I was struck by the comments that attended a recent post on speed-demon feline neutering (I’m going for the gold! Fifty-six cat neuters in ten hours? I can beat that!). While significant umbrage was understandably taken over the concept of surgery as sport, this is one area where the veterinary point of view varies vastly from that of the average animal lover.
Interestingly, all the vets I know who read it shared my POV: Cats in shelter settings (as was the case in this post’s discussion) must be neutered as quickly and efficiently as possible. Record or no record, that’s the reality of shelter medicine—every day, not just when attempting a Guinness Book of World Records admission).
While I do apologize for exposing a global audience to the back-room vet banter we revel in by means of dealing with our daily realities, the truth is much deeper than the superficial crassness you were exposed to in this post. Let me explain…
Shelter medicine is nothing like the pet medicine you’re exposed to at your vet hospital visits. As many of you who volunteer at your local shelters may know, treating a population of animals in a limited-resource setting is much like working in a war zone.
Pets under these conditions are treated much as the wounded in a war might be. Who’s worth saving? Whose injuries go beyond the limits our resources? How many can we realistically save in the time we have available with the money at our disposal?
In that context, speedy spays and neuters are considered the holy grail of shelter medicine. Speed = lower expenses, especially when vet time is a limiting factor, as it was at my local shelter the last time I checked (last week).
When two cats beget hundreds every year, alacrity is of the essence. When spays and neuters are the foundation of our no-kill goals, quickness is crucial.
Moreover, speed does not equal a lack of humane treatment. These animals may be exposed to third world human medical conditions, but it’s a far cry from inhumanity. While they may not get the extra attention and careful monitoring we’d want for our own loved ones, they are by no means handled cruelly. They still get pain meds. They still get quality anesthetics. They still get modern surgical attention and sterile conditions.
The fact that we vets occasionally beat our chests over our surgical speed under these conditions should in no way suggest that we don’t take our role seriously. Quite the opposite, I’d posit. We know exactly what’s at stake under these conditions: Nothing less than life and death.
As in a battle zone, speed is armor. Moving fast when there’s no money to meet everyone’s needs means that more are treated to our skills. Sure, there’s a point at which speed becomes a weapon, but professionals are trained to exercise their best judgment under many conditions. Why question our limits here?
I have an acquaintance who travels to Central and South America to practice his profession on impoverished children with cleft palates. His goal? Ten life-altering surgeries every day. He times every cut and stitch so he can manage this exhausting schedule. And he prides himself on his speed.
Need I say more?
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Well, the original article that you linked to
http://www.abc-7.com/articles/readnews.asp?article...
Has a number for owners to call, presumably to offer their pets up for this speed demon contest. So, it's not "shelter medicine" he was practising from what I can tell. Seems like these weren't shelter cats -- if this was open for the community to bring their own pets. Even if he was doing this stunt to call attention to the problem of the feral cat population, they are soliciting pet owners from the community in that article.
I know that high-volume spay/neuter facilities are a good thing for addressing the overpopulation problem, but in the best of those places, there is an entire assembly line of veterinary technicians and qualified monitoring staff on hand. If that cant' be assured, no matter how simple the procedure, I personally certainly wouldn't be one of the members of the community taking advantage of the offer, because you said yourself, it's not the degree of monitoring any of us would want for our own pets. Maybe for shelter cats, feral cats. But not my cats.
I've been reading veterinary disiplinary records from all over the country the last week, and I can't tell you how many botched spay cases there are as a total percentage. Lots. My mom's dog needs to be spayed (yes, I know -- not as easy as a neuter, and I've yet to see a botched neuter case, although I have seen a few died-from-dental anesthesia cases). I have told my mother there is NO WAY we are letting her pup be spayed anywhere EXCEPT the place I go to where they
a) Use all, and only, licensed vet techs
b) Have 24-hour monitoring and
c) I know their anesthesia protocols and have known the vet for over 10 years. She calls the minute my cats dentals are done, for example. She uses Iso and has them on IVs and intubated the whole time, just in case. That should be standard but it apparently isn't done everywhere, from what I have been reading.
This will cost more which means I will be paying for it since my mom is on social security. Which mean it may not get done for the next month or two. But even though my mom likes her vet, they aren't 24 hours and they don't have licensed techs, so if I'm paying, no way we are doing it there.
(So, this is what I do for fun, read veterinary disciplinary records. Hence, spay phobia).
Stefani February 11th, 2008 10:15:00 PM
As someone who does TNR and volunteers at a shelter, I can tell you we LOVE vets that can do fast spays and neuters--and when we get together with people from other shelters and rescues, we compare notes. "My vet can do a neuter in ten minutes." "Mine can do it in five." "Oh, yeah? How fast does your vet do a spay?" When we all get together for a spay/neuter clinic, we stand and admire the fast and confident hands that fly through surgeries. The more we can get done, the more litters we prevent, the more deaths we ultimately prevent. We've had thousands done and we've only lost one. Because it was a low cost spay and there was no blood work, we'll never know what underlying condition caused the problem. I would wager that it had nothing to do with surgical technique though.
Not all vets are are comfortable with doing fast neuters, however, and we are equally appreciative of vets who know their limits and don't endanger our animals by doing something they're uncomfortable with.
Does knitting help you improve your surgical speed Dr. K? Just curious. I'm applying to vet school this fall, and I thought I might try learning to knit.
Heather#2 February 11th, 2008 10:27:00 PM
I regularly participate in spay-neuter clinics that are put on by a faculty member at my vet school, that do roughly 60-80 surgeries a day. Every summer, she makes this into a moving spay-neuter caravan and travels to various shelters and does this. Senior veterinary students perform the surgeries, and young'uns like me do the physical exams, monitor anesthesia, and monitor recovery in a make-shift area comprised of cat carriers and blankets. I'm taking my Principles of Surgery and Anesthesia class right now, and it amazes me how much we do "wrong" in those clinics. But they do so much good, the trade-off is small. I went on the trip this summer - over 1,000 surgeries in 3 weeks, and only 1 or 2 calls about complications and 3 or 4 complications under our watch. I'd say that's not bad. And one of the "complications" - a kitty that died on the table - had a heart condition that takes hundreds of dollars in diagnostics to detect. We may not do it according to the strictest principles, but we do it well and we make a world of difference.
As for that article, it's not super-clear - it seems it's calling for stray cats to be neutered, not pets, and the registration is for people who can trap cats. There's plenty of those people. The prices do seem rather steep for this sort of event, but they're still discounted. Even if it is pets, if it gets people to bring in pets that wouldn't be neutered otherwise, it's great. Not everyone can afford amazing services for their pet. But after more googling, it seems that the service is aimed at rescue groups, not private owners. So I really have no problem with it.
Julia February 11th, 2008 10:55:00 PM
I have been in the veterinary operating room and know about the banter. But I think it should stay in there with the bloody swabs and scalpels and other things the client just does not want or need to see.
emily February 12th, 2008 09:35:00 AM
I am a technician at a high-end practice. Our patients get the best veterinary medicine has to offer. All of our surgeries get IV fluids, the best pain management and the most up-to-date anaesthetic protocols. On feral cat day however, corners certainly get cut in order to spay and neuter the number of cats we need to quickly and cheaply. (Our clinic does not charge for these services and the staff is volunteer) Our "quick and dirty" feral day provides better care than a lot of other clinics provide their paying patients. We have yet to lose a patient.
A speedy, competent surgeon is worth their weight in gold both in regular practice, and certainly in high volume situations. Less time in surgery means less time under anasthetic which means patients recover faster with fewer complications.
Cat neuters are a very rewarding surgery. They are quick and easy and you prevent many unwanted litters with each testicle you remove. I think it is important not to judge this vet negatively on his ability to neuter quickly. As long as he is providing good care and has a competant team, the cats in his care are not suffering. He is, in fact, providing a great service.
Meghan RAHT February 12th, 2008 03:12:00 PM
Oh don't cut out the behind-the-scenes stuff (dirty swabs and all)! I appreciate your candor, Dr. P, and anybody who regularly reads you knows how caring you are -- of people and of animals.
Someone dropped off a litter of kittens at our shelter late in the summer, and now mama cat has been dropped off -- pregnant again. Poor mama could have benefited from a quickie spay-neuter, since it was obvious that her owner wasn't going to spring for the usual one.
lin February 12th, 2008 04:58:00 PM
Meghan, that is really good to hear about your great track record. That is a good point about the anesthesia. The less time under the better. So I guess it's a trade off and in the case of the neuter, maybe I'm becoming convinced by you guys that the tradeoff is worth it.
The spay -- I still am wary of speed spay! Although I suppose with a very good team, the suffering prevented will certainly outweigh any losses as long as we are talking about ferals or shelters. I wouldn't want my mom's dog speed spayed, unless I knew these people were truly the best b/c they had it down to a science.
Stefani February 12th, 2008 05:47:00 PM
Stefani- if you are willing to pay for it you should absolutely take your pets to your regular vet for a standard spay. High volume/low cost is for homeless animals, people that can't afford to S/N and people who just don't think their pets are worth it. I think if more pet owners were as informed as you are they would be more willing to pay for better medicine. Unfortunately, I can lecture until I'm blue in the face about pain meds, monitoring and iv fluids but a lot of people still think I'm out to scam them. After all, if Dr. Shmoe from down the street can spay a cat for $50, how can we get away with charging $200???
Meghan RAHT February 13th, 2008 12:12:00 AM
Meghan,
I really sympathize with what you have to go through trying to convince pet owners that quality is worth money. I try to beat that into people's heads all the time. There is just no substitute for quality. Everyone I work with thought I was nuts when I told them I spent $1,000 on dentals for two of my cats. I practically zeroed out my checking account. But I know the quality standards of this place and I would rather go into debt paying for that than take risks.
Thank you for trying to get through to people. People need to understand that dropping a lot of money isn't a guarantee of quality, BUT the opposite is almost always true (cheap care is cheap for a reason). I really support good vets and techs getting paid what they are worth.
And licensed techs DEFINITELY need to be paid more.
Stefani February 13th, 2008 04:39:00 PM
Heather#2,
I think I posted some links about manual dexterity WRT surgeons (and knitting!) on a knitting post, but wouldn't know where to find it.....vet stress category maybe?
CathyA February 14th, 2008 07:53:00 AM
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