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Dwight Richards
5 years ago
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2 Community Cats at the Spay/Neuter Clinic Carolyn R. Brown, DVM Director of Surgery ASPCA Spay/Neuter Operations 2

3 Defining Community Cats Any cat presenting for spay/neuter surgery in a humane trap with the intention that the cat will be returned to the location of trapping. This may include: Feral cats with caretakers Feral cats without caretakers Free roaming socialized cats Indoor/outdoor pet cats 3

4 ASPCA SNO & Community Cats ,174 spay/neuter surgeries for community cats arrived in traps members of colonies with dedicated care takers projected>5,000 spay/neuter surgeries for community cats 4

5 Presentation Goals 1. Make veterinarians and medical staff comfortable in handling and providing care for community cats. 2. Minimize the stress and discomfort of the spay/neuter experience for community cats. 5

6 Trap Neuter Return 6

7 Trap 7

8 Havaheart Trap 8

9 Other Types of Traps Tomahawk Trap 9

10 Transfer Cage 10

11 Zip Ties for Security 11

12 Covering Traps Provides security and helps keep cats calm 12

13 Neuter 13

14 Quality of Care Spay/Neuter Medical Protocols ASV Guidelines JAVMA; July 1,

15 Visual Exam: Patient Selection General body condition Hair coat/skin condition Mucous membrane color Ocular and nasal discharges Breathing rate and effort / congestion Pregnancy Lactating Wounds/Injuries 15

16 Patient Health Challenges Unable to Auscult Chest or Palpate Abdomen: Heart Murmurs and Arrhythmias. Abnormal Lung Sounds. Abdominal Masses. Enlarged Kidneys. Pregnancy (if not visually obvious). Pyometras / Hydrometras. Upper Respiratory Infections Internal/External Parasites Injuries and Abscesses 16

17 Applying a Different Criteria Although spaying and neutering are elective procedures Consider: Will this patient allow itself to be treated? Will the stress of being held and treated result in overall poorer health? Will its health improve without treatment? Is there a wound or other issue that can be addressed at the same time as s/n? Will it allow itself to be trapped again? What will be the effect of postponing surgery on population? 17

18 Therefore Surgery is usually performed when: There is mild/moderate URI Patient is pregnant Patient is thin Patient has an abscess/wounds Patient has an unkempt hair coat Surgery is NOT performed if: Conditions are severe and anesthesia/surgery would be life threatening Euthanasia may be an option for patients rejected for surgery 18

19 Minimum Age and Size 2 months and 2 lbs 19

20 Anesthesia Protocols Select an appropriate anesthesia protocol IM Induction Sample Anesthesia Protocols 20

21 Determining Patient Weight 22

22 Anesthesia Chart Multi-modal Pain Management 23

23 Pain Management Multi-modal Approach Pain management included in pre-anesthesia protocol: Buprenorphine ( 30 minutes to maximum effect) Butorphanol (30 minutes to maximum effect) Pain Management for Immediate Post-op Period NSAID use single injection for 24 hour pain relief meloxicam, ketoprofen supplement SubQ fluids if marginal hydration Additional pain management techniques line blocks testicular blocks 24

24 Divider Method for Injections 25

25 Identifying Patients 26

26 Cage Card 27

27 Surgery Standard spay and neuter techniques Special considerations during spay: pregnancy lactation post-partum friable uterus minimize incision size Subcuticular closure / Reinforce with tissue glue Unable to use E Collars avoid tight sutures in body wall and necrosis 28

28 Late Term Spay Procedures What if you don t spay her now? What if you release her? Very high kitten mortality rate among community cats. Can the local environment support more community cats? Taxing available resources Competition Will negative perceptions and resistance increase? Nuisance Behaviors Affects on wildlife How many more litters will she have before you are able to trap her again? What if she is pregnant the next time? 29

29 Late Term Spay Procedures What if you don t spay her now? What if you hold her and allow her to have the kittens? What toll will the stress of being held take on the mom? How long can she be held and still be successfully returned? How early do you remove the kittens and start to socialize them? Will they need to be bottle fed? How will local shelter intake or live release rate be affected by the kittens of community cats? Absorbed into homes that might have adopted from shelter? Brought to a shelter to compete with adult cats for adoption? 30

30 Late Term Spay: Complicating Factors pressure on the diaphragm pre-operatively longer surgery time heat loss fluid Loss increased tendency to bleed larger vessels higher blood pressure larger incision 31

31 Sara C. White, DVM JAVMA, Vol 240, No. 10 May 15,

32 Patient Support and Precautions order of surgical patients careful monitoring additional supportive care fluids heat glucose adjusting medical protocols anesthesia pain management 33

33 Patient Monitoring 34

34 Thermoregulation: Warmed Prep Solutions 35

35 Providing Heat Sources: Gaymar Pump 36

36 Fluid Warmer iwarm IV Fluid Warmer 37

37 Mylar Blankets 38

38 Rice Socks 39

39 Identifying Spayed/Neutered Animals: Preventing Unnecessary Surgery Collar Ear Tipping (Ear Notch) Microchip Tattoo Scar (Requires Shaving) Females: Lack development of mammary tissue / vulva Male cats: Lack of Penile Spines 40

40 Ear Tipping 41

41 Policy Recommendation Consistency of Protocol All cats that present to the clinic in a humane trap or transfer cage are ear tipped All cats that present in pet carriers are not ear tipped Ear tips should be of uniform size and be visible when looking at an awake cat in a trap. There is no such thing as a slight or small ear tip 42

42 Procedure Ear tipping is performed under anesthesia prior to surgery. Place clean straight hemostat across tip of cat s left ear, exposing no more than 1 cm of ear tip for adult cat and proportionally less for kitten. Use new, clean hemostat for each cat. Use sterile blade to cut tip off of ear, leaving hemostat on ear for hemostais. Use new sterile blade for each cat. A silver nitrate stick is applied to cut edge of pinna. To reduce bleeding, keep hemostat on cat s ear until just before returning cat to trap. 43

43 Clamp, Cut, Cauterize 44

44 Infectious Disease Control 45

45 Separate Community Cat Patients 46

46 Avoid Surface Contamination 47

47 Disinfection 48

48 Disinfection Wysiwash 73% Calcium Hypochlorite 49

49 Disinfect All Supplies 50

50 Additional Services SNAP testing for FeLV / FIV TO TEST OR NOT TO TEST Is Testing for FeLV and FIV in Feral Cats Always Necessary? 51

51 Parasites, Fleas and Earmites Top Spot Products are GREAT for feral cats: Revolution Frontline Profender Single Dose Topical Earmite Treatments: Acarexx MilbeMite 52

52 Discharge Notes Prepare Standard Discharge Instructions Notify Rescuers of Special Circumstances: Females Pregnant Lactating Pyometra Other Health Issues Identified Additional Medications Administered or Needed Change in Standard Post-op Care Change in Standard Post-op Holding Time 53

53 Return 54

54 When??? Holding times guidelines: An actively lactating female cat may be returned to the site of trapping 24 hours after surgery Healthy male cats: hours following surgery Healthy female cats: hours following surgery Confinement may be extremely stressful for free-roaming cats. If the cat shows signs of stress repeated attempts to escape the trap or not eating the cat should be released. If the cat has a medical problem identified at the time of spay/neuter surgery, postoperative holding times and conditions may be adjusted. 55

55 Local Considerations 56

56 These Cats Have Homes! Each cat should be released at the site of his/her trapping Relocation of community cats is extremely difficult 57

57 58

58 Accountability 59

59 QUESTIONS? 60

60 61

August 16, Implementing High Quality, High Volume Spay/Neuter: Challenges & Solutions

August 16, Implementing High Quality, High Volume Spay/Neuter: Challenges & Solutions August 16, 2014 Implementing High Quality, High Volume Spay/Neuter: Challenges & Solutions Carolyn Brown, DVM Spay/Neuter Operations carolyn.brown@aspca.org Kathleen Makolinski, DVM Shelter Medicine Service