RPM Tuesday Night Live: Testes and Prostates

Evening, good evening, good evening. Here we are, Brendan and I, Dr. Brendan Clarke and Dr. Nick Thompson, and we are going to be talking about testes and prostate. To which you say, well, you normally talk a lot of balls, what's the difference? I'm gonna get that one in really early before you even begin to think about it. We haven't got Brady here, so we've got a— that we've got a certain a certain depth of rude and sly and snide and anatomical comments that we need to maintain, you know, even if he's not here. So all good. Ben, how are you?

Very well, thanks. Yeah, just building up to Christmas joy. Can't wait till next week. I hope everybody's going to be joining us for the Christmas party. I think we've got a little bit of a Q&A, haven't we? In the sense of being asked popular quiz questions.

Karen has got a quiz all lined up, and if it's not lined up now, it will be by then. She's going to do about 20 questions in 4 different sections. Nothing too taxing, I hope, Karen, but if you know what's good for you.

But it's, yeah, except for Conor's questions. I think they need to be really tactful.

Yeah, they should. Yes, put him on the spot. Karen says the quiz is done. Well done, you, Karen. She is the model of efficiency. Her middle name, in fact, is Efficiency, which is not a good name to have, but she is efficiency personified. Listen, Brent, any news? Any news?

We've got to tell everybody about the t-shirts. We're going to do t-shirts.

Okay, let's do all the notices first. Yes, so we're going to be talking, guys.

Yes, we are indeed. Um, but guys, uh, in the meantime, if you're interested in, um, t-shirts that, um, eulogize about your role, then, uh, please do follow through to this site. Uh, you'll see 3 designs on there. Thank you, uh, to to everybody who's helped with those, especially Fiona, but there are so many others. Karen, I know you were part of that too. And yeah, just have a little gander if you want to order them. Still time before Christmas to order your preferred t-shirt on rawpetmedics.tmill.com and get them to your home. So please have a little look, have a little chuckle, If you've got any ideas for future designs, please do post them here and we will take them on board. Okay, for those of you who's already ordered, thank you very much. They're flying off the shelves and we hope that you will post some pics of you wearing said t-shirts. That would be great.

Oh yeah, if you could post your pics. On Raw Pet Medics or on the Raw Feeding Veterinary Society community page, just anywhere really, just to get the word out. That's really, really good and inspire people to do some more. You know, there's no— there is no limit to how many we can do because the company T-Mail, God bless them, they do all the hard work, which is brilliant. Yeah, absolutely. I'm gonna— so, uh, we've also got to say we're on a podcast if you like podcasts. I love podcasts. You able to get it on every podcast medium available. So, um, uh, knock yourself out there. That's really, really fantastic. And also, we are on— he says, waiting for the Patreon link, which I can never remember, which I should be— patreon.com/rawpetmedics, which is, which is not the most, um, difficult one to remember, me thinks. Okay, so I'm going to say to people, now we've done the, the necessaries, If you've got any burning questions, please shout and put it into the— on the right-hand side there. Do jump in. We will try and have a look, but it means we've got to come out of BeLive into Facebook. Yeah, the Raw Pet Dynamics Facebook. And so that's kind of a jiggling thing. So, but we can do that. We're very on the ball. Uh, so there we go. Any— have I got any news? Uh, I think everything's getting a little manic. I think Christmas is coming and people mysteriously, uh, as ever, think, you know, they're thinking, oh, it's low, long time, a long, long time away, and then it's, oh my God, it's only 5 days to Christmas. So I think there's a bit of that. The snow has added to the chaos, and the post— we're having really terrible time with post in the UK, guys. I'm not sure what's happening in the States. We've got lots of people coming in from the States. There's Michelle Barchardon. That's how you say it, Michelle. You must give me a lesson on how to say your name. Yeah, I've got clients for whom we sent a guaranteed by 1 PM the next day, still hasn't arrived 2, 3 days later. Are you seeing the same?

Yeah, we are having to change all of our posting out of supplements and meds and remedies just because of this issue at the moment. We're sort of even going down a sort of specific, the, you know, if you want them absolutely to arrive, you know, you might need to pay for DPD. We've had quite a few that have been okay. But we just know that some are disappearing.

Yeah, it's a lottery. So there we go. So if your postal service is working well, enjoy it, because when it goes wrong— oh, here's Penny says, I've been waiting 3 weeks for a Royal Mail delivered parcel. Yeah, which is probably a 48-hour parcel. Okay, nightmare, nightmare. Let's stop talking about the post because it will just get us all depressed. It adds to that feeling of anarchy, don't you think? Bit of snow, bit of postal strike, bit of, I'm not sure when my, you know, Aunt Uncle John's socks are going to arrive so that I can send them to him in Skegness. Those kind of anxieties really weigh on people, I tell you. I'll tell you.

I can't believe you've got an Uncle John in Skegness.

No, I haven't. I just made that up. I just made that up for dramatic purposes.

Okay, of all the places. So the, so the other things to, uh, yeah, with those train strikes and everything else, it's just, uh, I hope Conor actually managed to make it to his glorious sunshine and he's not actually sat in some rainy hotel in Dublin pretending to Sun himself. Can you imagine?

Look it up, those— you guys in the States, look up Skegness. It's a lovely place, but it has a very, very particular charm, shall we say, in case—

I did have somebody comment about, um, when I made the comment on the RFVS thing about being out in the wilderness, that somebody— that surely going to Skegness was Enough of Into the Wilderness for anybody. Brilliant. We love you.

Yeah, yeah, yeah, absolutely. You're so wrong. Nothing wrong with Skeggy. Absolutely. It's just, it's a great place to take the mick out of Carol. That's all we're doing. We're just taking the mick. We love them anyway. Okay, um, uh, Bren, we're going to talk about testes and prostate, and we were just talking about before the show, guys, and we'll be saying, oh My goodness, where do we start? If it were me, I would start not with what, how do testes work and what do they do and what's the prostate and what have you. We're going to kind of assume that you guys have a, have a fair idea of that, and if you don't know, then go on to YouTube and there's some great videos— not those videos, the proper educational videos— that will teach you all about what that's all about. I think everyone probably got a fairly good idea. So we're going to assume you kind of know what fits to what and what does what and when. I, I'd like to start with what happens— no, on the debate of do we neuter or do we not nowadays. Do you want to start? I've got some thoughts on this. Now there's a book that I need to go and get from Lisa Hansen.

So yeah, you do that while I just maybe just talk about the different procedures and I'll just go roughly through what the two things mean, and then you can come back with Lisa's book as well, and all the things she's got there, because we'll talk about that. So for male dogs, the age-old adage was to castrate, and that means removal of both testes. There is a small incision made just in front of the scrotum, through which we pass the testes. And that could be either by an incision into the tunic, which means an open castration, or a just tying off through the membranes around the testes, which actually is a closed castration. Now, it was probably in the 1990s that there were many homeopaths discussing whether that was the right thing to be doing or not because of the effects on the body, and at what stage do we do that. And a lot of people were poo-pooing it as well. That's just, you know, people getting all shy about males wanting to have castrations, etc. And then some information came out in the early 2000s where a large corporate actually looked into their databases as to those dogs which were neutered versus those that weren't over in the States. And some really interesting information came through for both males and females about removal of the gonads— that's the testes in males and the ovaries in females— and the effects that can have on health. So with that in mind, there is another operation You can do this either by laparoscopy, where you actually would put a camera inside the abdomen to find the vas deferens, the tube that feeds the sperm from the testes in via the prostate into the urethra so that it can be ejaculated. The issues around that is that you have to go into an abdominal operation. There's lots of other things with— you need the expensive equipment, but you can actually do, just as they do with humans, a prescratal incision to actually enter and go in to find the spermatic cord on its descent to the testicles outside of the body cavity. Now, there are some slight risks. It can cause a little bit swelling postoperatively. We usually take a section out, maybe a centimetre. We generally tie off that spermatic cord at our practice. Some people just do the snip, and literally will incise it. There is a small risk of it joining back together, as nature has this way of overcoming injuries. But when you tie them off and you remove a centimetre, it's— I mean, it's rare anyway, but when you do that, it's virtually impossible for nature to overcome that. So do you have to bear in mind if you do any of these that there may be enough sperm in the spermatic cord to still impregnate an entire bitch at home for a few days post-operatively if the dog feels up to it. And therefore, don't just think, oh, that's it, they've been neutered, I can put them back together straight away. Do take advice from your veterinary surgeon about maybe giving them at least 10 to 14 days apart before putting back together if the bitch is on heat. Otherwise, so that is a vasectomy that I'm talking about, where we remove a bit of the spermatic cord, and that leaves the testes alone to continue their hormonal influence on the rest of the body. And Nick, there's lots of things that are at risk if we remove that hormonal influence, especially before puberty. You know, have you got the, uh, some of the references there?

There are, there are, there are. But just before we get into the, into some of the statistics, I'm just going to just stand back and just look at some of the, the, um, what would you say? It's, it's, it's, it's, what are they, uh, when we look at the epidemiology and, and, and when we look at the, the argument against for and against neutering, because a lot of— in the States and in Europe, we're very keen on neutering. We have been very keen up until about the '90s, as you say, Brent. But then after that time, some groups began to suggest that maybe you don't need to, and they just— they looked at the argument that you and I had, Brent, when we were at college, which was If you don't neuter male dogs, you run the risk of promoting the puppy population. Okay, obviously. But, and I think that back in the day, in the '80s and '90s, I think that that was possibly, and in the '70s and '60s, definitely. But I think the world is very different since the 2000s, that people are much more responsible about dog ownership nowadays. So it means that male dogs are less likely to be going running around the village, running around the town like our dog did when in the 1980s. Unfortunately, it wasn't such a big deal. It was frowned upon, but it wasn't, uh, oh my goodness, you know, the dog, there's the doctor's dog again. Yeah, my dad was a doctor. It was just, oh, there's George, you know, that was just how it was. And that was even in the '80s. 70s and 80s. So I think that the environment in Europe has changed a lot, and I don't think the possibility of dogs getting, uh, uh, uh, bitches getting pregnant is as great because of this control that we have now. Somehow that, that, that idea has changed. In, in the States, they say you've got to neuter because of the puppy population. In Europe, for example, in, in Scandinavia, and I think in Germany, where neutering is— you are— it is an illegal thing to do unless there is a medical prerogative, unless there is a medical need to neuter. The level of puppies in the shelters is about the same. Yeah, so you have on— in the States, everybody's— all the dogs are neutered, and in Scandinavia, very few are neutered, and yet the proportion relative to the number of dogs in the country, perhaps relative to the number of people in the country, is really quite low. So I don't think that argument stacks up.

So really useful thing that I discovered, I had a great vet that worked with me in the 2000s who, one of her studies when she— no, it was before Melaina, it was, sorry, after Melaina. It was literally she came to work with us and she had done a study in her final year of university on neutering clinics in Spain, south of Spain. And the study showed that actually neutering made no difference on the cat populations whatsoever. What made a difference was the amount of food and rubbish available for those cat populations to feed on. And I found that really interesting. So they were neutering like crazy, they were pumping loads of money into trying to neuter these cats, and it was making very, very little difference to the feral cat populations. Just because, you know, there'll be one or two that get away, they would quite easily make up for the numbers that were neutered. And it was all actually about the availability of food to those. And I think the same, um, that we then look at this puppy population argument. Well, there's very few latchkey dogs now in the UK, um, relatively speaking. And certainly I don't think that therefore the feral dog population, and therefore the risk of puppies and unwanted puppies, is anywhere near as relevant as it may have been back in the 1950s. But yet it's being kept up as that same old argument, hasn't it? And as you say, you know, if the studies show there's no difference now between the populations in Denmark and the populations in the States, regardless of whether they neuter or not.

Yeah, yeah. So I think that there is quite a lot of gray area But in the '80s and '90s, it was absolute. Everyone had to be neutered. That's it, you know, unless you're a breeding dog, which is kind of 1% of the entire population. That's it, you're neutered. That's it. There was no question of it. Whereas now we are asking questions, and therefore I think that it's difficult to say one way or another, but we can ask the question. And I think it's okay to choose not to nowadays, whereas that was frowned upon back in the the old days. And so for me, that leads to the question of, well, if neutering is such a benign intervention, well, why don't we all do it? Why don't we, you know, what's the problem? We just, you know, we're just neutered them, they're only dogs, we'll just, we'll take their ovaries, we'll take their testes, what have you. That was the old school argument, but nowadays there's really quite a lot of science coming up which is suggesting that by neutering, especially if you're neutering before puberty, or even worse, you're neutering down at 12, 9 weeks of age, and this is actually happening. I hate to say it, you probably know all about it, but this is actually happening. The earlier you take away that hormonal moderator, the worse the problems are. There was a little ping there, um, so if just looking through some of the references here, I was not really taught much about the downside of neutering. I was only taught mainly the upside of neutering. The obvious downside in female dogs is that 10 to 15% over a lifetime may get a little incontinent, post-spay incontinence. That's the most obvious one. However, when you look at large populations, we know that early neutering of dogs, not male or female, but early neutering of dogs doubles the chance of hip dysplasia. Early neutering increases joint disorders in all dogs by 4 times. Neutering dogs triples the risk of several joint problems in GSDs. Neutering decreases longevity in Rotties and increases the chance of cancer in all dogs, males and females, and all breeds overall, which I think is really pretty terrifying. However, the other side of that, that observation is that If your chance of getting a certain cancer is 1 in 10,000 and by neutering you go to 2 in 10,000, on paper you've doubled your chance of getting that cancer, but your chance of getting that cancer is still 2 in 10,000. So I think one needs to do the proper research. Personally, I think that that's really important. Because of that, you know, it sounds like it's a lot. Oh my God, I'm twice as likely to get a cancer. But actually, you're still more likely to, uh, I don't know, trip over a curb and, you know, whatever it might be.

It's really interesting though that the flip side of that— I mean, for some of the studies, they were shocking. I mean, I, I remember sitting in the WSABA World Small Animal Veterinary Association conference in 2017 in Copenhagen, and it was a whole debate. There's several aspects to this, from joint disease to cancer to behavior and all of the effects thereof of both spaying and castrating both dogs and cats. And we're going to deal with both tonight to some degree for the male side. So, but what was really shocking at that is the highlight of part of one of those reports where for Rottweilers, rather than preventing testicular cancer and prostate cancer, that actually we were moving— if you neutered pre-pubertally— from a 7% risk in males to a 27%. That's nearly a third of Rottweilers were likely to come down with osteosarcoma in that study. And that's, I mean, a third of Rottweilers. I mean, that's like a ridiculous number. And of course, you know, of all the breeds, people associated, well, you know, it's going to stop them being so aggressive if we take away the testes, they're going to be much more handleable, all the rest of it, which isn't frankly true. That's all down to a load of other social aspects that you need to do. But actually you know, to then think that they weren't being informed, that actually we've just hyped, not just doubled the risk of their cancer, but we've meant that actually almost a third of those dogs are going to have osteosarcoma. That's a shocking piece of news, and that's just one of the cancers and one of the diseases that they can be prone to. So I think it's really important that we get this across. It's a conversation that you must have with your vet if you're going to think about neutering. You know, is it— if they just say, oh, well, stop all of these spare puppies, well, think about vasectomy. You know, if you've got, you know, a female who's entire in the house and you don't want puppies, just think about vasectomy. For all of those kennels out there and all of the rescues that may put a caveat on your dog think that actually a lot of it is about those unwanted puppies, not about anything else. They want the healthiest option, so they may accept vasectomy rather than castration because ultimately it's going to do the same job to stop procreation. So let's, you know, have that conversation and come from an area of knowledge because there is the research out there as to why we should consider other options.

I think let's just go, I'm just going to say if you go and see your vet, they are going to say things like if you neuter between the first and second season, you will reduce mammary cancer. That's the age-old statistic that we were taught. I think that there is some work to suggest that that is not as robust as it might well be, that there are other factors. And you've got to remember that none of this work was done on raw-fed dogs, that's for sure. And I can guarantee that they were probably very up to date, shall we say, with all their pharmaceutical vaccines and wormers and what have you. Yeah, because they're very diligent owners and what have you. So I think that the environment in which these studies were done is different from perhaps some of the dogs that you and I might be discussing today in 2022. Okay, in this slightly unique group of very well-informed and very skeptical, should I say, uh, uh, individuals. You know, we're all asking questions essentially, so I think we need to be, uh, aware of that. If you do castrate a young dog, even at an appropriate time, you will by definition eliminate the chance of testicular cancer, because if you haven't got testes, you can't get testicular cancer. Okay, so yes, that is valid, that totally valid, but that's a bit like saying if I chop off your head, you're not going to get a headache. You know, possibly that's a slightly extreme example, but if you haven't got something, you're not going to get cancer in it. Okay, but it is valid. What is slightly more subtle is that if you haven't got any testes, it will reduce the chance of benign prostatic hyperplasia, which is where your prostate just, just grows because you're getting old. And most old gentlemen and older Male dogs get it to a certain extent, one way or another. And there are other cancers which rely on testosterone to keep them, to provoke them. And so all that, there's, you know, half a dozen that you can think of that they're not going to be provoked. But if you do neuter, spay a female, or castrate a male, you've got to think of What about the impact on other hormone systems? I'm thinking in particular thyroid. And if you have a read, if you don't know about the canine thyroid epidemic, then you must do that. However, before I tell you that, I went running off to get this book a minute ago, which will give you a very good background on this. This is by Lisa Hansen. Can you read that?

You can't, but Lisa Hansen, we can say it's Cat and Dog Health. So it's really, it's readily available on Amazon. You know, you can, I think it's possibly number 2 in cat and dog health or something like that. I think it's quite high up.

Oh, good for her. That's really, really good. And the other book, I'll just grab it from my bookshelf, guys. Is that one by Gene Dodds? By Gene Dodds, yeah.

So yeah, and I think any surgery, you've got to remember, yeah, any surgery can risk any immune-mediated disease, i.e., causing an attack on their own system. Secondly to that, the hormone effects on how efficient the immune system is, is known. And I think that's where Jean really comes into this as saying, no, that hormonal influence on immune regulation seems to be— they're much more predisposed to immune-mediated disease if they've been neutered. So I get that there's many different theories as to why that might be. I think, as somebody mentioned earlier, there are so many aspects to hormonal influence that we probably really don't understand. And we make assumptions that, you know, the hormones from the gonads are all about sex and that's all that they're thinking, which quite frankly it isn't. You know, there are so many other regulations and just seeing how cancer is influenced, you know, how the joint health, how immune-mediated disease, you know, not just thyroid, but, you know, you've got IMHA. So you know, haemolytic anaemias, the thrombocytopenias, that's the platelets being affected, you know, all of these things that can be affected by those hormones. So I would definitely say it's something to be really up to speed on when you're talking to your vet and really get the pros and cons nailed out as to why you might want to be avoiding neutering, certainly till much later. Even for kitty cats, I know lots of people complain, oh, but they're going to smell of tomcat, it's really horrible. I think there's lots of other aspects to that. You know, yes, it's not pleasant if they are urinating everywhere, but that can be a stress factor and not necessarily because they're tomcats. And I think that, you know, we know that the health of tomcats just as affected as it is for dogs. So we need to be mindful of when we're neutering. And I do groan every time I see those cat charities that are neutering at sub-12 weeks just so that they can get those kittens out to new homes. And you're just like, you know, bless the poor souls. Somebody asked earlier, and I think I do want to deal with this, about behavior. 'Is it really necessary for a hyperactive dog to be neutered?' And I would definitely say, look, think nutrition first. Definitely, you know, have you got them on the right food? The number of hyper spaniels that I've moved to raw that have stopped being hyperactive, you know, it's think about food first. If you think, 'Oh, they're really nervous,' or Aggressive? Yeah, check that aggression. Is it nervous aggression? Rather than just neutering, think about the anesthetics that they may want to use because that can have an effect on their behavior. Think about the actual neutering procedure as to how that's going to affect their confidence and how they're going to behave. There are things like implants like Suppolorin, which effectively will suppress the male hormone, give you a trial period of anywhere between 6 and 12 months depending on the dose that you give, that some people would prefer to do. And although it's not ideal to be suppressing those hormones in that sense, for many people, at least it gives them a stopgap to think, is this really going to affect my dog in the way that I want it to affect them? And, you know, is that the right way to go? So at least gives you a guess out that the vet can buy into. Okay, it may be the same cost as neutering, but let's face it, it's the health of your pet that you're trying to look after. So please, you know, think about how your companion may benefit if you just trial something else.

I think if Just thinking simple, simple, simple, which is how I like to start with these complex questions. Weight gain. I think it's very difficult to argue that weight gain will not be an issue in a neutered male or female, okay? And if your previously trim entire male, you then neuter him and he becomes really soft and fantastic and, you know, really easy, malleable, if that's what you're looking for. I think the chance of him just, just, just putting on weight is really quite high unless you're very, very careful with food, raw food or any other food, to be honest. Uh, it's even more difficult with a high-carb kibble-y type food to, to maintain weight. And if they become overweight or obese, then you're into Kidney disease, diabetes, dementia, you know, all these things. There is a link between neutering and dementia. Is that a direct link, you know, lack of testosterone, dementia, or is it via overweight or obesity? Possibly. I'm not sure. I'm sure— I think there is a strong link between obesity and dementia in humans, so there may well be something going there because fat is very hormonally active. Okay, and if you're overweight as a dog, then you're not likely to get type 2 diabetes, but diabetes is very common, especially in overweight individuals. That's absolutely for sure. So even at a simple level, weight is a thing that we need to think about. Weight gain, dementia, bone problems, risks of anesthesia. Of course, with anesthesia, what they won't say is that it predisposes to pancreatitis in some individuals. So, you know, that is there. So if I have to give a take-home message a little bit early in this show, to give take-home messages, however, If you have a chat with your vet and they don't give you a big long list of pros and a big long list of cons as to neutering, I'm not sure that that is possibly as complete a list as you might be able to get from other sources. I mean, we've only just started and we've got 30 minutes between us. We're only scraping the surface, really.

And we have to admit, you know, many of these vets may only have 10 minutes to go through a list and therefore will shorten their list beyond what they should be doing. And hopefully they've got some printed information on their websites or indeed, you know, to hand to give to you to take away. And maybe ask for that if they're only giving you a very shortened list within this. Or the references, you know, we'll post these references on Patreon and probably on the Facebook feed as well so that you can have a look at those and, you know, actually have a little think about options that are available outside of standard neutering. So you've still got some options there.

If you had to neuter a dog, Brend, when, where, what sort of timing would you go for? What's your— what in the old days, what was your advice and how has that changed now actually? There's a nice— there's a question.

Yeah, do you know what, I've been through the advice, you know, when I left uni and I had two male dogs pretty much within a year and two years from when I qualified, and it was very much— was, I think, actually my first dog I'd left till 9 months. These were Labradors, so just to give you a breed size, Labradors. The first one was 9 months The second one was 6 months for neutering because that was the standard at that time. And I would definitely say, you know, I saw cancer in the younger one at an earlier age. The older one, it was realistically senility that came to him. And, you know, we all look back and wish we'd done things differently, you know, but Young vet, did the standard. That's what we were told to do. And, you know, you follow that through. What would I do now? I would say, look, I have a conversation for dogs. I definitely say, look, do you really need to neuter? What's the situation? Where are we at with behavior? Look at all of these options that are available as alternatives. If they Owner absolutely says, no, I want to neuter, and they've got all the requisites to want to do that, then I would be trying to advise them to wait till 24 months before they neuter. Because with what size? There are reductions for a, well, anything really, at least Spaniel upwards, I'd be waiting for 24 months.

Okay.

I think, you know, some of the smaller dogs, yes, they'll have reached maturity much younger. Most of those dogs like Spaniels would have reached maturity by 12 months. But if you can leave it long enough, you know, do the training, do the diet, do the other stuff to see, you know, have you got control, you know, there is no reason why an entire male spaniel isn't going to be by your side attentive to what you do if you've got that training right. Okay, now if you're lapsadaisical and your spaniel does a bunk after every single squirrel and every other dog that's running around and pays very little attention to you, Is that the fault of the dog, or is that that you've not engaged with your dog to do the training? Okay, so I would definitely say think about how that dog's interaction with you, what you want to be doing as far as training and diet, and then if you have to go ahead, think about 24 months. For cats, look, I absolutely admit there is an aspect where many people will complain like crazy about the smell. It's probably second to having an entire male goat living within the house. So I would just say, think, you know, the smell can be pretty rank in some cats, not all cats. So don't make an assumption. And certainly if they start to smell, then, you know, with the strength of their urine in the litter tray and just how they smell around themselves, then actually neutering at that point will reduce that odor. But accept the risks that comes with that neutering. Okay. And think about, is that the right time? So I would, you know, for cats, again, delay. If you can get to a year before you think about neutering, I think all the better.

I'm going to make it even more simple than that. That's a good answer, but I'm going to make it even more simple and say maturity. Now, that will depend on the size of the dog in terms of skeletal maturity, but it will also depend on the level of exercise, the quality of the food, and what have you. And everybody, you know, if you talk in terms of humans, some of us hit puberty at 10 years old these days, or begin with puberty these days at 10-ish, and some of us don't kick in till 14, 15 years of age. Okay, so that's within humans, and therefore there's going to be a range with dogs as well. So if you have 100 spaniels, you'll find some of them will start with puberty 9 months or so, but some of them won't even be thinking about it until 15 months. So And that's just puberty. You've got to get through puberty. The other side of puberty, you've got to fill out, you know, in terms of males and testosterone, what have you. But even girls, they've got to, you know, develop that full mature body shape and size and strong bone health and what have you. And I would say I would be led by the dog rather than by the calendar as to when you neuter. Obviously, if they are— you've got a male dog and you've trained them like mad, but they still disappear at the drop of a hat and they're going to end up under a bus, then you may bring that neutering to the lower end of that. But if they're absolutely great and you don't really want to do it, but I don't know, your granny or your neighbor or your uncle or whoever is saying, got to get that dog done, then you might want to push that out that neutering period out as long as possible. Because if you get to, you know, 3 years old with a Spaniel or a Lab and they're just not that interested in sex, then you might get away with it. You might just say, listen, look at them, they're not humping anybody's leg, they're absolutely amazing, and therefore I don't want to. And so you've got an argument because you just say, look at the dog, I don't want to neuter that dog. I had a fantastic conversation, by the way, Bren, today. A lady said, I've just taken my dog— we've just been weaning this dog off ZD for skin and bowel problems and what have you. And she said, do you know what, ever since I came off ZD, the dog has stopped humping my leg. Young spaniel. Okay, so how cool is that? I thought I'd share, I'd share that little, uh, that little idea. I didn't even connect it with tonight's discussion. But there's a lot going on there, methinks. Yeah, what do you think?

I think I'd love to then just very briefly touch on if we're going to keep these entire— because we want to keep these entire males for as long as possible— I think it's really worth us touching on what to watch out for, what to look out for, for signs of testicular disease and signs of prostate disease. So we'll just take a moment, I think, to look at that, and I would certainly say For those dogs that are left, if you're getting to 6, 7 years of age, it's a really simple check, okay? It's the check that all middle-aged men should be doing, which is a very quick, you know, as you're grooming them, just have a little check of their testicles. Are they both the same size? Are they, you know, reasonably oval in shape? Do not get worried about a slight swelling towards one pole of the testicle. That's the epididymis, the area of the change of blood vessels so that the testicle stays cool on the outside of the body, and it allows heat exchange with those vessels. And so it might be slightly swollen, and you may feel like What we're more interested in is if the change between the two testes— so one becomes larger than the other significantly.

Yes, and comparison between the two.

Yeah, yeah. And if within the larger one you may feel almost like a stone in the shoe, a hard nodule within that lump. So what can happen is that we can get things called Sertoli cell tumors which actually release a female hormone, because the testes do release a combination of hormones. It's not just testosterone. And that Sertoli cell tumor will shrink the other testicle back, okay, as at the same time that this stony mass starts to grow. Now, occasionally those tumors can be significant in the sense of spreading. So it's worth having them checked. We talked about lumps and bumps last year, about doing fine needle aspirates, all the way through to whether you're going to castrate or not. And that, you know, I've got a blessed elderly setter who I know has one at the moment, has a myriad of other conditions going on, and bless I I'm monitoring that testicular growth at this point in time with regards to, is it fair to put that elderly setter through an anaesthetic and procedure to remove that tumor, knowing that some of them can be benign? Okay, so it is something that at least you can look out for. It's relatively easy. They're on the outside, you know, unlike the other tumors they could be predisposed to, which are internal, like osteosarcoma, lymphoma, hemangiosarcoma. These you won't spot until it's too late. Often with testicular tumors, if you're doing that regular check, you'll find early. Okay, so think about those checks.

Brilliant. Should we jump over to our friends on Patreon?

Yeah, I think we should. About prostate disease, uh, if you want to know more on that.

Yeah, let's talk a little bit about prostate, but also I'd like to talk to you about philosophically or physiologically, a bit of both, as to why the testes are on the outside and the ovaries are on the inside. And don't say it's because they work better at a low temperature. I'm thinking, why do they work better at a low temperature? Because having your gonads swinging in the breeze when you're trying to go hunting saber-toothed tigers, I don't think is the best evolutionary evolutionary plan in the world, you know.

But evolution, evolution made it so that it was super painful if you accidentally knocked that tackle, and that evolutionary step meant that you guard your tackle at all costs. But we're going to— yeah, I think we're going to talk about that because it's really important when we're talking about if they've got a retained testicle. Yeah, as to what you might consider.

Okay, okay, let's talk about a little bit about discharge, a little bit about Sertoli cell tumors, and a little bit about why testes are on the outside, balls around the outside. I have said balls several times, guys. People are complaining that there was no swearing tonight. Is balls— that's, that's slightly rude.

What, are they wanting you to say bollocks instead?

They're missing with an S. They're missing Brady. So sorry, the disappointing lack of swearing tonight. We did say balls, knackers, bollocks. We did actually say bollocks a bit earlier. Anyway, there you go.

I love Conor's little joke to us in the WhatsApp group was, "Ah, nuts, I'm gonna miss them." That's worse than my jokes.

At least mine are funny. Goodness me.

So, um, let's, uh, for all of you guys who want to know a little bit more, uh, please, uh, do switch over to Patreon. For some of you who just listen to our podcast, I think Pete is a little bit sneaky and sometimes he brings our Patreon, um, blurb into the Audible podcast, so you might be lucky and get the little extras. So keep a listen out if you haven't heard the Patreon stuff. Price of a cup of coffee, join us on patreon.com/rawpetmedics. Yeah, see you over there soon.

Thanks guys, all the best, see you later.