Good vet in Toronto/GTA, Ontario Ca Area ?

vetl

Tourist
Hello everyone,

Does anyone can refer a good vet in Toronto/GTA, Ontario, Canada area?
The one that doesn't have default "lets cut off ball/ but butcher female" methodology?

Just had an appointment with supposedly 4.6 star place for vaccination, and got a speach on spay is very good, prevents cancers and etc. But the vet could not tell me the side effects, and when i started mentioned some he was like " oh yeah it could happen". The worst part he mentioned the only solution for pyo is surgery.

Therefore, while I have time and for no issues with pyo, looking for a vet in case a help would be needed with pyo that would actually try to treat first instead of default butchering.

Any inputs are appreciated 😃

Or shall i just send spam emails to local vets what treatments are available at their places ?
 
In a city like that, there's bound to be a zillion clinics to pick from, you can look for one that fits you better.
That being said, A "good" vet will tell you to send a dog with pyometra to surgery, even if that's not what you want to hear. Medical management is often temporary solution at best. Failure to recommend surgery would definitely make them a bad vet in my opinion.

If you're looking for someone to do OSS, maybe look at the Parsemus website, and consider doing it while the dog is healthy, as I'd be really scared of a vet that does OSS on a dog that's got a history of pyo.
 
In a city like that, there's bound to be a zillion clinics to pick from, you can look for one that fits you better.
That being said, A "good" vet will tell you to send a dog with pyometra to surgery, even if that's not what you want to hear. Medical management is often temporary solution at best. Failure to recommend surgery would definitely make them a bad vet in my opinion.

If you're looking for someone to do OSS, maybe look at the Parsemus website, and consider doing it while the dog is healthy, as I'd be really scared of a vet that does OSS on a dog that's got a history of pyo.
Well the good vet would outline all options on the table with all risks intead of just giving one, simpliest to him. Medical management would get the dog to the healthy state to prepare for OSS.

Why would you be really scared of a vet that does OSS on a dog that got a history of pyo? Isn't it a mitigation procedure?
 
You're right, your vet should give you satisfactory explanations on what your options are and what you need to know.

A few things with medical management.
- It won't work on all dogs. If she's not feeling sick AND has open pyometra, different protocols with hormones + antibiotics range between 75-90% of dogs that get better. Of those, 50-75% get pyo again soon after. (So in other words, say if you have 10 dogs that aren't too sick, you've got about 2 that didn't get better and either went to surgery or died of sepsis, of the 8 that got better, 6 got pyo in their next 2 heats and went to surgery this time. So one year out, only 2 of them are still surgery-free. These numbers are for getting better from the infection, but 100% of them will still have their underlying uterine disease, so those 2 still intact dogs are at high risk of getting pyo still.)
- If the dog is clinically sick, it takes 2-3 days before they start improving with the medication, which makes these ones poor candidates and less likely for success.
- If it's closed pyo, it's much more likely to fail then to work (25-40%), and just as likely to come back.
- There are some side effects to the meds they use (vomiting, diarrhea, abdominal pain, etc), it's not exactly a walk in the park for the dog either.

Overall, most of these girls will end up needing to go to surgery. You're less likely to have recurrence, complications or death if you send the dog to surgery sooner then if you try medical treatment first. So why risk her life to try medical treatments? Maybe if she's a high value breeding dog and you feel the world needs more of her puppies, which didn't sound like your case. Maybe surgery isn't in the budget right now and we're trying to buy some time. Why is it "butchering" at this point?

As for OSS, the way I see it, you'd have to subject the dog to the previous risks mentioned for medical treatment and hope that works, then if it does, you'd have to ensure she doesn't have ovarian disease contributing to her pyometra. Then if she doesn't, you still put her through surgery with the risks that entails, only to end up with a dog that has a much higher risk for stump pyometra. All that for what benefit to the dog exactly?
- It won't reduce her chances of orthopedic problems on an older dog.
- It's unlikely to cause incontinence (which is not cool but overall rather easy to treat and more an inconvenience then a life-threatening problem in the grand scheme of things).
- There's little to no solid convincing information on the incidence of various cancers or on longevity for intact vs dogs spayed when they're old

So other then you still being able to have penetrative sex (there's a fair chance she'd still enjoy some non-penetrative contact), why not just go directly to ovariohysterectomy if she gets pyo? What's the actual benefit, for the dog, of putting her through all that, and piling up all the extra risk, why would your vet recommend that for her? I'd be scared of that vet because I feel he's just telling you what you want to hear instead of what's in your dog's best interest.
 
Looking at stats joint disorders are are common in neutered/fixed dog no matter early or not.


Statistically speaking, the females should live longer then males, but neutered do not

Well, all those risks are true, as well as risks of having side effects after full spay. So personally I don't really care how much it would cost but I would keep dog intact or with limited surgical interference(OSS) as possible unless there is no way around it. The difference in general dog health in the country were most dogs are fixed vs Easter Europe where they are not is dramatic ( obesity rates, energy levels and etc).
 
Those are 2 very interesting articles you refer to, thanks for putting those up.

This first article you quoted supports that the risk for cruciate ligament injury, hip dysplasia and lymphoma in female golden retrievers increases for early spayed females but NOT late spayed females. No difference there for an older dog with pyo.

It also indicates the risk for mast cell tumors and hemangiosarcoma increases in late spayed female golden retrievers but not early or intact females. This study looks at goldens spayed before vs after 12 months of age, and not dogs spayed after several years of being intact. There aren't that many studies looking at these effects if you spay the dog at something like 8 years old, for example. With the suspected mechanism of why the risk would increase (susceptibility to gonadal hormone removal), one would guess that even very late spay could still increase risk, but there's still little information available on that matter, and studies on different breeds didn't all show the same level of increase in risk. For an older dog with pyo, I still think the risk of leaving the ovaries greatly exceeds the risk of removing them in this regard.

In your second link, they refer to an older study that looked specifically at rotties, and there are several other studies (including much broader and better built studies) have been done with contradictory results. The paper on rotties mentions higher odds of living longer if spay is done after 6 years old vs before 4 years old. For our theoretical older dog with pyo, again, this won't change much.

I totally get why you would want to leave a healthy dog intact, and why one might consider OSS to reduce risk of pyometra while leaving hormones mostly intact. There's (finally!) more and more reason to change desexing practices on our healthy dogs. My point is, once you have a dog that's older and has pyometra, you're talking about something completely different then what's in those studies. It's going to be very difficult to find a vet who is willing to do OSS as a treatment for pyo (I can't even find a case report of OSS after pyometra) because the risk of doing so at this point exceeds the currently understood benefits of "full spay" on that specific individual dog.

As an aside, if you compare humans' health in America vs Europe, I'll bet you'd also find dramatic differences in the rates of obesity and lethargic lifestyles!

Also, if articles are your thing, have a look at some of the literature reviews if you haven't already. They put together several different studies on the same topics which lets you get a quick overview of the different results.
2015: Current perspectives on the optimal age to spay/castrate dogs and cats
2019: Desexing Dogs: A Review of the Current Literature
2020: Assisting Decision-Making on Age of Neutering for 35 Breeds of Dogs: Associated Joint Disorders, Cancers, and Urinary Incontinence
 
Those are 2 very interesting articles you refer to, thanks for putting those up.

This first article you quoted supports that the risk for cruciate ligament injury, hip dysplasia and lymphoma in female golden retrievers increases for early spayed females but NOT late spayed females. No difference there for an older dog with pyo.

It also indicates the risk for mast cell tumors and hemangiosarcoma increases in late spayed female golden retrievers but not early or intact females. This study looks at goldens spayed before vs after 12 months of age, and not dogs spayed after several years of being intact. There aren't that many studies looking at these effects if you spay the dog at something like 8 years old, for example. With the suspected mechanism of why the risk would increase (susceptibility to gonadal hormone removal), one would guess that even very late spay could still increase risk, but there's still little information available on that matter, and studies on different breeds didn't all show the same level of increase in risk. For an older dog with pyo, I still think the risk of leaving the ovaries greatly exceeds the risk of removing them in this regard.

In your second link, they refer to an older study that looked specifically at rotties, and there are several other studies (including much broader and better built studies) have been done with contradictory results. The paper on rotties mentions higher odds of living longer if spay is done after 6 years old vs before 4 years old. For our theoretical older dog with pyo, again, this won't change much.

I totally get why you would want to leave a healthy dog intact, and why one might consider OSS to reduce risk of pyometra while leaving hormones mostly intact. There's (finally!) more and more reason to change desexing practices on our healthy dogs. My point is, once you have a dog that's older and has pyometra, you're talking about something completely different then what's in those studies. It's going to be very difficult to find a vet who is willing to do OSS as a treatment for pyo (I can't even find a case report of OSS after pyometra) because the risk of doing so at this point exceeds the currently understood benefits of "full spay" on that specific individual dog.

As an aside, if you compare humans' health in America vs Europe, I'll bet you'd also find dramatic differences in the rates of obesity and lethargic lifestyles!

Also, if articles are your thing, have a look at some of the literature reviews if you haven't already. They put together several different studies on the same topics which lets you get a quick overview of the different results.
2015: Current perspectives on the optimal age to spay/castrate dogs and cats
2019: Desexing Dogs: A Review of the Current Literature
2020: Assisting Decision-Making on Age of Neutering for 35 Breeds of Dogs: Associated Joint Disorders, Cancers, and Urinary Incontinence
well regarding senior dogs, you absolutely right, its hard do make a call & to consider all underlying conditions. I think my line of thought was coming from blanked approach of spaying all dogs no matter what. For some owners it might make their life easy, and I suspect that the root cause of the popularity, since most people want a fluffy toy and not animal.

There is also a big difference in what I see as healthy dog in west vs eastern Europe and etc. If body missing parts it cannot be healthy by default. Lets say if a dog missing a leg, is it healthy? I would say for sure no, since core body systems impacted and it is pretty much special needs dog. By the west standards yes, its not dying and its not in pain. I do get where there is no other options or in case of senior dog with few years left, but turning a healthy dog into a special needs dog, I just don't understand. And 50% obesity rate in desexed animals, make them special needs dogs. I'm kind of interested in researches related to issues related to the obesity, I'm sure there is more than joints and heart issues.

I'm not a fan of Scandinavian countries but I adore their approach to animals. If you get a dog you should know what you get and altering an animal to your needs is not allowed and you have responsibilities to the animal.

My view my be biased, but strongly expect vets and other professionals to disclose all risks and potential complications from their procedures. I do see a lot of people coming to the forums asking for help with behavior issues after desexing surgeries, I'm not sure how many dogs after that end up in shelters, and how many dogs are not getting adopted because of that( even though I really love dogs, but I would not adopt from the shelter because their crazy processes, and because they spay/neuter and why would I take responsibility of adopting a dog with very high chance of special needs after that ?)

I do have few other resources, if you have something extra please add:


Anyways logically speaking I would exhaust all options to keep my dog initial state & healthy, and then if necessary assess an option with the least damaging outcome.

And I'm still searching for a place to do a full body scan & check up for my mate, it seems like if you have no issues and you are not dying you have not plate in clinic lol
 
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