 수의대에서 나온 자료라는거를 알려드리는 목적에서 원본 그대로 올렷고 단락마다 간단히 번역 첨부했습니다. 쉽지않은 결정인데 다들 어떻게 생각하시는지 의견공유하면 좋겟습니다.
Long-Term Health Risks and Benefits Associated with Spay / Neuter in Dogs
장기적으로 본 중성화 수술로 인한 위험 요인과 그로 인한 장점들
Laura J. Sanborn, M.S.
May 14, 2007
At some point, most of us with an interest in dogs will have to consider whether or not to spay / neuter our pet. Tradition holds that the benefits of doing so at an early age outweigh the risks. Often, tradition holds sway in the decision-making process even after countervailing evidence has accumulated.
많은 애견가들의 중성화를 이른 시기에 해야하는지 말아야하는지를 고민하는데 보편적으로는 이른시기에 이루어지는 것이 장점이 더 많다는 의견이 지배적이다. 보편적으로 행해지는 관습들이 그가 틀리다는 증거들이 제시되고 있음에도 계속 행해지고 있다는 점이 문제이다.
Ms. Sanborn has reviewed the veterinary medical literature in an exhaustive and scholarly treatise, attempting to unravel the complexities of the subject. More than 50 peer-reviewed papers were examined to assess the health impacts of spay / neuter in female and male dogs, respectively. One cannot ignore the findings of increased risk from osteosarcoma, hemangiosarcoma, hypothyroidism, and other less frequently occurring diseases associated with neutering male dogs. It would be irresponsible of the veterinary profession and the pet owning community to fail to weigh the relative costs and benefits of neutering on the animal’s health and well-being. The decision for females may be more complex, further emphasizing the need for individualized veterinary medical decisions, not standard operating procedures for all patients.
Sanborn 씨는 방대한 동물의학 서적과 논문들을 철저하게 분석했고 이 어려운 주제를 문제를 풀려고 노력했다. 중성화 수술이 여아 남아의 건강에 미치는 영향에 관한 50편이 넘는 논문들이 연구되었다. 한가지 간과되어서는 안될 문제는 뼈육종(뼈관련 암),혈관육종,갑상선 저하증을 비롯한 다른 질병들이 남아의 중성화 수술후 증가한다는점이다. 이러한 점들을 인지하고 중성화의 장 단점을 제대로 조명하지 못하고 있는점은 수의사계와 애견인 커뮤니티의 문제점이다. 여아의 경우 문제가 좀 복잡해지는데 각각의 애견에 따라 수의사의 더 많은 관심이 필요하다. 모든 여아견에게 통상적인 중성화를 행하는것은 문제가 있다.
No sweeping generalizations are implied in this review. Rather, the author asks us to consider all the health and disease information available as individual animals are evaluated. Then, the best decisions should be made accounting for gender, age, breed, and even the specific conditions under which the long-term care,
housing and training of the animal will occur.
This important review will help veterinary medical care providers as well as pet owners make informed decisions. Who could ask for more?
일반적인 보편화는 여기서 거론되지 않을것이다. 그것보다 작가는 우리에게 각각의 애견의 특성대로 평가하여 모든 건강과 질병 에 관한 정보들은 고려하기를 권할것이다. 이 결정은 애견의 성별,나이,종자 및 장기적인 케어로 인한 특수성까지 고려되어야 할것이다. 이 중요한 리뷰는 수의사들과 애견인들이 좀 더 좋은 결정을 내리는데 큰 도움이 될것이다.
Larry S. Katz, PhD
Associate Professor and Chair
Animal Sciences
Rutgers University
New Brunswick, NJ 08901
Larry S. Katz, PhD
럿거스 대학의 수의학대 학장및 교수
INTRODUCTION
Dog owners in America are frequently advised to spay/neuter their dogs for health reasons. A number of health benefits are cited, yet evidence is usually not cited to support the alleged health benefits.
When discussing the health impacts of spay/neuter, health risks are often not mentioned.
At times, some risks are mentioned, but the most severe risks usually are not.
This article is an attempt to summarize the long-term health risks and benefits associated with spay/neuter in dogs that can be found in the veterinary medical literature. This article will not discuss the impact of spay/neuter on population control, or the impact of spay/neuter on behavior.
미국의 애견인들은 애견의 건강을 위해 중성화 권유를 받고는 한다. 대체적으로 중성화가 좋다고 여겨지는 반면 그에 합당한 증거가 부족한게 현실이다. 중성화에 관해 이야기할때 그로 인한 위험 요소는 잘 알려지지 않고 있다. 가끔씩 위험요소들이 경고 되고 있지만 가장 중요한 위험 요소들은 거론되지 않고 있다.
이 글은 중성화로 인한 장기적인 건강문제들만을 다루고 있고 중성화로 인한 애견 인구 컨트롤의 장점이라던지 행동양식의 변화등은 다루지 않을것이다.
SUMMARY
An objective reading of the veterinary medical literature reveals a complex situation with respect to the longterm health risks and benefits associated with spay/neuter in dogs. The evidence shows that spay/neuter correlates with both positive AND adverse health effects in dogs. It also suggests how much we really do not yet understand about this subject.
동물 의학계의 논문들은 중성화로 인한 장기적인 장단점의 복잡한 문제들을 알리고 있다. 그 증거들은 중성화가 장점과 단점을 동시에 가지고 있음을 보여준다. 문제는 우리가 그것을 제대로 직시하고 있느냐는 것이다.
On balance, it appears that no compelling case can be made for neutering most male dogs, especially immature male dogs, in order to prevent future health problems. The number of health problems associated with neutering may exceed the associated health benefits in most cases.
남아들에게 행해지는 중성화는 크게 장점이 있는것으로 보여지지는 않는다. 미래의 있을수 있는 위험요소 제거를 위하여 행해진 중성화로 인해 발생되는 건강 위험요소가 더 많게 보여진다.
On the positive side, neutering male dogs
• eliminates the small risk (probably <1%) of dying from testicular cancer
• reduces the risk of non-cancerous prostate disorders
• reduces the risk of perianal fistulas
• may possibly reduce the risk of diabetes (data inconclusive)
중성화로 인한 장점으로는 (남아)
고환 암의 발병 (1프로 이내) 제거
암이 아닌 전립선관련 질병 감소
항문주위 질병 간소
당뇨 발병 감소(뒤받침할 데이터 없음)
On the negative side, neutering male dogs
• if done before 1 year of age, significantly increases the risk of osteosarcoma (bone cancer); this is a
common cancer in medium/large and larger breeds with a poor prognosis.
• increases the risk of cardiac hemangiosarcoma by a factor of 1.6
• triples the risk of hypothyroidism
• increases the risk of progressive geriatric cognitive impairment
• triples the risk of obesity, a common health problem in dogs with many associated health problems
• quadruples the small risk (<0.6%) of prostate cancer
• doubles the small risk (<1%) of urinary tract cancers
• increases the risk of orthopedic disorders
• increases the risk of adverse reactions to vaccinations
단점으로는
1살전에 행해질경우 뼈암 발병률 급격히 높아짐,중간,대형사이즈 견에게서 주로 나타남
심장혈관육종 질환 1.6배 증가
갑상선 저하 3배 증가
노견 인지 장애 발달 증가
비만 3배 증가, 많은 건강 위험요소가 비만으로 부터 발생
1프로였던 요로 감염증이 두배로 증가
정형외과 질병 증가
백신에 대한 알러지 반응 증가
For female dogs, the situation is more complex. The number of health benefits associated with spaying may exceed the associated health problems in some (not all) cases. On balance, whether spaying improves the odds of overall good health or degrades them probably depends on the age of the female dog and the relative risk of various diseases in the different breeds.
여아의 경우 좀더 복잡해진다. 중성화로 인한 장점이 단점을 넘어서기도 한다 (모든 케이스는 아님), 중성화가 전반적인 측면에서 건강의 질을 향상시킬수 있다고 볼수 있거나 여아의 나이나 종자에 따라서는 건강을 해하는 요소가 되기도한다.
On the positive side, spaying female dogs
• if done before 2.5 years of age, greatly reduces the risk of mammary tumors, the most common
malignant tumors in female dogs
• nearly eliminates the risk of pyometra, which otherwise would affect about 23% of intact female
dogs; pyometra kills about 1% of intact female dogs
• reduces the risk of perianal fistulas
• removes the very small risk (0.5%) from uterine, cervical, and ovarian tumors
장점측면, 여아
2.5살 전에 중성화가 행해지는 경우 유방암의 발병을 급격히 낮추어줌, 대개의 경우에
자궁축농증 거의 없앤다고 볼수있음, 23프로 중성화를 하지않은 여아들이 걸리고 1프로는 그중 사망함
항문관련 질병 감소
자궁, 자궁경부, 난소관련 암 발병 감소 0.5프로 (작은 숫자임)
On the negative side, spaying female dogs
• if done before 1 year of age, significantly increases the risk of osteosarcoma (bone cancer); this is a
common cancer in larger breeds with a poor prognosis
• increases the risk of splenic hemangiosarcoma by a factor of 2.2 and cardiac hemangiosarcoma by a factor of >5; this is a common cancer and major cause of death in some breeds
• triples the risk of hypothyroidism
• increases the risk of obesity by a factor of 1.6-2, a common health problem in dogs with many
associated health problems
• causes urinary “spay incontinence” in 4-20% of female dogs
• increases the risk of persistent or recurring urinary tract infections by a factor of 3-4
• increases the risk of recessed vulva, vaginal dermatitis, and vaginitis, especially for female dogsspayed before puberty
• doubles the small risk (<1%) of urinary tract tumors
• increases the risk of orthopedic disorders
• increases the risk of adverse reactions to vaccinations
단점으로는
1살 이전에 행해졋을 경우 뼈암 관련 질병 상당히 증가, 중,대형견
경맥류 혈관 육종 질병 증가 2.2배
심장류 혈관 육종 증가 5배(이 둘은 자주 발생하는 암이고 어떤 종자들은 주된 사망원인이 되기도 한다.
갑상선 저하 3배
비만 1.6-2배
난소 요실금 4-20프로 증가
방광 관련 질병 3-4배
생식기 관련 질병 증가, 여아가2차성장 전에 중성화 되엇을경우
방광암 두배 증가 (1프로 이내의 발병에서)
정형외과 질병증가
백신 리액션 증가
One thing is clear – much of the spay/neuter information that is available to the public is unbalanced and contains claims that are exaggerated or unsupported by evidence. Rather than helping to educate pet owners, much of it has contributed to common misunderstandings about the health risks and benefits associated of spay/neuter in dogs.
한가지 짚고 넘어가야할 문제는- 애견인들을 돕고 교육시켜야 할 중성화 수술의 관한 정보들이 한쪽에 치우쳐 있고(장점) 제대로 된 증거도 제시되어지지 않은채 과장되어 있다는 점이다.
The traditional spay/neuter age of six months as well as the modern practice of pediatric spay/neuter appear to predispose dogs to health risks that could otherwise be avoided by waiting until the dog is physically mature, or perhaps in the case of many male dogs, foregoing it altogether unless medically necessary.
보편적으로 6개월 전후로 행해지는 중성화 수술은 애견들을 건강위험에 노출시키면 애견이 완전히 성장할때까진 행해지지말아야 한다, 남아의 경우는 꼭 필요하지 않은 한 이루어져야 할 이유가 없다.
FINDINGS FROM STUDIES
This section summarizes the diseases or conditions that have been studied with respect to spay/neuter in dogs.
이 섹션은 중성화를 한 애견들에게서 나타는 질병들을 연구하였다.
Complications from Spay/Neuter Surgery
All surgery incurs some risk of complications, including adverse reactions to anesthesia, hemorrhage, inflammation, infection, etc. Complications include only immediate and near term impacts that are clearly linked to the surgery, not to longer term impacts that can only be assessed by research studies.
모든 수술엔 위험요소가 도사리고 있다. 마취에 알러지 반응, 출혈,감염, 염증 등등 수술로 관한 문제는 바로 나타날수 있고 장기적으로 나타날수있는 문제도 있다.
At one veterinary teaching hospital where complications were tracked, the rates of intraoperative, postoperative and total complications were 6.3%, 14.1% and 20.6%, respectively as a result of spaying female dogs1. Other studies found a rate of total complications from spaying of 17.7%2 and 23%3. A study of Canadian veterinary private practitioners found complication rates of 22% and 19% for spaying female dogs and neutering male dogs, respectively (4).
한 동물학회 병원에서 수술로 인한 문제들을 조사했는데 외과 수술중의 나타난 문제들의 퍼센티지가 6.3, 수술후 나타난 문제가 14.1프로로 총합 20.6프로가 수술로 인한 문제가 있엇음이 밝혀졋다. 다른 연구 발펴에서는 17.7프로와 23프로로 밝혀졋다. 캐나다의 시설에서 밝힌 바로는 여아가 22프로, 남아가 19프로 였다.
Serious complications such as infections, abscesses, rupture of the surgical wound, and chewed out sutures were reported at a 1- 4% frequency, with spay and castration surgeries accounting for 90% and 10% of these complications, respectively. (4)
심각한 문제들로는 감염, 농양, 수술부위의 파열, 봉합실 파열등이 1-4프로로 가장 많앗고 10프로의 중성화 수술이 이러한 문제점들을 보였다.
The death rate due to complications from spay/neuter is low, at around 0.1% (2).
중성화 수술의 합병증으로 인한 사망률은 낮다, 0.1프로
Prostate Cancer
Much of the spay/neuter information available to the public asserts that neutering will reduce or eliminate the risk that male dogs develop prostate cancer. This would not be an unreasonable assumption, given that prostate cancer in humans is linked to testosterone. But the evidence in dogs does not support this claim. In fact, the strongest evidence suggests just the opposite.
대부분의 중성화에 대하 정보가 남아의 전립선암 발병을 낮춰준다는것이다. 전립선암은 남성호르몬에 연결되어있으므로 사실상 맞는 말이다.하지만 보여지는 결과는 그 반대의 상황을 보여준다.
There have been several conflicting epidemiological studies over the years that found either an increased risk or a decreased risk of prostate cancer in neutered dogs. These studies did not utilize control populations, rendering these results at best difficult to interpret. This may partially explain the conflicting results.
몇년간의 역학조사에서 중성화가 전립선암을 증가 혹은 감소 시킨다는 다른 연구결과가 나왔다.
More recently, two retrospective studies were conducted that did utilize control populations. One of these studies involved a dog population in Europe5 and the other involved a dog population in America (6). Both studies found that neutered male dogs have a four times higher risk of prostate cancer than intact dogs.
최근에 애견 인구 컨트롤을 위해 미국과 유럽에서 행해진 두 중성화 수술의 사후평가 조사에서 중성화된 애견이 전립선암 발생률이 4배 높게 나왓다는 결과가 알려졌다.
Based on their results, the researchers suggest a cause-and-effect relationship: “this suggests that castration does not initiate the development of prostatic carcinoma in the dog, but does favor tumor progression” (5) and also “Our study found that most canine prostate cancers are of ductal/urothelial origin…. The relatively low incidence of prostate cancer in intact dogs may suggest that testicular hormones are in fact protective against ductal/urothelial prostatic carcinoma, or may have indirect effects on cancer
development by changing the environment in the prostate.” (6)
그 결과에서 연구자들은 원인과 결과의 관계의 주목했다. "거세를 하는것이 암을 발생시키는 것은 아니나 암의 진행을 돕는다","우리의 연구 결과는 대부분의 전립선 암이 요로상피세포암종에서 시작되는것을 발견했다. 이것은 상대적으로 중성화를 하지않은 개들에는 발병률이 낮았으므로 고환 호르몬이 요로상피세포암종의 발병을 억제하는 역활을 하거나, 전립선을 떼어내는 과정에서의 변화가 원인이라고 보여진다".
This needs to be put in perspective. Unlike the situation in humans, prostate cancer is uncommon in dogs. Given an incidence of prostate cancer in dogs of less than 0.6% from necropsy studies7, it is difficult to see that the risk of prostate cancer should factor heavily into most neutering decisions. There is evidence for an increased risk of prostate cancer in at least one breed (Bouviers) (5), though very little data so far to guide us
in regards to other breeds.
사람과는 달리 개에게는 전립선암이 드물다.0.6프로 이내의 발병률이므로 그 이유를 가지고 모든 중성화 수술이 전립선암을 가져온다고 보기는힘들다. 이 증거자료는 오직 한 종자 Bouviers종에게만 해당한다.
Testicular Cancer
Since the testicles are removed with neutering, castration removes any risk of testicular cancer (assuming the castration is done before cancer develops). This needs to be compared to the risk of testicular cancer in intact dogs.
고환이 중성화로 인해 제거되엇으므로 모든 고환관련 암은 제거되어야한다(암발병전에 수술한 경우). 중성화를 하지않은 개들과 비교가 필요하다.
Testicular tumors are not uncommon in older intact dogs, with a reported incidence of 7%8. However, the prognosis for treating testicular tumors is very good owing to a low rate of metastasis(9), so testicular cancer is an uncommon cause of death in intact dogs. For example, in a Purdue University breed health survey of Golden Retrievers(10), deaths due to testicular cancer were sufficiently infrequent that they did not appear on
list of significant causes of "Years of Potential Life Lost for Veterinary Confirmed Cause of Death” even though 40% of GR males were intact. Furthermore, the GRs who were treated for testicular tumors had a 90.9% cure rate. This agrees well with other work that found 6-14% rates of metastasis for testicular tumors in dogs (11).
고환암은 중성화 하지않은 노령견에겐 꽤 발병되는 편이다,7 프로
하지만 치유와 진단이 쉬우므로 사망률은 아주 낮은편이다. 퍼듀대에서 발표한 골든 리트리버의 질병 자료에 따르면 40프로의 중성화하지않은 개들이 걸렷음에도 불구 90.9프로의 완치율을 보였으므로 "올해의 사망에 이르게하는 위험한 질병 리스트"에는 이름을 올리지 않앗다. 고환암이 전이될 확률은 6-14프로이다.
The high cure rate of testicular tumors combined with their frequency suggests that fewer than 1% of intact male dogs will die of testicular cancer.
In summary, though it may be the most common reason why many advocate neutering young male dogs, the risk from life threatening testicular cancer is sufficiently low that neutering most male dogs to prevent it is difficult to justify.
An exception might be bilateral or unilateral cryptorchids, as testicles that are retained in the abdomen are 13.6 times more likely to develop tumors than descended testicles12 and it is also more difficult to detect tumors in undescended testicles by routine physical examination.
중성화 하지않은 개가 고환 암으로 사망할 확률은 1프로 이내이다. 남아를 고환암의 리스크때문에 중성화 시키는것은 현명한 방법이 아니다.잠복고환을 가지고 있는 경우는 예외인데 이는 암 발생률이 13.6배높고 검사시 발병을 알아채기도 힘들기 때문이다.
Osteosarcoma (Bone Cancer)
A multi-breed case-control study of the risk factors for osteosarcoma found that spay/neutered dogs (males or females) had twice the risk of developing osteosarcoma as did intact dogs (13).
This risk was further studied in Rottweilers, a breed with a relatively high risk of osteosarcoma. This retrospective cohort study broke the risk down by age at spay/neuter, and found that the elevated risk of osteosarcoma is associated with spay/neuter of young dogs14. Rottweilers spayed/neutered before one year of age were 3.8 (males) or 3.1 (females) times more likely to develop osteosarcoma than intact dogs. Indeed, the combination of breed risk and early spay/neuter meant that Rottweilers spayed/neutered before one year of age had a 28.4% (males) and 25.1% (females) risk of developing osteosarcoma. These results are consistent with the earlier multi-breed study13 but have an advantage of assessing risk as a function of age at neuter. A logical conclusion derived from combining the findings of these two studies is that spay/neuter of dogs before 1 year of age is associated with a significantly increased risk of osteosarcoma.
많은 종의 중성화를 한 개들이 뼈 관련 암 발생률이 두배 가량 높앗다. Rottweilers라는 종에서 뼈암의 발생률이 14세 이상의 견에게서 발생률이 높았다.1살 이전에 중성화를 한 여아에게서 3.1배, 남아에게서는 3.8배 높앗다. 그러므로 이른시기에 중성화 한 개들에게서는 (1살이전) 28.4프로-남아, 25.1프로-여아에게서의 총 발생률을 보였다, 이 결과는 1살 이전의 중성화를 한경우 뼈 관련 암 발생률아 급격하게 높아짐을 보여준다.
The researchers suggest a cause-and-effect relationship, as sex hormones are known to influence the maintenance of skeletal structure and mass, and also because their findings showed an inverse relationship between time of exposure to sex hormones and risk of osteosarcoma.(14)
연구자들은 원인과 결과의 관계를 보라고 제시한다. 성 호르몬은 뼈의 구조와 밀도에 연과이 있는것으로 잘 알려져있다. 그들의 연구결과는 성호르몬의 발달과 뼈 암의 발생 관련률을 보여주고 있다.
The risk of osteosarcoma increases with increasing breed size and especially height (13). It is a common cause of death in medium/large, large, and giant breeds. Osteosarcoma is the third most common cause of death in Golden Retrievers10 and is even more common in larger breeds (13).
뼈 암의 증가율은 개의 종과 사이즈, 특히 키에 관련이 있다. 중간사이즈나 대형견들이 사망률이 높은데 골든리트리버의 3대 사망원인 이기도 하다.
Mammary Cancer (Breast Cancer)
Mammary tumors are by far the most common tumors in intact female dogs, constituting some 53% of all malignant tumors in female dogs in a study of dogs in Norway (15) where spaying is much less common than in the USA.
유방관련 암은 중성화 하지 않은 암컷들에게 가장 흔한데 미국보다 중성화 수술이 흔하지 않은 노르웨이에서 53프로의 악성 종양이 발병되었다고 한다
50-60% of mammary tumors are malignant, for which there is a significant risk of metastasis (16). Mammary tumors in dogs have been found to have estrogen receptors(17), and the published research18 shows that the relative risk (odds ratio) that a female will develop mammary cancer compared to the risk in intact females is dependent on how many estrus cycles she experiences:
50-60프로의 종양은 악성이며 전의가 된다. 유방암은 여성호르몬 수용기관에서 발견되는데 학회 자료에서 여아들은 몇번의 발정 사이클을 걸쳣나가 발병률에 연관이 있다고 한다. 발정기 전-0.005발정기1번-0.082번이상 0.26, 중성화 안함-1
# of estrus cycles before spay Odds Ratio
None
0.005
1 0.08
2or more 0.26
Intact 1.00
The same data when categorized differently showed that the relative risk (odds ratio) that females will develop mammary cancer compared to the risk in intact females indicated that:
다른 통계에서 중성화를 하지않은 여아가 유방암이 생길 확률을 중성화를 한 여아와 비교
중성화를 29달 전에 할경우 0.06, 30달-0.40, 중성화 안함-1.00
Age at Spaying Odds Ratio
< 29 months 0.06
Please note that these are RELATIVE risks. This study has been referenced elsewhere many times but the results have often been misrepresented as absolute risks.
이것은 상대적인 위험이라는것을 알아야한다, 결과가 잘못 받아들여지는 경우가 빈재하다.
A similar reduction in breast cancer risk was found for women under the age of 40 who lost their estrogen production due to “artificial menopause”(19) and breast cancer in humans is known to be estrogen activated.
40대 이하의 여성중 폐경을 맞이한 여성에게서 유방암 발생률이 낮앗다, 유방암은 여성호르몬의 활동과 연관이 있다.
Mammary cancer was found to be the 10th most common cause of years of lost life in Golden Retrievers, even though 86% of female GRs were spayed, at a median age of 3.4 yrs(10). Considering that the female subset accounts for almost all mammary cancer cases, it probably would rank at about the 5th most common cause of years of lost life in female GRs. It would rank higher still if more female GRs had been kept intact up to 30 months of age.
3.4살정도에서 86프로의 중성화된 골든리트리버의 10번째 사망원인은 유방암이다. 그 비율로 봣을때는 5번째의 암컷의 사망원인이 유방암일것이다. 이는 이 여아들이 30달까지 중성화를 하지않고 기다렸다고 봤을때도 높은 수치이다.
Boxers, cocker spaniels, English Springer spaniels, and dachshunds are breeds at high risk of mammary tumors(15). A population of mostly intact female Boxers was found to have a 40% chance of developing mammary cancer between the ages of 6-12 years of age(15). There are some indications that purebred dogs may be at higher risk than mixed breed dogs, and purebred dogs with high inbreeding coefficients may be at higher risk than those with low inbreeding coefficients(20). More investigation is required to determine if these are significant.
In summary, spaying female dogs significantly reduces the risk of mammary cancer (a common cancer), and the fewer estrus cycles experienced at least up to 30 months of age, the lower the risk will be.
복서,코커스파니엘,잉글리쉬스파니엘,닥스훈트등이 유방암발병이 높은 종이다,중성화를 하지않은 복서의 경우 6-12살안에 40프로의 발병률을 보인다. 순종일경우 믹스 된 개보다 높은 발병을 보인다는 연구도 있다.
Female Reproductive Tract Cancer (Uterine, Cervical, and Ovarian Cancers)
Uterine/cervical tumors are rare in dogs, constituting just 0.3% of tumors in dogs (21).
Spaying will remove the risk of ovarian tumors, but the risk is only 0.5%22.
While spaying will remove the risk of reproductive tract tumors, it is unlikely that surgery can be justified to prevent the risks of uterine, cervical, and ovarian cancers as the risks are so low.
여아 생식기 암 (자궁, 자궁경부, 난소암)
자궁, 자궁경부암은 흔하지 않다, 0.3프로, 중성화는 난소암의 모든 원인을 제거한다 그러나 오직 0.5프로의 발병의 질병이다. 중성화가 발병률이 낮은편인 모든 생식기류 암의 원인을 제거한다는 이유만으로 행해지는것은 현명치 않다.
Urinary Tract Cancer (Bladder and Urethra Cancers)
An age-matched retrospective study found that spay/neuter dogs were two times more likely to develop lower urinary tract tumors (bladder or urethra) compared to intact dogs(23). These tumors are nearly always malignant, but are infrequent, accounting for less than 1% of canine tumors. So this risk is unlikely to weigj heavily on spay/neuter decisions.
Airedales, Beagles, and Scottish Terriers are at elevated risk for urinary tract cancer while German Shepherds have a lower than average risk (23).
방광,요도 암
중성화된 개들에게서 요도 방광암의 발병률이 2배 높다는 연구결과가 나왓다. 보통 발병시 악성인데 발병률이 낮고 1프로 미만이기때문에 크게 위험요소는 아니다.
Hemangiosarcoma
Hemangiosarcoma is a common cancer in dogs. It is a major cause of death in some breeds, such as Salukis, French Bulldogs, Irish Water Spaniels, Flat Coated Retrievers, Golden Retrievers, Boxers, Afghan Hounds, English Setters, Scottish Terriesr, Boston Terriers, Bulldogs, and German Shepherd Dogs (24).
In an aged-matched case controlled study, spayed females were found to have a 2.2 times higher risk of splenic hemangiosarcoma compared to intact females (24).
A retrospective study of cardiac hemangiosarcoma risk factors found a >5 times greater risk in spayed female dogs compared to intact female dogs and a 1.6 times higher risk in neutered male dogs compared to intact male dogs.(25) The authors suggest a protective effect of sex hormones against hemangiosarcoma, especially in females.
In breeds where hermangiosarcoma is an important cause of death, the increased risk associated with spay/neuter is likely one that should factor into decisions on whether or when to sterilize a dog.
혈관육종
자주 발병하는 질병이다, 어떤 종에게서는 주된 사망원인이다, 살루키,프렌치불독, 아이리쉬스파니엘, 리트리버,골든리트리버,복서,아프간하운다, 잉글리쉬 세터,스코티쉬 테리어,보스톤테리어,불독,저만쉐퍼드등이있다.
중성화된 암컷이 동맥류 혈관육종에서 2.2배 높은 발병률을 보였다. 심장류혈관육종에서는 중성화된 암컷이 5배 높은 발병률을, 수컷은 1.6배의 발병률을 보였다. 이는 성 호르몬의 발달이 특히 여아의 경우 혈관 육종에 대항하는 힘을 길러주는것을 보여준다.
Hypothyroidism
Spay/neuter in dogs was found to be correlated with a three fold increased risk of hypothyroidism compared to intact dogs. (26).
The researchers suggest a cause-and-effect relationship: They wrote: “More important [than the mild direct impact on thyroid function] in the association between [spaying and] neutering and hypothyroidism may be the effect of sex hormones on the immune system. Castration increases the severity of autoimmune thyroiditis in mice” which may explain the link between spay/neuter and hypothyroidism in dogs.
Hypothyroidism in dogs causes obesity, lethargy, hair loss, and reproductive abnormalities.(27)
The lifetime risk of hypothyroidism in breed health surveys was found to be 1 in 4 in Golden Retrievers (10), 1 in 3 in Akitas (28), and 1 in 13 in Great Danes (29).
갑상선 저하증
갑상성은 중성화와 관련을 가지는데 성호르몬이 면역체계에 미치는 영향과도 관련이 있다. 거세를 한 실험 쥐에게서 자가 면역체계의 어려움을 발견했는데 이는 개에게도 해당된다고 여겨진다.갑상선 저하는 비만, 무기력증, 털 빠짐, 생산능력저하등을 일으킨다.
Obesity
Owing to changes in metabolism, spay/neuter dogs are more likely to be overweight or obese than intact dogs. One study found a two fold increased risk of obesity in spayed females compared to intact females (30). Another study found that spay/neuter dogs were 1.6 (females) or 3.0 (males) times more likely to be obese than intact dogs, and 1.2 (females) or 1.5 (males) times more likely to be overweight than intact dogs(31).
A survey study of veterinary practices in the UK found that 21% of dogs were obese.(30)
Being obese and/or overweight is associated with a host of health problems in dogs. Overweight dogs are more likely to be diagnosed with hyperadrenocorticism, ruptured cruciate ligament, hypothyroidism, lower urinary tract disease, and oral disease(32). Obese dogs are more likely to be diagnosed with hypothyroidism, diabetes mellitus, pancreatitis, ruptured cruciate ligament, and neoplasia (tumors)(32).
비만
물질대사작용의 변화로 중성화 한 개들은 아닌개들보다 과 체중이 많다, 한 연구에서 중성화 한 개들이 아닌 개들보다 2배 정도가 비만이 많음을 밝혔고 다른 연구에서는 여아의 경우 1.6배 남아는 3배가 심히 비만이였으며 여아의 1.2배 남아의 1.5배가 과체중이였다.
영국에서의 바료에 21프로의 개가 비만인데 비만과 과체중은 많은 질환의 원인이되고있다.과체중인 개들은 부신피질항진증, 십자인대 파열, 방광 요도염, 구 질환 등이 더 많이 발병되고 비만인 개들은 갑상선 저하, 당뇨, 췌장, 십자인대 파열과 종양의 발생률이 높아진다.
Diabetes
Some data indicate that neutering doubles the risk of diabetes in male dogs, but other data showed no significant change in diabetes risk with neutering (33). In the same studies, no association was found between spaying and the risk of diabetes.
어떤 연구에선 중성화 한 남아의 경우 당뇨발생이 두배라고 한다 그러나 아니라는 연구결과도 있다.
Adverse Vaccine Reactions
A retrospective cohort study of adverse vaccine reactions in dogs was conducted, which included allergic reactions, hives, anaphylaxis, cardiac arrest, cardiovascular shock, and sudden death. Adverse reactions were 30% more likely in spayed females than intact females, and 27% more likely in neutered males than
intact males (34).
연구결과에서 백신에 알러지, 두드러기, 과민증,심장류 쇼크, 갑자기 사망하는등의 반응이 있다고 알려진다. 중성화한 암컷에서 30프로가 , 남아에서는 27프로가 중성화 하지 않은 개들보다 이러한 반응을 보인다.
The investigators discuss possible cause-and-effect mechanisms for this finding, including the roles that sex hormones play in body’s ability to mount an immune response to vaccination. (34)
Toy breeds and smaller breeds are at elevated risk of adverse vaccine reactions, as are Boxers, English Bulldogs, Lhasa Apsos, Weimaraners, American Eskimo Dogs, Golden Retrievers, Basset Hounds, Welsh Corgis, Siberian Huskies, Great Danes, Labrador Retrievers, Doberman Pinschers, American Pit Bull Terriers, and Akitas.34 Mixed breed dogs were found to be at lower risk, and the authors suggest genetic hetereogeneity (hybrid vigor) as the cause.
이는 성 호르몬의 면역체계에서의 역활을 보여주는 바이다. 소형견, 토이류의 개들이 더 발생률이 높은것으로 보여진다.
Urogenital Disorders
비뇨기관내 질병
Urinary incontinence is common in spayed female dogs, which can occur soon after spay surgery or after a delay of up to several years. The incidence rate in various studies is 4-20% 35,36,37 for spayed females compared to only 0.3% in intact females38. Urinary incontinence is so strongly linked to spaying that it is commonly called “spay incontinence” and is caused by urethral sphincter incompetence39, though the biological mechanism is unknown. Most (but not all) cases of urinary incontinence respond to medical treatment, and in many cases this treatment needs to be continued for the duration of the dog’s life. (40)
요실금은 중성화한 암컷에게 흔하다. 수술후 바로 나타나거나 몇년후에 발병한다. 4-20프로의 발병률은 중성화하지 않은 암컷이 오직 0.3프로인것에 비하면 높은 편이다. 이는 수술시 방광의 조임 능력 상실에서 비롯되는데 개의 일생동안 치료가 필요하다.
A retrospective study found that persistent or recurring urinary tract (bladder) infections (UTIs) were 3-4 times more likely in spayed females dogs than in intact females (41). Another retrospective study found that female dogs spayed before 5 ½ months of age were 2.76 times more likely to develop UTIs compared to those spayed after 5 ½ months of age.(42)
방광염또한 3-4배 이상 높아진다. 5달 반 이전에 중성화한 여아는 그후에 한 여아보다 2.76배 높은 방광염증상을 보인다.
Depending on the age of surgery, spaying causes abnormal development of the external genitalia. Spayed females were found to have an increased risk of recessed vulva, vaginal dermatitis, vaginitis, and UTIs. (43) The risk is higher still for female dogs spayed before puberty. (43)
중성화는 언제 하느냐도 중요하다. 생식기 관련 질병은 2차 성징전에 중성화를 한 여아들에게서 훨씨 많이 보여진다.
Pyometra (Infection of the Uterus)
Pet insurance data in Sweden (where spaying is very uncommon) found that 23% of all female dogs developed pyometra before 10 years of age (44). Bernese Mountain dogs, Rottweilers, rough-haired Collies, Cavalier King Charles Spaniels and Golden Retrievers were found to be high risk breeds (44)/ Female dogs that have not whelped puppies are at elevated risk for pyometra45. Rarely, spayed female dogs can develop “stump pyometra” related to incomplete removal of the uterus.
Pyometra can usually be treated surgically or medically, but 4% of pyometra cases led to death (44). Combined with the incidence of pyometra, this suggests that about 1% of intact female dogs will die from pyometra.
중성화가 흔치않은 스웨덴의 개 보험회사의 데이터에 따르면 10살 이내의 암컷에게서 23프로의 자궁축농증이 발견됫다.버니즈 마운틴 덕, 러트웨일러,콜리,케비어 스파니엘, 골든리트리버가 높은 위험군의 개들이라고 하고 자식을 낳지 않은 암컷의 발병률이 더 높앗으며 흔치않게 중성화 한 암컷중에서도 자궁 부분이 남아잇는 경우 축농증이 발생하기도 한다.
Perianal Fistulas
Male dogs are twice as likely to develop perianal fistulas as females, and spay/neutered dogs have a decreased risk compared to intact dogs (46).
German Shepherd Dogs and Irish Setters are more likely to develop perianal fistulas than are other breeds. (46)
항문질병
남아들이 여아에 비해 2배의 발생률이 보이고 중성화는 발생률을 낮춘다.저먼세퍼드와 아이리쉬 세터가 발병률이 높다.
Non-cancerous Disorders of the Prostate Gland
The incidence of benign prostatic hypertrophy (BPH, enlarged prostate) increases with age in intact male dogs, and occurs in more than 80% of intact male dogs older than the age of 5 years47. Most cases of BPH cause no problems, but in some cases the dog will have difficulty defecating or urinating.
Neutering will prevent BPH. If neutering is done after the prostate has become enlarged, the enlarged prostate will shrink relatively quickly.
BPH is linked to other problems of the prostate gland, including infections, abscesses, and cysts, which can sometimes have serious consequences.
암이 아닌 전린선류 질병
양성전립비대증은 중성화 하지 않은 개들에게서 많이 발생하는데 5살 이사의 80프로 이상의 중성화 하지 않은 개에서 발견됬고 대부분의 경유 치유가쉬우나 개들에게서 변을 보거나 소변을 볼시 고통을 느끼기도 한다.
중성화는 이 질환을 예방하고 이 발병이 더 퍼지기전에 중성화를 한다면 염증이 빨리 사라지기도 하다.
이 질환은 전립샘의 질병과도 연관이 있고 염증,농양, 낭종등의 다른 심각한 질환으로 이어지기도 한다.
Orthopedic Disorders
In a study of beagles, surgical removal of the ovaries (as happens in spaying) caused an increase in the rate of remodeling of the ilium (pelvic bone) (48), suggesting an increased risk of hip dysplasia with spaying. Spaying was also found to cause a net loss of bone mass in the spine (49).
Spay/neuter of immature dogs delays the closure of the growth plates in bones that are still growing, causing those bones to end up significantly longer than in intact dogs or those spay/neutered after maturity (50). Since the growth plates in various bones close at different times, spay/neuter that is done after some growth plates have closed but before other growth plates have closed might result in a dog with unnatural proportions, possibly impacting performance and long term durability of the joints.
정형외과관련 질병
비글종의 연구에서 난소를 제거한경우 골반뼈 재건축 수술의 빈도가 높아졌다.엉덩이뼈 수술의 빈도가 높아진것은 중성화가 골밀도를 낮게 만들었다는것을 보여준다. 다 성장하지 못한 강아지를 중성화시켯을때 뼈의 성장을 저하시키고 (성장판이 닫히는 과정을 방해함) 뼈가 중성화 하지 않은 개들이나 성장후 수술한 개들에 비해 길어지는 현상을 보인다. 성장판이 닫히는 시기가 부위마다 다르므로 어렸을때 중성화된 개들은 뼈의 분포가 일정치 않고 관절등의 이상이 생길수 있다.
Spay/neuter is associated with a two fold increased risk of cranial cruciate ligament rupture (51). Perhaps this is associated with the increased risk of obesity (30).
중성화는 앞쪽십자 무릎인대파열을 많이 증가시킨다는 연구결과가 있다. 이는 과체중이 원인인것으로 보인다.
Spay/neuter before 5 ½ months of age is associated with a 70% increased aged-adjusted risk of hip dysplasia compared to dogs spayed/neutered after 5 ½ months of age, though there were some indications that the former may have had a lower severity manifestation of the disease (42). The researchers suggest “it is possible that the increase in bone length that results from early-age gonadectomy results in changes in joint conformation, which could lead to a diagnosis of hip dysplasia.”
5달 반 전에 중성화를 하는것은 성장후에 수술을 하는 개들이나 중성화를 하지않은 개들에 비해 엉덩이 관절 이상 발병률을 70프로까지 증가시킨다. 연구자들은 성장기가 지나기전 생식샘절제술로 인한 연골의 변화나 뼈의 길이 성장이 엉덩이 관절 이상을 발병시킨다고 생각한다.
In a breed health survey study of Airedales, spay/neuter dogs were significantly more likely to suffer hip dysplasia as well as “any musculoskeletal disorder”, compared to intact dogs52, however possible confounding factors were not controlled for, such as the possibility that some dogs might have been spayed/neutered because they had hip dysplasia or other musculoskeletal disorders.
연구에서 중성화한 개들은 근육골격계통의 질환과 엉덩이 관절 질환의 발병률이 그렇지 않은 개들보다 현저히 높다.하지만 이 연구결과는 이미 골격계통의 질환의 요인을 가진 개들이 중성화 수술을 햇을 경우수를 고려한 것은 아니라는 점을 밝힌다.
Compared to intact dogs, another study found that dogs neutered six months prior to a diagnosis of hip dysplasia were 1.5 times as likely to develop clinical hip dysplasia. (53)
Compared to intact dogs, spayed/neutered dogs were found to have a 3.1 fold higher risk of patellar luxation. (54)
중성화 하지 않은 개에 비교해서 다른 연구결과 에서는 엉덩이 골격관련 질환을 가진 개들이 발병진단 6개월 이상 전에 중성화를 했을경우 악성 골격 장애로 넘어갈확률이 1.5배였다.
Geriatric Cognitive Impairment
Neutered male dogs and spayed female dogs are at increased risk of progressing from mild to severe geriatric cognitive impairment compared to intact male dogs (55). There weren’t enough intact geriatric females available for the study to determine their risk.
Geriatric cognitive impairment includes disorientation in the house or outdoors, changesin social interactions with human family members, loss of house training, and changes in the sleep-wake cycle (55).
The investigators state “This finding is in line with current research on the neuro-protective roles of testosterone and estrogen at the cellular level and the role of estrogen in preventing Alzheimer’s disease in human females. One would predict that estrogens would have a similar protective role in the sexually intact female dogs; unfortunately too few sexually intact female dogs were available for inclusion in the present
study to test the hypothesis” (55)
노견의 병
중성화한 남 녀 개들은 약한경우서 심한 경우까지 인지능력을 상실하는경우가 많았다. 중성화 하지 않은 여아들의 연구결과가 충분치 않다는 점을 알려둔다.
노견의 인지능력 상실에는 집 안과 밖에서의 방향감각 상실, 가족과의 인간관계 능력상실, 하우스 트레이닝 상실, 잠자는 사이클의 변화 등이다.
연구자들은 이는 현재 연구중인 신경 보호계에서 성 호르몬이 미치는 영향을 보여준다며 여성의 치매 발병에서 여성호르몬이 미치는 영향을 보여주는것과 흡사하다고 했다.
여성 호르몬은 중성화 하지 않은 암컷에게서 비슷한 보호제 역활을 하는데 안타깝게도 중성화 하지 않은 암컷의 연구결과가 부족하다.
CONCLUSIONS
An objective reading of the veterinary medical literature reveals a complex situation with respect to the longterm health risks and benefits associated with spay/neuter in dogs. The evidence shows that spay/neuter correlates with both positive AND adverse health effects in dogs. It also suggests how much we really do not yet understand about this subject.
동물학계의 발표자료에 따르면 장기적 관점에서의 중성화 수술에 따른 장 단점은 모두 존재한다. 문제점은 우리가 얼마나 제대로 인지하고 있는가 이다.
On balance, it appears that no compelling case can be made for neutering most male dogs to prevent future health problems, especially immature male dogs. The number of health problems associated with neutering may exceed the associated health benefits in most case.
결과적으로는 수컷의 중성화가 크게 미래의 질병의 예방한다는것은 설득력이 없는 주장이다. 중성화를 함으로써 발생하는 건강상의 문제가 장점을 넘어선다는 의견이다.
For female dogs, the situation is more complex. The number of health benefits associated with spaying may exceed the associated health problems in many (not all) cases. On balance, whether spaying improves the odds of overall good health or degrades them probably depends on the age of the dog and the relative risk of various diseases in the different breeds.
암컷의 경우 좀더 문제가 복잡해진다. 중성화로써 해결되는 건강상의 장점이 단점을 넘어선다는 의견이나 중성화가 전반적으로 모든 암컷 개들의 건강을 향상시킨다고 보기에는 개들마다의 나이나 종자에 따라서의 변수가따른다.
The traditional spay/neuter age of six months as well as the modern practice of pediatric spay/neuter appear to predispose dogs to health risks that could otherwise be avoided by waiting until the dog is physically mature, or perhaps in the case of many male dogs, foregoing it altogether unless medically necessary.
통상적으로 행해지는 6개월 전후의 중성화 수술은 개가 성장할때까지 미뤄줘야 할것이다. 수컷의 경우는 굳이 중성화가 건강상의 이유로는 필요치 않다고 하겠다.
The balance of long-term health risks and benefits of spay/neuter will vary from one dog to the next. Breed, age, and gender are variables that must be taken into consideration in conjunction with non-medical factors for each individual dog. Across-the-board recommendations for all dogs do not appear to be supportable from findings in the veterinary medical literature.
장기적인 관점에서의 중성화의 장점은 개개마다 틀려진다. 종자, 나이, 성별등의 다른점이 고려되어야 할것이고 의학적이지않은 다른 변수들도 영향을 끼친다. 각각의 상황을 고려하지 않고 추천되는 중성화 수술은 이 연구 결과들을 종합해 봤을때 설득력이 없어 보인다.
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Long-Term Health Risks and Benefits Associated with Spay / Neuter in Dogs
장기적으로 본 중성화 수술로 인한 위험 요인과 그로 인한 장점들
Laura J. Sanborn, M.S.
May 14, 2007
At some point, most of us with an interest in dogs will have to consider whether or not to spay / neuter our pet. Tradition holds that the benefits of doing so at an early age outweigh the risks. Often, tradition holds sway in the decision-making process even after countervailing evidence has accumulated.
많은 애견가들의 중성화를 이른 시기에 해야하는지 말아야하는지를 고민하는데 보편적으로는 이른시기에 이루어지는 것이 장점이 더 많다는 의견이 지배적이다. 보편적으로 행해지는 관습들이 그가 틀리다는 증거들이 제시되고 있음에도 계속 행해지고 있다는 점이 문제이다.
Ms. Sanborn has reviewed the veterinary medical literature in an exhaustive and scholarly treatise, attempting to unravel the complexities of the subject. More than 50 peer-reviewed papers were examined to assess the health impacts of spay / neuter in female and male dogs, respectively. One cannot ignore the findings of increased risk from osteosarcoma, hemangiosarcoma, hypothyroidism, and other less frequently occurring diseases associated with neutering male dogs. It would be irresponsible of the veterinary profession and the pet owning community to fail to weigh the relative costs and benefits of neutering on the animal’s health and well-being. The decision for females may be more complex, further emphasizing the need for individualized veterinary medical decisions, not standard operating procedures for all patients.
Sanborn 씨는 방대한 동물의학 서적과 논문들을 철저하게 분석했고 이 어려운 주제를 문제를 풀려고 노력했다. 중성화 수술이 여아 남아의 건강에 미치는 영향에 관한 50편이 넘는 논문들이 연구되었다. 한가지 간과되어서는 안될 문제는 뼈육종(뼈관련 암),혈관육종,갑상선 저하증을 비롯한 다른 질병들이 남아의 중성화 수술후 증가한다는점이다. 이러한 점들을 인지하고 중성화의 장 단점을 제대로 조명하지 못하고 있는점은 수의사계와 애견인 커뮤니티의 문제점이다. 여아의 경우 문제가 좀 복잡해지는데 각각의 애견에 따라 수의사의 더 많은 관심이 필요하다. 모든 여아견에게 통상적인 중성화를 행하는것은 문제가 있다.
No sweeping generalizations are implied in this review. Rather, the author asks us to consider all the health and disease information available as individual animals are evaluated. Then, the best decisions should be made accounting for gender, age, breed, and even the specific conditions under which the long-term care,
housing and training of the animal will occur.
This important review will help veterinary medical care providers as well as pet owners make informed decisions. Who could ask for more?
일반적인 보편화는 여기서 거론되지 않을것이다. 그것보다 작가는 우리에게 각각의 애견의 특성대로 평가하여 모든 건강과 질병 에 관한 정보들은 고려하기를 권할것이다. 이 결정은 애견의 성별,나이,종자 및 장기적인 케어로 인한 특수성까지 고려되어야 할것이다. 이 중요한 리뷰는 수의사들과 애견인들이 좀 더 좋은 결정을 내리는데 큰 도움이 될것이다.
Larry S. Katz, PhD
Associate Professor and Chair
Animal Sciences
Rutgers University
New Brunswick, NJ 08901
Larry S. Katz, PhD
럿거스 대학의 수의학대 학장및 교수
INTRODUCTION
Dog owners in America are frequently advised to spay/neuter their dogs for health reasons. A number of health benefits are cited, yet evidence is usually not cited to support the alleged health benefits.
When discussing the health impacts of spay/neuter, health risks are often not mentioned.
At times, some risks are mentioned, but the most severe risks usually are not.
This article is an attempt to summarize the long-term health risks and benefits associated with spay/neuter in dogs that can be found in the veterinary medical literature. This article will not discuss the impact of spay/neuter on population control, or the impact of spay/neuter on behavior.
미국의 애견인들은 애견의 건강을 위해 중성화 권유를 받고는 한다. 대체적으로 중성화가 좋다고 여겨지는 반면 그에 합당한 증거가 부족한게 현실이다. 중성화에 관해 이야기할때 그로 인한 위험 요소는 잘 알려지지 않고 있다. 가끔씩 위험요소들이 경고 되고 있지만 가장 중요한 위험 요소들은 거론되지 않고 있다.
이 글은 중성화로 인한 장기적인 건강문제들만을 다루고 있고 중성화로 인한 애견 인구 컨트롤의 장점이라던지 행동양식의 변화등은 다루지 않을것이다.
SUMMARY
An objective reading of the veterinary medical literature reveals a complex situation with respect to the longterm health risks and benefits associated with spay/neuter in dogs. The evidence shows that spay/neuter correlates with both positive AND adverse health effects in dogs. It also suggests how much we really do not yet understand about this subject.
동물 의학계의 논문들은 중성화로 인한 장기적인 장단점의 복잡한 문제들을 알리고 있다. 그 증거들은 중성화가 장점과 단점을 동시에 가지고 있음을 보여준다. 문제는 우리가 그것을 제대로 직시하고 있느냐는 것이다.
On balance, it appears that no compelling case can be made for neutering most male dogs, especially immature male dogs, in order to prevent future health problems. The number of health problems associated with neutering may exceed the associated health benefits in most cases.
남아들에게 행해지는 중성화는 크게 장점이 있는것으로 보여지지는 않는다. 미래의 있을수 있는 위험요소 제거를 위하여 행해진 중성화로 인해 발생되는 건강 위험요소가 더 많게 보여진다.
On the positive side, neutering male dogs
• eliminates the small risk (probably <1%) of dying from testicular cancer
• reduces the risk of non-cancerous prostate disorders
• reduces the risk of perianal fistulas
• may possibly reduce the risk of diabetes (data inconclusive)
중성화로 인한 장점으로는 (남아)
고환 암의 발병 (1프로 이내) 제거
암이 아닌 전립선관련 질병 감소
항문주위 질병 간소
당뇨 발병 감소(뒤받침할 데이터 없음)
On the negative side, neutering male dogs
• if done before 1 year of age, significantly increases the risk of osteosarcoma (bone cancer); this is a
common cancer in medium/large and larger breeds with a poor prognosis.
• increases the risk of cardiac hemangiosarcoma by a factor of 1.6
• triples the risk of hypothyroidism
• increases the risk of progressive geriatric cognitive impairment
• triples the risk of obesity, a common health problem in dogs with many associated health problems
• quadruples the small risk (<0.6%) of prostate cancer
• doubles the small risk (<1%) of urinary tract cancers
• increases the risk of orthopedic disorders
• increases the risk of adverse reactions to vaccinations
단점으로는
1살전에 행해질경우 뼈암 발병률 급격히 높아짐,중간,대형사이즈 견에게서 주로 나타남
심장혈관육종 질환 1.6배 증가
갑상선 저하 3배 증가
노견 인지 장애 발달 증가
비만 3배 증가, 많은 건강 위험요소가 비만으로 부터 발생
1프로였던 요로 감염증이 두배로 증가
정형외과 질병 증가
백신에 대한 알러지 반응 증가
For female dogs, the situation is more complex. The number of health benefits associated with spaying may exceed the associated health problems in some (not all) cases. On balance, whether spaying improves the odds of overall good health or degrades them probably depends on the age of the female dog and the relative risk of various diseases in the different breeds.
여아의 경우 좀더 복잡해진다. 중성화로 인한 장점이 단점을 넘어서기도 한다 (모든 케이스는 아님), 중성화가 전반적인 측면에서 건강의 질을 향상시킬수 있다고 볼수 있거나 여아의 나이나 종자에 따라서는 건강을 해하는 요소가 되기도한다.
On the positive side, spaying female dogs
• if done before 2.5 years of age, greatly reduces the risk of mammary tumors, the most common
malignant tumors in female dogs
• nearly eliminates the risk of pyometra, which otherwise would affect about 23% of intact female
dogs; pyometra kills about 1% of intact female dogs
• reduces the risk of perianal fistulas
• removes the very small risk (0.5%) from uterine, cervical, and ovarian tumors
장점측면, 여아
2.5살 전에 중성화가 행해지는 경우 유방암의 발병을 급격히 낮추어줌, 대개의 경우에
자궁축농증 거의 없앤다고 볼수있음, 23프로 중성화를 하지않은 여아들이 걸리고 1프로는 그중 사망함
항문관련 질병 감소
자궁, 자궁경부, 난소관련 암 발병 감소 0.5프로 (작은 숫자임)
On the negative side, spaying female dogs
• if done before 1 year of age, significantly increases the risk of osteosarcoma (bone cancer); this is a
common cancer in larger breeds with a poor prognosis
• increases the risk of splenic hemangiosarcoma by a factor of 2.2 and cardiac hemangiosarcoma by a factor of >5; this is a common cancer and major cause of death in some breeds
• triples the risk of hypothyroidism
• increases the risk of obesity by a factor of 1.6-2, a common health problem in dogs with many
associated health problems
• causes urinary “spay incontinence” in 4-20% of female dogs
• increases the risk of persistent or recurring urinary tract infections by a factor of 3-4
• increases the risk of recessed vulva, vaginal dermatitis, and vaginitis, especially for female dogsspayed before puberty
• doubles the small risk (<1%) of urinary tract tumors
• increases the risk of orthopedic disorders
• increases the risk of adverse reactions to vaccinations
단점으로는
1살 이전에 행해졋을 경우 뼈암 관련 질병 상당히 증가, 중,대형견
경맥류 혈관 육종 질병 증가 2.2배
심장류 혈관 육종 증가 5배(이 둘은 자주 발생하는 암이고 어떤 종자들은 주된 사망원인이 되기도 한다.
갑상선 저하 3배
비만 1.6-2배
난소 요실금 4-20프로 증가
방광 관련 질병 3-4배
생식기 관련 질병 증가, 여아가2차성장 전에 중성화 되엇을경우
방광암 두배 증가 (1프로 이내의 발병에서)
정형외과 질병증가
백신 리액션 증가
One thing is clear – much of the spay/neuter information that is available to the public is unbalanced and contains claims that are exaggerated or unsupported by evidence. Rather than helping to educate pet owners, much of it has contributed to common misunderstandings about the health risks and benefits associated of spay/neuter in dogs.
한가지 짚고 넘어가야할 문제는- 애견인들을 돕고 교육시켜야 할 중성화 수술의 관한 정보들이 한쪽에 치우쳐 있고(장점) 제대로 된 증거도 제시되어지지 않은채 과장되어 있다는 점이다.
The traditional spay/neuter age of six months as well as the modern practice of pediatric spay/neuter appear to predispose dogs to health risks that could otherwise be avoided by waiting until the dog is physically mature, or perhaps in the case of many male dogs, foregoing it altogether unless medically necessary.
보편적으로 6개월 전후로 행해지는 중성화 수술은 애견들을 건강위험에 노출시키면 애견이 완전히 성장할때까진 행해지지말아야 한다, 남아의 경우는 꼭 필요하지 않은 한 이루어져야 할 이유가 없다.
FINDINGS FROM STUDIES
This section summarizes the diseases or conditions that have been studied with respect to spay/neuter in dogs.
이 섹션은 중성화를 한 애견들에게서 나타는 질병들을 연구하였다.
Complications from Spay/Neuter Surgery
All surgery incurs some risk of complications, including adverse reactions to anesthesia, hemorrhage, inflammation, infection, etc. Complications include only immediate and near term impacts that are clearly linked to the surgery, not to longer term impacts that can only be assessed by research studies.
모든 수술엔 위험요소가 도사리고 있다. 마취에 알러지 반응, 출혈,감염, 염증 등등 수술로 관한 문제는 바로 나타날수 있고 장기적으로 나타날수있는 문제도 있다.
At one veterinary teaching hospital where complications were tracked, the rates of intraoperative, postoperative and total complications were 6.3%, 14.1% and 20.6%, respectively as a result of spaying female dogs1. Other studies found a rate of total complications from spaying of 17.7%2 and 23%3. A study of Canadian veterinary private practitioners found complication rates of 22% and 19% for spaying female dogs and neutering male dogs, respectively (4).
한 동물학회 병원에서 수술로 인한 문제들을 조사했는데 외과 수술중의 나타난 문제들의 퍼센티지가 6.3, 수술후 나타난 문제가 14.1프로로 총합 20.6프로가 수술로 인한 문제가 있엇음이 밝혀졋다. 다른 연구 발펴에서는 17.7프로와 23프로로 밝혀졋다. 캐나다의 시설에서 밝힌 바로는 여아가 22프로, 남아가 19프로 였다.
Serious complications such as infections, abscesses, rupture of the surgical wound, and chewed out sutures were reported at a 1- 4% frequency, with spay and castration surgeries accounting for 90% and 10% of these complications, respectively. (4)
심각한 문제들로는 감염, 농양, 수술부위의 파열, 봉합실 파열등이 1-4프로로 가장 많앗고 10프로의 중성화 수술이 이러한 문제점들을 보였다.
The death rate due to complications from spay/neuter is low, at around 0.1% (2).
중성화 수술의 합병증으로 인한 사망률은 낮다, 0.1프로
Prostate Cancer
Much of the spay/neuter information available to the public asserts that neutering will reduce or eliminate the risk that male dogs develop prostate cancer. This would not be an unreasonable assumption, given that prostate cancer in humans is linked to testosterone. But the evidence in dogs does not support this claim. In fact, the strongest evidence suggests just the opposite.
대부분의 중성화에 대하 정보가 남아의 전립선암 발병을 낮춰준다는것이다. 전립선암은 남성호르몬에 연결되어있으므로 사실상 맞는 말이다.하지만 보여지는 결과는 그 반대의 상황을 보여준다.
There have been several conflicting epidemiological studies over the years that found either an increased risk or a decreased risk of prostate cancer in neutered dogs. These studies did not utilize control populations, rendering these results at best difficult to interpret. This may partially explain the conflicting results.
몇년간의 역학조사에서 중성화가 전립선암을 증가 혹은 감소 시킨다는 다른 연구결과가 나왔다.
More recently, two retrospective studies were conducted that did utilize control populations. One of these studies involved a dog population in Europe5 and the other involved a dog population in America (6). Both studies found that neutered male dogs have a four times higher risk of prostate cancer than intact dogs.
최근에 애견 인구 컨트롤을 위해 미국과 유럽에서 행해진 두 중성화 수술의 사후평가 조사에서 중성화된 애견이 전립선암 발생률이 4배 높게 나왓다는 결과가 알려졌다.
Based on their results, the researchers suggest a cause-and-effect relationship: “this suggests that castration does not initiate the development of prostatic carcinoma in the dog, but does favor tumor progression” (5) and also “Our study found that most canine prostate cancers are of ductal/urothelial origin…. The relatively low incidence of prostate cancer in intact dogs may suggest that testicular hormones are in fact protective against ductal/urothelial prostatic carcinoma, or may have indirect effects on cancer
development by changing the environment in the prostate.” (6)
그 결과에서 연구자들은 원인과 결과의 관계의 주목했다. "거세를 하는것이 암을 발생시키는 것은 아니나 암의 진행을 돕는다","우리의 연구 결과는 대부분의 전립선 암이 요로상피세포암종에서 시작되는것을 발견했다. 이것은 상대적으로 중성화를 하지않은 개들에는 발병률이 낮았으므로 고환 호르몬이 요로상피세포암종의 발병을 억제하는 역활을 하거나, 전립선을 떼어내는 과정에서의 변화가 원인이라고 보여진다".
This needs to be put in perspective. Unlike the situation in humans, prostate cancer is uncommon in dogs. Given an incidence of prostate cancer in dogs of less than 0.6% from necropsy studies7, it is difficult to see that the risk of prostate cancer should factor heavily into most neutering decisions. There is evidence for an increased risk of prostate cancer in at least one breed (Bouviers) (5), though very little data so far to guide us
in regards to other breeds.
사람과는 달리 개에게는 전립선암이 드물다.0.6프로 이내의 발병률이므로 그 이유를 가지고 모든 중성화 수술이 전립선암을 가져온다고 보기는힘들다. 이 증거자료는 오직 한 종자 Bouviers종에게만 해당한다.
Testicular Cancer
Since the testicles are removed with neutering, castration removes any risk of testicular cancer (assuming the castration is done before cancer develops). This needs to be compared to the risk of testicular cancer in intact dogs.
고환이 중성화로 인해 제거되엇으므로 모든 고환관련 암은 제거되어야한다(암발병전에 수술한 경우). 중성화를 하지않은 개들과 비교가 필요하다.
Testicular tumors are not uncommon in older intact dogs, with a reported incidence of 7%8. However, the prognosis for treating testicular tumors is very good owing to a low rate of metastasis(9), so testicular cancer is an uncommon cause of death in intact dogs. For example, in a Purdue University breed health survey of Golden Retrievers(10), deaths due to testicular cancer were sufficiently infrequent that they did not appear on
list of significant causes of "Years of Potential Life Lost for Veterinary Confirmed Cause of Death” even though 40% of GR males were intact. Furthermore, the GRs who were treated for testicular tumors had a 90.9% cure rate. This agrees well with other work that found 6-14% rates of metastasis for testicular tumors in dogs (11).
고환암은 중성화 하지않은 노령견에겐 꽤 발병되는 편이다,7 프로
하지만 치유와 진단이 쉬우므로 사망률은 아주 낮은편이다. 퍼듀대에서 발표한 골든 리트리버의 질병 자료에 따르면 40프로의 중성화하지않은 개들이 걸렷음에도 불구 90.9프로의 완치율을 보였으므로 "올해의 사망에 이르게하는 위험한 질병 리스트"에는 이름을 올리지 않앗다. 고환암이 전이될 확률은 6-14프로이다.
The high cure rate of testicular tumors combined with their frequency suggests that fewer than 1% of intact male dogs will die of testicular cancer.
In summary, though it may be the most common reason why many advocate neutering young male dogs, the risk from life threatening testicular cancer is sufficiently low that neutering most male dogs to prevent it is difficult to justify.
An exception might be bilateral or unilateral cryptorchids, as testicles that are retained in the abdomen are 13.6 times more likely to develop tumors than descended testicles12 and it is also more difficult to detect tumors in undescended testicles by routine physical examination.
중성화 하지않은 개가 고환 암으로 사망할 확률은 1프로 이내이다. 남아를 고환암의 리스크때문에 중성화 시키는것은 현명한 방법이 아니다.잠복고환을 가지고 있는 경우는 예외인데 이는 암 발생률이 13.6배높고 검사시 발병을 알아채기도 힘들기 때문이다.
Osteosarcoma (Bone Cancer)
A multi-breed case-control study of the risk factors for osteosarcoma found that spay/neutered dogs (males or females) had twice the risk of developing osteosarcoma as did intact dogs (13).
This risk was further studied in Rottweilers, a breed with a relatively high risk of osteosarcoma. This retrospective cohort study broke the risk down by age at spay/neuter, and found that the elevated risk of osteosarcoma is associated with spay/neuter of young dogs14. Rottweilers spayed/neutered before one year of age were 3.8 (males) or 3.1 (females) times more likely to develop osteosarcoma than intact dogs. Indeed, the combination of breed risk and early spay/neuter meant that Rottweilers spayed/neutered before one year of age had a 28.4% (males) and 25.1% (females) risk of developing osteosarcoma. These results are consistent with the earlier multi-breed study13 but have an advantage of assessing risk as a function of age at neuter. A logical conclusion derived from combining the findings of these two studies is that spay/neuter of dogs before 1 year of age is associated with a significantly increased risk of osteosarcoma.
많은 종의 중성화를 한 개들이 뼈 관련 암 발생률이 두배 가량 높앗다. Rottweilers라는 종에서 뼈암의 발생률이 14세 이상의 견에게서 발생률이 높았다.1살 이전에 중성화를 한 여아에게서 3.1배, 남아에게서는 3.8배 높앗다. 그러므로 이른시기에 중성화 한 개들에게서는 (1살이전) 28.4프로-남아, 25.1프로-여아에게서의 총 발생률을 보였다, 이 결과는 1살 이전의 중성화를 한경우 뼈 관련 암 발생률아 급격하게 높아짐을 보여준다.
The researchers suggest a cause-and-effect relationship, as sex hormones are known to influence the maintenance of skeletal structure and mass, and also because their findings showed an inverse relationship between time of exposure to sex hormones and risk of osteosarcoma.(14)
연구자들은 원인과 결과의 관계를 보라고 제시한다. 성 호르몬은 뼈의 구조와 밀도에 연과이 있는것으로 잘 알려져있다. 그들의 연구결과는 성호르몬의 발달과 뼈 암의 발생 관련률을 보여주고 있다.
The risk of osteosarcoma increases with increasing breed size and especially height (13). It is a common cause of death in medium/large, large, and giant breeds. Osteosarcoma is the third most common cause of death in Golden Retrievers10 and is even more common in larger breeds (13).
뼈 암의 증가율은 개의 종과 사이즈, 특히 키에 관련이 있다. 중간사이즈나 대형견들이 사망률이 높은데 골든리트리버의 3대 사망원인 이기도 하다.
Mammary Cancer (Breast Cancer)
Mammary tumors are by far the most common tumors in intact female dogs, constituting some 53% of all malignant tumors in female dogs in a study of dogs in Norway (15) where spaying is much less common than in the USA.
유방관련 암은 중성화 하지 않은 암컷들에게 가장 흔한데 미국보다 중성화 수술이 흔하지 않은 노르웨이에서 53프로의 악성 종양이 발병되었다고 한다
50-60% of mammary tumors are malignant, for which there is a significant risk of metastasis (16). Mammary tumors in dogs have been found to have estrogen receptors(17), and the published research18 shows that the relative risk (odds ratio) that a female will develop mammary cancer compared to the risk in intact females is dependent on how many estrus cycles she experiences:
50-60프로의 종양은 악성이며 전의가 된다. 유방암은 여성호르몬 수용기관에서 발견되는데 학회 자료에서 여아들은 몇번의 발정 사이클을 걸쳣나가 발병률에 연관이 있다고 한다. 발정기 전-0.005발정기1번-0.082번이상 0.26, 중성화 안함-1
# of estrus cycles before spay Odds Ratio
None
0.005
1 0.08
2or more 0.26
Intact 1.00
The same data when categorized differently showed that the relative risk (odds ratio) that females will develop mammary cancer compared to the risk in intact females indicated that:
다른 통계에서 중성화를 하지않은 여아가 유방암이 생길 확률을 중성화를 한 여아와 비교
중성화를 29달 전에 할경우 0.06, 30달-0.40, 중성화 안함-1.00
Age at Spaying Odds Ratio
< 29 months 0.06
30 months 0.40 (not statistically significant at the P<0.05 level)Intact 1.00
Please note that these are RELATIVE risks. This study has been referenced elsewhere many times but the results have often been misrepresented as absolute risks.
이것은 상대적인 위험이라는것을 알아야한다, 결과가 잘못 받아들여지는 경우가 빈재하다.
A similar reduction in breast cancer risk was found for women under the age of 40 who lost their estrogen production due to “artificial menopause”(19) and breast cancer in humans is known to be estrogen activated.
40대 이하의 여성중 폐경을 맞이한 여성에게서 유방암 발생률이 낮앗다, 유방암은 여성호르몬의 활동과 연관이 있다.
Mammary cancer was found to be the 10th most common cause of years of lost life in Golden Retrievers, even though 86% of female GRs were spayed, at a median age of 3.4 yrs(10). Considering that the female subset accounts for almost all mammary cancer cases, it probably would rank at about the 5th most common cause of years of lost life in female GRs. It would rank higher still if more female GRs had been kept intact up to 30 months of age.
3.4살정도에서 86프로의 중성화된 골든리트리버의 10번째 사망원인은 유방암이다. 그 비율로 봣을때는 5번째의 암컷의 사망원인이 유방암일것이다. 이는 이 여아들이 30달까지 중성화를 하지않고 기다렸다고 봤을때도 높은 수치이다.
Boxers, cocker spaniels, English Springer spaniels, and dachshunds are breeds at high risk of mammary tumors(15). A population of mostly intact female Boxers was found to have a 40% chance of developing mammary cancer between the ages of 6-12 years of age(15). There are some indications that purebred dogs may be at higher risk than mixed breed dogs, and purebred dogs with high inbreeding coefficients may be at higher risk than those with low inbreeding coefficients(20). More investigation is required to determine if these are significant.
In summary, spaying female dogs significantly reduces the risk of mammary cancer (a common cancer), and the fewer estrus cycles experienced at least up to 30 months of age, the lower the risk will be.
복서,코커스파니엘,잉글리쉬스파니엘,닥스훈트등이 유방암발병이 높은 종이다,중성화를 하지않은 복서의 경우 6-12살안에 40프로의 발병률을 보인다. 순종일경우 믹스 된 개보다 높은 발병을 보인다는 연구도 있다.
Female Reproductive Tract Cancer (Uterine, Cervical, and Ovarian Cancers)
Uterine/cervical tumors are rare in dogs, constituting just 0.3% of tumors in dogs (21).
Spaying will remove the risk of ovarian tumors, but the risk is only 0.5%22.
While spaying will remove the risk of reproductive tract tumors, it is unlikely that surgery can be justified to prevent the risks of uterine, cervical, and ovarian cancers as the risks are so low.
여아 생식기 암 (자궁, 자궁경부, 난소암)
자궁, 자궁경부암은 흔하지 않다, 0.3프로, 중성화는 난소암의 모든 원인을 제거한다 그러나 오직 0.5프로의 발병의 질병이다. 중성화가 발병률이 낮은편인 모든 생식기류 암의 원인을 제거한다는 이유만으로 행해지는것은 현명치 않다.
Urinary Tract Cancer (Bladder and Urethra Cancers)
An age-matched retrospective study found that spay/neuter dogs were two times more likely to develop lower urinary tract tumors (bladder or urethra) compared to intact dogs(23). These tumors are nearly always malignant, but are infrequent, accounting for less than 1% of canine tumors. So this risk is unlikely to weigj heavily on spay/neuter decisions.
Airedales, Beagles, and Scottish Terriers are at elevated risk for urinary tract cancer while German Shepherds have a lower than average risk (23).
방광,요도 암
중성화된 개들에게서 요도 방광암의 발병률이 2배 높다는 연구결과가 나왓다. 보통 발병시 악성인데 발병률이 낮고 1프로 미만이기때문에 크게 위험요소는 아니다.
Hemangiosarcoma
Hemangiosarcoma is a common cancer in dogs. It is a major cause of death in some breeds, such as Salukis, French Bulldogs, Irish Water Spaniels, Flat Coated Retrievers, Golden Retrievers, Boxers, Afghan Hounds, English Setters, Scottish Terriesr, Boston Terriers, Bulldogs, and German Shepherd Dogs (24).
In an aged-matched case controlled study, spayed females were found to have a 2.2 times higher risk of splenic hemangiosarcoma compared to intact females (24).
A retrospective study of cardiac hemangiosarcoma risk factors found a >5 times greater risk in spayed female dogs compared to intact female dogs and a 1.6 times higher risk in neutered male dogs compared to intact male dogs.(25) The authors suggest a protective effect of sex hormones against hemangiosarcoma, especially in females.
In breeds where hermangiosarcoma is an important cause of death, the increased risk associated with spay/neuter is likely one that should factor into decisions on whether or when to sterilize a dog.
혈관육종
자주 발병하는 질병이다, 어떤 종에게서는 주된 사망원인이다, 살루키,프렌치불독, 아이리쉬스파니엘, 리트리버,골든리트리버,복서,아프간하운다, 잉글리쉬 세터,스코티쉬 테리어,보스톤테리어,불독,저만쉐퍼드등이있다.
중성화된 암컷이 동맥류 혈관육종에서 2.2배 높은 발병률을 보였다. 심장류혈관육종에서는 중성화된 암컷이 5배 높은 발병률을, 수컷은 1.6배의 발병률을 보였다. 이는 성 호르몬의 발달이 특히 여아의 경우 혈관 육종에 대항하는 힘을 길러주는것을 보여준다.
Hypothyroidism
Spay/neuter in dogs was found to be correlated with a three fold increased risk of hypothyroidism compared to intact dogs. (26).
The researchers suggest a cause-and-effect relationship: They wrote: “More important [than the mild direct impact on thyroid function] in the association between [spaying and] neutering and hypothyroidism may be the effect of sex hormones on the immune system. Castration increases the severity of autoimmune thyroiditis in mice” which may explain the link between spay/neuter and hypothyroidism in dogs.
Hypothyroidism in dogs causes obesity, lethargy, hair loss, and reproductive abnormalities.(27)
The lifetime risk of hypothyroidism in breed health surveys was found to be 1 in 4 in Golden Retrievers (10), 1 in 3 in Akitas (28), and 1 in 13 in Great Danes (29).
갑상선 저하증
갑상성은 중성화와 관련을 가지는데 성호르몬이 면역체계에 미치는 영향과도 관련이 있다. 거세를 한 실험 쥐에게서 자가 면역체계의 어려움을 발견했는데 이는 개에게도 해당된다고 여겨진다.갑상선 저하는 비만, 무기력증, 털 빠짐, 생산능력저하등을 일으킨다.
Obesity
Owing to changes in metabolism, spay/neuter dogs are more likely to be overweight or obese than intact dogs. One study found a two fold increased risk of obesity in spayed females compared to intact females (30). Another study found that spay/neuter dogs were 1.6 (females) or 3.0 (males) times more likely to be obese than intact dogs, and 1.2 (females) or 1.5 (males) times more likely to be overweight than intact dogs(31).
A survey study of veterinary practices in the UK found that 21% of dogs were obese.(30)
Being obese and/or overweight is associated with a host of health problems in dogs. Overweight dogs are more likely to be diagnosed with hyperadrenocorticism, ruptured cruciate ligament, hypothyroidism, lower urinary tract disease, and oral disease(32). Obese dogs are more likely to be diagnosed with hypothyroidism, diabetes mellitus, pancreatitis, ruptured cruciate ligament, and neoplasia (tumors)(32).
비만
물질대사작용의 변화로 중성화 한 개들은 아닌개들보다 과 체중이 많다, 한 연구에서 중성화 한 개들이 아닌 개들보다 2배 정도가 비만이 많음을 밝혔고 다른 연구에서는 여아의 경우 1.6배 남아는 3배가 심히 비만이였으며 여아의 1.2배 남아의 1.5배가 과체중이였다.
영국에서의 바료에 21프로의 개가 비만인데 비만과 과체중은 많은 질환의 원인이되고있다.과체중인 개들은 부신피질항진증, 십자인대 파열, 방광 요도염, 구 질환 등이 더 많이 발병되고 비만인 개들은 갑상선 저하, 당뇨, 췌장, 십자인대 파열과 종양의 발생률이 높아진다.
Diabetes
Some data indicate that neutering doubles the risk of diabetes in male dogs, but other data showed no significant change in diabetes risk with neutering (33). In the same studies, no association was found between spaying and the risk of diabetes.
어떤 연구에선 중성화 한 남아의 경우 당뇨발생이 두배라고 한다 그러나 아니라는 연구결과도 있다.
Adverse Vaccine Reactions
A retrospective cohort study of adverse vaccine reactions in dogs was conducted, which included allergic reactions, hives, anaphylaxis, cardiac arrest, cardiovascular shock, and sudden death. Adverse reactions were 30% more likely in spayed females than intact females, and 27% more likely in neutered males than
intact males (34).
연구결과에서 백신에 알러지, 두드러기, 과민증,심장류 쇼크, 갑자기 사망하는등의 반응이 있다고 알려진다. 중성화한 암컷에서 30프로가 , 남아에서는 27프로가 중성화 하지 않은 개들보다 이러한 반응을 보인다.
The investigators discuss possible cause-and-effect mechanisms for this finding, including the roles that sex hormones play in body’s ability to mount an immune response to vaccination. (34)
Toy breeds and smaller breeds are at elevated risk of adverse vaccine reactions, as are Boxers, English Bulldogs, Lhasa Apsos, Weimaraners, American Eskimo Dogs, Golden Retrievers, Basset Hounds, Welsh Corgis, Siberian Huskies, Great Danes, Labrador Retrievers, Doberman Pinschers, American Pit Bull Terriers, and Akitas.34 Mixed breed dogs were found to be at lower risk, and the authors suggest genetic hetereogeneity (hybrid vigor) as the cause.
이는 성 호르몬의 면역체계에서의 역활을 보여주는 바이다. 소형견, 토이류의 개들이 더 발생률이 높은것으로 보여진다.
Urogenital Disorders
비뇨기관내 질병
Urinary incontinence is common in spayed female dogs, which can occur soon after spay surgery or after a delay of up to several years. The incidence rate in various studies is 4-20% 35,36,37 for spayed females compared to only 0.3% in intact females38. Urinary incontinence is so strongly linked to spaying that it is commonly called “spay incontinence” and is caused by urethral sphincter incompetence39, though the biological mechanism is unknown. Most (but not all) cases of urinary incontinence respond to medical treatment, and in many cases this treatment needs to be continued for the duration of the dog’s life. (40)
요실금은 중성화한 암컷에게 흔하다. 수술후 바로 나타나거나 몇년후에 발병한다. 4-20프로의 발병률은 중성화하지 않은 암컷이 오직 0.3프로인것에 비하면 높은 편이다. 이는 수술시 방광의 조임 능력 상실에서 비롯되는데 개의 일생동안 치료가 필요하다.
A retrospective study found that persistent or recurring urinary tract (bladder) infections (UTIs) were 3-4 times more likely in spayed females dogs than in intact females (41). Another retrospective study found that female dogs spayed before 5 ½ months of age were 2.76 times more likely to develop UTIs compared to those spayed after 5 ½ months of age.(42)
방광염또한 3-4배 이상 높아진다. 5달 반 이전에 중성화한 여아는 그후에 한 여아보다 2.76배 높은 방광염증상을 보인다.
Depending on the age of surgery, spaying causes abnormal development of the external genitalia. Spayed females were found to have an increased risk of recessed vulva, vaginal dermatitis, vaginitis, and UTIs. (43) The risk is higher still for female dogs spayed before puberty. (43)
중성화는 언제 하느냐도 중요하다. 생식기 관련 질병은 2차 성징전에 중성화를 한 여아들에게서 훨씨 많이 보여진다.
Pyometra (Infection of the Uterus)
Pet insurance data in Sweden (where spaying is very uncommon) found that 23% of all female dogs developed pyometra before 10 years of age (44). Bernese Mountain dogs, Rottweilers, rough-haired Collies, Cavalier King Charles Spaniels and Golden Retrievers were found to be high risk breeds (44)/ Female dogs that have not whelped puppies are at elevated risk for pyometra45. Rarely, spayed female dogs can develop “stump pyometra” related to incomplete removal of the uterus.
Pyometra can usually be treated surgically or medically, but 4% of pyometra cases led to death (44). Combined with the incidence of pyometra, this suggests that about 1% of intact female dogs will die from pyometra.
중성화가 흔치않은 스웨덴의 개 보험회사의 데이터에 따르면 10살 이내의 암컷에게서 23프로의 자궁축농증이 발견됫다.버니즈 마운틴 덕, 러트웨일러,콜리,케비어 스파니엘, 골든리트리버가 높은 위험군의 개들이라고 하고 자식을 낳지 않은 암컷의 발병률이 더 높앗으며 흔치않게 중성화 한 암컷중에서도 자궁 부분이 남아잇는 경우 축농증이 발생하기도 한다.
Perianal Fistulas
Male dogs are twice as likely to develop perianal fistulas as females, and spay/neutered dogs have a decreased risk compared to intact dogs (46).
German Shepherd Dogs and Irish Setters are more likely to develop perianal fistulas than are other breeds. (46)
항문질병
남아들이 여아에 비해 2배의 발생률이 보이고 중성화는 발생률을 낮춘다.저먼세퍼드와 아이리쉬 세터가 발병률이 높다.
Non-cancerous Disorders of the Prostate Gland
The incidence of benign prostatic hypertrophy (BPH, enlarged prostate) increases with age in intact male dogs, and occurs in more than 80% of intact male dogs older than the age of 5 years47. Most cases of BPH cause no problems, but in some cases the dog will have difficulty defecating or urinating.
Neutering will prevent BPH. If neutering is done after the prostate has become enlarged, the enlarged prostate will shrink relatively quickly.
BPH is linked to other problems of the prostate gland, including infections, abscesses, and cysts, which can sometimes have serious consequences.
암이 아닌 전린선류 질병
양성전립비대증은 중성화 하지 않은 개들에게서 많이 발생하는데 5살 이사의 80프로 이상의 중성화 하지 않은 개에서 발견됬고 대부분의 경유 치유가쉬우나 개들에게서 변을 보거나 소변을 볼시 고통을 느끼기도 한다.
중성화는 이 질환을 예방하고 이 발병이 더 퍼지기전에 중성화를 한다면 염증이 빨리 사라지기도 하다.
이 질환은 전립샘의 질병과도 연관이 있고 염증,농양, 낭종등의 다른 심각한 질환으로 이어지기도 한다.
Orthopedic Disorders
In a study of beagles, surgical removal of the ovaries (as happens in spaying) caused an increase in the rate of remodeling of the ilium (pelvic bone) (48), suggesting an increased risk of hip dysplasia with spaying. Spaying was also found to cause a net loss of bone mass in the spine (49).
Spay/neuter of immature dogs delays the closure of the growth plates in bones that are still growing, causing those bones to end up significantly longer than in intact dogs or those spay/neutered after maturity (50). Since the growth plates in various bones close at different times, spay/neuter that is done after some growth plates have closed but before other growth plates have closed might result in a dog with unnatural proportions, possibly impacting performance and long term durability of the joints.
정형외과관련 질병
비글종의 연구에서 난소를 제거한경우 골반뼈 재건축 수술의 빈도가 높아졌다.엉덩이뼈 수술의 빈도가 높아진것은 중성화가 골밀도를 낮게 만들었다는것을 보여준다. 다 성장하지 못한 강아지를 중성화시켯을때 뼈의 성장을 저하시키고 (성장판이 닫히는 과정을 방해함) 뼈가 중성화 하지 않은 개들이나 성장후 수술한 개들에 비해 길어지는 현상을 보인다. 성장판이 닫히는 시기가 부위마다 다르므로 어렸을때 중성화된 개들은 뼈의 분포가 일정치 않고 관절등의 이상이 생길수 있다.
Spay/neuter is associated with a two fold increased risk of cranial cruciate ligament rupture (51). Perhaps this is associated with the increased risk of obesity (30).
중성화는 앞쪽십자 무릎인대파열을 많이 증가시킨다는 연구결과가 있다. 이는 과체중이 원인인것으로 보인다.
Spay/neuter before 5 ½ months of age is associated with a 70% increased aged-adjusted risk of hip dysplasia compared to dogs spayed/neutered after 5 ½ months of age, though there were some indications that the former may have had a lower severity manifestation of the disease (42). The researchers suggest “it is possible that the increase in bone length that results from early-age gonadectomy results in changes in joint conformation, which could lead to a diagnosis of hip dysplasia.”
5달 반 전에 중성화를 하는것은 성장후에 수술을 하는 개들이나 중성화를 하지않은 개들에 비해 엉덩이 관절 이상 발병률을 70프로까지 증가시킨다. 연구자들은 성장기가 지나기전 생식샘절제술로 인한 연골의 변화나 뼈의 길이 성장이 엉덩이 관절 이상을 발병시킨다고 생각한다.
In a breed health survey study of Airedales, spay/neuter dogs were significantly more likely to suffer hip dysplasia as well as “any musculoskeletal disorder”, compared to intact dogs52, however possible confounding factors were not controlled for, such as the possibility that some dogs might have been spayed/neutered because they had hip dysplasia or other musculoskeletal disorders.
연구에서 중성화한 개들은 근육골격계통의 질환과 엉덩이 관절 질환의 발병률이 그렇지 않은 개들보다 현저히 높다.하지만 이 연구결과는 이미 골격계통의 질환의 요인을 가진 개들이 중성화 수술을 햇을 경우수를 고려한 것은 아니라는 점을 밝힌다.
Compared to intact dogs, another study found that dogs neutered six months prior to a diagnosis of hip dysplasia were 1.5 times as likely to develop clinical hip dysplasia. (53)
Compared to intact dogs, spayed/neutered dogs were found to have a 3.1 fold higher risk of patellar luxation. (54)
중성화 하지 않은 개에 비교해서 다른 연구결과 에서는 엉덩이 골격관련 질환을 가진 개들이 발병진단 6개월 이상 전에 중성화를 했을경우 악성 골격 장애로 넘어갈확률이 1.5배였다.
Geriatric Cognitive Impairment
Neutered male dogs and spayed female dogs are at increased risk of progressing from mild to severe geriatric cognitive impairment compared to intact male dogs (55). There weren’t enough intact geriatric females available for the study to determine their risk.
Geriatric cognitive impairment includes disorientation in the house or outdoors, changesin social interactions with human family members, loss of house training, and changes in the sleep-wake cycle (55).
The investigators state “This finding is in line with current research on the neuro-protective roles of testosterone and estrogen at the cellular level and the role of estrogen in preventing Alzheimer’s disease in human females. One would predict that estrogens would have a similar protective role in the sexually intact female dogs; unfortunately too few sexually intact female dogs were available for inclusion in the present
study to test the hypothesis” (55)
노견의 병
중성화한 남 녀 개들은 약한경우서 심한 경우까지 인지능력을 상실하는경우가 많았다. 중성화 하지 않은 여아들의 연구결과가 충분치 않다는 점을 알려둔다.
노견의 인지능력 상실에는 집 안과 밖에서의 방향감각 상실, 가족과의 인간관계 능력상실, 하우스 트레이닝 상실, 잠자는 사이클의 변화 등이다.
연구자들은 이는 현재 연구중인 신경 보호계에서 성 호르몬이 미치는 영향을 보여준다며 여성의 치매 발병에서 여성호르몬이 미치는 영향을 보여주는것과 흡사하다고 했다.
여성 호르몬은 중성화 하지 않은 암컷에게서 비슷한 보호제 역활을 하는데 안타깝게도 중성화 하지 않은 암컷의 연구결과가 부족하다.
CONCLUSIONS
An objective reading of the veterinary medical literature reveals a complex situation with respect to the longterm health risks and benefits associated with spay/neuter in dogs. The evidence shows that spay/neuter correlates with both positive AND adverse health effects in dogs. It also suggests how much we really do not yet understand about this subject.
동물학계의 발표자료에 따르면 장기적 관점에서의 중성화 수술에 따른 장 단점은 모두 존재한다. 문제점은 우리가 얼마나 제대로 인지하고 있는가 이다.
On balance, it appears that no compelling case can be made for neutering most male dogs to prevent future health problems, especially immature male dogs. The number of health problems associated with neutering may exceed the associated health benefits in most case.
결과적으로는 수컷의 중성화가 크게 미래의 질병의 예방한다는것은 설득력이 없는 주장이다. 중성화를 함으로써 발생하는 건강상의 문제가 장점을 넘어선다는 의견이다.
For female dogs, the situation is more complex. The number of health benefits associated with spaying may exceed the associated health problems in many (not all) cases. On balance, whether spaying improves the odds of overall good health or degrades them probably depends on the age of the dog and the relative risk of various diseases in the different breeds.
암컷의 경우 좀더 문제가 복잡해진다. 중성화로써 해결되는 건강상의 장점이 단점을 넘어선다는 의견이나 중성화가 전반적으로 모든 암컷 개들의 건강을 향상시킨다고 보기에는 개들마다의 나이나 종자에 따라서의 변수가따른다.
The traditional spay/neuter age of six months as well as the modern practice of pediatric spay/neuter appear to predispose dogs to health risks that could otherwise be avoided by waiting until the dog is physically mature, or perhaps in the case of many male dogs, foregoing it altogether unless medically necessary.
통상적으로 행해지는 6개월 전후의 중성화 수술은 개가 성장할때까지 미뤄줘야 할것이다. 수컷의 경우는 굳이 중성화가 건강상의 이유로는 필요치 않다고 하겠다.
The balance of long-term health risks and benefits of spay/neuter will vary from one dog to the next. Breed, age, and gender are variables that must be taken into consideration in conjunction with non-medical factors for each individual dog. Across-the-board recommendations for all dogs do not appear to be supportable from findings in the veterinary medical literature.
장기적인 관점에서의 중성화의 장점은 개개마다 틀려진다. 종자, 나이, 성별등의 다른점이 고려되어야 할것이고 의학적이지않은 다른 변수들도 영향을 끼친다. 각각의 상황을 고려하지 않고 추천되는 중성화 수술은 이 연구 결과들을 종합해 봤을때 설득력이 없어 보인다.
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