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Holding a spay and neuter clinic is the best way to improve the lives of as many cats as possible. In assembly line fashion, stations help guide a cat from trap to anesthesia and through surgery to other necessary treatment areas. Stations can include: check in/registration, anesthesia, prep, surgery, vaccination, grooming, and discharge/recovery. The following outlines Alley Cat Allies’ approach to running a clinic, but there are many different approaches to a successful spay and neuter clinic.
This clinic walk-through can be viewed in our Feral Cat Clinic Procedure video. Also there, learn more about why high-volume, high-quality techniques are important by viewing our Spay and Neuter Day Demonstration, and hear testimonials from veterinarians describing the effectiveness of the techniques and how they can be applied even in their regular practices in Veterinarian Testimonials.
When trappers or caregivers bringcommunity cats to the clinic in traps, assign each cat her own number, and print that number on two tags. Secure one tag to the trap; the other, called the cat tag, will be tied to the cat’s paw (a rubber band works great) after she is anesthetized, so tape the cat tag to the trap to be used after anesthesia kicks in.
- Anesthesia Station
Once a cat is deemed healthy enough for surgery based on their physical state, take them to the anesthesia station. Use an “isolator,” (an object that looks like a large comb) to crowd her toward one end of the trap. This restricts the cat’s movement so that the licensed veterinary technician can inject an “anesthesia cocktail” called TKX (telazol, ketamine, and xylazine) directly into the muscle.
After TKX has been administered, leave the cat in the trap and monitor her until she is fully unconscious. Then, carefully take her out of the trap and attach the cat tag to her paw.
The cat tag must stay with the cat through every clinic station, and every medication administered to each cat is recorded on the cat tag. Also record the amount of TKX administered in the Anesthesia Log.
Express the cat’s bladder carefully and evaluate the sex and health of the cat. Check off “male” or “female” on the cat’s tag. The veterinarian will complete a full physical exam once the cat is under anesthesia.
- Prep Station
At the Prep Station, the veterinary technician injects Metacam, a pain killer, subcutaneously, or ‘just under the skin,’ and records the dose on the cat tag.
Because cat’s eyes may dry out under anesthesia, apply a lubricant to keep them moist.
One technique for holding females in place for surgery is the use of spay-boards. These are special boards that hold the female cats in the correct position for surgery. Learn how to build your own spay board using Alley Cat Allies' spay board design instructions.
Shave the female cat’s surgical site and sterilize the area with betadine and alcohol. Administer betadine and alcohol alternately three times starting from the point where the incision will be made and moving out in a circular pattern, purposefully never doubling back over the incision site.
- Waiting Area
If the prep station gets ahead of the veterinarians completing surgeries, the cats wait in the order in which they were prepped for surgery until a veterinarian is available. This ensures that veterinarians are never waiting for patients and takes full advantage of the veterinarians’ time.
In the waiting area, volunteers should closely monitor each cat’s breathing and level of sedation to ensure the cats are comfortable.
- Surgery Station
When the cat is on the operating table, the surgery assistant opens a sterile spay pack containing a gauze, drape, and instruments. A new sterile spay pack and materials should be used for each cat.
Spay Surgery Instruction – A Step-by-Step
The surgeon takes a standard mid-line approach with a one-inch incision in the caudal half between the umbilical scar and the pubis.
The initial incision is always small: ½ to ¾ inch, as it can be enlarged if necessary. The veterinarian uses a spay hook, which makes it easier to work with a small incision.
The veterinarian exteriorizes the ovary by cutting the ovarian ligament.
Instead of double ligating the uterine artery, the artery is ligated on itself using the same technique used for a neuter.
The surgeon ligates the uterine body using a modified Miller’s knot. Most cats only need a single ligature. Very pregnant cats or those in heat may be double ligated.
Closure is a two-layer process. The first layer begins at the cranial end of the incision. The suture tag is left long and is clamped to keep it out of the incision. Using a simple continuous pattern, the vet sutures the abdominal wall closed. After the caudal knot is made, only the loop is cut off. A bit of tissue that is deep to superficial is then pulled up to start the second layer. A simple continuous pattern is maintained in the subcuticular layer. At the cranial end of this layer, the final bit of tissue is taken in a superficial to deep pattern. This strand is tied to the long tie left at the beginning. This process buries the knot.
In the event of a large incision, the top layer should be tacked to the bottom layer once or twice during the subcuticular closure, or a third layer should be put in (but the surgeon must remember to end the subcuticular layer at the long strand so the knot can be buried).
Following surgery, the cat’s left ear is tipped by placing a straight hemostat 3/8” from the tip of the left ear and removing the tip with a scalpel. To reduce bleeding, the hemostat is left in place until the cat arrives at the vaccine station or is just about to be returned to her cage. Learn more in the eartipping section.
The cat then receives a subcutaneous rabies vaccination on the right hip. There is an extremely low occurrence of rabies in outdoor cats, but this vaccination will protect them if they happen to come in contact with a rabid animal. Alley Cat Allies does not recommend testing for FIV (Feline Immunodeficiency Virus) or FeLV (Feline Leukemia Virus) because the percentage of infected cats is low, sterilization contains the spread of these viruses, infected cats can be asymptomatic, there can be false positives, and testing is costly.
All surgical information, particularly anything unusual that may have occurred, is then recorded in the Veterinarian’s Surgery Log and on the cat tag. Then transport the cat to the vaccine station.
- Vaccine Station
At the vaccine station, remove female cats from the spay boards and take the hemostat off their ears. If there is any bleeding from the eartip, apply styptic powder to stop it.
Other vaccinations can be administered at the discretion of the veterinarian and based on the caregiver’s ability to pay. For example, some clinics vaccinate for distemper using the FVRCP vaccine at this point in the clinic. Because there are parts of the United States which are not prone to distemper, some clinics choose not to vaccinate so that they can spend that money to neuter more cats. It costs $2-3 to vaccinate and when added up over the hundreds of cats a clinic neuters, the cost can multiply. One consideration may be to ask clients to shoulder the cost if they choose to have the vaccine administered.
Record all medications administered on the cat tag.
- Grooming Station
Gently comb the cat for fleas and matted fur, and shave away serious mats. Some clinics administer flea treatment for a flea infestation. Often this treatment is an added cost which is itemized for the client. Because flea treatments do not last long and will likely be the only one a feral cat receives, the costs may outweigh the benefits of providing the treatment.
Do not cut the nails of feral cats.
Under certain circumstances—cold weather, pregnancy or lactation, or under vet recommendations—administer subcutaneous fluids.
Record every treatment on the cat tag and then transport the cat to recovery.
- Recovery/Discharge Station
When the cat arrives at the recovery station, remove the tag from her leg and record all information on it in both the Medical Record and Intake/Discharge Log.
Compare the cat’s tag number with the tag number on the trap so that she is returned to the same trap she came to the clinic in, which has been cleaned and lined with fresh newspaper. Cats who received fluids should be positioned in the traps so that as little fluid as possible leaks from the puncture site.
At the recovery station, arrange the traps in numerical order and by colony for proper caregiver matching. Cover the traps so that the cat has privacy but can still be seen from the front so that trained observers can monitor the cats constantly while they are waking up from anesthesia.
To find a spay and neuter clinic or a veterinarian that treats feral cats in your area, click here to request a list of Veterinary Feral Friends.
• Alley Cat Allies’ Feral Cat Spay and Neuter Clinic Video
• Feral Cat Spay/Neuter Project’s Our Clinic Model
• Working with Feral Cats in Veterinary Practice Video
• Humane Alliance’s High-Volume Surgical Technique Videos
• The American Humane Association’s The Case for Early Neutering: A Tool for Companion Animal Population Control Video
• Feral Cat Management by Julie Levy, DVM. Excerpt from Shelter Medicine for Veterinarians and Staff reprinted with permission. Please email ACA at email@example.com to obtain a copy.
• Alley Cat Allies’ summary of research about feral cats in general, their health, and Trap-Neuter-Return. Building the Body of Scientific Evidence
• Other videos from Alley Cat Allies: