Balancing risks when deciding when to spay a dog expected to be > 45lbs.

These recommendations attempt to balance risk of orthopedic disease, USMI, and some cancers associated with early sterilization, against risk of mammary neoplasia, unwanted litters, and possible other cancers if sterilized later. 

These medical recommendations may need to be balanced against certain nonmedical extenuating circumstances, such as likelihood of future access to veterinary care, financial incentives provided by adoption groups, or the opportunity to perform surgical sterilization concurrently with another anesthetized procedure.

USMI, urethral sphincter mechanism incompetence.