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Spay and Neuter Risks: What Pet Owners Should Know

Spay and Neuter Risks: What Pet Owners Should Know

Spay and Neuter

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Owners

Spaying or neutering your dog comes with benefits—and risks. Learn about joint, cancer, and behavioral risks so you can make an informed, breed-specific decision

By 

Sustainable Vet Group

Updated on

July 17, 2026

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This article is for informational purposes only and is not a substitute for professional veterinary advice. Every case is unique, so always consult your veterinarian for guidance specific to your pet.

This content is intended for veterinary professionals for educational purposes. It does not replace clinical judgment or tailored advice. Always rely on your training, expertise, and the specific context of your patients.

Spay and Neuter Risks: What Pet Owners Should Know

Most conversations about spaying and neutering focus on the benefits. The risks get a shorter mention, often reduced to "complications are rare" and left at that.

That is not enough information to make a fully informed decision.

The risks are real, they vary significantly by breed, size, sex, and age at surgery, and understanding them puts you in a better position to have a productive conversation with your veterinarian. If you are not yet familiar with what happens during the surgery itself, reading through the full surgical process first gives useful context for understanding where each risk originates. This article covers both short-term surgical risks and the longer-term health risks that current research has identified.

 

Quick answer: Spay and neuter surgeries carry a low overall death rate of around 0.1%. Short-term surgical risks include anesthetic complications, bleeding, and infection. Long-term risks, which vary by breed and timing, include urinary incontinence in spayed females, certain joint disorders in large breeds neutered early, and some cancer associations. Most risks are manageable through appropriate timing and good post-op care.

 

Key takeaways

  • Overall surgical mortality is very low: Studies place the death rate from spay and neuter complications at approximately 0.1%.
  • Short-term risks are real but manageable: Bleeding, infection, anesthetic reactions, and incision problems can occur in the days following surgery.
  • Long-term hormonal risks are breed and size dependent: Large and giant breeds neutered before skeletal maturity face the highest orthopedic and some cancer risks.
  • Urinary incontinence is underreported: Up to 20% of spayed females may develop urinary incontinence, with greatest risk in dogs over 33 pounds.
  • Timing is the biggest lever you have: Many long-term risks decrease significantly when surgery is timed appropriately for your dog's breed and size.
  • The benefits still outweigh risks for most dogs: Understanding risks is about informed decision-making, not avoiding surgery.

Short-term surgical risks

Any surgery under general anesthesia carries some degree of risk. For healthy dogs undergoing spay or neuter procedures, serious complications are uncommon, but they do occur and are worth knowing about.

Anesthetic complications

General anesthesia is required for both spaying and neutering. Reactions to anesthetic agents can range from mild to severe.

Approximately 1 in 1,000 healthy animals experience life-threatening complications from anesthesia. Risk increases in dogs that are very young, very old, overweight, or have underlying health conditions such as heart murmurs or organ dysfunction.

Pre-anesthetic bloodwork is recommended precisely to catch issues that could increase anesthetic risk before the dog goes under. This is worth discussing with your vet, particularly for older dogs or dogs with unknown health history.

Bleeding during or after surgery

Some degree of bleeding occurs in all surgeries. Excessive hemorrhage during a spay occurs in roughly 1 to 10% of cases, with greater severity in dogs over 50 pounds.

Post-operative bleeding after the dog goes home occurs in approximately 2% of cases. Signs include swelling at the incision site, unusual bruising, or a distended abdomen. Contact your veterinarian immediately if you observe any of these.

Factors that increase bleeding risk include inexperienced surgeons, incisions that are too small for the dog's size, and accidental laceration of nearby structures.

Surgical site infection

Infection at the incision site is one of the more common post-operative complications and is largely preventable with proper aftercare.

The primary cause is the dog licking, chewing, or scratching the incision. An E-collar (cone) worn consistently for 10 to 14 days after surgery eliminates most of this risk. Keeping the incision dry and watching for warning signs after neutering a dog, such as redness, discharge, swelling, or unusual odor, allows early intervention before an infection becomes serious.

During surgery, veterinary teams work to reduce contamination risk through proper site preparation and sterile technique. Some surgeons also use an intraoperative antiseptic lavage such as Simini Protect Lavage to reduce bacteria and biofilms in the wound before closure, reducing two of the most significant sources of post-surgical infection risk.

Pain

Pain after abdominal surgery is well-documented and no longer considered acceptable to leave unmanaged. Most veterinary practices provide pre-surgical pain management, anesthetic drugs that include analgesic components, and take-home pain medication.

If your clinic does not mention pain management during the discharge conversation, ask specifically about it. A dog that returns home without adequate pain control will be reluctant to eat, lethargic, and more likely to interfere with its incision.

Ovarian remnant syndrome

This is a surgical error rather than a complication per se. It occurs when a small piece of ovarian tissue is inadvertently left behind during a spay. The remaining tissue continues to produce hormones, causing the dog to periodically come into heat despite being "spayed."

It is uncommon, but it does happen. If your spayed female dog shows signs of heat, including behavioral changes, attracting males, or a swollen vulva, contact your veterinarian. A test for estrogen levels can confirm the presence of ovarian tissue.

Long-term health risks: what the research shows

This is where the conversation gets more nuanced and more important for large-breed dog owners specifically.

Sex hormones, estrogen and testosterone, do not only regulate reproduction. They influence bone and joint development, immune function, certain aspects of cancer biology, and urinary tract integrity. Removing them through spaying or neutering has downstream effects that researchers have spent the past two decades studying in detail.

Joint disorders in large and giant breeds

The most well-established long-term risk is the association between early neutering and orthopedic problems in large breeds.

Researchers at UC Davis, in studies covering more than 40 breeds, found that dogs neutered before growth plate closure showed higher rates of:

  • Hip dysplasia
  • Cranial cruciate ligament rupture (a knee injury)
  • Elbow dysplasia

The mechanism is straightforward. Sex hormones signal growth plates to close at the appropriate time. Removing those hormones before the plates close can delay closure, affecting how the joint ultimately forms and how stable it is long-term.

This risk is most pronounced in large and giant breeds. Small breeds mature faster and show minimal effect. For how age affects surgical risk in your specific breed, a conversation with your vet using the breed-specific UC Davis data is the most useful starting point.

Cancer associations

The relationship between spaying and neutering and cancer is complex, and it varies significantly by breed.

Some cancers are reduced by surgery:

  • Mammary tumors: Spaying before the first heat dramatically reduces risk. Each subsequent heat cycle raises it.
  • Testicular cancer: Eliminated entirely by neutering.
  • Pyometra (uterine infection): Eliminated by spaying. Pyometra is not cancer, but it is life-threatening.

Some cancers show increased association after early neutering in specific breeds:

  • Osteosarcoma (bone cancer): Rottweilers neutered before one year of age were 3.1 to 3.8 times more likely to develop osteosarcoma than intact dogs, according to published studies.
  • Lymphoma and hemangiosarcoma: Elevated rates have been identified in Golden Retrievers and German Shepherds neutered early.
  • Mast cell tumors: Some associations identified in specific breeds.

It is important to note that these cancer risk increases are breed-specific and age-dependent. The same early neutering that raises osteosarcoma risk in Rottweilers shows no significant effect in many small breeds. This is why blanket statements in either direction are not useful. The risk profile is individual.

Urinary incontinence in spayed females

This is one of the most underreported long-term risks of spaying.

Estrogen plays a role in maintaining the tone and strength of the urethral sphincter. After spaying, estrogen levels drop, and in some females the sphincter weakens enough to cause urine leakage, most commonly during sleep or rest.

The incidence in intact females is under 1%. In spayed females, estimates range from around 5% to as high as 20% in some studies, with the highest risk in females over 33 pounds. The condition is called hormone-responsive incontinence or spay-related incontinence.

It is manageable with medication in most cases, but it is a genuine long-term consideration, particularly for large breed females.

Hormonal changes and the role of LH

Newer research funded by the AKC Canine Health Foundation has identified another mechanism worth knowing about.

After the gonads are removed, the body loses its normal hormonal feedback loop. Luteinizing hormone (LH) becomes elevated, sometimes to levels 30 times above normal in spayed or neutered dogs. LH receptors are present in many non-reproductive tissues, including the urinary tract, thyroid, and immune system.

Ongoing research at Oregon State University is investigating how chronically elevated LH may contribute to conditions such as urinary incontinence, hypothyroidism, and certain immune-mediated diseases. This research is still developing, but it reinforces the view that spaying and neutering have systemic effects beyond the reproductive system.

Risks that depend entirely on timing

Many of the long-term risks above are not fixed. They are modifiable through timing.

Neutering a large breed male after his growth plates close, typically around 12 to 15 months, significantly reduces orthopedic risk compared to neutering at six months. The same surgery, done six to nine months later, carries a meaningfully different risk profile.

This is the key practical takeaway: for most dogs, the question is not whether to spay or neuter, but when to do so with the least downstream risk for that specific dog.

RiskMost affectedReduced by
Joint disordersLarge/giant breed malesDelaying until after growth plate closure
OsteosarcomaRottweilers, large breedsDelaying past 12 months
Urinary incontinenceLarge breed spayed femalesNo clear prevention; awareness and monitoring
Mammary cancerIntact femalesEarly spaying, before first heat
PyometraIntact females (any age)Spaying at any age
Anesthetic riskOlder, obese, or unwell dogsPre-surgical bloodwork and evaluation

 

Hormone-sparing alternatives

For pet owners concerned about long-term hormonal effects, hormone-sparing sterilization options exist, though they are not widely offered.

Ovary-sparing spay (OSS) or hysterectomy: Removes the uterus but leaves one or both ovaries intact. The dog is sterilized and cannot get pregnant or develop pyometra, but continues to produce estrogen. This reduces the orthopedic and incontinence risks associated with estrogen loss while still preventing reproduction.

Vasectomy for males: Prevents reproduction while leaving the testes intact and testosterone production ongoing.

These procedures are less commonly available and may require a referral to a specialist or a clinic familiar with the techniques. They are worth discussing if you have a large breed dog with known orthopedic risk factors, or if you are concerned about hormone-related long-term effects.

How to reduce your dog's surgical risk

Most of the risks described in this article are manageable with the right preparation and aftercare.

Before surgery:

  • Ensure pre-anesthetic bloodwork is done, especially for dogs over five years or with health concerns
  • Discuss breed and size-specific timing with your veterinarian
  • Confirm what pain management protocol the clinic uses

After surgery:

  • Keep the E-collar on consistently for 10 to 14 days
  • Monitor the incision daily for redness, swelling, discharge, or odor
  • Restrict activity as directed
  • Administer all prescribed medications on schedule
  • Know the signs of post-surgical complications and have your vet's after-hours contact number on hand

For a full guide on how to reduce risk during recovery, the post-operative period is where most preventable complications actually occur.

Frequently asked questions

What is the death rate from spay or neuter surgery in dogs?

The overall death rate from spay and neuter complications is approximately 0.1%, based on veterinary literature. This is low for a surgical procedure, but not zero. Pre-surgical evaluation, proper anesthetic monitoring, and experienced surgeons all contribute to keeping that number low.

Are large breed dogs at higher risk than small breeds?

Yes, for specific long-term risks. Large and giant breeds face elevated orthopedic risks, particularly joint disorders and some cancers, when neutered early. Small breeds show minimal effect from early neutering. The risk difference is well-documented in UC Davis breed-specific studies.

What are the signs of an infected incision after spay or neuter?

Signs include redness, swelling, warmth, discharge, or unusual odor at the incision site. Fever, lethargy that persists beyond 24 to 48 hours, and loss of appetite are also warning signs. Contact your veterinarian promptly if you observe any of these.

Can spaying cause urinary incontinence?

Yes, in some females. Estrogen supports the tone of the urethral sphincter. After spaying, estrogen drops, and in a percentage of females (estimates range from 5% to 20%, with higher rates in larger dogs) this results in urine leakage, typically during sleep. It is manageable with medication in most cases.

Does neutering increase cancer risk?

For some breeds, early neutering is associated with increased risk of specific cancers, including osteosarcoma in Rottweilers and lymphoma in Golden Retrievers. For other breeds, these associations are not present. Neutering also eliminates testicular cancer and reduces the risk of mammary tumors in females when done early. The net effect depends entirely on the breed, sex, and timing.

Are there alternatives to traditional spaying and neutering?

Yes. Hormone-sparing options include ovary-sparing spay (hysterectomy) for females, which prevents pregnancy and pyometra while preserving estrogen production, and vasectomy for males, which prevents reproduction while keeping testosterone intact. These are not widely available but are worth asking about if long-term hormonal effects are a concern for your specific dog.

Understanding the risks of spaying and neutering is not an argument against the procedures. It is an argument for doing them thoughtfully, at the right time, for the right dog. Most of the serious long-term risks are concentrated in specific breeds, at specific ages. For the majority of dogs, a well-timed surgery with good post-operative care carries minimal risk and real, lasting health benefits.

Resources

The following sources were used as reference and background for this article:

  • American Veterinary Medical Association (AVMA). Spaying and Neutering. avma.org
  • AKC Canine Health Foundation. Exploring How Spay/Neuter Impacts Long-Term Health in Dogs. akcchf.org
  • AKC. Should You Spay or Neuter Your Dog? Considerations for Spay-Neuter. akc.org
  • Parsemus Foundation. How Spay and Neuter Affect Health. parsemus.org
  • Animal Humane Society. Pros and Cons of Spaying or Neutering Your Dog or Cat at an Early Age. animalhumanesociety.org
  • Hart, B.L., Hart, L.A., Thigpen, A.P., Willits, N.H. (2020). Assisting Decision-Making on Age of Neutering for 35 Breeds of Dogs. Frontiers in Veterinary Science, 7: 388.
  • Sanborn, L.J. Long-Term Health Risks and Benefits Associated with Spay/Neuter in Dogs. National Animal Interest Alliance. naiaonline.org

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