Glacier

Caterwauling cats. Some first-time cat owners don't know why their female cats suddenly became "sick". Rolling, scratching, rubbing ears, meowing as if in pain. Making lots of noises. Actually such cats are caterwauling and want to go out to mate.

Many owners bring the caterwauling cats to the vet to be spayed. Now, this is not in the interest of the cat as her blood vessels are enlarged and chances of haemorrhage are high. Deaths due to bleeding have been a complication of spay. It takes a much longer time to spay a caterwauling cat as more time is need to double ligate the uterus. Some sophisticated owners will wait till the cat stops caterwauling. However, they may wait too long and the next caterwauling appears 3 weeks later!

Below are my record of anaesthetic dosage used for 3 cases of caterwauling cats spayed by me and some tips on presenting a good image by using short incisions to do the same job. Obviously, each vet has his or her own style and technique. What I write here is to share what I have had experienced in my cat spay for the past 30 years with veterinary students.

CASE 1
Cat 1. Around 6 months
Caterwauling started in Jul 3, 2009. The young slim lady owner in her 20s adopted the cat found under her car hood. I advised giving Ovarid 20 mg x 1 was given at 1/4tab/day for 4 days to stop the caterwauling. After around 7 days, she brought in the cat to be spayed.

Stray Cat adopted by young lady. Caterwauled. Spayed. Toa Payoh Vets

I was referred by her friend to spay her cat when I asked why she took the trouble to drive some half an hour to get her cat spayed by me. Many Singaporean owners prefer the proximity of vets and sometimes I do ask why the pet owner took so much trouble and time to consult me. Part of market survey and feedback.

Referrals play an important part in building up a practice and it is important for the young vet to provide the USP (Unique Selling Proposition) to get referrals. After all, cat spays are common operations and any vet would be able to do it. Therefore the USP must be something that attracts referrals and one USP will be the presentation of the short skin incision and the stitching after the spay and the lack of complications. Well, cheap spays are definitely a USP too but it is hard to sustain a practice by going into under pricing as there are so much in overheads in a veterinary surgery.

Jul 12, 09. 3.2 kg.
Xylazine 20 @ 0.1 ml, Ketamine 100 @ 0.4 ml in one syringe IM
Insufficient time, cat growled towards the end of surgery. Top up isoflurane gas 5% for < 1 minute. Ovaries - Yellow corpus luteum. The blood vessels were still enlarged. I had to triple ligate the uterine body, hence taking around 35 minutes to complete the surgery. In cats that are not caterwauling, the time taken is around 15 minutes and it is a much easier and less stressful surgery.

Therefore, I always pray that I don't get caterwauling cats to spay. But my prayers are seldom answered as another 2 caterwauling cats came to me within the next 3 days. Things do happen in threes. I just document this Case 1 using photographs. It takes a lot of time to create the pictures for veterinary students and therefore I just present this Case 1 in detail.



2508 - 2511. Terribly large blood vessels in the ovaries and uterus require extra care in ligation and stress to the vet. Death due to bleeding post-surgery is not a very serious matter and the event taints a reputation of the veterinarian.

CASE 2
Cat 2. Around 18 months. One gentleman in his 50s (an old customer) and living more than 15-minute drive away came with a noisy cat to be spayed. He could not stand the noise anymore.
Jul 6, 09. Caterwauling 7 days ago.
Jul 13, 09. Spayed.
3.65 kg
Xylazine 20 @ 0.15 ml, Ketamine 100 @ 0.5 ml in one syringe IM
Excellent anaesthesia. I took note of the time for surgery in this case.

2.40 pm Injection xylazine & ketamine. Clipping after 3 minutes.
2.47 pm Incision started.
3.16 pm Skin suture (horizontal mattress) completed.
Duration: 29 minutes.

Caterwauling Cats take twice as long to spay compared to normal cats. Toa Payoh Vets

Surgery was not under pressure as Cat 2 had a sufficient duration of excellent anaesthesia. Ovarian blood vessels large as in Cat 1. Around 3 mm in diameter. Uterine blood vessels around 3 mm in diameter
Ligate ovarian blood vessels. Double ligate uterine body. In Cat 1, I had to transfixed ligature as well as double ligate the uterine body. My assistant James Ang said that I took a shorter time to spay Cat 2 compared to Cat 1. This was because there was no need to top up with isoflurane gas. Therefore, this dosage --- Xylazine 20 @ 0.15 ml, Ketamine 100 @ 0.5 ml in one syringe IM would be excellent for cats 3-4 kg.
Ovaries - One cystic ovary in this cat?

I noted that James of 73 years of age had several cat scratch marks in his hands. He showed me proudly his scars in his hands as if he had gone to battle and had won a medal of courage. He had helped Dr Jason Teo in one cat spay 2 evenings ago and had got scratched as he restrained the cat.

I had to teach James again how to restrain the cat by the scruff of the neck firmly so that he would never get scratched. He tended to forget what to do as he is 73 years old. A loss of long-term memory? In any case, I trained him again to prevent more scratch marks.

CASE 3
Cat 3. Around 6 months.

The lady in her 40s came with a caterwauling cat. She said that the cat was making so much noises that she could not sleep. Her neighbours adopted cats and had as many as 10 cats. None of the cats soiled the surroundings and gardens of the neighbours. But in the evening, one cat would be sitting on the car of the neighbours. I just could not imagine that the neighbours are so tolerant as cats do scratch the tyres and the car paint sometimes.

Where do we find such a cat-friendly neighbourhood in Singapore? Even the government (the Agri-Food and Veterinary Authority) is known to be all out to catch all stray cats and euthanase them irrespective of whether they had been spayed or not if you read the blogs and the internet forums of cat activists and cat lovers battling against Goliath to give the spayed stray cats a decent life.

"Each neighbour will have one cat resting on top of their cars in the evening," the lady said.
"No complaints from neighbours?" I asked her. "Not like the long-running bitter fights in the saga of The Everitt Road neighbours?".
The lady shook her head. In fact, this caterwauling cat strayed over from her neighbour. When this cat caterwauled, she thought that the cat had ear infections and skin itchiness. Therefore she bathed the cat.

The kind lady accepted my advice to ward the cat for 2 days before spaying. On July 16, 2009, I spayed this 3rd caterwauling cat. Around 6 months of age, 2.2 kg. I gave xylazine 0.1 ml and ketamine 0.4 ml IM in one syringe.

Unfortunately one gentleman came for pregnancy diagnosis of his Shih Tzu. So the spay was delayed around 20 minutes after injection. I noted that the duration of surgical anaesthesia was around 25 minutes after injection. The cat needed isoflurane gas top up. This caterwauling cat was the 3rd in a short-time. No e-collar was recommended for this cat.

Things do come in threes, it seems. All is peaceful and less stressful for me again.

SHARING MY EXPERIENCES ABOUT SURGERY - SUBCUTICULAR SUTURES IN SPAYS
The cat in the left picture below was not spayed by me and my tips are recorded in the picture.

"A longer skin incision will heal as fast as a short incision," my Veterinary Surgery professor said during my 4th year lecture some 30 years ago at Glasgow University in 1973. He was the famous Professor William Weipers. Somehow I remembered this advice from him as he said that new vets should not attempt "keyhole" spay surgery as they are not familiar with the technique yet. He was correct in his advice to new graduates.

Cat Spay Surgery & Stitching Techniques. Toa Payoh Vets

In practice, this theoretical advice has not been satisfactory for me. In a shorter incision, there is less chances of infection and irritation and "earlier" recovery as the cat has less area to lick. It took a much shorter time in performing surgery too.

In any case, some cat and dog owners seem to equate "surgical competence" with the "length of skin incision" when their cat or dog is spayed.

For me, the most efficient spay method is the shortest incision possible. To save time. To reduce the risks of infected wounds and increase costs to owners. I doubt owners will refer cases to you if they encounter unpleasant complications. Bad-mouthing is worst.

Veterinary professors probably advise subcuticular suturing too. I find that to be unnecessary in cat and dog spays. In fact, they may cause irritation and infection. But new vet graduates may not agree with me.

Remember "KISS" - Keep It Simple, Stupid makes for less irritation, infection and good recovery from surgery.

SHARING MY EXPERIENCES ABOUT SURGERY - INJECTABLE ANAESTHETICS IN CAT SPAYS, I record the following:

Delays are caused by:
1. Too much time is spent in waiting (> 5 minutes in Cat 1 for the cat to be sedated before clipping hair and preparing the site for surgery).
2. Incorrect restraint. Experienced assistant like James Ang tended to forget the proper procedure. The correct restraint here is to hold the cat upwards by the scruff of the neck. I asked him to lift the cat off the table. I injected IM. There was no reaction from the injection unlike Cat 1. In Cat 1, James positioned incorrectly, gripping the cat on the table with his right hand across the shoulder of the cat from the right side of the cat, instead of being on the left side of the cat., so that his grip was not firm. The cat moved as I injected 60% of the anaesthetic. He got scratches on his hand, in earlier case of another cat spay when he assistant another vet.

Fierce stray cats
How to inject such cats?
1. Put cat inside small crate. Put telephone books and other books to push him into corner. Tilt the crate. Inject IM when the cat is distracted. Not really ideal as some cats reacted first during injection. Xyalzine 0.2 ml IM in local Singapore cats would be easy and quick for injection, but not the larger amount in xylazine:ketamine combinations. Isoflurane via gas mask is used in cases where xylazine 0.2 ml is given.
2. Lasso held the cat's pelvic area and back towards side of crate. Inject IM.
3. Do not give 2nd injections if the vet missed or gave insufficient amount as the cat may die of heart failure due to the stress. Postpone surgery to another day.