127. Animal shelter medicine - NANAS

On Saturday Jan 26, 2008, I brought two 2nd-year vet students from Murdoch University to visit NANAS during my off-day. I hope that they would learn more about shelter animal medicine and I hope to see Bobby who was relocated from Yishun Fishing Pond to NANAS some months ago by Mr Raymund Wee and Ms Lynda Goh.

Much practical knowledge is transmitted from the older folks to young ones. But they need to record the knowledge rather than be an observer. I seldom see the young ones doing any writing. It is a pity that the two vet students did not bother to write how other vets or senior staff do the work at NANAS.

What drug they use? What is the dosage? How long will the drug take effect? Any side effects?

If they record such "meaningless" data during their visit to NANAS, they record Animal Shelter Medicine and Surgery for their storage of knowledge. When they study veterinary pharmacology in the 3rd year or so, the records will make their lectures alive. Much practical knowledge and short cuts get forgotten in the sands of time. It is quite sad to see young ones not knowing the value of practical knowledge which would help them later in life or in examinations.


I record the following to share with young vets doing animal shelter medicine.

ANAESTHESIA AND SURGERY OF 3-MONTH-OLD KITTENS AT NANAS.

ANAESTHESIA & SURGERY

1. Zoletil 100
2. Xylazine 100 mg/ml 2 ml
3. Ketamine 100 mg/ml 8 ml
Total 10 ml in Zoletil bottle.
Can be used for 50 cat spays and neuter?
0.01 ml /kg recommended? Did I hear this figure incorrectly from Raymond Wee?


In practice, 0.15 ml IM for 1 kg kitten was effective!
5-6 hours after being fed a bland diet.

Compare to my Toa Payoh Vets practice:
Adult cats are starved 12 hours before surgery in my practice. I don't spay cats less than 6 months old. I use xylazine:ketamine IM (0.5 ml IM combination/2 kg kitten). The NANAS combination method uses very little volume (0.15 ml IM/1 kg kitten). It appears economical for mass sterilisation? It seems effective after observing around 8 surgeries.


Milk bladder to empty bladder.
Tongue pulled out. I see that the tongue is bright red in colour with this combination.
Eye ointment applied to eyes.

Onset: If given IM correctly, less than 2 minutes.
Duration of anaesthesia: Said to be 35 minutes.
Spay surgery: Should be done in 15 minutes.

Incision: Anterior and around 1 cm from the last pair of mammary glands. Sort of divide umbilical area to last pair by three 1/3. Use the posterior most 1/3 area to incise the linea alba. This incision is just above the bladder. Therefore and in any case, all muscle layer must be pulled up before stitching. Otherwise, the bladder is punctured by the stitching needle.

In adult cats, the incision is also around that area. It can be quite difficult to ligate the ovarian ligament as the incision is too posterior, in my opinion.
As for me, I incise about 1 cm from the umbilical area and find this spot the best.

ANAESTHESTIC DRUG COMBINATION IF ZOLETIL 50 IS USED.

1. Zoletil 50
2. Xylazine 100 mg/ml 1 ml
3. Ketamine 100 mg/ml 4 ml
I presume this will be sufficient for 25 cat spays and neuter?


PAIN MANAGEMENT

Tolfedine ? I need to check on this drug.


0.3 ml SC given at the end of surgery. Apparently, the kitten or cat eats the next day. No pain. This is a non-steroidal anti-inflammatory.

ANTIBIOTICS
Amoxycillin suspension 0.5 ml SC.
I don't give antibiotics to cats after spay generally and seldom have complaints of fever. Cats eat after 1-2 days usually. But if pain management is used, they may eat a few hours after surgery based on feedback from NANAS?

3-MONTH-OLD PUPPY
Uterine horns will be 1/4 size of kitten of same age.
So, it will be very thin.

Incision should be one finger's width from umbilicus, not so posterior as in the kitten.

Bladder is expressed in a different way, said Mr Wee.

Will need to learn more about the NANAS method which has been shared by various vets from animal shelters in other parts of the world.

E-mail to judy@toapayohvets.com if you have any feedback to give to me.