Thursday, December 12, 2013

1259. Videos: SOP for pregnant cat.


Extra care is needed in operating a heavily pregnant cat. The ovarian and uterine blood vessels are much enlarged and if not properly ligated, there will be lots of bleeding in the surgical area and a possible bleeding to death post-op. A pre-op examination to ensure that the heavily pregnant cat is fit for surgery should be part of the SOP. This was done by me (Dr Sing Kong Yuen). Blood test was not taken owing to financial considerations. The dilemma is whether the heavily pregnant cat should be spayed or should she give birth first. it is extremely difficult to find new homes for the kittens and so spaying was the decision of the owner. The other concern of the owner was whether to starve the cat for 24 hours before surgery.

The cat had eaten 6 hours ago but there is no vomiting with the xylazine + ketamine IM sedation in my experience. No vomiting was present in this case. 

I advise the use of the 3-forceps method to clamp and ligate the uterine body with its engorged uterine blood vessels. The lowest 3rd forceps is clamped and then released, showing a grooved line caused by clamping. Ligate this groove and the ligature will not slip off as compared to ligation of the non-grooved smooth uterine body area. In this way, there is a guarantee of no haemorrhage. The uterine body is then incised between forceps 1 and 2, leaving a good area for the ligated stump to be released into the body.

This spay was done by Dr Daniel Sing using absorbable sutures.  Xyalzine 0.15 ml + ketamine 0.6 ml combined IM was given in this 3.6 kg cat. Isoflurane + oxygen gas top up was needed. There was no bleeding in this spay as the ligatures were properly placed and tight.  The cat was operated in the afternoon and went home in the evening.

A handing over inspection with the owner should be part of the SOP so that the owner can see that the skin stitches are properly tied. At that time, post-op instructions are given preferably by the vet to build good client relationships. Follow up 2 days later is advised by me but most vets do not bother. As at 7 days post-op, the cat is normal and the stitches should be taken out 14 days after surgery although they are absorbable monosyn.

Standard operating procedures are in place to maintain the highest standard of surgery. Handing over inspection of the surgical site with the owner is shown. The cat is OK as at 7 days post-op.

More instructional videos for vet students and pet owners are at

This video was filmed and edited by Intern Clara Chua as part of her experiential learning at Toa Payoh Vets. Interns learn more by writing and making videos than by being an observer looking at the vet's working.

It appears to me to be well edited and has good music. My grateful thanks to Clara. I purchased the Corel software recently as the free Windows Movie Maker does not have many features.

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