© 2011 ASPCA . All Rights Reserved. - Spay Neuter Conference€¦ · 4 © 2011 ASPCA ®. All...

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© 2011 ASPCA®. All Rights Reserved.

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Community Cats at the Spay/Neuter Clinic

Carolyn R. Brown, DVM Director of Surgery ASPCA Spay/Neuter Operations

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Defining Community Cats

Feral cats with caretakers Feral cats without caretakers Free roaming socialized cats Indoor/outdoor pet 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:

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ASPCA SNO & Community Cats 2013—4,174 spay/neuter surgeries for community cats

•arrived in traps •members of colonies with dedicated care takers.

2014—projected>5,000 spay/neuter surgeries for community cats

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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.

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Trap Neuter Return

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Trap

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Havaheart Trap

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Other Types of Traps

Tomahawk Trap

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Transfer Cage

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Zip Ties for Security

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Covering Traps

Provides security and helps keep cats calm

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Neuter

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Quality of Care

Spay/Neuter Medical Protocols ASV Guidelines JAVMA; July 1, 2008

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Patient Selection • Visual Exam:

•General body condition •Hair coat/Skin condition

•Mucous membrane color •Ocular and nasal discharges

•Breathing rate and effort / congestion •Pregnancy •Lactating

•Wounds/Injuries

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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

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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?

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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

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Minimum Age and Size 2 months and 2 lbs

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Anesthesia Protocols Select an appropriate anesthesia protocol

IM Induction

Sample Anesthesia Protocols • http://www.sheltervet.org/displaycommon.cfm?an=1&subarticlenbr=23

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Determining Patient Weight

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Anesthesia Chart Multi-modal Pain Management

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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

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Divider Method for Injections

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Identifying Patients

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Cage Card

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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

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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?

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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?

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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

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Sara C. White, DVM JAVMA, Vol 240, No. 10 May 15, 2012

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Patient Support and Precautions

•order of surgical patients •careful monitoring

•additional supportive care •fluids •heat

•glucose •adjusting medical protocols

•anesthesia •pain management

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Patient Monitoring

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Thermoregulation: Warmed Prep Solutions

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Providing Heat Sources: Gaymar Pump

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Fluid Warmer iWarm—

IV Fluid Warmer

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Mylar Blankets

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Rice Socks

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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

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Ear Tipping

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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

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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.

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Clamp, Cut, Cauterize

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Infectious Disease Control

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Separate Community Cat Patients

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Avoid Surface Contamination

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Disinfection

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Disinfection—Wysiwash

73% Calcium Hypochlorite

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Disinfect All

Supplies

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Additional Services

•SNAP testing for FeLV / FIV •TO TEST OR NOT TO TEST • Is Testing for FeLV and FIV in Feral Cats Always Necessary?

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Parasites, Fleas and Earmites

Top Spot Products are GREAT for feral cats: Revolution Frontline Profender

Single Dose Topical Earmite Treatments: Acarexx

MilbeMite

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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

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Return

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When??? •Holding times guidelines:

•An actively lactating female cat may be returned to the site of trapping 24 hours after surgery

•Healthy male cats: 24-48 hours following surgery •Healthy female cats: 48-72 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.

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Local Considerations

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

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Accountability

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QUESTIONS?

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© 2011 ASPCA . All Rights Reserved. - Spay Neuter Conference€¦ · 4 © 2011 ASPCA ®. All...

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Transcript of © 2011 ASPCA . All Rights Reserved. - Spay Neuter Conference€¦ · 4 © 2011 ASPCA ®. All...