Analgesia post neutering in cats - who's doing it?

RE: Analgesia post neutering in cats - who's doing it?

David Mills — Fri, 19 Aug 2016 19:26:52 GMT

Post-op nsaids in cats (esp castrates!) is overkill. Especially if you're using triple (with ket and bupe) or quad combos.

The recommendations are only opinions - and let us consider how many making the recommendations are doing cat spays and castrates every day.

Also, those giving post-op nsaids are you using meloxicam (or other) pre-operatively i.e. pre-emptively or post-operatively once the horse has bolted?

Let us not forget, above all, tissue handling - how many of these post-op nsaiders are hiding deficiencies in speed or technique?

Dangerously close to agreeing with Toddy/Atko here. Long week.

RE: Analgesia post neutering in cats - who's doing it?

Stephen Pointing — Fri, 19 Aug 2016 19:00:23 GMT

Since going over to the use of subcuticular stitches in cat spays I don't think we've had any problems with cats having a go at their stitches. We use the same method of closure for dog castrations. Everything gets a post op injection of meloxicam and occasionally a longer course depending on how the operation went and the nature of the animal (and of the animal's owner!) Some animals seem to be more stoical than others - as is the case for most human beings.

RE: Analgesia post neutering in cats - who's doing it?

Martin Atkinson — Fri, 19 Aug 2016 18:42:43 GMT

[quote user="Richard Carter"] I do view the need for a collar on a neutering as a failure in surgical technique.[/quote]99% don't need one but you only need one to eat its own intestines when its herniated to think it might be a good idea. Some might also consider the need for several days of analgesia following routine surgery is also a failure of surgical technique!

RE: Analgesia post neutering in cats - who's doing it?

Braden Collins — Fri, 19 Aug 2016 04:12:25 GMT

Everything goes home with at least 3 days analgesia, including cat castrates. For cats, we just draw doses of meloxicam oral into syringes and put a little cap on them. Easy and cheap.

I can't justify not giving post-op analgesia to cat castrates. Even if they don't show it, I can't see it not hurting after 24 hours. I also don't think that oral meloxicam will cause a problem in terms of safety - it will be the injection at the time of surgery I imagine if anything causes issues.

I hate the idea of pain relief being an "optional extra". They either need it or they don't. To me, it's that sort of thing that undermines the profession and gives the impression of profiteering.

RE: Analgesia post neutering in cats - who's doing it?

Joyce Whitehead — Thu, 18 Aug 2016 23:04:10 GMT

We dont send most cats home with NSAIDs - they get a pre op shot, and then triple combo, and we rarely have problems, with a tiny percentage using a collar. Dog castrates and bitch spays all go home with a 10ml bottle of metacam and instructed to use them for 5-7 days. Very rarely use collars - in those rare dogs with very sensitive skin/atopy/clipper rash we use pet T shirts, much more comfortable for dog and owner.

RE: Analgesia post neutering in cats - who's doing it?

svn — Thu, 18 Aug 2016 21:12:34 GMT

All our neuters incl cat castrates go home with NSAIDs and a buster collar, and it is included in the price

RE: Analgesia post neutering in cats - who's doing it?

emma o'connor — Thu, 18 Aug 2016 16:03:09 GMT

Dog spay and castrates go home with 10ml bottle of Metacam and are advised to use for 4-5 days, cat spays get a 3ml bottle of cat metacam, and cat castrates just a single injection at the time of surgery. Local anaesthetic is applied at all op sites prior to skin closure and intradermal sutures used. No elizabethan collars to go home with.

RE: Analgesia post neutering in cats - who's doing it?

Anthony Todd — Thu, 18 Aug 2016 15:37:13 GMT

[quote user="Emily Rainbow"]

Our bitch spays and cat spays go home with pet shirts which we hire out for the 10-14d needed.

[/quote]

Why do you need them?

RE: Analgesia post neutering in cats - who's doing it?

Hannah Wynne Richards — Thu, 18 Aug 2016 15:22:41 GMT

I agree with Evelyn and Bob

Wynne

RE: Analgesia post neutering in cats - who's doing it?

Emily Rainbow — Thu, 18 Aug 2016 15:21:07 GMT

Our bitch spays and cat spays go home with pet shirts which we hire out for the 10-14d needed.

RE: Analgesia post neutering in cats - who's doing it?

Bob Russell — Thu, 18 Aug 2016 14:12:14 GMT

Pain relief is not an optional extra. It is either needed (or preferred) or not!

This is a choice our owners do not make, we do!

I prefer owners to have a buster collar in reserve to stick on if there are issues out of hours. Rarely needed in practice though!

RE: Analgesia post neutering in cats - who's doing it?

Evelyn Barbour-Hill — Thu, 18 Aug 2016 13:58:31 GMT

[quote user="Clive Ansell"] offers clients the choice of 3-4 days post op nsaid at extra cost.[/quote]

Of all the different approaches, that's the one I find despicable and unprofessional.

RE: Analgesia post neutering in cats - who's doing it?

Clive Ansell — Thu, 18 Aug 2016 13:52:25 GMT

Some observations as a locum visiting numerous practices:

Most, almost all, practices routine give an opiate within the pre-med and a nsaid at the time of surgery to all routine neuters

None of the practices I've worked in routinely send cats home with follow on nsaid's, and don't appear to have any problems.

About half send dogs home with 3 to 4 days post op nsaid's. Some send the speys home with but not the castrates.

One practice gives no opiate or nsaid analgesia to charity cat neuters, citing costs as the reason (Although I think the nurses give it anyway )

One practice gives peri op analgesia and offers clients the choice of 3-4 days post op nsaid at extra cost.

Personally, I like bitch speys to go home with 5 days nsaid, and cat speys where more invasive than normal. I don't think dog and cat castrates need any beyond 1 injection pre/peri/post op.

RE: Analgesia post neutering in cats - who's doing it?

Anthony Todd — Thu, 18 Aug 2016 13:47:31 GMT

[quote user="Anthony Dennison"]Put them on whilst they're still asleep.[/quote]

Why do people put them on at all?

RE: Analgesia post neutering in cats - who's doing it?

Evelyn Barbour-Hill — Thu, 18 Aug 2016 13:33:54 GMT

[quote user="Anthony Todd"]

Just a question.

How many of you send dog or cat spays or dog or cat castrations home with an Elizabethan collar?

[/quote]

I haven't put a lampshade on a dog for 34 years. Maybe once a year I've put one on a cat after heavy ear surgery. Horrible things.

RE: Analgesia post neutering in cats - who's doing it?

Anthony Dennison — Thu, 18 Aug 2016 13:29:35 GMT

[quote user="Anthony Todd"]Cats and owners hate them. some cats even walk backwards!![/quote]

Put them on whilst they're still asleep. If they wake up with them on they're much more tolerant. Putting them on once awake, especially if they're still a little trippy from the ketamine in the triple combo GA, causes this.

Cats that flip out with collars on are in the minority for me.

RE: Analgesia post neutering in cats - who's doing it?

Anthony Todd — Thu, 18 Aug 2016 13:24:46 GMT

[quote user="Anthony Dennison"]Only cat castrates don't get a collar with us. [/quote]

Cats and owners hate them. some cats even walk backwards!!

They shouldn't ever be necessary in routine surgery; never were back in the day, when the numbers were far greater.

RE: Analgesia post neutering in cats - who's doing it?

Anthony Dennison — Thu, 18 Aug 2016 12:45:49 GMT

[quote user="Seadna "]

[quote user="Anthony Dennison"] split up a larger 15ml bottle [/quote]

Hi Anthony, curious how you go about this? Do you send a syringe and a little bottle home with the cat or three measured syringes?

[/quote]

Little bottle - we have some tiny brown medicine bottles (16ml) that we dispense it into and give a 1ml syringe - 0.1ml/kg of 0.5mg/ml Loxicom Cat.

[quote user="Richard Carter"][quote user="Anthony Todd"]How many of you send dog or cat spays or dog or cat castrations home with an Elizabethan collar?[/quote] I do view the need for a collar on a neutering as a failure in surgical technique. If the dog or cat is itching or painful, either the sutures are too tight, or someone has closed with s/c with inappropriate material (monocryl feels like foreign material with sharp edges even when using the finest gauge) or the clipping has been too vigorous and the skin been damaged or the wound and prep area have been overcleaned (scrubbed) with reaction or there has been some soap left on after the op.[/quote]

Only cat castrates don't get a collar with us. I would rather send the animal home with one and the owner take it off after a few days if not needed than risk potential post-op complications. It's incorporated in to the cost of the neutering.

RE: Analgesia post neutering in cats - who's doing it?

Richard Carter — Thu, 18 Aug 2016 12:09:08 GMT

[quote user="Anthony Todd"]How many of you send dog or cat spays or dog or cat castrations home with an Elizabethan collar?[/quote] I do view the need for a collar on a neutering as a failure in surgical technique. If the dog or cat is itching or painful, either the sutures are too tight, or someone has closed with s/c with inappropriate material (monocryl feels like foreign material with sharp edges even when using the finest gauge) or the clipping has been too vigorous and the skin been damaged or the wound and prep area have been overcleaned (scrubbed) with reaction or there has been some soap left on after the op.

we do use marcain intra-op on skin incision which may help and if there is any inflammation of prep site, isaderm before they go home.

RE: Analgesia post neutering in cats - who's doing it?

Richard Carter — Thu, 18 Aug 2016 11:39:34 GMT

surprised there is this campaign after the IFSM article agreeing that the triple with ketamine and medotomidine actually gave quite acceptable pain relief.

RE: Analgesia post neutering in cats - who's doing it?

Anthony Todd — Thu, 18 Aug 2016 11:37:40 GMT

Just a question.

How many of you send dog or cat spays or dog or cat castrations home with an Elizabethan collar?

RE: Analgesia post neutering in cats - who's doing it?

Bob Russell — Thu, 18 Aug 2016 10:44:55 GMT

Ours generally get three days meloxicam. We use a bulk bottle and dispense doses into the appropriate dosing syringe.

Dogs and cats except cat castrates. they make do with preop opiates and post op meloxicam. Yet to see my first complication in a post op cat! Today will probably be my first!

RE: Analgesia post neutering in cats - who's doing it?

Martin Atkinson — Thu, 18 Aug 2016 10:42:56 GMT

[quote user="Emily Rainbow"]

Our bitch spays, dog castrates and cat spays go home with a course of metacam and more if necc.

Our cat castrates get peri-op analgesia only.

[/quote]Pretty well much my approach only they rarely get a course of NSAIDs I generally find one post operative shot is enough. I am anyway very wary of giving cats courses of NSAIDs, I've seen too many complications.

RE: Analgesia post neutering in cats - who's doing it?

Seadna — Thu, 18 Aug 2016 10:28:22 GMT

[quote user="Anthony Dennison"] split up a larger 15ml bottle [/quote]

Hi Anthony, curious how you go about this? Do you send a syringe and a little bottle home with the cat or three measured syringes?

RE: Analgesia post neutering in cats - who's doing it?

Anthony Dennison — Thu, 18 Aug 2016 09:55:55 GMT

Cat spays get 3 days of meloxicam to go home with. We split up a larger 15ml bottle into individual doses to keep costs down. It's something we started about 18 months ago, and have possible seen a slight reduction in post-op interference.

Bitch spays/Dog Castrates get a 10ml bottle of meloxicam to go home with. Dog's trust neuters get 3 days of carprofen.