In this enlightening episode, hosts Janet, Alice, and renowned veterinary surgeon, Dr. Karen Tobias, dive deep into the often misunderstood world of spaying and neutering pets. Join them as they address the most pressing questions from listeners about the surgical procedures involved and what they really mean for our furry companions.
Discover the difference between spaying and neutering including the standards and practices in the U.S. compared to other countries. What about those quirky artificial testicles known as Nudicles? Are they really necessary? Dr. Tobias shares her insights on the cosmetic nature of these implants and the potential risks.
The conversation shifts to the benefits of spaying and neutering, touching on behavioral improvements and health considerations, including the risk of conditions like pyometra and mammary tumors in female pets. The hosts also discuss the ideal ages for spaying and neutering, considering breed-specific needs and the complexities of growth.
Dr. Tobias is a graduate of the University of Illinois College of Veterinary Medicine. She completed an internship at Purdue University and a surgical residency and master’s degree at the Ohio State University. Dr. Tobias served as a clinical instructor at the University of Georgia and a tenured faculty member at Washington State University and is currently a professor of small animal surgery at the University of Tennessee College of Veterinary Medicine. Dr. Tobias is an author or coauthor and editor of 3 textbooks, including Veterinary Surgery: Small Animal, and has authored more than 100 peer-reviewed publications.
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All footage is owned by SLA Video Productions.
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Listen to the Podcast here
To Snip Or Not To Snip: The Great Spay Debate With Dr. Karen Tobias
Welcome to Speaking of Pets. I’m Dr. Alice Novotny Jeromin, a board-certified veterinary dermatologist.
I’m Janet Novotny King. I’m the doctor’s sister. I’m not board-certified or medically anything other than I go to shop at CVS or Walgreens. We’re here to provide you with science-based information so you can become a better pet owner. I know my sister’s sick of me calling her at 2:00 AM with dumb pet questions. Hopefully, we can answer some of yours and make you a much better pet owner and lover. Al, who do we have? I hear there’s a Buckeye in the house.
We have Dr. Karen Tobias, who is a small animal professor and surgeon at the University of Tennessee, Knoxville. Our paths crossed unknowingly to her in the ‘80s when I was a vet student and she was a resident and getting her master’s at Ohio State. I have to tell you, Dr. Tobias. I remember my memories of you because I was older. I was 31 when I got into vet school. I was a pharmacist before that.
I was older, and so I appreciated worker bees and things like that. I always remember Dr. Tobias scurrying around and always being busy doing something. She was this petite, cute surgical resident. All these others were these big, burly ex-football player types. I greatly admired that. I thought, “Look at her go. You go, girl.” I’m so glad that we finally got to meet and plaster you with all of our questions.
It’s going to be fun.
Where are you originally from, if I may ask?
I’m originally from around Chicago, Illinois.
You’re a Midwesterner like we are. She talks like we do, Janet.
I don’t talk like that anymore only because I’ve moved around.
Janet, as you probably know, with all of our guests on the show, as vets, we’ve lived in eighteen million places. It is amazing to me that vet students who have always had pets could find rental places that allowed pets. Janet, why don’t you start?
We want to talk a little bit about spay and neutering because our audience has a lot of questions about it. Surgically, what is involved in a spay and neutering surgical procedure?
Spay And Neuter Procedures And Definitions
The classic definition for dogs and cats for neutering is removing the testicles. The classic definition in the United States for spaying is removing the ovaries and the uterus. Although you don’t have to remove the uterus as long as you take the ovaries out.
The classic definition of neutering in dogs and cats is the removal of the testicles. In the United States, spaying is defined as the removal of the ovaries and uterus. Share on XDo most veterinarians remove both the uterus and the ovaries? Is that standard in the US?
Most general practitioners remove both. If we’re doing the procedure laparoscopically, which is a minimally invasive procedure. We just take out the ovaries because that is much faster.
Is it different in different countries?
Which part of it? What they remove? I would say that there are a lot of countries where they don’t neuter at all. They don’t spay. They don’t do castrations. When they do neuter these animals, for the most part, they’re using the traditional techniques. It’s the United States that has some more unusual techniques like the hysterectomy, where you leave the ovaries but you take out the uterus.
Janet, I have to ask Karen. I know you’ve never heard of this, but would you explain what Neuticles are?
We have a T-shirt. What are Neuticles?
Neuticles are also one of those things you see in the United States. Those are artificial testicles. That’s probably a specific brand of artificial testicles.
Is there more than one brand?
That is not something I search for. There’s certainly more than one different kind. If you go to the Neuticles’ site, you can find the standard balls, or you can have some that feel much more realistic, or some that are soft and pliable. It’s a little weird that people are going around feeling these things.
I’m going to ask. Does it matter to the animal?
Scientifically or medically?
There is no reason to put them in. It is all something that is in the mind of the owner.
It’s cosmetic.
Cosmetic, for sure.
Have you ever seen Neuticles done badly, like a bad facelift?
It’s because you’re putting an artificial substance in, you have the risk of getting an infection. In most dog castrations, there’s a risk of contamination because we don’t clip widely. It’s because those private parts can sometimes be a little sensitive, and because the dogs tend to go after these incision sites anyway. If you are putting an artificial body of rubber and plastic in there, there’s the risk that they could have terrible infections. It’s something that’s cosmetic and only for the owners. There’s no reason to do it. It’s a lot like ear cropping. It’s one of those things that’s cosmetic.
What are the benefits of spay and neutering for both cats and dogs, for our audience?
If I were to have a cat, I would always want it to be neutered. I would not want to live with an intact male cat. The smell, the fighting, and all those types of things, those cats are spraying. It’s very hard to get that scent out of your house.
Is that why male cats spray?
That is a territorial thing. If we neuter those cats at an early age, they’re not going to go around and spray things. If they do, the urine isn’t going to be as strongly scented. For the female cats, it reminds me of when I was in veterinary school. I answered phones from 10:00 at night until 8:00 in the morning. I remember getting this call from an owner who said, “I have a cat. She’s lying on the floor, screaming and moaning.” I said, “You better bring her right in.” I called the intern on duty. He said, “Is he intact?” “Was I supposed to ask that?” “That’s what they look like when they want to be bred.” I thought it was excruciating pain.
As senior students, we were also put on phone duty at night, Dr. Tobias. I have to tell you. The most common question I ever got was, “Can my dog get lice from me?” The answer is no because it’s species-specific. Dog lice stay on the dog. We should put those questions in a book.
Even a once-a-week little show short of Answer Me This.
I’m curious. Who was the supervisor who corrected you? Do you remember?
It was one of the interns at the University of Illinois. They were the first line of defense for emergency calls. I had told the owner, “Come on in.” There we are.
You’re going to be going off duty.
I was there to receive the cat. I learned a lot that day. I’d never been with a female cat that was in heat.
Did you put some sexy lingerie on her? Bring it on.
We got a Q-tip out. We made her feel better, so she’d stop screaming.
It’s sad when you think about it. They can have kittens like that.
For population control and behavior-wise, it’s good to neuter the cats. It’s very rare to have a breeding population of cats that you want. For cats, it’s an easy decision because there are not a lot of side effects to spaying and castrating cats.
Is it true that female cats can get pregnant with two different male cats?
You’re reaching outside of my surgical zone.
I read that somewhere.
I would assume it’d be possible.
Are they step-cats?
Half-sisters and half-brothers.
What’s the appropriate age for kittens and puppies to be spayed?
Age Considerations And Risks For Neutering Puppies
Puppies are a different consideration. That one is going to take a lot of thought. For cats, one thing is that they have more difficulty. Any of our dogs and cats have difficulty processing anesthetics before about twelve weeks of age. Most of our anesthesiologists for the owned pets would much prefer to wait until the animal can process anesthetics well, maintain blood sugar, and warm themselves up. The younger they are, the harder those things are to do.
It’s a different situation if we’re working at an animal shelter because we know that spay and neutering cats before they leave, and the same with dogs, is more likely to get those animals sterilized than if you send them out the door with them intact and then give people a coupon to bring them back in. There’s not as much follow-up as there should be for those animals. The easy thing about doing the spays and castrations at 8 to 10 weeks of age in cats is that everything’s small. You don’t need a lot of materials. You don’t need a lot of anesthetic. The surgery’s pretty quick. It’s uncomplicated for somebody who does it all the time.
Spaying and castration in cats at 8 to 10 weeks is straightforward because everything is small. Less material and anesthetic are needed, the surgery is quick, and for experienced surgeons, it’s relatively uncomplicated. Share on XDogs are a different story.
It’s very size-related and breed-related. That takes a lot more thinking.
For some people, their vets are telling them with female dogs to wait a couple of cycles before they have them spayed. Is that a good thing or a bad thing? Is that widespread practice?
It is going to become more widespread. That’s because of all of the research that’s been coming out about the effects of early-age spaying on joint development and on cancer development. Urinary incontinence is a major cause of euthanasia, that is if you end up with an incontinent dog. There are some breeds where it’s going to be very important to delay castrations and spays because of those issues. That doesn’t hold for all breeds. So far, it’s specific. The paper that came out covered 40 breeds plus mixed-breed dogs. We don’t know for every breed.
Unfortunately, it’s not always consistent. For those breeds, they saw big issues with German Shepherds, Labrador Retrievers, and Golden Retrievers when we neutered them early, but they didn’t see issues with Great Danes. You would think a giant-breed dog would be something where you get worried about it because they take so long for their growth plates to close and things like that. It is very much breed-related.
Dr. Tobias, we had a local vet in our hometown in Ohio that, when he would spay a female dog, a big-chested breed, they would “tack” the stomach. Can you talk about that? Janet, I don’t think you’ve ever heard of that.
We heard about doing something with the stomach, though, in the Great Danes, because it flips.
That is a good descriptor of it. It’s called a gastric dilatation and volvulus. The stomach turns on itself. It is very commonly deep-chested dogs. They’ve seen some familial problems with Great Danes where if one or two puppies in the litter get this condition, the other puppies in the litter might be more exposed to it. There are going to be some hereditary aspects of it. It’s any of these deep-chested dogs, any of these expensive working dogs, and any dog that’s anxious, panting. We even see the doodles having this condition. When the stomach flips, that can kill them.
For these deep-chested dogs, the recommendation is to tuck the stomach over to the side so it can’t turn on itself. The problem is if we tack that stomach at about six months of age, and you have a dog that continues to grow. You can imagine how much a Great Dane changes from 6 to 18 months of age. We’ve had the stomach kink itself off after it’s been tacked because you can’t predict which way it will grow. Does the stomach go that way? Does the chest go that way? There isn’t a good study on what the appropriate age is.
Most of us feel that those animals need to be close to their mature size before we do that. That means if you’re doing a female dog, if you want to do the two procedures at once, you wait until those animals are 9 to 12 months of age, depending on the breed. It’s twelve months for sure for the Great Dane because they get so much bigger. That way, you don’t take that chance of having the stomach malposition, which means that those Great Danes are probably going to go through a heat cycle before then.
What about small-breed dogs? What does the research show on them, like little Poodles, Maltese, and all the mixes?
Let’s start with the mixed breed. For the mixed breed dogs, what they found was that if the mixed breed dogs are less than about 20 kilograms, so 44 pounds, it probably doesn’t make a difference unless they’re half and half. Doodles are mixed-breed dogs, not standard Poodle and half-Poodle or half-Lab. What you have to figure out is, what is my dog a mix of? If I have a Bernie Doodle and I have a Bernese Mountain Dog, is it going to be more prone to getting histiocytic sarcoma of the joints?
It does depend on if it’s a strong mix, like the two breeds put together. For the most part, if we’re looking at smaller dogs, it’s going to be less of a problem in terms of joint disease. There’s still an increased risk of incontinence. When we are spaying dogs at less than 7 or 8 months of age, then there’s going to be that increased risk of incontinence.
That’s where letting them go through a cycle to strengthen their sphincter, because you have an effective estrogen on their sphincter and making that hopefully a little bit tighter. Maybe that will reduce their chance of having that incontinence. One of the classic incontinence breeds is a Sheltie. That’s a little dog. Other incontinence breeds like Doberman Pinschers. That’s a big dog. When you think about trying to adjust when you’re going to spay these animals, it’s not just the size. There are also these breed-related issues.
There is so much involved.
Honestly, as a pet owner, when you get a puppy, it’s “We’ll make an appointment for your spay.” It’s very routine. It’s pretty serious surgery.
It’s serious surgery. The important thing about making this consideration is that anybody who delays the surgery needs to think about, first of all, how am I going to manage my pet? If I have an intact animal, what do I need to do if it goes into heat? If I have an electric fence, maybe my dog can’t get out, but the other dogs can come on in.
Spaying is a serious surgery. The key consideration when delaying it is planning for management—if you have an intact animal, you need to know how you’ll handle it, including what to do when it goes into heat. Share on XIt’s a party in the hood.
Managing Complications Of Spaying Large Breed Dogs
What are these puppy panties that my dog has to wear? You have to know things about that. The other thing that’s important for owners to realize is that if we are going to do a spay properly on a big dog, a mature dog, it’s going to take more time, it’s going to take more equipment, and there is a greater risk of complications. Everybody thinks, “I’m going to go in for a spay. I’m going to have a little tiny incision.” No. With our change in recommendation here at the University of Tennessee, we have seen an increased rate of hemoabdomen, where the dogs are bleeding into their bellies after the surgery.
That is because the veterinarians are bowing to owner expectations like, “I only want a little shave. I only want a tiny incision.” That’s not the safest thing for your animal. It’s a lot faster to do the surgery if you make a bigger incision. You’re not pulling on things as much. That’s where the owners have to become invested because there’s a financial investment to that as well. If you have a bigger dog, it should cost more to have these procedures.
When we got our kittens during COVID, they were little like eight weeks old. We had to take them back to get fixed, and we did. They were male and female. The female, Isabelle, ended up getting infected where the sutures were because Atticus was helping her clean and doing all kinds of stuff. We figured it out because she was lethargic and was very warm, like her belly, and took her to Cornell after hours. They were fantastic, but it was a little scary. That thing went from this vibrant, fluffy kitty to complete lethargy.
Besides having to limit your large breed dog from its friends at the house who are going to be helping it out. How are you going to deal with that giant e-collar on that giant Great Dane, and it running into you? You’ve got to do that. As veterinarians, we have to get imaginative and say, “Do you want to purchase a recovery suit?” We’ve got Lycra bodysuits that the dogs can wear, so it covers the incision line because it’s hard to get owners to keep E-Collars on their dogs.
What’s that line? “It’s no fun until somebody gets a cone on their head.”
Can you imagine if they lick that suture site? That could be a disaster.
The bigger the dog, the bigger the incision, the more likely there are incisional complications.
If Isabelle had been a single cat without the brother, it would have been a whole different situation. I never make tuna salad because nobody else eats it here. It’s just me. I thought, “I’m craving a tuna fish salad sandwich.”
That does sound good.
I made the toast. I’ve got the can open. I’m mixing it with a little bit of the mayo. Who do you think my BFF is?
I bet.
The male cat who can’t stand me is in the kitchen, rubbing against my legs. I’m like, “You never come near me. You hate my guts. Miss Chicken of the Sea, you’re my best friend.”
Was that the sound of the can opener?
No, they don’t know that.
I know they don’t know that. That’s why I was asking.
It was the smell of the tuna. That thing was hanging out with me. I’m like, “Get lost, buddy.” Seriously, I walk in the room, Dr. Tobias.
They don’t like you, Janet.
Only the male cat doesn’t like me.
Dr. Tobias, say you adopted, and not from rescue, because when we get a dog from rescue, they’re all spayed and neutered, as they should be. Same with cats. Say you adopted a Golden Retriever puppy. You didn’t get it from rescue, which I know we all would. It was a male. You would wait until a year and a half or two?
For the males, for Golden Retrievers, you want to wait until they’re at least thirteen months of age before you neuter them. That is because of the risk of joint disease. For Golden Retrievers, let me think now. If you castrate a Golden Retriever at less than six months of age, there’s an 18% to 27% chance of joint disease. You’re looking at 1 in 4 or 1 in 5 of those dogs having joint disease.
If you castrate them at a year of age, it’s 10%. If you leave them intact for at least two years, you’re looking at 3% to 5%. When you’re looking at lifelong pain and suffering in the dog, and you think about an animal having ruptured cruciate or hip dysplasia, if we can get them through that growth phase so that all of their growth plates close and they develop good muscle mass, then that is going to help those animals.
It’s not been directly correlated to weight gain, but we do know neutering them does increase their weight as well. Some of it may be reaching an age where they’re not as active. We know that in cats, their metabolic rate slows down. In dogs, they tend to gain weight for other reasons, but they tend to gain weight after they’re neutered. If I were to have a large breed dog that was going to be neutered after a year of age, I would go for a male because I can figure out how to manage those. Males are trickier.
I don’t know if this is true or not, but somebody told us, because we had an old male Golden that was neutered very young. He could never lift his leg when he peed. He was a squatter.
It’s probably not a mobility thing. It’s more of a behavioral thing. I wouldn’t make fun of that.
I didn’t care as long as he was peeing.
That’s right.
I’ve had many people say, “He squats because you had him fixed too early.”
Don’t you love that? I just love the crazy myths that go along with this.
I have to Google all of them.
There are a lot of different reasons people choose to neuter animals. One of the reasons for neutering male dogs was changes in behavior. There have been some newer studies out on that. What they show is that at one year of age, an intact male dog is going to have more male behaviors than a dog that was castrated at six months of age. However, those behaviors gradually decline. The only thing that doesn’t decline is going to be marking. You’re in marking.
There’s not a great percentage of difference. I can’t remember. It was something like 75% of the intact males marked and 66% of the castrated ones marked. It’s what their owner thinks of as marking. They’re peeing on the wall. Behavior-wise, it’s a maturity issue. That’s why in Europe and England. You think about all those animals that are left intact. They go to the pubs with their owners.
They sit quietly under the chair when they go to the restaurant. They’re all intact. It’s because their owners have worked with them. Unfortunately, we’re sometimes trying to take the easy way out like, “Let’s just fix this so I don’t have to deal with this issue.” When instead, you could be working on training, exercise, and all those things.
Unfortunately, we sometimes try to take the easy way out—thinking, “Let’s just fix this so I don’t have to deal with it.” But instead, we could be focusing on training, exercise, and the work that actually addresses the underlying issu Share on XWith females, talk to us about the pyometra issue. Janet, do you know what pyometra is?
Pyro is a uterine infection. Dogs that are intact going through these cycles, where the uterus gets thicker and thinner, after a while will have a much higher risk of having an infection in their uterus. For most dogs, that infection happens after four years of age. If you’re going to be delaying a spay, you’re not going to have an increased risk of pyometra in those first four years. Unless the animal has something anatomically wrong with it. It is something that we have to worry about. As an animal gets older and older, the risk gets higher.
That’s the same thing with mammary tumors. The risk gets higher. That is one of the things that people bring up. They say, “We should spay these animals early because of the risk of mammary tumors.” You have to balance everything because we do know that the risk is lowest if you neuter them before the animals go into their first heat. If you say the risk is 0.08 times what it would be if we left them intact, what you need to know with each breed is what the risk is if they’re left intact.
Decision-Making Factors For Breed-Specific Health Risks
From the California study, they didn’t follow the dogs out to fourteen years of age. It’s not a perfect study. For instance, all the Westies that were in that study, none of them got mammary tumors. Their risk was 0%. If you decrease the risk by 100%, 0 times 100 is still 0. It doesn’t matter. What you want to do is think about this being important for breeds that have a very high risk of mammary tumors. For instance, the Cocker Spaniels have a higher risk of mammary tumors. That would be something that you might want to take into consideration when you are trying to think of when you should neuter these animals.
I’ve got a little problem-solving slide that I show the students. That is how to make these decisions. If you have a Rottweiler, what you want to think about is, altogether, what’s going to be the most important thing? The risk of mammary cancer in Rottweilers that are spayed before two and a half years of age is 0% from this paper. You spay them before two and a half years of age. They’re going to go through one or two heats. If they’re intact, the risk is a little over 13%. The mortality rate is 36% for mammary tumors. You’ve got that in your mind.
The risk of pyometra, if they’re intact for more than four years, is going to be 6% to 12%. That has about a 7% mortality. Maybe we should spay these. The risk of urinary incontinence in Rottweilers is 4% to 6% with many people euthanizing those animals, depending on the paper, if they are spayed before twelve months. They can’t live with a large-breed dog that is incontinent. The risk of bone sarcoma, if you spay the animals at less than a year of age, is 14%. That’s almost 100% mortality.
It’s a lot of thinking, but you’ve got to weigh all of those things. For a Rottweiler, you’d better not spay that animal until it’s at least a year of age. It’d be better to wait until it’s two years of age because of the risk of bone cancer. If you leave them intact, the risk is 7%. If you spay them before they’re a year of age, it’s 14%. It doubles the death rate of those dogs. That’s where each breed has to be taken into consideration. Unfortunately, there isn’t any data on each breed.
If you have a mutt, you’re not going to know unless you have the DNA thing.
That’s where we have to go with those general recommendations of the safest thing is, if they’re over 20 kilograms, to wait until they’re a year of age. Somebody’s got to get out there and tell people, “How do I manage my intact dog until this happens?”
They’ll end up in a shelter.
You can’t just put a condom machine out in the yard.
Especially for cats. Karen, is any of that true in humans? I’m curious, comparatively speaking. I’ve not read that it is. Urinary incontinence in postmenopausal women, we see commercials for that all the time.
That means it’s true.
The question would be, do we have a data set on humans? We’d have to go back to, at least for males, the castratos, because we might have a data set. Those are the young boys who were castrated so that they would maintain their high voice. There might be a data set on those, but that’s not a deep dive I want to do on the university computer because that’s where I do my searches.
You’ll get a call from HR.
“This is science. I swear.”
I do want to ask you, though, about my department, ear surgeries. Over the years, there have been certain breeds, and you named the Cocker Spaniel earlier, which made me think. Janet, there are so many dogs that ear infections let go for a while. Some dogs respond hyper to try to get their ear infection cured, and then you get all this extra tissue in there. It hardens. They have to see Dr. Tobias for surgery.
What gets hard in there?
Ear Canal Surgery And Chronic Infection Treatment
They have cartilaginous L-shaped canals. They’re lined with epithelium, like skin. That epithelium and the cartilage will get thick and proliferative.
Janet, when you feel it, it’s rock hard. You have to cut that out, surgically.
There’s a condition called cauliflower ear in wrestlers, where they’ve been hit a couple of times. There’s a paper out on using a laser to take out some of those proliferations and having reasonable success. That’d be something a dermatologist does. I don’t know how successful that is in dogs. It’s reported that it could be a possibility. When they come to me, I have to take their ear canals out.
Does that affect their hearing?
It depends on how you think about hearing. When you think about the way that dogs hear naturally, and you have air, sound waves going in and vibrating. If those canals are full of tissue, you’re not going to have the air going down into the canals. The way they’re hearing is by vibrations along their skull, which they’ll have either way if the inner ear is working. The inner ear is pretty delicate. With chronic inflammation, the little hair cells that are in there are going to get all stiff. They’re not going to work. Taking their ear canals out is not going to cause a major change in their hearing for most animals because they’ve already lost a lot of their hearing.
Does the whole ear canal come out like a piece, a whole?
The ear canal is so beautiful. The skull has bony rings. Over that bony ring is another cartilage ring. Over that next cartilage ring is the funnel. It’s a three-piece system that collapses like a telescope. The ears are so pretty.
It is complicated.
I learned an interesting fact. There’s a little vein in front of the ear canal that I tell people, “Try not to hit that.” It turns out that it drains the temporal lobes of the dog’s brain.
I was going to ask you if you have ever seen an ear infection so bad that it affected the brain.
Yes, quite a bit. We take out the ear canal, so we open up the middle ear and let the infection drain out. A lot of times, they get better.
I’m a horrible mother because I’m yelling at my son, “Kyle, what’s with you? You’re not listening to me. You don’t hear me. I’m yelling,” He goes, “I swear to God, Mom. I didn’t hear you.” He was ten years old. I’m like, “Come on. What’s your problem?” We go to the pediatrician for a regular checkup. They do that thing where they put the thing on, and then the nurse is turning it. I’m looking at the nurse. It turned out he had a serious case of double swimmer’s ear infection, and he really couldn’t hear me.
Did it hurt, though?
No. What we had to do then was, after every swimming thing, we had to do drops of alcohol on each side. It dried out the water. I was the worst. “You heard me. You didn’t answer me.” The poor kid is like, “I didn’t hear you.”
I just think about how many of these dogs have been in chronic pain for so long.
That is amazing.
They shake.
One of the big discussion points here is that anesthesia says, “That’s such a painful surgery.” What I find is when I take those ear canals out and open up the middle ear, like those children screaming on the planes. The next day, the dogs are so much more comfortable. The fact that their condition was so painful, it must be jaw aches, headaches, and just terrible. Before we had all these good drugs and treatments, a lot of those mean Cocker Spaniels were in chronic pain. The medications are so much better. The general practitioners are so much better at dermatology. Better than I am on dermatology. They’re helping these dogs. It’s an awful condition.
Can those infections be treated with topicals or oral medication?
We start initially with using some topical medications. There are even some medications that can be applied once instead of two times a day by the owner. Applied once and then you go back to the veterinarian and have them rechecked. For some ear conditions, those will work. The issue that we have with some of these is that the dogs have allergies. If we don’t figure out what they’re allergic to, they’re going to continue to have skin reactions. A lot of it shows up in their ears and their feet.
The sad part is they’re so painful that when they see the owner coming toward them with their ear medicine, I don’t blame the dog or cat, for that matter. I had a vet here in Florida text me about what my favorite long-acting medication is to put in a cat’s ears. I said, “None. I use very few topicals in cats’ ears because what goes in doesn’t come out.”
Good luck getting it in there.
As I tell people, you’ll get it the first time.
That cat’s scramming.
Surgical Removal Of Polyps In Cats
Talk to us about polyps because cats get polyps, Janet.
In their ears or everywhere?
Polyps in cats are fun. I like polyps in cats. They grow in two different directions. They can grow down the Eustachian tube and into the back of the nose. Those are the cats that will sound all snuffly and will start having trouble swallowing or they can grow out of the ear. I get to usually take out the ones that are up behind the soft palate in the back of the mouth. Those are fun. We’ll pull out a big piece of tissue out of the back of a cat’s throat. It’s so miraculous.
It’s very satisfying. The ones down inside the ear canal. The nice thing about cats is that they’re usually inflammatory in nature. They’re down from the middle ear. We have polypectomy snares, as you use in people. When you’re getting your colonoscopy, if you need your polyps pulled, that’s what they’ll use. We can put them down in a scope and pull them out of the cat’s ears. We put them on a course of steroids. For a lot of cats, that’s all we need to do.
Do you tattoo where the polyp was?
If the cat has a regrowth of the polyp after being treated with steroids, then we have to surgically go into the middle ear.
If a cat has regrowth of the polyp after steroid treatment, surgical access to the middle ear becomes necessary. Share on XWhat’s the most interesting surgery you’ve done on an animal? It was Holy Toledo when you got in there.
Was it heart surgery?
I’ve done heart surgeries. I had a dog that had a pacemaker that was placed under the neck and into the heart, so it goes through the vein. I was inside the heart. The dog started having hiccups.
From the pacemaker?
Yes. It hiccupped 80 to 120 times a minute, which happened to be the pacemaker rate. We realized, “There’s something. The pacemaker isn’t working.” We have to keep turning it up even higher. We went into that dog. Thank goodness I went into the dog’s chest through its belly, so I’d have a lot of space. The pacemaker was all the way through the heart, sticking out, up against the nerve that moves the diaphragm and causes hiccups.
I don’t know if you’ve seen this, but some folks are posting on Instagram that the dog swallowed one of your earbuds.
I saw.
You’re playing the music, and it’s coming out of the dog’s gut.
I did not see that.
There have been hundreds of them. They play whatever song, like an Elvis song, and you hear it. The dog’s lying there, and it’s coming out of the side of the dog.
It’s probably Hound Dog.
It’s Cat Scratch Fever, just saying.
Speaking of that, I have read stories of where people, in humans, had dental fillings, and they were getting radio transmissions. That was in the Enquirer.
You have to be careful what you believe from the internet.
Consider the source. I remember when my kids were little, they got these toothbrushes that you would put in. It would play music through the bone. It would play two minutes of music, so the kid would brush for two minutes, while they had the toothbrush. It was a little electric toothbrush.
Speaking of kids, I wanted to ask Karen. Why don’t they put tubes in dogs’ ears as they do in Janet’s kids’ ears?
I never did that.
I know.
There are some old papers about putting tubes in ears, but most dogs don’t have middle ear disease. They have a disease in the outer canals. The tubes themselves are probably not going to do anything that’s going to help them long term. Even short term, it’s not going to help them. If you don’t take care of the underlying cause, say the dog’s got allergies or overproductive adrenal glands, or something like that, you’re not going to fix the issue.
Have you done surgery on your own dog ever?
They wouldn’t know if they’re knocked out.
I know, but she would know.
I would not have done surgery on my favorite dog. I had other people do that surgery. I have a Dachshund now. I’d be happy to do surgery on him. He’s trouble. I adopted him after he’d been brought back to the animal shelter three times.
For behavior?
I should have asked that question.
What are his issues?
He’s a Dachshund, so he barks, chews, and digs.
That’s all?
He ate a glass jar of peanut butter.
He chewed the glass?
He ate the glass and the 16 ounces of peanut butter.
Does he have separation anxiety? Does he go on walks with you?
He’s hungry. He’s a Dachshund. They’re always hungry. I said, “Put him out in the backyard. We’ll see.” All comes out.
Our older sister Penny, when I spent my summers with her, had a Basset. It would go into the bathroom and eat the toilet paper.
It ate the razor blades.
They’re those flat razor blades. Nothing ever happened.
It also ate the wrapped-up man’s leather belt.
We’ve had a dog that’s been in a couple of times for intestinal surgery because it keeps going in the bathroom and getting the dirty tampons.
That’s a big one.
They’re dogs.
Right down the hatch.
Thankfully, the pet lived. What’s the funniest thing that you’ve ever taken out of a stomach that they’ve ingested?
The oddest thing, like a strange object?
The oddest thing besides tampons or underwear.
I would say there are two. The first one was the one that surprised me because the dog had these little Heckle and Jeckle squeaky.
I love Heckle and Jeckle.
They are little squeaky crows. I was doing the gastronomy because it had a stomach obstruction. I made the incision. The little Heckle pops out. The head came up and out of the incision. I could squeak it. I turned to the students and said, “Where there’s Heckle, there’s Jeckle.” I pulled it out, and Jeckle pops out.
As someone who’s never done surgery other than pulling things out of kids’ noses, does it come out clean?
No. Whatever they’ve been eating, if it’s partially digested, it’s in there. I also had a dog that grabbed the crockpot cord and pulled the crockpot off the countertop. Not my dog. It was one of my surgical cases. It ate the roast that was inside, fire roast, and then, because there was plenty of juice, ate the glass lid. The glass lid is safety glass, so it breaks up like a windshield.
When we took an X-ray, the dog had glass throughout its stomach and intestines. I thought, “This too shall pass.” We ended up having to empty its stomach, but everything else went out the other end. The dog was a little uncomfortable when it pooped. I’m pretty sure it would not have put those two incidents together. Note to self, don’t leave the cord hanging down.
Can you imagine the owner like, “Where’s the lid?”
“Where’s the roast? Where’s the lid?”
It was just the little plastic nylon strap.
The big metal rim was all that was left.
Was it a big breed dog to get through his jaws through that glass?
It shattered.
The glass shattered.
I thought he chewed it up.
It’s a safety glass, so it cracks as windshields do.
It’s because it had beef juice on it.
The dog is like, “This is delicious.”
I bet a young resident now wouldn’t know Heckle and Jeckle. If Heckle popped up, he wouldn’t say, as Dr. Tobias said, “There must be Jeckle, too.”
Speaking of, we went to a Comic-Con party. We had to go in costume. I ordered the Spy versus Spy costume.
Nobody remembers that.
The people who are hosting it are Scottish. We go to their house. We’re out there with the dynamite with this big nose. Donald has a little fake bomb with the big nose. One’s black. One’s white. We’re at the door. They open the door and they’re like, “What are you?” It was such a letdown. Once we got inside, the Americans knew what we were from Mad Magazine. We thought we were brilliant. Nobody’s going to do this. Nobody did, but nobody got what we were. You’re right. Heckle and Jeckle, they wouldn’t get. They wouldn’t get Spy versus Spy.
I love Heckle and Jeckle now that she mentioned it.
We’re going to have to go to YouTube and find some.
I’m not sure it’s politically correct anymore. I think some of it.
Dr. Tobias, we’re going to ask you what we ask all of our guests. What are you most passionate about in your work?
Passion For Teaching And Mentoring In Veterinary Medicine
I would say teaching and the interactions I get either through teaching or through working with my co-workers, the doctors, and the nurses. Being at a university, I learn so much from everybody, including my students. The students will say, “We diagnosed a corneal ulcer in this French bulldog.” I’ll say, “Why don’t you pull out your notes and tell me what the latest is on treating corneal ulcers before we get a consult?” They can tell me about it. It’s very exciting because I’m always learning. I love my job. I’ve got the best job in the world. I’m not going to work every day. I’m coming home.
With that Dachshund.
What’s the Dachshund’s name?
I’m coming home when I get to the office.
What’s his name?
Hamish Macbeth.
I was going to say it’s Evel Knievel.
Had I known. I came home one day and I had this one-pound box of women’s vitality mix, which is raisins, chocolate, and nuts. It was all gone from the kitchen counter. He was out in the backyard emptying his intestines. I came back in. He shot through the dog door ahead of me. He jumped on the dining chair, jumped on the dining table, leapt across to the kitchen bar stool, and got on the kitchen counter. He had eaten an entire pound of chocolate and raisins, which are toxic to dogs. He was great.
There’s a devil in him. I swear to God.
There’s drive.
Dr. Tobias, what is your pet or human peeve? What gets you?
From my Dachshund, I would say that he can’t control his tongue. If he’s next to somebody, he’s constantly licking them. He can’t keep his tongue off of anything.
He has issues.
That is my pet, and that is my pet peeve.
Good answer.
Have you ever seen the welcome mat that says, “Caution, dog can’t hold its licker?”
That’s pretty dog appropriate.
That’s hysterical. What you need is a little warning sign. This has been a pleasure. This has been incredibly informative.
This is a dream come true for me to get to meet Dr. Tobias one-on-one. It only took 30 years.
You’re still fanning.
I am. I’m so proud of all of your accomplishments. I swear to God. At 31, when I went back to vet school, I saw a lot of young people. I love to see what they’ve become. I’m so proud of you and thankful for what you do.
Thank you. That is so nice.
Janet, I know you think I’m fan-gushing, but I am.
You are. That’s fantastic.
Why did I go into dermatology? It’s because I’m terrified of surgery. Any surgeon, I’m like, “Kudos to you.”
Kudos to the dermatologist because you keep seeing things over and over again.
That’s true. It is chronic.
You get all those bugs and stuff.
I love that. I love it when I find scabies because I know I’m going to get that dog better.
The exciting part of each of our fields is that there are things that we can do to make the animals better.
The exciting part of our field is that there are always things we can do to help make animals better. Share on XThat must be satisfying. I can’t imagine being a veterinarian because the pet can’t communicate. You’ve got to figure it out, as you say, Alice, from nose to tail. I just can’t imagine. That’d be frustrating for me. What the hell is wrong with you?
You’ve had children. You had to figure out what was wrong with your baby. It’s the same thing.
Our oldest son had colic for four straight months. I’ve got to tell you. It was hell.
What do you do for that? Horses, we walk them around.
If people just aren’t burping them and getting them to get rid of gas, there are some little massage and positioning things you can do.
You put the baby seat on top of the dryer.
You want the motion.
You put the Dachshund on top of the baby seat.
You drink a big glass of wine while that kid’s screaming. They scream uncontrollably. There’s nothing you can do to stop it.
There was an article I was looking at where they’ve deciphered what some of the baby cries are. The beauty of having YouTube and the internet, one, make sure you do your research to find out that it is accurate, but to get some ideas of what you can do if you have that colicky baby, because we haven’t figured out how to burp them properly or get some of that gas out of them.
On that note, thank you for being a part of our craziness and our informative shows.
You’re very welcome.
Janet, we’re going to wrap it up. We wish Dr. Tobias so much luck with the Dachshund. This is Dr. Alice Novotny Jeromin, thanking you for joining us.
This is Janet Novotny King, one of the Novotny sisters who hail from Cleveland, Ohio. Thanks for being a part of the show. We hope you learned something. Thank you, Dr. Tobias. This was super informative. I feel like I know a lot more about surgery.
You are very welcome.
Thank you.
Thanks, everybody. Kiss the pets for us.
Important Links
- Dr. Karen Tobias on Today’s Veterinary Practice
- VetriMax Veterinary Products
- Chewy
- The Country Critter Journal
About Dr. Karen Tobias
Dr. Karen Tobias is a professor and ACVS board-certified surgeon at the University of Tennessee College of Veterinary Medicine. She received her DVM from University of Illinois and completed an internship at Purdue University and surgery residency and Master’s Degree at Ohio State University.
Dr. Tobias has authored or co-authored over 170 scientific articles and book chapters and mentored authorship by more than 80 residents, interns, students, and technicians. She is the author of the Manual of Small Animal Soft Tissue Surgery (Wiley/Blackwell, 2010; 2017); co-editor of Veterinary Surgery: Small Animal (Elsevier/Saunders, 2012; 2017); and co-author of Atlas of Ear Diseases of the Dog and Cat (Wiley/Blackwell, 2013).
In 2020, she was named Institute Professor of University of Tennessee’s Institute of Agriculture, one of the highest rankings at her university, and in 2023 she was named the Lindsay Young Professor of Veterinary Medicine at UTCVM.