Prepubertal gonadectomy in cats: different injectable anaesthetic combinations and comparison with gonadectomy at traditional age

Randomised, prospective, blinded, clinical trial of opioid-free injectable anaesthesia with or without multimodal analgesia in kittens undergoing ovariohysterectomy

OBJECTIVES

This study compared an opioid-free injectable anaesthetic protocol with or without multimodal analgesia in kittens undergoing ovariohysterectomy.

METHODS

In this prospective, randomised, blinded, clinical trial, 29 healthy kittens (mean ± SD weight 1.55 ± 0.46 kg; aged 10 weeks to 6 months) were included. Anaesthesia was performed with an intramuscular injection of ketamine (4 mg/kg), dexmedetomidine (40 μg/kg) and midazolam (0.25 mg/kg). In the multimodal group (MMG), cats (n = 14) received meloxicam (0.1 mg/kg SC) and intraperitoneal bupivacaine 0.25% (2 mg/kg), whereas the same volume of saline was administered in the control group (CG; n = 15). Atipamezole (0.4 mg/kg IM) was given 15 mins after ovariohysterectomy. Postoperative pain was assessed using the UNESP-Botucatu multidimensional feline pain assessment scale - short form. Rescue analgesia (buprenorphine 0.02 mg/kg IM in MMG/CG and meloxicam 0.1 mg/kg SC in CG) was administered if pain scores were ⩾4/12. Soft food intake (after 2 and 60 mins) was evaluated at specific time points postoperatively. Statistical analyses were performed with linear models and post-hoc pairwise comparison with Benjamini-Hochberg corrections (P <0.05).

RESULTS

The prevalence of rescue analgesia was higher in the CG (n = 15/15) than the MMG (n = 1/14; P <0.001). Pain scores at 1 h, 2 h and 4 h postoperatively were higher in the CG (4.1 ± 2.8, 4.8 ± 3.0 and 5.3 ± 1.2, respectively) than in the MMG (1.6 ± 1.0, 1.1 ± 1.0 and 0.9 ± 0.8, respectively; P <0.001). Food intake (%) at 1 h postoperatively was higher in the MMG after 2 and 60 mins (10.4 ± 9 and 71.9 ± 29, respectively) than in the CG (1.4 ± 2 and 13.9 ± 7, respectively; P <0.001).

CONCLUSIONS AND RELEVANCE

This opioid-free protocol using multimodal analgesia produced adequate postoperative pain relief, while almost eliminating the need for rescue analgesia in kittens undergoing ovariohysterectomy. Pain decreased food intake.

Intensive Adoption as a Management Strategy for Unowned, Urban Cats: A Case Study of 25 Years of Trap-Assess-Resolve (TAR) in Auckland, New Zealand

Globally, unowned urban cats are a major concern because they may suffer from poor welfare and cause problems, including public health risks, nuisances, and urban wildlife predation. While management options are often presented as a choice between culling or trap−neuter−return (TNR), for 25 years, the Lonely Miaow (Inc.) charity in Auckland, New Zealand (hereafter LM), has used a third strategy—intensive adoption or trap−assess−resolve (TAR). As of 2019, of 14,611 unowned cats trapped, 64.2% were adopted, 22.2% were euthanized if unsocialised or in grave ill-health, 5.7% were neutered and returned to the site, and 7.9% had other outcomes, such as being transferred to other shelters. Adoption rates increased over this time, exceeding 80.0% in 2018 and 2019. The cost of processing each cat from capture to adoption rose from NZD 58 in 1999 to NZD 234 by 2017. Approximately 80% of colonies (sites where cats were trapped) were around residential areas. Approximately 22% of cats required veterinary treatment after capture; common ailments included respiratory infections, ringworm, dental problems, and trauma. Consistently, 52% of cats were young kittens (<10 weeks old), c. 80% of cats were <1 year old, and only c. 2% were estimated to be >5 years old. TAR avoids euthanasia where possible. Its effectiveness would be enhanced by fewer abandonments of owned cats and kittens, fitting within integrated strategies for the control of unowned cats involving community education. Cat adoptions improve the welfare of cats and, with appropriate husbandry, should alleviate concerns about nuisances, public health, and attacks on wildlife or the cats themselves, essentially benefitting the community and the cats. This case study is relevant to other cities around the world that are seeking to manage unowned cats.

A shift towards early-age desexing of cats under veterinary care in Australia

The global problem of unowned domestic cats, driven by their phenomenal reproductive success, carries significant economic, animal welfare and biodiversity costs. Desexing owned cats prior to puberty prevents unwanted litters that contribute to unowned cat populations. The prevalence and predictors of desexing, and the age at which surgery was carried out were investigated using anonymized electronic patient records in the VetCompass Australia database of cats presented to veterinary practices. Of 52,941 cats born between 2010 and 2017, 83.6% were desexed. Among 7463 desexed females, 21.5% had been desexed by 4 months of age, 59.8% by 6 months and 85.4% by 1 year. Sex, breed, location and socioeconomic indices significantly influenced desexing status and age at surgery. Cats born between 2010 and 2017 had greater odds of being desexed than cats born between 1995and 2009 at each age cut-off (≤ 4 months [OR 1.76, CI₉₅ 1.58-1.97], ≤ 6 months [OR 1.50, CI₉₅ 1.38-1.62] and ≤ 1 year [OR 2.33, CI₉₅ 2.11-2.57] p < 0.001). Most cats presented to veterinarians in Australia are desexed. Compared with cats born before 2010, cats born later are significantly younger at desexing but, even so, many cats would have reached sexual maturity before surgery. These findings will inform the design of front-line strategies promoting prepubertal desexing and they demonstrate, for the first time, a shift towards desexing younger cats.

Contrasting practices and opinions of UK-based veterinary surgeons around neutering cats at four months old

BACKGROUND

Many cats in the UK are not neutered before reaching potential breeding age. The purpose of this investigation was to understand the prevalence of veterinarians' behaviours around neutering cats at four months of age and to identify any needs of the veterinary profession on this.

METHODS

A sample of 483 veterinarians that completed a cross-sectional online questionnaire were included in quantitative and qualitative analyses.

RESULTS

Almost 70 per cent of veterinarians indicated they were comfortable carrying out neutering on cats of four months of age, and approximately half of veterinarians indicated they would recommend neutering client-owned cats at four months of age if practice policy permitted. There was no association found between these practices and geographic risk factors. Instead, neutering at four months was associated with the gender of the veterinarian, their practice policy and whether they routinely neuter unowned cats. Veterinarians have contrasting beliefs on similar themes, depending on whether they neuter kittens at four months or not, including differing opinions on general anaesthetic, surgery risks, owner compliance and their perceptions of neutering practices within the wider profession.

CONCLUSION

Familiarity and experience with the procedure, alongside perceived norms, are central to beliefs. We also highlight informational and learning barriers.

French veterinarians' opinions and practices regarding early neutering of cats: a convenience sampling survey interpreted in an international context

BACKGROUND

Although data are still needed, early neutering of cats appears to be as safe as neutering at the traditional age of six months or older and beneficial to the individual and the population. The aim of this observational study was to obtain an overview of veterinarians' opinions and practices about feline early neutering (ie, until the age of four months).

METHODS

In this retrospective work, a web survey was distributed to French practitioners.

RESULTS

A total of 609 veterinarians returned the survey. Majority of the veterinarians (56 per cent) reported never performing early neutering, 42 per cent reported performing it inconsistently, and 2 per cent reported consistently performing it. When carried out, it was mainly on kittens from commercial breeding, following breeders' request, and performed at the age of three months. An overwhelming majority (93 per cent) of veterinarians performing early neutering reported no incidents. Veterinarians who did not practise early neutering neutered mostly (81 per cent) kittens from four to six months of age.

CONCLUSION

In conclusion, early neutering is still not a common practice among French veterinarians. Opinions differed as to its advantages and disadvantages, although reported incidents were scarce. Veterinarians who do not perform early neutering reported a lack of interest in this practice rather than reluctance.

A retrospective internet-based survey of French cat breeders about early-age neutering

OBJECTIVES

The aim of this study was to analyse cat breeders' application of and opinions concerning early-age (ie, <16 weeks old) neutering in cats in France.

METHODS

This study analysed a retrospective cohort. A web survey was designed for French cat breeders and was published in June 2017 on the Facebook page of Livre Officiel des Origines Félines, the official feline studbook for purebred cats born in France. The early-age cat neutering habits, opinions and expectations of breeders were collected.

RESULTS

A total of 999 breeders returned the questionnaire. Almost half of the breeders (49%) reported consistently requesting neutering of kittens before selling them, 32% claimed that they never requested it and the remaining 19% reported that they inconsistently requested it. When performed, 83% of breeders had kittens neutered at 12 weeks of age; for a large majority of these breeders (94%), the neutering was undertaken on their own initiative. Various reasons for neutering were provided, including the prevention of uncontrolled breeding, short- and long-term welfare benefits for neutered cats, and practical and economic reasons. Reported incidents related to early-age neutering were scarce. Nearly half of breeders who did not apply early-age neutering to their kittens cited a veterinarian's unwillingness to perform the surgery as a cause.

CONCLUSIONS AND RELEVANCE

A large majority of surveyed French cat breeders supported early-age neutering that would occur before kittens were sold, most of the time at the age of 3 months. These breeders reported high satisfaction with early-age neutered cats, with a low number of incidents and accidents reported.

Use of nalbuphine as a substitute for butorphanol in combination with dexmedetomidine and tiletamine/zolazepam: a randomized non-inferiority trial

OBJECTIVES

The goal of this study was to determine whether a drug combination using nalbuphine with dexmedetomidine and tiletamine/zolazepam is non-inferior to one that uses butorphanol.

METHODS

All healthy cats presenting solely for gonadectomy to two trap-neuter-return mobile clinic days were randomly assigned to induction with a combination of tiletamine/zolazepam 3 mg/kg, dexmedetomidine 7.5 µg/kg and either butorphanol or nalbuphine at 0.15 mg/kg. All participants were blinded to the identity of the combinations. The primary endpoint was clinician satisfaction, comprised of the mean of four satisfaction ratings on a 7-point Likert scale (highly dissatisfied through to highly satisfied) recorded for induction, maintenance of anesthesia, surgery and recovery. Exploratory endpoints included each individual score, number of injections, duration of induction, duration of recovery and need for reversal agent. To assess non-inferiority for the primary endpoint and individual scores, the difference and 95% confidence intervals (CIs) of the difference between the mean clinical scores for the nalbuphine and butorphanol-based combinations were calculated and compared with a prespecified non-inferiority margin of 20% (1.4 points).

RESULTS

Seventy-two cats were enrolled, 36 in each group. The mean ± SD composite score for the combination with nalbuphine was 6.06 ± 0.59 (95% CI 5.86-6.25) points, while the combination with butorphanol was 6.22 ± 0.62 (95% CI 6.01-6.43). The difference between mean scores was 0.17 (-0.12 to 0.45), which did not exceed the prespecified boundary of 1.4, establishing the non-inferiority of nalbuphine. No individual clinical score for nalbuphine was inferior to butorphanol, and there were no significant differences for any secondary endpoints.

CONCLUSIONS AND RELEVANCE

The clinical experience of the nalbuphine-based combination was non-inferior to the butorphanol-based combination. Nalbuphine is an effective substitute for butorphanol, providing another option if butorphanol is unavailable due to shortage, controlled status or cost, without requiring a change in anesthetic workflow.

Attitudes and Practices of Australian Veterinary Professionals and Students towards Early Age Desexing of Cats

Simple Summary

Globally, desexing is used to reduce/prevent overpopulation of cats. However, its effective use is hampered by widely held views that it should occur at around six months of age, whereas female cats can breed from four months of age. As a result, many cats may have an unplanned litter before they are desexed. In Australia, increasing numbers of municipalities are mandating desexing of cats by three months of age, before the traditional age of 4–6 months. Achieving this goal requires support from veterinary professionals, so we used online and face-to-face surveys to determine the preferred desexing ages for cats and rationale of 957 Australian veterinarians, veterinary nurses, veterinary science students, and veterinary nursing students. A complementary survey of 299 veterinary practice websites across Australia documented information provided about desexing cats. Vet nurses and nursing students were more conservative than vets or vet students, preferring to desex cats (especially females) after four months because of concerns about anaesthetic risk. Over half of surveyed websites provided no information about desexing cats or offered desexing without explaining why it was necessary or when to perform it. In Australia, the preferences and practices of some current/future veterinary professionals do not match changing cat legislation.

Abstract

Surgical desexing of cats is typically carried out after six months of age (Mature Age Desexing, MAD); between 4–6 months (Traditional Age Desexing, TAD); or before four months (Early Age Desexing, EAD). We complemented existing surveys of veterinarians’ acceptance of EAD with online and face-to-face surveys, to ascertain the preferred desexing ages for cats and rationale of 957 Australian veterinarians, veterinary nurses, veterinary science students, and veterinary nursing students. A complementary survey of 299 veterinary practice websites across Australia documented any information provided about desexing cats. The most common reason for preferred desexing ages was reducing stray cat populations (30%); 78% of these respondents chose ages aligning with EAD. Vet nurses and nursing students were more conservative than vets or vet students, preferring to desex cats >4 months. Perceived anaesthetic risk was a major motivation, especially for nurses ≤5 years’ experience. Across 299 urban practices in Australian capital cities, 55% of surveyed websites provided no information about desexing cats or listed desexing without explaining why it was necessary, or when to perform it. Increasingly, Australian legislatures mandate desexing of cats by three months of age, so the practices of some current/future veterinary professionals do not match changing legislation.

Effect of non-steroidal anti-inflammatory drugs on postoperative respiratory and heart rate in cats subjected to ovariohysterectomy

Objectives The use of physiological parameters such as respiratory rate and heart rate to assess pain has long been discussed. The aim of the study was to compare postoperative respiratory rate and heart rate in cats subjected to flank ovariohysterectomy treated with a preoperative non-steroidal anti-inflammatory drug (NSAID) or no NSAID, and determine whether these parameters are suitable for postoperative pain assessment in cats. We hypothesised that cats without an NSAID would experience more postoperative pain, which may increase heart rate and respiratory rate. Methods A total of 168 female privately owned cats were studied. All cats were premedicated with medetomidine (0.08 mg/kg) and butorphanol (0.4 mg/kg) subcutaneously and anaesthesia was induced with intramuscular ketamine (5 mg/kg). Cats were divided into subgroups; controls (no NSAID) or cats given an NSAID, carprofen (4 mg/kg) or meloxicam (0.3 mg/kg), at premedication or induction of anaesthesia. Cats were subjected to flank ovariohysterectomy by the same surgeon. Atipamezole was administered 2.5 h after induction of anaesthesia. Respiratory rate and heart rate were measured 3.5 h after the induction of anaesthesia. Data were analysed using one-way ANOVA with mixed procedure and Tukey's adjustment method for multiplicity. Results The postoperative respiratory rate and heart rate per minute for all cats were 34.0 ± 8.6 and 167.5 ± 27.4, respectively. Neither respiratory rate nor heart rate differed significantly between the control group and the NSAID groups or between different time points of administration of NSAIDs. Conclusion and relevance Assuming there was less postoperative pain in the group administered NSAIDs, the results of the study presented no support for use of respiratory rate and heart rate as parameters for postoperative pain assessment in individual cats. Study limitations included a lack of pain scoring and baseline data for respiratory rate and heart rate.

Relationship between age at gonadectomy and health problems in kittens adopted from shelters

Prepubertal gonadectomy (PPG) is promoted as a way of managing overpopulation in cats, but concerns about PPG and potential health issues still exist. The objective of the present study was to evaluate short-term and long-term health problems in cats subjected to PPG in comparison to gonadectomy at traditional age (TAG). In a prospective clinical trial, 800 shelter kittens aged between approximately 8 weeks and 12 weeks were recruited before adoption and randomly assigned to either the PPG group (gonadectomy performed immediately) or the TAG group (gonadectomy delayed until six months to eight months of age). Short-term health issues included mortality between when kittens arrived at the clinic and up to seven days after they returned to the shelter, as well as the occurrence of various other health issues arising in the first month following adoption. Kittens were followed-up until 24 months of age specifically for feline lower urinary tract disease, urethral obstruction (male cats), lameness, fractures and hypersensitivity disorders with dermatological presentation. In the short term, there were no significant differences between health problems in PPG and TAG kittens. Similarly, no significant differences were observed between treatment groups in terms of the type or number of health issues in the long term. In conclusion, there are no health-related contraindications to advocating PPG strategies in shelter cats. Ideally, PPG should be performed at the shelter facility itself as long as excellent infectious disease control and postoperative clinical observation before adoption are guaranteed.