79-88 million pet cats in the US 80-85% are sterilized 10-90 million free roaming cats in the US Approximately the human population divided by 6 some variation based on community 2% sterilized

Pet Cats- 79million Female/OVH- 50-85% Litter/year: 1.4 Live birth/year: 3 Kittens born/year: 25million Kittne survival: 75% Live at 3 months: 18 million Community Cats- 79million Female/OVH- 50-2% Litter/year: 1.4 Live birth/year: 3 Kittens born/year: 166million Kittne survival: 25% Live at 3 months: 42 million

Trap Neuter Release and Spay Neuter Flashcards by Alyssa Sorum

Cat-Human Relationship

Cats have been living outdoors among humans for over 10000 years
Cats may be the only species to domesticate themselves
Indoor only cats are primarily a N. American phenomenon
- UK preferential outdoor
Indoor cats are relatively recent development
- 1947- Edward Lowe invents kitty litter

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Cats in the USA

79-88 million pet cats in the US
- 80-85% are sterilized
10-90 million free roaming cats in the US
- Approximately the human population divided by 6
  - some variation based on community
- 2% sterilized

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Free-Roaming Unowned Community Cats

Stray Cats
- Community Cats
- Abandoned/Lost Pets
Feral Cats
- Evasive and untamed
  - Born wild
  - Stray cats turned wild
1 unspayed female, her mate, and all offspring (2.8 kittens/litter) can total:
- 1 year: 12
- 5 years: 11,801
- 9 years: 11,606,077

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Cat Factory

Pet Cats- 79million
- Female/OVH- 50-85%
- Litter/year: 1.4
- Live birth/year: 3
- Kittens born/year: 25million
- Kittne survival: 75%
- Live at 3 months: 18 million
Community Cats- 79million
- Female/OVH- 50-2%
- Litter/year: 1.4
- Live birth/year: 3
- Kittens born/year: 166million
- Kittne survival: 25%
- Live at 3 months: 42 million

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Controversies and Concerns

Environmental
- non-native species impact on wildlife (birds)
Public Health
- Zoonotic disease concerns
Cat welfare
Management Options
- Traditional sheltering
- No-kill sheltering
- TNR

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Free-Roaming Community Cats

Most important source of cat overpopulation
single larest souce of shelter animal intake

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Community Cats - Public Opinion

2007 telephone survey
What would you do about unowned cats on the street
- 81% leave them alone
- 14% trap and kill

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Animal Welfare Inequality - Dogs vs Cats

Intake approximately equal
Return to owner rate
- Dogs - 38%
- Cats - <2%
Length of Stay
- Dogs - 14 days
- Cats - 28 days
Adverse Outcome
- Cats euthanized at a rate consistently 20% or higher thadogs

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Community Cat Control - Things to Consider

Free roaming community cats may not cause or have problems
Programs or efforts that only impact a small portion of the resident population are ineffective
Killing cats in shelters accomplishes nothing.
- not good for the cats
- not good for the shelter
- does not effect the community cat population

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Community Cat Management

Scale must be significant enough to manage the given unowned cat population
Safe for the environment
Affordable
Sustainable
Socially acceptable

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Community Cat Management - Goals

Improve the welfare of individuals cats and the population
Reduce the negative impact of the cats
Decrease the resident population
Decrease shelter intake
Decrease shelter euthanasia

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Community Cat Management - Options

Lethal Control
- Destruction, poison, hunting trapping etc.
  - Effective on isolatd populations
- Animal Control/Shelter euthanasia controls nuisances short term only
Adoption
- Ideal outcome
- Not enough homes
- Feral cats are not suitable for adoption
Sanctuary
- Limited capacity
Trap-Neuter-Return (TNR)

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Trap - Neuter - Return

Goals
- Population reduction via non-lethal means
- Improved cat population health
- Minimized negative impacts
- Reduce complaints from the public
Process
- Live trapping
- Spay/neuter
- Ear tipping (traditionally left)
- Rabies vaccination
- Triage/treat/euthanize the sick
Community Education
Colony level targeted approach

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Community Cat Management - TNR

Improve the welfare of individuals cats ad the population
Reduce the negative impact of the cats
Decrease the resident population
Decrease shelter intake
Decrease shelter euthanasia

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Spay and Neuter - the Good, Bad, and Ugly

Sterilization surgeries have exsisted for over 100 years
- advaned techniques and anesthetics to minimize risk
Still only 74% of dogs and 84% of cats are altered
- Decreases for underserved areas:
  - 12% altered
  - 69% pets have never seen a vet
Factors include:
- Cost
- Time
- Feelings the procedure is unnecessary
- Too young/unsure of age
- Desire to breed
- Receive advice against the surgery
- Not usually based on fact/coming from reputable sources

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Spay and Neuter Benefits

Benefits for dog neuter:
- decrease to several types of diseases (benign prostatic hyperplasia, prostatitis, prostatic cysts, etc)
- elimination of testicular tumors
- decreased risk of perneal hernia
- decreased risk of perianal adenoma
- decreased drive for male versus male aggression
Benefits for cat neuter:
- decrease roaming and marking
- decreased inter-cat aggression (cat-bite abscesses)
- reduced urine odor
Benefits for Dog spay:
- reduce disease (Brucellosis and Transmissible Venereal Tumor, mamary neoplasia)
- eliminate disease (pyometra, ovarian and uterine neoplasia)
Beneits for cat spay:
- eliminate disease (pyometra, ovarian and uterine neoplasia)
- eliminates estrus behaviors
Overall benefit: Control of unwanted pet population

Spay and Neuter - Risks

Established risks of spay/neuter:
- Decreased metabolic rate in cats
Risk of surgery/anesthesia:
- increased risk of prostatic tumors in dogs
- delayed closure of long bone growth plates
Potential risks are being studied:
- changes in skeletal growth (hip dysplasia, cranial cruciate ligament disease)
- neoplasia (lymphoma, hemangiosarcoma, mast cell tumor, transitional cell carcinoma, osteosarcoma)
- Other diseases (hypothyroidism, diabetes mellitus)
These are potential risks, however people read these as absolutes

Reading literature

Reading current literature on the topic of of risks, must be done in a critical manner
deterimine what type of study is being done
- expert opinion, case report/series, cross sectional, case control, cohort, randomized controlled trial, systemic review, meta-analysis
- Each type has its pros and cons
- Study types exist as a hierarcy (the ones at the start of the list are less prone to bias and systemic error)
Must critique each study
Generally 4 associations found in a study:
- True correlation
- Bias
- Confounding
- Chance
- Reader must identigy which way the association is created

Types of Literature

Weakest to Strongest
- Case reports, opinion papers, and letters
- Animal trials & in vitro studies
- Cross sectional studies
- Case-control studies
- Cohort studis
- Randomized Controlled trials
- Meta-analyses & Systematic reviews

Study Considerations

Truth
Bias
- Error in design/implementation
  - Enrolled the wrong animals
  - Colleced the wrong data or error in data collection
Confounding
- 2 differences in 2 groups we are comparing. The 2 groups are not excangeable because their is another pathway for possible association
Chance
- Random samples are used to extrapolate to a larger population. The sample we use will be a little above or below what we expect for the general population, this is the chance we take

High Quality High Volume Spay Neuter (HQHVSN)

Started in the 1970s in California
- only 10% of dogs and 1% of cats were receiving sterilization surgery
- 20 million animals were being euthanized in shelters nationwide
Government funded clinic was not popular among general practice veterinarians
A veterinarian in CA opened a new style of clinic- functioned as a low cost spay/neuter clinic during they day and aemergency clinic in the evening
- advanced “quick spay” techniques throughout the decades
- Many are still running today
1990s were several HQHVSN organizations across he country
- Many still running today
  - Inluding ASPCA Spay/Neuter Alliance, Operation CatNip, and SpayUSA
Despite success, the idea is not completely accepted by general practitioners
- “How to Keep a Humane Society Clinic Out of Your Community” published in June 1990 Veterinary Economics
2008 Nationally recognized guideline for Spay/Neuter programs
- Updated in 2016 by Veterinary Medical Care Guidelines for Spay-Neuter Programs by the Association of Shelter Veterinarians
Today, they are a vital part of the Veterinary Profession, and make the greatest impact for reducing cat and dog overpopulation
- critical to lowring shelter intake and euthanasia numbers
- expanded to provide care in underserved populations

HQHVSN Guidelines

Having standards:
- instills confidence by the public
- promote acceptance by the veterinary profession
- provide guidance for veterinarians
- provide transparency
- opens the door for research to document impact
Certain aspects are emphasized
- separate sterile instruments for each patient
- use of proper surgical technique
- gentle tissue handling
- surgeon expectations
- complete removal of both testies and ovary
Despite large numbers of surgeries, mobitidy/mortality rates are at or below those in private practice
- partly due to technique
- largley comes from repetition, highly trained staff, selected anesthesia/analgesia protocols, and patient selection

HQHVSN Surgical Techniques

May differ from traditional techniques utilized in private practice
Can be implemented in prvate practine
Male Dogs:
- Scrotal apprach to neuters are typically performed
  - Incision into he scrotum to facilitate removal of the testicles- the incision can be partially closed or left open to allow drainage post-op
Female Cats:
- use ovarian pedicle tie (“augoligation”) rather than the traditional double ligation of the ovarian pedicle
- Approaching a spay through flank incision may also be more appealing for feral/community cats and lactating queens
Using permanent marker to identify altered animals
- Feral cats - removal of the distal most portion of the ear (often left ear tip)
  - Creates a visual that the animal need not be removed for TNR
- Companion animas - often delineated with a green tatoo on the ventral abdomen
  - implementation of this in private practice assures that animals won’t have to undergo unnecessay anesthetic to verify S/N status

ASV Standards

Surgeon
- Steril hand/arm scrub
- Cap, mask, sterile gloves
- +/- gown
- Change gloves between each patient
Use separate sterile instruments for each patient
Proper surgical technique
Gental tissue handling
- Meticulous homeostasis
- Aseptic technique
- Attentive suture handling and security
Both testicles or ovaries need to be removed
- Ovario-hysterectomy vs. ovariectomy

High Volume and High Quality

* Speed = Safety * Not just a podut of surgical technique * Repitiion * Well oiled, highly trained team * Anesthesia/analgesic protocol * Patient selection * Peditrics * TNR * NOT cutting corners * Morbidity/Mortality rates at or below privat practice * Techniques valid in private practice

Alternative Canine Neuter Techniques

* Traditional - Pre-scrotal Incision * clossed or open procedure * Double ligature * SQ and skin closure * Alternative - Scrotal Incision * Closed procedure * Double or single ligature * Single suture closing the raphe * No sutures in the skin

Scrotal vs Pre-Scrotal studies

* Unpublished study at Oklahoma State University * 84 dogs * Randomized prospective case series * Rechecks at 1hr, 3 days, 7 days, and 14 days * Observations for ste-redness, swelling, hemorrage, dischage or dehiscee * No statistical difference between the 2 groups * Scrotal approach is their standard technique \>5 years * Scrotal Castration vs. Pre-scrotal Castration in Dogs: Veterinary Medicine, May 2015 * 437 dogs * Prospectie case series * rechecs at 2, 4, 6, 24, and 72 hours * Observations for bleeding from the site, pain, self trauma, and swelling at the site and scrotum * Pre-scroal approach = higher incidence of self trauma, otherwise no difference in complications * Scrotal approach = 30% faster

Suture-less Scrotal Castrations in Canines

* Parients typically \<5 months of age and \<25 lbs * Single scrotal incision * spermatic cords are pedicle/instrument tied * closure with tissue glue or left open * May be safer than pre-scrotal appeach in puppies * Suture cost savings in addition to time * Ongoing study at Oregon Stae University * Preliminary data shows no increased risk

Feline Spays

* Traditional = Double ligate ovarian pedicle * Midline incision * Double ligate ovarian pedicle * Alternative = Ovarian pedicle tie * Relatively new technique * Rarely mention in literature * Alernative = Flank Incision * Feral cats - TNR * Lactating Queens