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	Toa Payoh Vets 08 May 2008
TIPS FOR A LONGER LIFE FOR YOUR PETS --- Be Kind To Pets educational stories for pet lovers Community Education for first-time pet owners and animal lovers --- sponsored by asiahomes.com and toapayohvets.com

ANIMAL SHELTER SURGERY AT NANAS COMPARED TO TOA PAYOH VETS

Cat house in animal sanctuary, NANAS. Toa Payoh Vets

An incredibly beautifully designed cat house in NANAS. Waterfront views and wooden floor boards designed and built by Mr Raymund Wee.

Part of NANAS cattery has an open balcony concept. Toa Payoh Vets

An open area permitted cats to get out and enjoy the views and sun.

NANAS - no-kill animal shelter for homeless cats. Toa Payoh Vets.

A 2nd-year vet student who loves cats visited NANAS. Would she set up a cats only practice in Singapore? Would such a practice be feasible?

Sunday, Apr 27, 2008

I visited NANAS (Noah's Ark and Natural Animal Sanctuary), an animal sanctuary in Johor on a fine cloudy humid Saturday afternoon of April 26, 2008 to know more about animal shelter medicine. I had the opportunity to study the effects of Zoletil combination being used.

To share knowledge with others working in shelter medicine in other countries via the world wide vet, I have recorded below the following effective anaesthetic regime in NANAS. It is an alternative to gas anaesthesia and the dosage is as follows:

1. Zoletil 50 (Virbac) white powder is present in a bottle.
Tiletamine 125mg, Zolazepam 125 mg.

2. Xyalzine 100mg/ml in a bottle. Put 2 ml of this into the Zoletil bottle.

3. Ketamine 100mg/ml in a bottle. Put 8 ml of this into the Zoletil bottle.

4. The bottle now contains a clear solution of 10 ml.

FOR CAT SPAYS
1-2 kg. 0.15 - 0.18 ml IM
Bigger cats 0.2 ml IM.

I noted that the duration of surgical anaesthesia was more than 30 minutes in cats 1-2 kg being spayed. The tongue is pulled out as a routine to prevent food being vomited during surgery. Such food gets into the lungs and cause death by inhalation pneumonia. Surgical incision is midway between umbilical scar and pelvic brim in the young cats being spayed.

FOR DOG SURGERY
In a dog of around 15kg , a 0.8 ml IM permitted surgical anaesthesia of around 30 minutes in one case of conjunctival growths being removed. As the dog showed signs of waking up (eye reflex and mouth clamping), a 0.6 ml IM was injected. The dog was under surgical anaesthesia within 1 minute. This was my only experience using the combination drugs of NANAS.

POST-OPERATION
In NANAS, the following were given for cats and dogs.

1. Tolfedine 4% (tolfenamique 4g) at 0.5 ml IM or SC for cats after spay and neuter. A pain-killer.

2. Amoxicillin (Longamox) at 0.5 ml SC for cats after spay. An antibiotic.

Information for cat and dog owners
sterilising their pets at Toa Payoh Vets

Recently, some owners asked me why there were no antibiotics given after sterilisation of their male cats.

Generally, no pain-killers or antibiotics are given to your male and female cats post-operation from Toa Payoh Vets for cases operated by Dr Sing as experience indicates that they are not necessary. Many owners find it hard to give oral medication to cats.

In big dogs, non-steroidal anti-inflammatory pain-killer and antibiotics may be prescribed after spay.

For Dr Sing's cases at Toa Payoh Vets, the anaesthetic regime is usually:

Xylazine & Ketamine injectable anaesthesia are used for cats. Dosage is xylazine 20 mg/100 ml at 0.2 ml mixed with ketamine 100 mg/ml 0.8 ml in 1 syringe, IM injection. This dosage is most effective for a cat around 2-3 kg. Onset of anaesthesia is 2 minutes after IM injection in most cases. Duration of surgical anaesthesia is at least 30 minutes.

For fat cats or young ones less than 2 kg, half the above dose is sufficient but surgical anaesthesia is less than 10 minutes compared to 30 minutes in above full dose. If necessary, anaesthetic gas is given by mask for one minute to complete the surgery.

Xylazine & gas anaesthesia or gas anaesthesia alone are used for dogs.

Please note that the xylazine solution I used is 5X less potent than that used for the Zoletil combination at NANAS. It is 20 mg/100 ml xylazine, not 100 mg/ml.

INCISION SITE.
In NANAS, I observed that the incision begins at the middle 1/3 area between the umbilical scar and the pelvic brim. Cats I observed were around 6 months of age. The cat's tongue was pulled out to one side of the mouth to prevent vomitus from being swallowed. Bladder was expressed so that the bladder would not be nicked.

At Toa Payoh Vets, I incise at the cranial 1/3 area, at 1 cm from the umbilical scar in dogs and cats. This position enables me to easily access and ligate the swollen "on-heat" ovaries easily, especially in dogs. Palpate for the full bladder and express it free from urine before spaying. Be careful not to nick the full bladder. Seldom do I encounter a full bladder at this location but there needs to be care in incising the linear alba in case the bladder is just below. Palpate the abdomen first to check for the bladder and express the urine.

Typical anaesthetic regimes for cats living and born in Singapore are shared with fellow veterinarians by Dr Sing Kong Yuen. Some vets may seek such internet information. They are as follows:

2 well loved fat cats of Singapore neutered by Dr Sing. Toa Payoh Vets

Xylazine:ketamine injectable combination for the 2 fat cats of around 5 kg neutered by Dr Sing. Dosage was halved for cats 2-3 kg. Surgical anaesthesia was around 5 minutes as the dosage should be higher. Neutered around 5 minutes after injection. No topping up was needed in this case. If necessary, I would use gas anaesthesia for 1 minute. That would be sufficient to provide surgical anaesthesia.

Many Singapore stray cats are sent to the vet for sterilisation by volunteers. Toa Payoh Vets

For this pregnant 4-kg cat, the xylazine:ketamine at 0.2 ml:0.8 ml IM (usually given to cats 2-3 kg) permitted excellent surgical anaesthesia of around 30 minutes for spaying.

Dr Sing's incision for spaying of cats is normally 1 cm caudal to the umbilical scar. The incision length is 1 cm if the cat is not pregnant. In this case, it is longer as the womb is much larger due to the presence of foetal lumps. Ligate the uterine body in this pregnant cat two areas although there should be no slippage of sutures with one ligation.

Spay at 5 months before the cat gets pregnant. Toa Payoh Vets

A street cat weighing less than 2 kg. The xylazine:ketamine dosage was less than half of that used for cats 2-3 kg. The skin incision is around 1 cm. 2 horizontal mattress sutures are usually given.

5-month-cat spayed. Remove plaster in 10 days if the cat has not done so. Toa Payoh Vets

How young should your cat be spayed? If it is a street cat, some are spayed as young as 4 months. For your pet cat, I would advise 6 months and after caterwauling, making sure she does not get pregnant. The above cat in Singapore was spayed around 5 months of age by Dr Sing Kong Yuen.

A stray male cat after neuter by Dr Sing in 2003 using xylazine 0.2 ml IM and gas anaesthesia at that time. Clipped left ear tip in stray cats indicate they have had been sterilised. But stray dogs do not get such treatment and it is difficult to know the status of whether the female stray has been spayed or not.

Despite a first-world country status, Singapore unfortunately does not have a charitable foundation like the People's Dispensary for Small Animals (PDSA) in the UK to cater to the treatment of sick street cats and dogs for owners who can't afford veterinary treatment.

I saw practice with a private vet in in England in the 1973 during my 4th year at Glasgow University. He spent 1 day a week at the PDSA to offer his veterinary services. What stuck in my mind was the arrival of a driver/owner of a Jaguar car. He brought in a dog for free treatment. One presumes that the Jaguar car owner does not need the help of the PDSA.

It is hoped that one day, one of our successful entrepreneurs will set up a Singapore PDSA to help owners who can't afford veterinary attention for their pets.