10. Too wild a female to handle

DRAFT - TIPS FOR NEW VET SURGEONS.

"Don't grab him with your bare hands," I shouted to assistant, James. "Use a towel."
The cat was hissing and spreading her claws as she had waken up from the anaesthesia. The surgery took 30 minutes when normally I would take less than 10 minutes. The injectable anaesthesia usually lasted 60 minutes. However, the cat was alert at the 40th minute.

Normally I would just tape a plaster but this time, I put 3 and also an Elizabeth collar. This was the wildest domestic cat I had ever met in my past 20 years of practice. So, I was making sure that this cat would not come back to me with guts coming out of her operation wound as this was too wild a female to handle.

TIPS FOR NEW VETS

1. Caterwauling will usually be the main reason the owner wants to spay. A noise nuisance as apartment neighbours need to sleep at night while the cat meows a lot.

2. When the cat caterwauls, the uterine bodies are very fragile. So, this is the worst time to operate. The following are precautions to prevent bleeding to death after surgery or dying on the operating table.

RESTRAINT. Prepare the injectable general anaesthetic early. The owner had put the cat inside the carrier crate. The crate was then put inside a big crate. When I was ready, Mark, the cat catcher looped the fierce cat's hip area and slide her back towards one side of the crate. I asked James to talk to the cat to distract her while I injected IM the backside of right hind.

INJECTABLE GENERAL ANAESTHETIC. I use two types of injectable anaesthetic in one syringe: 0.2 ml plus 0.8 ml IM for the normal adult Singapore domestic shorthair cat from 2 kg - 6kg.

It was not possible to weight this wild cat but this formula worked. She should be around 2 - 4 kg. As to the name of the drugs, each vet will have his own favourite.

SPAY SITE. Cat's head facing left of op table. Raise hydraulic op table to level so that the surgeon needed not to hunch his back.

I note that 1 cm from the umbilical scar is best to start the skin incision. Make a 1-cm cut. This was done in this case.

For new vets, a 2.5-cm (1-inch) skin incision may be preferred.

Spay hook was angled at 45 deg to horizon with the curved tip facing right. It was inserted into abdomen and twisted upwards clockwise to hook up the uterine body near the ovaries.

Ovaries will be reddish and swollen about 0.8 cm in this case. Ovarian blood vessels 10 times the size. Pull up the ovaries by 1 c.m. Clamp. Ligate below the clamp. Ligate again when clamp is removed so that you have had 2 ligatures to be safe.

The left uterine body is now exposed. I asked James to loosen the string tying the front legs of the cat tautly to the op table. He puts his hand below the cat's shoulder blades to lift up the cat's front half.

This technique and the 1 cm from the umbilical scar seemed to make it easier for me to see the other uterine horn at the junction with the left uterine horn. Take artery forceps to pull it out.

Expose the ovaries and ligate as above.

UTERINE BLEEDING
Bleeding was non-stop in this case. Bright red blood. The uterine tissue was fragile as I clamped, breaking the uterine horn to pieces. More red blood filled the incision area which was around 1 cm. The gauze swab took away the blood and more blood filled the area. Where was the bleeding from and the uterine horns were clamped?

The bleeding was from a hole in the left uterine horn. Blood was coming out from the uterine wall as this cat was on heat. On clamping or during lifting of the uterine horn, it had lacerated. Just a 4 mm wound but blood was oozing out from the tissues.

Ligate the uterine horns two times each as for the ovaries. One below the clamp and one on the clamped area.

SKIN INCISION. Close muscle layer by 3/0 absorbable suture interrupted, one stitch. Close skin layer with same suture material with horizontal mattress.

TAPE. Tape 3 tapes. As this is a wild cat, 3 tapes may delay licking off by the cat.



ELIZABETH COLLAR. In case the owner can't handle this cat, I put on an Elizabeth collar. The cat seemed to hate it. It was taken off. The cat was calm when the owner came to bring her home. She was adopted from the picture in the internet. After e-mailing, the owner got a reply. Somebody checked her out before letting her adopt the cat.

"Was it the SPCA or the Cat Welfare Society?" I asked her.

"I can't remember," she said.


How do other places deal with numerous stray cat spays?

I phoned up an old contact dealing with stray cats.
He said that the vet used 4/0 subcuticular under the skin suture and 4/0 nylon (3 interrupted sutures).

"Or elephant glue to close up the skin incision and it looked as if there is no incision," he said. No need Elizabeth collar or plaster. No problem in all cases.

After talking to him, I wonder whether I have been too paranoid about guts spilling out after spay with so much protective layers in this case.