Category Archives: spay neuter

Cornell’s Shelter Medicine Program provides spay/neuter services to community cats of CU employees & students

 

The dedication and care you give to the feral/barn cats of the Cornell community is absolutely outstanding. I truly value your work and dedication to the care of our cat colonies. The free spay/neuter service means the world to me and my cats. Thank you again.      

-Client, CornellVetCARES Community Cat Spay/Neuter Clinic

In April 2019, Maddie’s® Shelter Medicine Program (MSMP) at Cornell began to provide subsidized spay/neuter clinics for outdoor & community cats of Cornell faculty, staff, and students through our CornellVetCARES (CVC) Community Cat Spay/Neuter Clinics . These monthly clinics were made possible through a grant by Dr. Hollis Erb, Emeritus Professor of Epidemiology. Since then, MSMP faculty and staff have organized and executed 12 spay/neuter clinics for community cats at Cornell’s Small Animal Community Practice Building located on Cornell’s Ithaca campus.

204 cats have been served by our clinics thus far. “I love it – The people that run the clinic were friendly. Informative, and very helpful. Thanks so much! I’m excited for NO MORE KITTENS – love them but don’t want any more!”, said one of our clients. Along with spay/neuter, we also provide routine vaccinations, ear mite and flea & tick checks and treatments (as necessary), and the option for ear tipping for feral and community cats.

Several Cornell veterinary students have also gained hands-on clinic experience while participating in these clinics, either as volunteers or while on Shelter Medicine Clinical Rotation with MSMP:

During the clinic, I helped facilitate the flow of cats through the clinic, from intake to anesthesia, and during surgery to discharge. I was also able to perform some surgeries (both spays and neuters).  I think it was great that people really wanted to bring us these cats to have them spayed or neutered. They were very appreciative of the services. The supervising veterinarians were great! I liked working with a great team of other students and vets, and I enjoyed getting to practice my surgical skills.

Lauren Alyssa Johnson (DVM ’20)

This was my first high-volume spay/neuter experience. I helped in recovery and made sure all cats safely recovered from anesthesia and received preventives and vaccines as necessary…. I learned that when recovering feral cats, it’s important to put them in their carrier early in recovery because they can become aggressive quickly and wake up very rapidly.

-Victoria Robertson (DVM ’20)

Clinics scheduled in March and April of 2020 were cancelled due to COVID-19. Clinics resumed in June and July 2020 with COVID-related guidelines and procedures in place. We just completed our 12 CornellVetCARES Community Clinic on August 21st, with 2 more clinics scheduled in September, October of 2020. We plan on offering similar clinics again next year under a new grant from the Feline Health Center.

All three of the cats I brought in are doing great. I truly appreciate this “gift” as I have exhausted my own ability to finance the spay/neuter of these community cats.

-Client, CVC Community Cat Spay/Neuter Clinics

Click here to learn more about our CornellVetCARES Community Cat Spay/Neuter Clinics.

#ThanksToMaddie

Modeling of Effect of PAUSE on TNR Programs: An ACC&D Video Report

As a result of the COVID-19 pandemic, many organizations who engage in feral, community and shelter cat spay-neuter programs halted their surgical operations. In late February and early March, the unknown virus levels and spread in our community, the scarcity of surgical supplies and PPE, and the fear of feline SARS-CoV-2 infections caused uncertainty about continuing with normal operations. Many organizations agonized over this choice and worried that years of hard fought spay-neuter progress would unravel. So, did it?

Although the empirical data is not yet in, epidemiological modelers working with the Alliance for Contraception for Cats and Dogs (ACC&D) have created a short video report about using their supercomputing skills to try and answer that question. Epidemiological models take selected elements of an ecosystem and try to predict what will happen when conditions are manipulated. You may recognize one of these models as the viral pandemic “infection curve,” steep when people gather as usual, and flatter when citizens wear masks, wash hands, and physically distance. The same sort of graph can be used to describe the effects on a cat population when a spay-neuter program is enacted.

What the ACC&D modelers illustrated was this: High intensity targeted TNR programs — defined as 75% sterilization of a cat population with re-captures every 6 months — maintain the cat population level at about 50-60% of their pre-program population after a few years. If the year-long pause is in year 2 or later of the TNR program, the cat population does not grow much at all (~5%). All growth is from emigration, abandonment, or one or two un-captured females having litters. And it takes only one subsequent year to bring the population back down to pre-pause levels.

Lower intensity TNR programs — defined as sterilizing only 25% of one cat population with recaptures every 6 months — generally maintain the cat population level at about 70-80% of their pre-program population after a few years. A year-long pause in these programs adds more cats (~10%,) because more of the population is fertile, but emigration and abandonment can also play a part. Because of the lower intensity of trapping, it takes a couple more years to catch up. The good news is that increasing the intensity of trapping easily makes up for that lost time, and doesn’t cost any more in the long term.

These models are heartening theoretical evidence that pausing to catch our breath and gather information about COVID for a few months will not erode our years of spay-neuter work. They also illustrate the importance of intensive targeting for TNR programs if population reduction is the main goal; the greater the proportion of a population we can sterilize and maintain, the more lasting and effective that intervention will be in the long run.

 

ASPCA Cornell Maddie’s Shelter Medicine Conference to be held online in 2020

 

July 11-12, 2020 | All Online | Tuition Waived!

To bring you the critical, timely information you need in a safe way, this year’s conference will take place virtually from July 11-12, 2020, and registration fees will be waived. Featuring twelve free workshops in two tracks—medical and operations—the 2020 ASPCA® Cornell Maddie’s® Shelter Medicine Conference is a unique educational opportunity for veterinarians and other animal welfare professionals to learn from our field of highly regarded speakers. Both RACE and CAWA CE approval is pending. Click here to learn more and register.

Highlights of this year’s conference include:

  • A high-quality, high-volume spay/neuter (HQHVSN) panel discussion featuring Drs Phil Bushby, Emily McCobb, Leslie Appel, and Karla Brestle
  • Epidemiological modeling of COVID-19 from Dr. Rachel Kreisler
  • Access to basic veterinary care and the impacts of COVID-19 from Dr. Brittany Watson
  • A panel discussion on COVID-19 response and what tactics to keep

Download agenda

And there are more benefits to attending, too:

  • Quick, easy, and free registration
  • An entirely virtual format, allowing more team members to attend from the comfort of their own homes—no stressful, long travel required!
  • The opportunity to learn from experts in their fields
  • Critical workshops geared towards COVID-19 response
  • Continuing education credits*

Register now!

#ThanksToMaddie

FAQ: How can I support my spay/neuter program when we aren’t doing surgery?

Great question! Now is the perfect time to work on all of the activities your practice or shelter always thought would be nice but you didn’t have time for. A well-attended webinar entitled “Flattening the kitten curve while spay/neuter is on hold” and hosted by Maddie’s Fund on 4/15/20 addressed this very question, and gave five ways that shelters, community cat programs and spay/neuter clinics can hit the ground running when restrictions are relaxed.

  1. Funding and support

Just because you aren’t currently operating doesn’t mean you can’t ask for monetary or material resources from your community, your donors, and granting organizations. Engage your community through social media outreach, virtual fund-raising events, spay-neuter pledges, and “kitten showers.” Reach out to your bigger donors, thank them, and see how they’re coping. Grants from many sheltering support organizations are available to help with COVID-related tasks- these applications can be easily written from home. Engage with your current network of foster parents and recruit more. Beef up your amazon wish list.  Hannah Shaw, the “Kitten Lady,” recommends social media posts that explain the seriousness of the current situation, explain the impact of people’s help, contain a message of hope, and end with a call to action.

  1. Helping neighborhood cats

During this down time, in addition to fundraising mentioned above, community cat programs can reach out to spay/neuter clinics and shelter spay/neuter programs, solidifying older relationships and seeking new ones. From the public, solicit donations of food to support colony caretakers, engage in practical physical improvements for cat colonies such as tidying the colony area, recruit groups like scouts or school kids to build attractive hide boxes, and take a colony census. For shelters and spay/neuter clinics, reaching out to your area community cat programs and making plans for what a return to surgery will look like can help everyone feel engaged and less anxious. Some colony managers have asked about the use of contraceptives until surgery can be performed; please see below for resources. Finally, for shelters and community cat programs, creating a GIS or mapping system to track all of the reports of found kittens can significantly increase the impact of TNR in your community, because it will allow you to target the most prolific locations later.

  1. Staff training

Training your intake, dispatch, ACO and adoptions staff in best practices for intake diversion can significantly slow the surge of kittens into your shelter. The first lessons should be on how to help the public avoid kitten-napping when they stumble upon healthy kittens in their community. Education about the move to essential ACO services, including no longer picking up healthy stray animals is also essential. Diversion cannot stop at simply saying “no” to concerned finders; resources must also be offered. These could include adding animals to lost reports, posting animals on social media for the finder, printing posters, driving by and scanning pets for microchips, aging and checking on kittens, and even returning healthy kittens to their feral moms. Other important shelter training sessions right now should include foster care support- with so many animals in foster, more than one person will be needed to coordinate. Finally, remote adoptions training for adoption staff and foster parents is great, so animals don’t need to come back into the shelter to leave your care.

  1. Supplies

ACO vehicles, cat cages, restraint equipment, and cat traps all require maintenance and upkeep. With the volume of animals in many animal shelters low, now is the perfect time to vacuum out and completely disinfect the trucks, install portals into too-small cat cages, oil and clean restraint equipment, and weigh, label, and inventory all of your feral cat traps. If you are anticipating increasing the volume of trapping once surgery gets the go-ahead, now is also a good time to order more traps; Tomahawk has a 10% discount code (MCC2020) good for the rest of the year. This is also a great request for public donors who like to sponsor material objects.

  1. Kittens

For truly orphaned, sick, or injured kittens, encouraging finders to become foster parents has been extremely successful for many shelters. The shelter should provide virtual training to the new foster through on-line videos and foster program counseling, as well as the milk, food, litter, and medical care that these kittens may require. Finding a tiny helpless creature is a powerful motivator to provide care; many of these new fosters will also be willing to foster again in the future. Second, even though most shelters aren’t performing surgery right now, kittens should still be placed for adoption around 8 weeks of age. Vouchers for neutering should be given to the new owners, and care should be taken to place only same-sex pairs when adopting two at a time. Neutering male cats before adoption is also provisionally allowed at this time

Although we don’t know exactly what a future return to surgical capacity will look like, this pause in operations will not last forever. Some locations will likely start sooner than others; some may have to pause again if new waves of COVID-19 strike. This uncertainty is anxiety-provoking but doesn’t mean we can’t continue to communicate, make connections, and make plans. Your spay/neuter service is a great cause and your community wants to help you; now is a great time to show them how.

Resources:

Maddie’s Fund Webinar: https://zoom.us/webinar/register/WN_vHqz1kswQKWdnGkl455_hg?fbclid=IwAR1AwoOZCUM0CSfA52fCrKvSJiwlasaHD4QHLYnwDsvPUqQS646E2RRbyy8

Megestrol Acetate FAQ from Cornell Shelter Medicine:

https://blogs.cornell.edu/cornellsheltermedicine/2020/04/16/faq-should-we-be-using-birth-control-for-cats-now-that-we-cant-spay-them/

Kitten Lady’s kitten care webinars: https://www.kittenlady.org/webinar

FAQ: Should we be using birth control for cats now that we can’t spay them?

Image of stray cats from petdoctorvet.com.au
Image from PetDoctorVet.com.au

You may have heard some shelter medicine experts and the Alliance for Contraception in Cats and Dogs (ACC&D) promoting the use of a birth control medication called megestrol acetate (MA) to slow the tide of the kitten flood sure to come this spring if we can’t spay outdoor cats.

Quick answer:

  • Low doses have been used with success to temporarily suppress estrus in community cat colonies,  but little scientific evidence exists for efficacy and safety
  • Side effects could be an issue, so consultation with a veterinarian is required before prescribing, and care should be taken when handling the medication and dosing it to cats
  • The medication for cat doses is only available through a compounding pharmacy and it is not FDA approved in cats
  • If other litter prevention techniques won’t work for you (separating males and females, for instance), do your homework first, then share your data with ACC&D

The nitty gritty:

MA is a potent synthetic progestin hormone that has actually been used for many years in many species. Two early studies on its effects in cats were published in 1977. Unfortunately, there hasn’t been much in the way of actual controlled clinical research on this medication since then. At the high doses originally studied (0.5mg/kg daily), many serious side effects were reported. These included pyometra, mammary cancers and mammary enlargement (males and females), diabetes (maybe reversible), adrenal gland dysfunction (maybe reversible), uterine disease (reversible), and finally, birth defects, dystocia and failure to produce milk in pregnant cats. MA can also be dangerous to the people administering it, since it can be absorbed through the skin, so gloves must be worn by people handling and administering this medication.

More recently, some veterinarians and community cat caretakers have advocated for using low doses of MA, anywhere from 0.625mg/kg weekly to 0.1-0.2mg/kg weekly as a stop-gap before spay/neuter in community cat management. We have some evidence of side effects for use at intermediate doses, because MA is used in other countries to treat other feline endocrine conditions (MA attaches to glucocorticoid receptors just like prednisone), and mammary enlargement and adrenal dysfunction are still problematic. In Europe, an antidote medication is available if these effects are seen- but this isn’t available in the US. Anecdotal reports of using extra low doses in colonies of feral cats report fewer side effects and fewer kittens, but there is limited to no scientific research data on efficacy or safety at those doses to guide us.

MA should not be used in male cats or in pregnant cats for the reasons mentioned above, kittens under 4 months old due endometrial disease, or cats with other endocrine disorders. MA does not prevent lactation in queens already nursing, but we don’t know about its concentration in milk. So that leaves us with healthy, non-pregnant, >5-month-old female cats. In order to confirm whether use is appropriate, Romagnoli et al in 2015 recommended the following: detailed history, clinical exam, abdominal and mammary palpation, and a vaginal swab with cytology. A quick abdominal ultrasound would also be ideal.

So should shelter veterinarians be using this medication? Here are the risk factors we would like you to consider.

  • Is the cat likely to become pregnant?
  • Can you not mitigate the risk some other way?
  • Remove all males from household, don’t allow cat out, rehome or re-foster, etc
  • Have you already examined the cat and/or would examining the cat be possible without compromising owner, staff or foster parent social distancing?
  • In some cases, for example, an outdoor cat for whom pregnancy is extremely likely, a telehealth prescription might be appropriate, depending on VPCR requirements in your state.
  • Can the cat be safely medicated (in food, liquid in syringe, or capsule) by an informed and prepared caretaker (wearing gloves)?
  • Do you have a plan in place for side effect management?
    • Some of these side effects, even at very low doses, can be fatal.
  • Is the shelter management and/or pet owner okay with using an experimental drug not approved by the FDA for this particular species/usage?
  • Are you willing to collect data about dosing/side effects/success for the good of science?

If the answer to all of the questions above is YES, then a trial run of low-dose MA may be right for this cat. To procure the drug, you will need to call your local compounding pharmacy, (Dr. Julie Levy recommends 0.625mg/kg weekly, so 2.5mg/ml liquid) and order MA either as “office stock” to your shelter if owned by the shelter, or as an individual prescription that can be shipped directly to the owner. The 20mg FDA approved canine MA tablet (OvaBan™) does not dissolve in liquid and should not be used to self-compound. For in heat cats, double your dose and give daily for 3 days before switching to a weekly schedule. Not recommended for treating longer than 30 weeks.

Finally, if you do decide to test this medication out for a few months, please share the results of your treatment trial. Contact the ACC&D to let them know how things are going.

Resources:

  1. Houdeshell, JW, Hennessey, PW. Megestrol acetate for control of estrus in the cat. Vet Med Small Anim Clin 1977; 72: 1013–1017
  2. Oen, EO. The oral administration of megestrol acetate to postpone oestrus in cats.
  3. Nordisk veterinaermedicin 1977: 29 (6)
  4. Romagnoli S. Progestins to control feline reproduction: Historical abuse of high doses and potentially safe use of low doses. J Feline Med Surg. 2015;17(9):743-752. doi:10.1177/1098612X15594987
  5. Greenberg, M., D. Lawler, S. Zawistowski, and W. Jochle. “Low-dose megestrol acetate revisited: A viable adjunct to surgical sterilization in free roaming cats?” Veterinary Journal (2013) 196:304-308
  6. Alliance for Contraception in Cats and Dogs COVID-19 response page: https://acc-d.org/available-products/progestin-contraceptives/covid-19-updates
  7. Levy/Greenberg Webinar: https://alliance-for-contraception-in-cats–dogs.mailchimpsites.com/