How to save & take care of a kitten and feral cats - an advocacy tool kit

High-Quality, High-Volume Spay and Neuter Clinic Guide

Guide/How-to| Spay/Neuter, Veterinarian Awareness

Holding a high-quality, high-volume (HQHV) spay and neuter clinic is one of the best ways 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. HQHV spay and neuter clinics are a critical part of Trap-Neuter-Return (TNR), the humane, effective approach to community cat populations.The following information outlines Alley Cat Allies’ tried-and-true approach to running a HQHV spay and neuter clinic. Keep in mind, though, that there are many different approaches to a successful spay and neuter clinic. Adjust this outline and its stations as necessary to fit your own resources and needs.

See our general Spay and Neuter Protocol Considerations for Community Cats at and more resources at

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 their attention to 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

Check-in/Registration Station

When trappers or caregivers bring community cats to the clinic in humane box 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. Until that time, you can tape the cat tag to the trap to be used after anesthesia kicks in.

Our Cat Clinic Tag can help ensure that both trappers or caregivers and clinic fully understand the expectations for this visit and the needs of each cat.

At this time, cats should be scanned for a microchip. The microchip ID can be recorded on the cat tag, and the microchip can be scanned at each step of the spay and neuter process to ensure you are treating the right cat. Learn more at including how to scan community cats for microchips.

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,” (see to guide her toward one end of the trap. This restricts the cat’s movement so that the licensed veterinary technician can inject an anesthesia combination 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 must be 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, 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 female cats 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 here at

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.

HQHV clinics often utilize special surgery techniques that are faster and ensure a follow-up visit is unnecessary. These techniques include smaller incision, modified Miller’s knot (see our video how-to), and dissolvable sutures.

Eartipping Station

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 or straight edge. 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 trap.

See our eartipping protocol at

All surgical information, particularly anything unusual that may have occurred, should have been recorded in the Veterinarian’s Surgery Log and on the cat tag by this time. Once that is done, transport the cat to the vaccine station.

Post-Op and Vaccine Station

At the post-op and 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.

The cat 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.

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 they can spend that money to neuter more cats. It can cost $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.

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. Learn more at

Microchipping can also be done at this time. Alley Cat Allies encourages caregivers to have all the cats they care for microchipped. Learn more at

Record all medications administered on the cat tag.

Grooming Station

Gently comb the cat for fleas and matted fur, and shave away any serious mats. Some clinics administer flea treatment at an added cost which is itemized for the client. Because flea treatments do not last long and will likely be the only one a community cat receives, the costs may outweigh the benefits of providing the treatment. With similar considerations, deworming and treatment for ear mites may be administered at this time.

Do not cut the nails of community cats.

Under certain circumstancescold weather, pregnancy or lactation, or by a veterinarian’s recommendation 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 should have been cleaned and lined with fresh newspaper or another trap liner. 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 the cats have privacy but can still be seen from the front so trained observers can monitor them while they are waking up from anesthesia.


A veterinary professional tends to a community cat during a high-quality, high-volume spay and neuter clinic.