CAT SPAY

The procedure and nursing considerations

Ensure the patient is on a heat pad and is pre-oxygenated prior to intubating, and remember to wait 30-90 seconds after using Intubeaze before placing an ET tube.

Remember to lubricate the eyes (especially important is the patient has had ketamine in their premed).

Cat spays can either be done midline or, more traditionally in the UK, via a flank incision. If clipping the flank, place the patient in right lateral recumbency and clip a square over the left flank. (Make sure to double check that the patient is definitely female prior to clipping! This mistake happens more often than you would think!)

Top tip for getting the correct location: palpate the two "bumps" of the pelvis (the wing of the ilium and the greater trochanter of the femur) with your index and middle fingers and use your thumb to make a triangle. The location of your thumb is roughly the point of incision.

At this stage I recommend performing an local line block using bupivicaine (not exceeding 1mg/kg dose in felines) - this is especially useful if your premed only contained a partial opioid such as buprenorphine. Even with other analgesia on board, this can make it more comfortable for the patient when suturing the skin. Don't discard whatever is left of your dose though as this can be used as a splash block during surgery too.

Position your patient on the surgical table in right lateral recumbency - some surgeons like to have the hind legs tied and pulled back to stretch out the abdomen. Then give another quick scrub and prep the area using a final cleaning stage e.g. ChloraPrep.

The surgeon can then perform the spay. Usually the procedure is quick without complications but occassionally you can find a pain response is ilicited when clamping. Top up doses of ketamine can sometimes be useful here but always check what meds have already been given for pre-medication.

Remember to lubricate the eyes during the surgery and again on recovery to reduce risks of corneal ulcers forming and keep the patient wrapped up warm. It is a quick surgery but they can still lose heat fast so don't forget to monitor the temperature.

If your patient has had a "triple" (a medetomidine, buprenorphine, and ketamine combination pre-med), the recommendation is to wait for 30-45 minutes after the ketamine was given before giving any atipamezole, to avoid the patient becoming dysphoric on recovery.