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Protocols: Spay and Neuter Surgery - Alley Cat Allies

Fact Sheet| Veterinarian Awareness

Spaying and neutering improves the lives of community cats.

Spay and neuter surgery for community cats requires slightly different protocols that reflect the cats’ unique needs and circumstances. The following information will help you treat community cats while upholding both their safety and yours.

Alley Cat Allies has decades of experience working with veterinary experts. Our goal is to ensure veterinary professionals have the accurate, current, and specialized information they need about cats from all walks of life and to bring to their attention the big issues impacting cats. Veterinary professionals have a uniquely powerful voice that is critical for advocating on cats’ behalf. Alley Cat Allies is here to help streamline that advocacy. Learn more at

Spay and Neuter Surgery Protocol Considerations for Community Cats

  • Require that community cats come into the clinic in humane traps. This policy is critical to ensure the safety of the staff, veterinarian, and cats. Cats in their traps are also easier to treat. Please emphasize the importance of keeping a cat in their trap at all times to clients, including during recovery if the client plants to take the cat to their home to recover.
  • Scan the cat for a microchip immediately upon intake. If the community cat is already microchipped, this will increase the chance of reuniting her with her caregiver as fast as possible. You can learn more about how to scan community cats at
  • Health evaluations should be a part of the pre-surgical process. A visual examination should be conducted to ensure the cat meets the health requirements for anesthesia. Veterinarians must weigh the risks and benefits of neutering a cat with mild infections or noninfectious conditions and make the final decision as to whether the cat is accepted for surgery. It is likely the benefits of neutering a community cat as part of a TNR program outweighs potential risks. Due to the nature of community cats, who are not socialized to people, the opportunity to neuter may not present itself again. Once the cat is under anesthesia, perform a full physical examination while determining the sex of the cat.
  • Anesthesia protocol should involve the anesthesia combination of telazol, ketamine, and xylazine (TKX). According to Brenda Griffin, DVM, MS, DACVIM, prepare TKX by reconstituting one vial of Telazol (500 mg) with 4 ml ketamine (100 mg/ml) and 1 ml xylazine (100 mg/ml). Note: this is the concentration of xylazine marketed for use in large animals, not the 20 mg/ml small animal product. The dosage of TKX is 0.25 ml per cat IM. Do not exceed 0.3 ml per cat. For very small kittens, use 0.15-0.2 ml. This provides approximately 30 minutes of anesthetic time. If additional time is required, isoflurane should be used.For community cat spay and neuter programs where an accurate weight cannot be determined before anesthesia drugs are administered, use readily and safely reversible agents and refrain from the use of drugs that result in marked cardio-respiratory depression.

    Reversal (if needed) is achieved with yohimbine (2 mg/ml; 0.5 ml/cat IM or IV). An additional dose of yohimbine may be given after 30 minutes if results are inadequate. The cat should be returned to her trap immediately after reversal.

    To safely anesthetize the cat, do not remove her from her humane trap. Instead, administer the anesthesia through the trap wire. You can use a trap divider to keep the cat in a small section of the trap so you can successfully inject her.

    After TKX has been administered, leave the cat in her trap until she is fully unconscious, with trained observers monitoring her continually. Conscious cats should never be taken out of traps for the safety of the cat and the clinic personnel. Once surgery is finished, the cat should be returned to her trap before she regains consciousness.

  • Dissolvable sutures must be used to eliminate the need for a follow-up visit to remove them. Trapping a community cat for a second time is not only very stressful for her, it can also be exceedingly difficult if she has become trap-savvy. That is why it is critical to implement protocols, like use of dissolvable sutures, to avoid need for a second clinic visit. Use high-volume, low-cost, high-quality surgical techniques that can reduce the number of sutures required and reduce the size of the incision to eliminate the need for internal sutures, which have the propensity to become infected. For more detailed surgical information, visit the Feral Cat Project ( and ASPCA Spay/Neuter Alliance (
  • Learn more about high-volume, high-quality surgical approaches. Community cat spay and neuter surgery can be more efficient and more cats can be sterilized if high-volume techniques are employed. These techniques include creating stations to perform different steps of the process and making smaller surgical incisions. For more detailed information, see our high-quality, high-volume clinic resource at We also have a poster available detailing the different stations for a successful high-volume clinic. You can also view our Community Cat Clinic Procedure video to see a high-volume technique called the Modified Miller’s Knot at
  • Practice standard procedures for controlling potential infectious diseases. All equipment that has direct patient contact should be thoroughly cleaned and disinfected between each cat. Use cleansers known to destroy common veterinary pathogens. Staff, volunteers, and veterinarians should wash and sanitize their hands between patients or gloves should be worn by all. Veterinarians spaying female cats should perform proper hand and arm scrubs with appropriate cleaning agents before performing surgical procedures. Single-use surgical gloves should be used when performing surgery.
  • Eartip cats while they are still under anesthesia. Eartipping is an effective and universally accepted method to identify a spayed or neutered and vaccinated community cat. With a scalpel or straight blade, remove of the distal one-quarter of a cat’s left ear, which is approximately 3/8 inch, or 1 cm, in an adult and proportionally smaller in a kitten. For more information on eartip protocol and technique, visit our resource at
  • Learn safe techniques to spay pregnant or lactating females that can mitigate the risk of complications. Because it is difficult to trap a cat a second time, Alley Cat Allies believes that the benefits outweigh the risks when spaying pregnant or lactating females. After spaying a pregnant female, administer 150 ml subcutaneous fluids before returning her to her trap. Be sure to keep her warm while recovering. If the kittens are near-term, euthanasia solution should be injected into the uterus after it has been removed. While the decision to spay a pregnant female is a difficult one, remember that the goal of a spay and neuter program is to reduce the number of kittens.
  • Establish emergency readiness and clinical policies and incorporate them into your consent forms. Consent forms should be used for all patients and clearly explain the risks of infectious disease exposure, anesthesia, and surgery. Consent forms should also give authorization for surgery and gather client contact information, including an emergency phone number. Create a policy that clearly states how your clinic handles the euthanasia of very ill cats and how pregnant and nursing females are treated. Make certain that all clients are aware of your policies by posting them in a visible location or including them with the intake paperwork and requiring a signature.
  • Keep in mind the weather and season when treating community cats. Because community cats live outdoors, their treatment in particularly hot or cold weather must be taken into account. For example, in cold weather, groomers should shave less fur for surgery preparation. Learn more about community cat care: and Trap-Neuter-Return protocols:
  • Consider potential fatality. In the event of a cat dying, their caregiver should be notified and a necropsy should be performed by a third party to establish the cause of death.

For more information on surgery preparation, anesthesia protocols, and spaying and neutering community cats, see Alley Cat Allies’ High-Quality, High-Volume Spay and Neuter Clinic Guide.