Gatos Ferales

Feral cats disappearing after surgery

Question from Jen:

We currently do a high volume MASH clinic for feral cats. We feel we are working very hard to uphold quality and sterile procedures. Recently though we are finding that many of the cats we return back to caretakers are not being seen - either at all or infrequently. Some of our volunteers are now worried that maybe we are doing something wrong and that we shouldn't be doing high volume surgeries. I am hoping that it is because they just need to get away because of the stress of the situation or because now they are fixed and are less likely to roam or they are friendly and getting picked up by people to adopt them; but now I am worried too. How can we make sure we are doing right by the cats and still maintaining our surgeries to get the numbers down?

Response from Brenda Griffin:

I am sure Dr. Levy will have a lot to offer here, but here is my experience...

We always warn caretakers that bring cats to our clinic that the cats may lay low for days or even weeks following spay/neuter. We try to inform them of this, without alarming them. We also explain that in the vast majority of instances, the cats return to their usual behavior and routines in time, and we emphasize how improved their welfare will be. They will be cats, we tell them... and, they will try to make you fell "guilty" for trapping them and bringing them in, but ultimately, they will be much healthier for it, and it is the right thing to do. When the alternative is multiple litters of kitten, a high kitten mortality rate, fighting, territorial aggression/marking, and continued hormonal stress and welfare issues for the cats, plus nuisance complaints, and the moral issues of allowing uncontrolled reproduction, the reality that it is the best thing sinks in. Stick to the facts. Get them to think logically, be patient. They love the cats and it may be hard, but as you know, it is the right thing to do.

By the way, Dr. Levy's is the largest and the original veterinary college based program. We are just copycats!

Response from Julie Levy:

Some cats are so freaked out by the whole trapping and surgery procedure that they move to a new location once they are released. Often, these cats will reappears days or weeks later.

If this happens a lot, I would investigate further. Visit the colony sites and talk to the caretakers about their procedures. Could the management of the colony be improved to make the area more attractive to the cats?

There is also a concern that cats who disappear have become ill or had surgical complications. This is the worse possible outcome and the one that we fear the most.

If the disappearance of cats is a recent development, this should prompt a thorough search for any changes in procedures that might have triggered it. A review of clinic procedures and perhaps a visit from an outside consult (unbiased observer) would be helpful.

How to talk to vets when experiencing high mortality rates

Question from Jessica:

We are very fortunate to have a supportive spay/neuter clinic in our area to whom we take a lot of our feral cats, but our mortality rate is much higher than what you suggested in a previous answer. We have had at least 10 cats die in the past year out of the approximately 1,000 cats and kittens we have done there, maybe even a few more. When we raise our concerns the staff explains that this is to be expected, because feral cats cannot be examined or given any pre-op blood tests, etc., and also because ferals may be malnourished and under greater stress than the companion animals on whom they do surgery.

We suspect there may be an issue with their anesthesia protocols but don't know how to verify this nor how to discuss the issue with them without putting them on the defensive. The cats are sometimes still groggy 6 or 8 hours after surgery. But we also feel we are the advocates for the cats and must speak to them about this high mortality rate.

We really appreciate all they have done for our feral cat program and want to keep a good relationship. However, it is uncomfortable to always worry that the cats we take in may not make it out. Can you suggest what we should be looking for to help pinpoint the potential areas causing this problem and how we could document it, since we are not vets or medical professionals?

Response from Julie Levy:

The first step is to document the actual mortality rate. Exactly how many animals have died compared to how many have been anesthetized? The next step is to institute a policy of having necropsies performed on all of the cats that die. We do this, and approximately half of cats that die have an identifiable contributor such as heartworms, cardiomyopathy, cancer, etc. Sometimes it is due to a surgical error that leads to hemorrhage. This is important to know, so we can inform our surgeons of
any problems encountered in their patients.

I do agree that feral cat anesthesia and surgery presents some special challenges that pet cats do not. They are extremely stressed, they may have poor body condition and large parasite burdens, traumatic injuries, or undetected metabolic problems or cardiopulmonary diseases. Since we cannot examine the cats before anesthesia, we are at a disadvantage in protecting their health.

If the death rate appears too high, then a close examination of the causes of death, as well as any procedures that may have changed or might not be optimal for feral cats should be carried out. Why did cats die and in what stage of their care did it occur? Sometimes procedures evolve without anyone being aware of it, so an advisory visit from someone who does not usually work at the clinic can be helpful.

Long anesthesia recovery times are a problem for cats in Operation Catnip as well. We use injectable anesthesia, and some cats are not fully recovered until the following morning. This can cause problems in kittens, who may develop hypoglycemia if they fast too long.

A thorough review of the findings over time will help you to determine if there are systematic problems or this was just a bad year. Our fatality rate varies a lot from year to year, but over time, it averages 3.5 cats/1,000.

La tasa de mortalidad de Spay/Panama es de 2.1 animales/1,000

Esterilizacion Lateral y Protocolo de Anestesia

Flank spays

Question from Liza:

What are the advantages and disadvantages of the flank spay (in cats)?

Response from Julie Levy:

Great question Liza.

Let me start by saying that the benefits of one approach over the other are not so great that they exceed other issues, such as the comfort zone of the surgeon.

The flank approach places the incision on the flank of the cat about halfway down the side from the spine. The left side is more commonly used than the right, but it can be done on either side. The midline incision runs on the middle of the abdomen. The full uterus and ovaries can be removed from either approach. Out of tradition, the flank approach is taught in the UK, whereas the midline approach is taught in the US.

Benefits of the flank approach:
- It's a little faster (at least for me)
- An incisional complication will not lead to evisceration
- It is out of the way of mammary glands in lactating cats
- Caretakers can monitor the incision without handling the cat
- Good for cats with pyoderma of the ventral abdominal skin

Disadvantages of the flank approach are mainly due to the inability to perform a thorough exploratory of the abdomen.
- Harder to confirm that a cat has been previously spayed
- Nearly impossible to retrieve a dropped vessel, ovary, or uterus
- Unable to figure out those cats with weird anatomy that are missing parts of their reproductive tracts.

For feral cats, I prefer the flank approach. It's just a little easier for me. I don't like to spay juveniles this way because their tract is a little tighter and tears easier. It's harder to get the whole thing out via the flank in kittens. I also don't like to do pregnant cats via the flank, mostly because it leaves a large visible scar. However, I have ended up spaying both pregnant cats and cats with pyometra this way.

For pet cats, I prefer the midline approach. Sometimes hair on the incision line grows back kinky or another color or the scar is visible at the surgery site. There are no cosmetic problems with a midline approach. I don't think feral cats are as vain as pet cats.

Response from Brenda Griffin:

Some surgeons prefer a flank approach rather than the traditional ventral midline incision. The flank approach allows caretakers to monitor a cat's incision from a distance and helps prevent evisceration should dehiscence of the surgical wound occur. The flank approach is not generally recommended for pregnant queens, but is desirable for lactating queens. I think Dr. Levy has covered this question very thoroughly, and I agree... as long as the surgeon is experienced, the cats should do well with either approach. I usually do the ventral mid-line approach myself.

Can you believe that Dr. Levy taught me to spay a cat when I was a senior student, which is when she was an intern (her first year out of vet school) at the MSPCA! Years later, I learned the flank approach at one her Operation Catnip clinics!

Best anesthesia protocol

Question from Cathy:

Can each of you detail your anesthesia and other drug protocols for high-volume (50 or more) spay days? What kind/how do you give pain management drugs? What about drugs to wake the cats up faster after surgery? What is your reasoning for the particular protocol(s) you recommend? Have you made any changes to your protocols since inception of your programs, and why? Is there anything in particular you would NOT recommend or would warn against? Thank you.

Response from Julie Levy:

Our situation is pretty specialized. We only sterilize feral cats in large-scale clinics once a month.

The ideal anesthetic for us would be cheap, easy to administer to cats in their traps, allow a dosing scheme that does not require weighing the cats, have a rapid induction with minimal vomiting, provide predictable surgical anesthesia without the need for supplemental drugs, support the physiologic status of the cats, be rapidly reversible, provide potent and durable analgesia, and be completely safe for the cats and personnel. It would also be nice if the drugs were not controlled by the DEA.

Such an anesthetic has not yet been discovered, so we make lots of compromises. We use "TKX." To make this cocktail, take one vial of dry Telazol and add 4 ml of ketamine (100 mg/ml) and 1 ml of large animal xylazine (100 mg/ml). Regular adult cats receive 0.25 ml injected "intracat." Very large toms and advanced pregnant cats get 0.3 ml. Kittens get 0.1-0.15 ml. This is an off-label use of the drugs and no studies have been performed on the stability of the mixture. It costs about $1.70/cat.

TKX is very predictable with a low mortality rate (3.5 deaths/1000 cats). Cats are recumbent within 5 minutes of injection and usually remain in a surgical plane of anesthesia long enough to complete the surgery. We have isoflurane machines that are used to supplement cats by mask if they are too light for surgery. At the end of surgery, an equal amount of yohimbine is given IV to speed recovery. Some groups reduce the recovery time by cutting back on the TKX dose.

Although mortality is very low, we have also documented low blood pressure and low oxygen levels in more cats than we are comfortable with. We also have slow recoveries (partly due to hypothermia that develops), which forces us to release cats to their caretakers before they are fully recovered. I am certain that the analgesia provided by TKX, especially after reversal, is not optimal.

For these reasons, we are experimenting with other drug combinations to improve the safety and pain control of our anesthetic procedures. Currently, we are studying a cocktail of medetomidine, ketamine, buprenorphine. Stay tuned!

Here's an abstract of a paper we wrote about our experience with TKX.

J Am Vet Med Assoc. 2002 May 15;220(10):1491-5.
Use of the anesthetic combination of tiletamine, zolazepam, ketamine, and xylazine for neutering feral cats.
Williams LS, Levy JK, Robertson SA, Cistola AM, Centonze LA.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610, USA.

OBJECTIVE: To evaluate the use of the anesthetic combination tiletamine, zolazepam, ketamine, and xylazine (TKX) for anesthesia of feral cats at large-scale neutering clinics.

DESIGN: Original study. ANIMALS: 7,502 feral cats.

PROCEDURE: Cats were trapped by their caretakers for a feral cat neutering program from July 1996 to August 2000. The anesthetic combination TKX was injected IM into cats while they remained in their traps. Each milliliter of TKX contained 50 mg of tiletamine, 50 mg of zolazepam, 80 mg of ketamine, and 20 mg of xylazine. Females were spayed by veterinarians, whereas males were castrated by veterinarians or veterinary students. Yohimbine (0.5 mg, IV) was administered at the end of the procedure. Logs were kept of the individual drug doses, signalment of the cats, and any complications encountered. These data were analyzed retrospectively (1996 to 1999) and prospectively (2000). RESULTS: Of the 5,766 cats for which dosing records were complete, 4,584 (79.5%) received a single dose of TKX. The mean initial dose of TKX was 0.24 +/- 0.04 ml/cat, and the total mean dose of TKX was 0.27 +/- 0.09 ml. Overall mortality rate was 0.35% (26/7,502) cats, and the death rate attributable solely to potential anesthetic deaths was 0.23% (17/7,502) cats.

CONCLUSIONS AND CLINICAL RELEVANCE: The use of TKX for large-scale feral cat neutering clinics has several benefits. The TKX combination is inexpensive, provides predictable results, can be administered quickly and easily in a small volume, and is associated with a low mortality rate in feral cats.

Response from Brenda Griffin:

Dr. Levy's response and mine are virtually the same. We sterilize 60 - 100 cats in a morning and use TKX. We advise that cats be held in their traps overnight by their caretakers prior to release. Some cats do have more prolonged recoveries than others with this anesthetic cocktail.

TKX is prepared by reconstituting one vile of Telazol (500mg) with 4ml of Ketamine (100mg/ml) and 1ml Xylazine (100mg/ml). It should be noted that this is the concentration of Xylazine marketed for use in large animals and not the 20mg/ml small animal product. The dosage of TKX is 0.25ml per cat IM. A maximum dosage of 0.3ml per cat should not be exceeded. For very small kittens a slightly smaller dose of 0.15-0.2ml is used. This provides 20-30 minutes or more of anesthetic time. If additional time is required, an inhalent anesthetic such as Isoflurane should be used. Reversal (if needed) is achieved with Yohimbine (2mg/ml; 0.5ml per cat IM or IV). An additional dose of Yohimbine may be given after 30 minutes if results are inadequate.

Alternatively, a cocktail known as KDT) may be used. This is prepared by adding 10 ml vial of Ketamine (100 mg/ml), 1.0 ml medetomidine (Domitor, 1 mg/ml), and 3 ml butorphanol (Torbugesic, 10 mg/ml) to an empty 15 ml vial. Alternatively, the cocktail could be mixed in a 10 ml vial of Ketamine by first removing and discarding 1 ml of Ketamine to allow adequate space in the vial to add 0.9 ml medetomidine and 2.7 ml butorphanol. Dosage is 0.6 ml per average cat (slightly more for large cats and slightly less for small cats). Reversal is accomplished with antipamasol (Antisedan 5 mg/ml) at a dosage of 0.2 ml IM per cat. This does not buy you as much anesthetic time in my experience as TKX, and spays require supplemental isoflurane. Recovery time, however, is usually quicker. If I am working alone (not in the high volume clinic) doing a few cats myself, I use this.

Nothing is perfect, but we do the best we can to keep it safe, cost-effective, and balanced anesthesia, with good pain control.

Esterilizacion Temprana

Mortality rates in pediatric

Question from Ann:

I am a big supporter of early age spay/neuter and our group does 2lbs/2months. However, there is another group in town that won't do early age, because they have seen 5 kittens die after surgery and feel the risks are too high. I have tried to explain that this could happen in adult surgeries too. It could be an unknown condition or some other reason besides the early age surgery, but they are adamant that they will not do below 5 months because of this. I have offered countless studies but they say that their vet agrees below 5 months is too young and can cause problems. When you are arguing against this type of emotion and personal experience they had, what can you do to help convince them to try it again and give it more of a chance?

Response from Brenda Griffin:

Wow, now there's a question! I am hoping Dr. Levy will have some answers for you here...

I have to say, that first off, you can't convince everyone. No such thing as 100%, and that's okay. Just go about convincing everyone else... and in the end, the others will likely follow. Try some of the video resources I described in my answer to the last question; those would be great to give them to watch.

Second, it will be very hard for them to "go against" the advice of their own vet. Difficult situation. Maybe the vet will attend a CE on pediatric spay/neuter sometime.

Keep up your good work... and let's see what other advice Dr. Levy can offer.

Response from Julie Levy:

Death after surgery should be a rare event, regardless of the age at which it was done. It's hard to say much without knowing more. Did the kittens die at the same time or were all the deaths unrelated? A cluster would suggest something unusual, such as an outbreak of panleukopenia, a medication error, or a high-risk litter. Intermittent deaths might suggest a more systematic problem such as inappropriate anesthetic protocols or monitoring.

To put surgical death rates in perspective, the rate of death in our feral cat sterilization program is 0.35% (3.5 deaths per thousand surgeries). We sterilize cats as young as 12 weeks in that program. In our foster program, we've sterilized more than 2000 kittens as young as 7 weeks, and I can count the deaths on one hand.

There is no question that kittens and puppies can be safely sterilized at very young ages. There are differences in how we handle them compared to adults, such as short fasting times, attention to preserving body temperature, and rapid recovery times. I am a big believer that most animals that are healthy enough for adoption should be healthy enough to be sterilized. "Neuter-Before-Adoption" takes the guesswork out of sterilization contracts and guarantees that we won't unwittingly contribute to the problem we are trying to solve.

With this in mind, it is also important that everyone work within his/her comfort zone. Veterinarians who have had a bad experience might prefer to restrict the animals on which they perform surgery. In doing this, they are looking after the welfare of the animals, which should always be the primary concern.

Change does not happen in a day. Some groups have embraced early neutering with gusto and others have been more cautious. Since everyone is working toward the common goal of ending overpopulation in their own way, it's more important to focus on what we all agree on than on the few differences we have.

Wet labs for vets on pediatrics and feral cats

Question from Sandy:

How useful do you think wet labs are in helping convince vets to try pediatric spay/neuter and also on feral cats? If you think it is useful, how do you go about setting one up?

Response from Brenda Griffin:

Hi, great question!!!!!

I think wet labs are very helpful for teaching pediatric spay/neuter. Having the opportunity to see one and do one in that setting can really jump start the learning curve and be a real confidence builder. I find that vets are often "scared" to perform surgery on very young/small patients. Once they see it is easy and okay, they are ready to go.

I teach a pediatric Spay/neuter wet lab at the Annual Veterinary Conference hosted each year by Auburn University College of Vet Med. I have had vet's tell me how surprised they were by how easy it was. One very skeptical and nervous vet emailed me a few months after the lab to tell me she had since spay/neutered almost 800 puppies and kittens since participating in the lab. I almost fell out of my chair. There's a testimonial!

After attending the NMHP Symposium in California, one attendee who heard me singing the praises of wet labs set up several in her area hosted by the Animal Match Rescue Team (AMRT). Their web site is www.amrt.net. They may be able to give you ideas on how to organize a lab based on their experience.

Go for it!!!

Response from Julie Levy:

Nothing beats first-hand experience. Trying out a scary new procedure under the watchful eye of a trusted experienced colleague is a real confidence builder.

This can be done in several ways. Formal wet-labs are nice because they are organized specifically for teaching. Educational materials, lectures, demonstrations, and practice can be organized to provide a thorough review and step-by-step practice.

The limitations of formal wet-labs are the cost and effort that needs to go into them, as well as the limited times and places they can be offered. One should also be cautious about running afoul of regulations that are designed to protect animals used for teaching. You may know that your animals are well cared for, but that does not absolve you of the need to comply with state and federal regulations (which are constantly changing). The last thing you want is to be cited for an animal welfare violation because your paperwork was not in order.

If a formal wet-lab can't be organized, an alternative is to invite your veterinarians to observe and perform surgeries somewhere they are already being done. This has the advantage of providing a "real world" context, and they can observe how the supporting environment is organized. Spay/neuter clinics and shelters are great places to see quality pediatric surgery being performed and to witness the quick recoveries these patients have compared to adults. Large-scale feral cat neutering clinics operate all over the country and provide examples for how the cats can be safely handled, methods for efficiently sterilizing large numbers of cats, and how to incorporate volunteers into the process.

The benefits of visiting other facilities is that vets can get their feet wet without putting their practice and private patients at risk. In my experience, once they've done it a few times, the fears evaporate and they tend to loosen up on their own turf as well. Anyone who has spayed a puppy will curse the necessity of performing surgery on a 100-pound obese in-heat female dog in the future. 

Long-term studies on pediatric surgeries

Question from Crystal:

If I had a dollar for every person who said, "Gee, I didn't know my five-or-six-month-old cat could go into heat and have kittens!" I'd be rich enough to start my own spay/neuter clinic! For this and many other reasons, I'm inclined to believe that early-age spay/neuter is the way to go for shelters and rescues.

My question is... have any studies been done on the long-term effects of early-age spay/neuter? The kittens I have seen who have been spayed or neutered at a young age all seem to bounce back beautifully and are romping and playing the next day. But are there long-term negative effects once they grow up?

Thank you for your time. I believe that spay/neuter is the only way we are ever going to make a difference in pet overpopulation.

Response from Brenda Griffin:

Although virtually all animal shelters require adopted pets to be sterilized, the compliance rate of owners according to the American Humane Association is only approximately 50-60% on a national basis, despite implementation of spay/neuter contracts, coupons, other incentives and time-consuming follow-up. For these reasons, the American Veterinary Medical Association advises that all pets be neutered before adoption, including puppies and kittens as young as 8 weeks of age.

The ideal age to spay/neuter dogs and cats is unknown. Currently, the most common age or the "traditional age" for recommending spaying/neutering is 6 months. This recommendation, however, is not based on research indicating that this is the ideal age to perform these procedures, but was probably chosen because anesthetic and surgical techniques were less advanced at the time and surgical success was more likely in a larger patient.

Approximately 30 years ago, humane organizations began sterilizing young puppies and kittens. Understandably, many veterinarians expressed concerns and questions regarding the short- and long-term safety of sterilizing pediatric patients. In response to these concerns, numerous controlled prospective studies and retrospective cohort studies have been performed to verify the safety of early age spay/neuter. Based on these studies, we can now conclude that sterilizing young puppies and kittens is a medically sound practice, and is not associated with any serious medical or behavioral risks. In addition, early age spay/neuter offers many advantages including well-established, safe anesthetic and surgical techniques, shorter surgical and recovery times, and avoidance of the stresses and costs associated with spaying while in heat, pregnant or with pyometra.

There are also numerous long-term health benefits including virtual elimination of the risk of mammary and testicular tumors. Finally, in addition to benefiting the individual patient, early age spay/neuter helps veterinarians to fight the single largest killer of dogs and cats: overpopulation and euthanasia of unwanted, homeless pets.

Reasons to Perform Early Age S/N:
- No substantial medical reasons to wait
- Guaranteed compliance
- No "whoops litters" (pregnancies at <6 mos)

Controlled studies have been done looking at everything from body composition to growth rates, immune function, urinary tract disorders, behavior, and long term effects. So many studies have been done; it would take me several pages to describe them all to you. No significant differences have been found in cats spayed or neutered at an early age versus a traditional age. Most recently, a retrospective study done at Cornell by Spain and Scarlett showed that no serious long-term medical or behavioral risks are associated with early age sterilization.

In cats, there is no increase whatsoever in the risk of urinary tract disease, and development (including size and function) of the urethra is normal in neutered cats compared to intact controls, regardless of age at neuter. For cats, this has always seemed to be the biggest concern among practitioners - the thought that if spayed/neutered too young, the urinary tract would not develop correctly. It is clear from numerous studies that it develops just fine! The one thing I would say is that for female puppies, there is a higher risk of incontinence later in life if spayed before 12 weeks of age (Spain and Scarlett showed that). Bear in mind, that incontinence in female dogs is easily and inexpensively treated, and in the study was not associated with relinquishment, which was notable to me. Finally, bear in mind all health benefits those young pups got from being spayed that young, no mammary cancer, no uterine infection... all good things. This increased risk of incontinence does NOT occur in cats.

See below for a handout I like to use to explain all the medical benefits of S/N

SPAYING/NEUTERING
Why it's medically best for your pet

FOR YOUR FEMALE DOG OR CAT:
Spayed females are often healthier than those who are not spayed. Intact females commonly develop problems such as:
Breast cancer
Ovarian or Uterine Cancer
Uterine Infections
Vaginal Prolapse

These problems can be life threatening.
- Breast cancer occurs more frequently in dogs and cats than in humans.
- Mammary tumors are the most common tumors in female dogs and nearly 50% are malignant. A dog spayed before she has had her first heat cycle has virtually NO RISK of developing breast cancer. Her risk dramatically increases if she is spayed after experiencing heat cycles.
- In cats, mammary tumors are the 3rd most common type of cancer and nearly 90% are malignant. They have usually spread to other parts of the body by the time they are diagnosed. A cat spayed before she is 2 years of age is 7 TIMES LESS likely to develop mammary tumors.

FOR YOUR MALE DOG OF CAT:
Intact males are at risk to develop serious problems such as:
Testicular Cancer
Prostate Disease
Hernias
Perianal Tumors

 

Young kittens being stressed after surgery at the shelter

Question from Lea:

Our organization does some work with a large municipal shelter that does on-site spay/neuter before adoption. We are very thankful of that.

We have been concerned lately about their protocols with a new staff veterinarian. They previously did not do surgery unless the juveniles were at least 2 pounds and at least close to 8 weeks. There is a small yet effective foster program for the ones that are pulled but are too young, and most are willing to keep them as long as needed.

However, we are seeing ones done that are 5 and 6 weeks and as small as 1.5 pounds or even just under that. I know there are vets that have been doing pediatric s/n for years, and are doing very young and small like that, but this vet is not only new to pediatric s/n, but new, period.

The little ones get adopted so quickly, and this shelter, being very large, municipal, short-staffed, and very low on volunteers, doesn't have time to do counseling or follow-up. But many of those that are around for a couple of days or so, look like they aren't recovering well. That usually gets attributed to the upper respiratory that perpetually goes around in shelters, and that may be so. But we are worried that at that age, their immune systems just can't handle it and wonder if this is serious enough to be addressed. We don't want to offend the vet or the rest of the staff, but we are concerned.

Response from Julie Levy:

I've sterilized very small kittens without problems, although I don't see the benefit of doing them much younger than the age of adoption. On a technical level, the anesthesia and surgery are no problem. Is this shelter adopting out 5 week-old-kittens?

The bigger issue is whether it is a problem to add an additional stressor at the time when kittens are undergoing weaning stress and may be in the gap between good maternal immunity and their own acquired immunity. This can be a difficult time for juveniles, and surgery can be another drain. Delaying the surgery to 7 or 8 weeks may help reduce that drain, but it does not remove it entirely.

In general, I believe that time in the shelter should be minimized due to the risk of infectious diseases such as upper respiratory infection. The shelter may be trying to do this by neutering the juveniles young and adopting them out quickly. An alternative is to put them in foster homes until they are older, then bring them back for sterilization and adoption. During kitten season, it may not be possible to provide enough foster space for all of the underage kittens, and it can be complicated to manage such a system.

I wonder how many people reading this are wishing they had these problems: vets wanting to sterilize cats and dogs very young and the shelter adopting out animals very quickly! So many groups can't find vets to sterilize before 6 months and so many shelters are nothing more than a holding facility for condemned animals. I think I'd count your blessings. How about arranging a big "thank you" party for the shelter for being so progressive? After you've made a public display about how much you support the shelter, you might arrange a private meeting about how you'd like to help improve any problem areas.

Percepción es la Realidad

Algunas percepciones:

Preocupación de calidad.   Erróneamente muchos creen que la única manera que Spay/Panamá puede hacer tantas cirugías y cobrar tan poco es cortando esquinas.  No podemos enfatizar más el hecho que el alto volumen y bajo costo nunca se logran a costa de la calidad.  Los veterinarios de Spay/Panamá han desarrollado estándares altos de calidad y alto volumen que son iguales o superiores a los de una clínica privada.

Temor a los números.  Algunos veterinarios se sienten intimidados por el número de cirugías en un día.  El veterinario experto de Spay/Panamá puede hacer hasta 50 cirugías en un día.  La mayoría de los veterinarios en clínicas veterinarias nunca han llegado cerca a esta cifra.  Tenemos que estar claros con nuestra expectativa, pero al mismo tiempo asegurar a un nuevo veterinario interesado en unirse a la causa, que la rapidez viene con el entrenamiento y práctica.  Dándole la oportunidad de observar un equipo en acción; esto le dará al nuevo veterinario interesado de ver por si mismo qué se puede lograr con el apoyo de voluntarios y procedimientos y protocolos establecidos.

Veterinario de segunda clase.  El veterinario de Spay/Panamá puede estar preocupado de que es percibido como un profesional que no puede funcionar en una clínica veterinaria o que estará limitado en lo que hace y pueda aprender.   Spay/Panamá le ofrece al veterinario la oportunidad de una educación continua y fomenta que se involucre con las asociaciones veterinarias y escuelas veterinaria local y del extranjero.   La tutoría a los estudiantes de veterinaria y nuevos veterinarios adicionan una dimensión interesante al puesto.   Hay que aclarar que todavía seguirá examinando los animales, diagnosticando enfermedades y condiciones, monitoreando pacientes y mejorando la calidad de vida.   La situación de esterilización de tantos animales, le permite al veterinario ver una amplia gama de casos clínicos.

Reputación profesional.  El veterinario puede preocuparse de cómo es percibido por sus colegas.  Lo más probable que oirá que ´haciendo esterilizaciones a bajo costo estás degradando la medicina veterinaria o estas abaratando el valor de dichas cirugías´ o ´veterinario que trabaja con Spay/Panamá no pueden trabajar en la práctica real´.  Estos comentarios son falsos y desleales.  Es de suma importancia que Spay/Panamá se mantenga conectada a organizaciones internacionales para que la profesión reconozca que el precio no determina la calidad y que nuestros veterinarios están al corriente y son competentes.  Tenemos que hacerle entender a todos que la configuración correcta, eficiencias y volumen de procedimientos hacen la economía muy diferente a una práctica típica.

Competencia desleal.  Algunos veterinarios argumentan que Spay/Panamá les quita negocio de sus prácticas privadas.  Hay que hacer hincapié en el hecho de que Spay/Panamá da un servicio de una sola vez a clientes que lo más probable no serán esterilizados en una clínica privada.  Hay que aclarar que parte de nuestro servicio es educar a los clientes y fomentar que ellos lleven a sus animales a clínicas veterinarias privadas para su cuido rutinario.

La misión de Spay/Panamá es aumentar el bienestar animal y poner un alto a la crueldad hacia los animales poniendo al alcance de los más necesitados el servicio de la esterilización a un bajo costo.  Pero al final del día es una empresa que contra viento y marea está tratando de ser auto sostenible.  El veterinario será compensado y será tratado como un profesional y se le dará la capacidad de hacer un impacto real en el país.   Evidencia de este impacto es nuestra relación con el MINSA.

Algunos beneficios de trabajar con Spay/Panamá:

Los días son más cortos que de muchos veterinarios en clínicas privadas.

Menos responsabilidad administrativa y de supervisión

Se trabaja con los animales y no con los guardianes de los animales

Se siente bien ayudando los animales

Puede disfrutar y concentrarse en la cirugía (con instrumentos adecuados) y se tiene la satisfacción de esterilizar animales para hacer una diferencia

Oportunidad de intercambiar ideas y conocimientos con profesionales de otros países