Monday, 25 January 2016

Behind the scenes: Cat Spay

When it’s time for your female cat to have her oavriohysterectomy - removal of ovaries and uterus, or spay surgery - you bring her to clinic, leave her here for the day, and pick her up in the evening… do you wonder what happens to your feline friend?

Here’s a behind the scenes look at what goes on at St John’s Vet when you drop your kitty off!

When you arrive at the clinic and pass your pet off to one of our receptionists, they bring your cat out to our treatment area and put an ID collar on them, as well as a label on their carrier - we have a lot of patients come through our clinic during the day and we are careful not to get any confused! It’s not uncommon to have several cats of the same colour in the wards in one day!

Lucille 2 getting her ID collar in place!

Once your cat has been properly labeled, the receptionist will weigh them, set them up in a kennel, and write them up on the patient board so our technicians know they have arrived and what they are here for.

One of our technicians, with the help of an assistant, will then look over your pet - make sure it is a girl (don’t worry, if we call you to say your girl is a boy you are not the first person to make this mistake!), that there are no obvious health concerns, and collect some blood for presurgical bloodwork. If they find anything concerning on their check or on the bloodwork, they will alert the surgeon before proceeding to the next step.

We typically collect blood samples in cats from a vein in their back leg.

If all is well, your cat will get a “good to go” circle on the patient board so the technician responsible for preparing surgical patients knows that the procedure is going ahead. When the time is right, the technician will prepare a “pre-medication” to give the pet. For a cat spay, this typically involves a combination of a pain medication and a sedative. This helps relax your pet prior to surgery, as well as begins the important process of pain management to make sure your pet is as comfortable as possible on their big day.

Pre-medication is given into the muscle, Lucille 2 thought this was kind of rude - but it is for her own good!

Once the technician has given the pre-medication, a “P” is written in their “good to go” circle so the surgeon knows who is ready and waiting. The surgical assistant will lay out and prepare everything the surgeon needs to get your cat ready for surgery, and the surgeon will prepare the medication used to make your cat sleepy enough for surgery.

To get your cat ready for surgery, the surgeon gives an injection into the vein of an anesthetic drug.

Dr. Brown-Bury administering the "induction agent" - the drug used to make Lucille 2 sleepy enough for surgery.

Once the pet is asleep, the veterinarian places a tube down the trachea - the tube in the throat used for breathing - and connects this “endotracheal tube” to an anesthetic machine. The anesthetic machine delivers oxygen and a drug that is inhaled by the pet to keep it asleep for surgery. By doing this, your cat stays asleep until we disconnect the machine, even though the injection we gave will wear off in a few minutes. Also, because we have a tube going into the lungs, we can easily help your pet breathe if they are not breathing well during surgery. This is the safest way to maintain the “anesthetic plane” - amount of sleepiness - for surgery.

Lucille 2 is completely asleep at this point!

Once your pet is deeply asleep, we apply lubrication to their eyes so they don't dry out (they won't blink while under anesthesia!) and we shave their belly in preparation of surgery. For a spay surgery we do open up their belly, so we want things as clean as possible. We shave a wide area so we can be sure no fur gets into our work area, or “surgical field”. We’ll also trim their nails now, because there’s nothing easier than trimming a cat’s nails while they’re asleep!
Applying tear gel to Lucille 2's peepers.

Pedicure time!

Belly all shaved and bare, we'll use a vacuum so ensure no fur clippings stick around.

Now your cat is ready to be moved the to surgical suite. All the prep work up until now has been done in our treatment area, which is clean but certainly not sterile. Our surgical suite is a separate room dedicated just for surgery. There is a separate anesthetic machine, fresh blankets, and dedicated warming pads that do not leave that room - so the assistant will disconnect the patient from the anesthetic machine in treatment, leave behind the blanket they were on that may have bits of fur and nails, and place the cat on a fresh blanket and reconnect them to a new anesthetic machine. Once the patient is in position and secured to the table, the surgical assistant will give the surgery field a good scrub with special soap, and prepare the skin with 3 solutions to ensure as little bacteria as possible remains in the area the surgeon will be working.
We use tape and ties to keep Lucille 2 in the proper position while she sleeps.

Our final scrub has iodine in it, which we'll clean off after surgery so your pet isn't yellow when they go home!

While the assistant is doing this, the surgeon is preparing themselves as well. The veterinarian scrub their hands with special soaps and put on a surgical gown and sterile gloves. Both surgeon and any assistants in the room wear caps and masks as well. In these ways we are doing our best to prevent any infections complicating the healing your pet will need to do after the procedure.
A sterile drape covers Lucille 2 so the surgeon only touches the scrubbed belly or the sterile drape.

Making the first cute through the skin!

An assistant is monitoring Lucille 2's heart rate, breathing rate, blood pressure, and other things. They do this with machines as well as with their own hands, eyes, and ears!

Once the surgery is done, the assistant will turn off the anesthetic drug, but leave the oxygen connected to your pet while they clean up the skin around the surgical incision.  While they do this, another assistant is preparing a kennel in our ICU for your pet to recover in. This kennel will have a cozy blanket, and a heated disc. Patients often get a bit cold during surgery and their body temperature will be a little low while they recover - warming them up helps them recover more quickly. The assistant in ICU will also check with the veterinarian about pain medications to be given after surgery and get these injections ready. We don’t want your cat to feel any discomfort.
The endotracheal tube doesn't come out until the patient is awake enough to swallow. We want to protect the airway as much as possible!

Lucille 2 is feeling pretty weird right now, but she has done very well!

The veterinarian will then write up your pet’s file - describing what techniques were used, what suture materials were used, and what medications they would like to go home with your pet. They will also decide when your pet should be ready to go home, so that when one of our team members calls to say all is well, they can let you know when to come get your little kitty!
Lucille 2 getting an injection of antiinflammatory medication once she was awake enough to sit up - she just had he belly cut open, and we don't want her to feel any pain!

As much as a cat spay is considered “routine” and a procedure that happens for us almost every day, it is in fact a major surgery and a big deal for you and your pet. Please do not hesitate to ask us any questions you may have before you leave your precious one with us - we want you to be comfortable with the care your pet is receiving!