Ability of a Complexity Scoring System to Predict Veterinary Student Surgical Procedure and Clinic Duration.

The Midwestern University College of Veterinary Medicine hosts student-run free clinics that offer surgical sterilization of male and female dogs and cats, with the goal of 20 surgical cases per clinic. Surgical complexity varies significantly between the surgical procedures for males (castration) and females (ovariohysterectomy) and is also influenced by weight and age for dogs. A surgical complexity scoring system was implemented to ensure the minimum number of patients while providing a diverse mix of cases. The aim of this study was to determine whether the surgical complexity scoring system accurately predicted procedure duration. Surgical records were collected between August 2016 and October 2019. Points (1-5) were assigned to each patient at the time of appointment based on species, sex, additional procedure, age and weight, and the schedule was targeted for 50 points. Each point was predicted to account for 15 minutes of surgical time. The duration for each point category was assessed via rank-sum against the predicted median. Sixteen clinics occurred during the study period, having a mean of 40.4 points and 17 patients, 29.5 (74%) of which were allocated to students. There were 264 surgeries, with 241 (91%) having complete start and end times. Surgical duration for student surgeries was not different from the estimate for each point category, with the exception of 2-points, which had a median 5.0 minutes longer than anticipated (p = .0004). The surgical complexity scoring system is an effective tool to optimize scheduling of educational spay/neuter mobile clinics.

Arizona Veterinarians' Perceptions and Consensus Regarding Skills, Knowledge, and Attributes of Day One Veterinary Graduates.

The purpose of this study was to assess Arizona veterinarians' perceptions and consensus regarding the importance of items in the domains of clinical skills, knowledge, and attributes of Day One graduates of veterinary school and to determine demographic predictors for items on which consensus was low. In this survey-based prospective study, respondents were asked to rate the importance of 44 items on a 5-point Likert scale ranging from 1 (not at all important) to 5 (extremely important). Responses were visualized as divergent stacked bar charts and evaluated via summary quantitative and qualitative analyses. Several items had a median score of 5. For clinical skills, items were the ability to formulate a preventive health care plan, the ability to interpret test results, and basic safe handling and restraint of animals; for knowledge, knowledge of pain management and anesthesia; and for attributes, teamwork, problem-solving skills, and client communication skills. The majority of items (80%) had a strong or very strong consensus measure, 18% had a moderate consensus measure, and 2% had a weak consensus measure. Six items (14%) varied by at least one demographic category. We found demographic differences between large and small animal practices in the clinical skill of ability to perform a necropsy, knowledge of large animal theriogenology, and knowledge of canine theriogenology. In conclusion, we found differences in the importance of items and agreement among practitioners, suggesting that critical evaluation of the mapped curriculum, particularly with regard to core curriculum compared with electives and clinical tracks, may benefit students and future employers.

Promoting access to care in pyometra treatment: pathways to collaboration between high-quality, high-volume spay-neuter clinics and private practices.

OBJECTIVE: To compare results from 2 previously published surveys aimed at determining how pyometra is treated in high-quality, high-volume spay-neuter clinics (HQHVSNCs) and private practices (PPs), with a specific focus on identifying opportunities for partnership between the clinic types to improve access to care in pyometra treatment. SAMPLE: Responses from 123 PPs and 87 HQHVSNCs. METHODS: A previously published survey of PPs conducted from June to July 2021 and a similar previously published survey of HQHVSNCs conducted from June to July 2020 were compared regarding demographics, pyometra treatment availability, estimated outcome, alternative outcome, disruption, cost, and protocol between HQHVSNCs and PPs. A comparison was also run of the surveys' responses regarding referral of a pyometra to an HQHVSNC by a PP. RESULTS: Although PPs estimated that economic euthanasia is the most likely alternative outcome for 13% of patients unable to access care at their practice, 80% would be reluctant to refer to an HQHVSNC. The 3 primary reasons indicated by PPs with a reluctance to refer were a perceived lack of prompt appointment availability (20%), lack of aftercare (18%), and lack of adequate equipment (14%). In contrast, most HQHVSNCs estimated that they generally accept referrals the same day (50%) or the next day (30%) and 95% of HQHVSNCs reported having the resources needed to treat most pyometras. CLINICAL RELEVANCE: There are several opportunities for partnership between PPs and HQHVSNCs in the treatment of pyometra. The most frequent concerns expressed by PPs regarding referral to HQHVSNCs were not shared by HQHVSNCs or could be ameliorated by referral to an HQHVSNC for surgery and transfer back to the PP for aftercare.

Effects of peripheral active warming and passive insulation on core body temperature during feline ovariohysterectomy: a multi-arm randomized clinical trial.

OBJECTIVES: Hypothermia is a common complication of anesthesia, particularly in cats. Some veterinarians insulate the extremities of cats as a preventive measure, and there is evidence that heating the extremities of dogs decreases the rate of heat loss from the core. This study investigated whether active warming or passive insulation of the extremities of cats resulted in a slower decrease in rectal temperature during anesthesia. METHODS: Female cats were assigned via block randomization to passive (cotton toddler socks), active (heated toddler socks) or control group (uncovered extremities). Rectal temperature was monitored every 5 mins from induction through return to trap/carrier (final temperature). Multivariable linear regression models were used to compare temperature (rate change and final) between groups. RESULTS: There were 164 cats with 1757 temperature readings. Mean total duration of anesthesia was 53 ± 13 mins. The temperature of all groups decreased linearly over time (all P <0.0001), with the rates of temperature decrease being -0.039°F/min (95% confidence interval [CI] -0.043 to -0.035)/-0.022°C (95% CI -0.024 to -0.019), -0.039°F/min (95% CI -0.042 to -0.035)/-0.022°C (95% CI -0.023 to -0.019) and -0.029°F/min (95% CI -0.032 to -0.025)/-0.016°C (95% CI -0.018 to -0.014) for the control, passive and active groups, respectively. The control, passive and active groups had median final temperatures of 98.4°F (interquartile range [IQR] 97.6-99.4)/36.9°C (IQR 36.4-37.4), 98.0°F (IQR 97.2-98.7)/36.7°C (IQR 36.2-37.1) and 99.1°F (IQR 97.7-100.0)/37.3°C (IQR 36.5-37.8), respectively. After controlling for weight, postinduction temperature and duration of anesthesia, and as compared with controls, the final temperature of the active group was predicted to be 0.54°F (95% CI 0.03-1.01)/0.3°C (95% CI 0.02-0.56) greater (P = 0.023), while the passive group was not significantly different (P = 0.130). CONCLUSIONS AND RELEVANCE: The rate of rectal temperature decrease was significantly slower for the active group compared with the other groups. Although the cumulative difference in final temperature reading was modest, superior materials might enhance performance. Cotton toddler socks alone did not slow the rate of temperature decrease.

Ear-tipping practices for identification of cats sterilized in trap-neuter-return programs in the USA.

OBJECTIVES: Ear-tipping practices and the meaning of the ear tip in trap-neuter-return (TNR) programs have not been well documented. The purpose of this study was to report the frequency of common ear-tipping practices in the USA, to identify the most effective methods and to establish a foundation for ear-tipping practice standards. METHODS: An anonymous 24-question survey was advertised from 4 to 20 October 2021 to individuals who participate in TNR programs that routinely perform ear tipping. RESULTS: There were 526 survey responses from individuals who participate in TNR programs, of whom 410 completed the survey. For ear-tip meaning, nearly 100% of respondents indicated that an ear tip meant that a cat had been sterilized. Several respondents answered that it also indicated rabies vaccination or socialization status, with 92 (22%) selecting both, 79 (19%) selecting rabies only and 50 (12%) selecting unsocial only. The majority of respondents tipped the left ear (81%), used a visual estimate to determine the cut (92%) and described the ideal silhouette as straight across (92%). The median percentage of cats where ear tips bled after initial hemostasis was 5% (interquartile range [IQR] 2-10), and the median percentage of negative feedback regarding the ear tip was 1% (IQR 0-5). In terms of weighted rank order, the most common feedback was that too much ear tip was removed (5.5), followed by a cat being ear tipped in error (4.7), persistent bleeding (4.2) and not enough ear tip being removed (4.2). Responses revealed heterogeneity regarding technique for both excision and hemostasis, as well as personnel performing the procedure. There were no significant associations between techniques and bleeding or negative feedback. CONCLUSIONS AND RELEVANCE: There is variation in the methods for performing an ear tip, as well as what an ear tip signifies. Standards for this procedure would be helpful.

The Impact of Incorporating Multiple Best Practices on Live Outcomes for a Municipal Animal Shelter in Memphis, TN.

Modern animal shelters are encouraged to adopt "best practices" intended to promote life-saving for the animals that enter their systems. While these best practices have been defined and widely promoted within the profession, few studies have tracked how making the recommended changes affects live release rates (LRR) and other shelter metrics. In 2017, the municipal animal shelter in Memphis, TN (Memphis Animal Services) implemented five new strategies and analyzed their resultant life-saving data. The interventions included managed strategic shelter intake, pet owner safety net, community cat return to field, transition of field services from punitive to assistive, and streamlined adoption and transfer protocols. The median LRR for cats prior to 2017 was 35% (IQR 22, 36). After the intervention, the LRR increased to a median of 92% (IQR 92, 94). The correlation between intake and euthanasia for cats prior to the intervention was significant (P < 0.001) and very strong (r = 0.982), while after there was no relationship (-0.165) and it was not significant (P = 0.791). The median LRR for dogs prior to 2017 was 25% (IQR 19, 48). After the intervention, the LRR increased to a median of 87% (IQR 86, 88). The correlation between intake and euthanasia for dogs prior to the intervention was significant (P < 0.001) and very strong (r = 0.991), while after there was a moderate relationship (-0.643) that was not significant (P = 0.242). The median LRR for kittens prior to 2017 was 34% (IQR 23, 38), which increased (P = 0.001) to 92% (IQR 91, 92) after intervention. The percent of kittens entering the shelter with an outcome of euthanasia decreased (P < 0.001), from a median of 59% (IQR 54, 73) to a median of 3% (IQR 1, 3). The median return to owner (RTO) rate for dogs increased (P = 0.007) from 10% (IQR 9, 11) to 13% (IQR 13, 13). Implementation of these best practices accelerated Memphis Animal Services' progress toward a live release rate of at least 90%, particularly for cats, dramatically decreased kitten euthanasia, increased the RTO rate for dogs and severed the historical correlation between euthanasia and intake.

Pyometra Management in the Private Practice Setting.

Current management practices of pyometra in the private practice setting are not well documented. The goal of this study was to understand pyometra management in the private practice setting, and the current relationship private practices have with high quality, high volume, spay-neuter (HQHVSN) clinics regarding referral for pyometra surgery. An anonymous electronic survey was piloted and distributed using SurveyMonkey via email, social media, and the Independent Veterinary Practitioners Association targeting veterinarians who see companion animals. A total of 153 responses were received from June to July 2021, with respondents distributed throughout the United States. Practices performed a median of 10 spay and neuters per week, with the median spay cost being $350 (IQR 250-500) for dogs and $250 (IQR 180-350) for cats. The median cost of a pyometra surgery was $1000 (IQR 700-1500) for dogs and $750 (IQR 450-1000) for cats. All practices treated pyometra at least sometimes, despite the disruption (major 19%, moderate 47%, mild 29%, none 5%) to their day. All pyometra presentations were accepted for treatment at least sometimes: BAR/QAR (98%), depressed or non-ambulatory (88%), and obtunded or lateral (62%) with mean estimated survival of 96%, 74%, and 31%, respectively. The majority (56%) of clients were reported to sometimes have trouble paying for all recommended services, while it was less often reported that clients often (31%) or rarely (13%) had trouble. Private practices willing to refer only did so always 20% of the time and sometimes 36% of the time. Private practices will do what they can to treat most pyometras that present at their practice within a timely manner before referring elsewhere. There is currently inconsistent utilization of HQHVSN clinics as a potential referral resource due to location or appointment availability.

Assessment of Dilute Epinephrine and Mechanical Pressure for Prevention of Feline Postoperative Scrotal Hematoma: A Randomized Controlled Trial.

To determine whether two immediately postoperative preventive procedures, dilute epinephrine (1:400,000) as a scrotal wash or application of controlled mechanical pressure to the scrotum, reduce the risk or severity of scrotal hematoma following routine castration. Male cats with two descended testicles presenting to Midwestern University's Trap Neuter Return program were eligible for inclusion. Cats were assigned via block randomization to control, dilute epinephrine wash, or controlled mechanical pressure groups. For the epinephrine group, 0.2 ml (0.008 mg) of epinephrine diluted with sterile saline was instilled inside the scrotum. In the case of mechanical pressure, a broad-based clip generating less than 0.5 kg of pressure was applied for 10 minutes. Cats were evaluated for scrotal hematoma and the need for treatment by a veterinarian blinded to treatment group. Multivariable logistic regression was used to determine if the incidence of scrotal hematoma or scrotal hematoma requiring treatment was different between groups while controlling for other variables. There were 276 cats with a median age of 30 months (IQR 12,48) and a mean weight of 3.5 kg (SD 1.2). Scrotal hematomas were noted in 15 of the 92 (16%) control cats, as compared with 12 of the 92 (13%) epinephrine and nine of the 92 (10%) pressure cats. Treatment was required for 10 (67%) control, six (50%) epinephrine, and three (33%) pressure hematomas. Regression demonstrated a decreased risk of scrotal hematoma requiring treatment for cats in the pressure group (OR = 0.2, P = .044) controlling for weight (OR = 2.2, P = .006) and surgical duration (OR = 1.1, P = .026). Weight was the only significant variable for the presence of scrotal hematoma (OR = 2.2, P < .0001). Controlled mechanical pressure applied immediately after routine castration can help decrease the proportion of scrotal hematomas that require treatment.

Comparison of the effect of isopropyl alcohol and chlorhexidine solution rinses on body temperature of female cats undergoing sterilization surgery.

OBJECTIVES: Isopropyl alcohol 70% as a rinse agent for chlorhexidine scrub has been shown to decrease body temperature more quickly than chlorhexidine solution in mice prepared aseptically prior to surgery. For this reason, some high-quality, high-volume (HQHV) surgical sterilization clinics use chlorhexidine solution rather than alcohol. We sought to determine if temperature upon entry to recovery, heat loss per kg and rate of temperature decline during surgery were different between cats rinsed with chlorhexidine solution vs 70% isopropyl alcohol following surgical scrub, and if there were significant predictors of recovery temperature. METHODS: Female cats admitted for surgery to trap-neuter-return (TNR) clinics at a veterinary college were assigned chlorhexidine solution or alcohol rinse agents via block randomization. Veterinary students and veterinarians performed spay surgeries using HQHV techniques. In recovery, heat support and reversal agents were available for cats with a low body temperature or that were slow to recover. Baseline values, outcome variables and duration of each stage (preparation, surgery, recovery) were assessed using Wilcoxon rank-sum and t-tests. Recovery temperature was evaluated using random effects multiple linear regression. RESULTS: The recovery temperature, heat loss per kg, heat loss per min, need for reversal and need for heat support in recovery were not significantly different between rinse groups. Weight <2.3 kg, body condition score <4, duration of surgery and postinduction temperature were predictors of recovery temperature. The rate of heat loss in the first 30 mins of surgery was slightly lower for cats in the alcohol rinse group and the recovery duration was shorter for cats weighing less <2.3 kg in the alcohol rinse group. CONCLUSIONS AND RELEVANCE: There were no clinically meaningful differences in body temperature between chlorhexidine and alcohol rinses. Both chlorhexidine solution and isopropyl alcohol 70% are appropriate rinse agents for aseptic preparation of feline spay surgeries.

Cats Are Not Fish: A Ricker Model Fails to Account for Key Aspects of Trap-Neuter-Return Programs.

In a frequently cited 2005 paper, a Ricker model was used to assess the effectiveness of trap-neuter-return (TNR) programs for managing free-roaming domestic cat populations. The model (which was originally developed for application in the management of fisheries) used data obtained from two countywide programs, and the results indicated that any population reductions, if they existed, were at best modest. In the present study, we applied the same analysis methods to data from two long-term (i.e., >20 years) TNR programs for which significant population reductions have been documented. Our results revealed that the model cannot account for some key aspects of typical TNR programs, and the wild population swings it predicts do not correspond to the relative stability of free-roaming cat populations. A Ricker model is therefore inappropriate for use in assessing the effectiveness of TNR programs. A more recently developed, stochastic model, which accounts for the movement of cats in and out of a given area, is better suited for predicting the sterilization effort necessary to reduce free-roaming cat numbers through TNR programs.

Pyometra Management Practices in the High Quality, High Volume Spay-Neuter Environment.

Pyometra management in the high quality, high volume spay-neuter (HQHVSN) environment is not well documented. The goal of this study was to identify pyometra management practices and patient outcomes in the HQHVSN environment. An electronic survey was piloted and distributed to HQHVSN clinics using Survey Monkey via email lists and social media. A total of 118 responses were received from June to July 2020. Respondents were distributed across the United States with the majority of clinics associated with a shelter (75%). Clinics performed a median of 25 spays and neuters per day and 5000 per year. Most clinics (86%) were willing to treat nonincidental pyometras at least sometimes, and nearly all of these clinics (97%) were willing to accept pyometra referrals. Of these clinics, nearly all (95%) felt they had the necessary resources to treat most pyometras that presented and that a pyometra case was only modestly disruptive to their surgery flow. Most clinics (70%) charged a fee for treatment, charging a median of $200 for dogs and $125 for cats. This is much lower as compared to the estimated ranges for private practice ($600-$2500) and emergency hospitals ($1500-$3579). The majority of patients that HQHVSN clinics accepted for treatment were seen the same day (50%) or next day (42%). These clinics estimated that of the animals who presented, 76% were BAR or QAR, 20% were depressed or nonambulatory, and 4% were obtunded and lateral. Estimated survival for these treated groups were 98%, 80%, and 38%, respectively. HQHVSN clinics may represent a resource for treating pyometras when treatment is disruptive to the schedule of a private practice or clients present with financial limitations. There is an opportunity for HQHVSN and private practice to form a partnership to leverage the strengths of both models and improve access to care for pets.

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.

Corrigendum: Decrease in Population and Increase in Welfare of Community Cats in a Twenty-Three Year Trap-Neuter-Return Program in Key Largo, FL: The ORCAT Program.

[This corrects the article DOI: 10.3389/fvets.2019.00007.].

Decrease in Population and Increase in Welfare of Community Cats in a Twenty-Three Year Trap-Neuter-Return Program in Key Largo, FL: The ORCAT Program.

The objective of this study was to evaluate the effect of a long-term (23-year) trap-neuter-return program on the population size of community cats in the Ocean Reef Community and to describe the demographic composition and outcome of enrolled cats. A retrospective study was performed using both cat census data collected between 1999 and 2013 as well as individual medical records for cats whose first visit occurred between 3/31/1995 and 12/31/2017. Medical record entries were reviewed to determine program inputs, cat outcomes, retroviral disease prevalence, and average age of first visit, sterilization, and death through 6/11/2018. Change over time was analyzed via linear regression. The free-roaming population decreased from 455 cats recorded in 1999 to 206 recorded in 2013 (55% decrease, P < 0.0001). There were 3,487 visits recorded for 2,529 community cats, with 869 ovariohysterectomies and 822 orchiectomies performed. At last recorded visit, there were 1,111 cats returned back to their original location, and 1,419 cats removed via adoption (510), transfer to the adoption center (201), euthanasia of unhealthy or retrovirus positive cats (441), died in care (58), or outcome of dead on arrival (209). The number of first visits per year decreased 80% from 348 in 1995 to 68 in 2017. The estimated average age of the active cat population increased by 0.003 months each year (P = 0.031) from 16.6 months in 1995 to 43.8 months in 2017. The mean age of cats at removal increased 1.9 months per year over time (P < 0.0001) from 6.4 months in 1995 to 77.3 months in 2017. The mean age of cats at return to the original location was 20.8 months, which did not change over time. The overall retrovirus prevalence over the entire duration was 6.5%, with FIV identified in 3.3% of cats and FeLV identified in 3.6%. Retrovirus prevalence decreased by 0.32% per year (P = 0.001), with FIV decreasing by 0.16% per year (P = 0.013) and FeLV decreasing 0.18% per year (P = 0.033). In conclusion, a trap-neuter-return program operating for over two decades achieved a decrease in population and an increase in population welfare as measured by increased average age of population and decreased retrovirus prevalence.

Outcomes of elective gonadectomy procedures performed on dogs and cats by veterinary students and shelter veterinarians in a shelter environment.

OBJECTIVE To determine complication rates for elective gonadectomy procedures performed by veterinary students on dogs and cats in an animal shelter, characterize these complications, and compare rates with those for shelter-employed veterinarians (SEVs). DESIGN Retrospective cohort study. ANIMALS 10,073 dogs and cats for which gonadectomy was performed by a veterinary student (n = 3,048 surgeries) or SEV (7,025 surgeries) at an urban animal shelter over a 16-month period. PROCEDURES Electronic medical records for included dogs and cats were reviewed and data collected regarding patient signalment, duration of gonadectomy, surgeon type (student or SEV), and types of surgical complications recorded (including death or euthanasia) during the period from anesthetic induction to 72 hours after surgery. Complication and mortality rates were compared between veterinary students and SEVs. RESULTS No significant differences were identified between students and SEVs regarding rates of overall complications for both species, minor complications for both species, major complications for both species, and overall complications for dogs or cats specifically. The most common complications were self-limiting, with no long-term consequences, for both students and SEVs. Differences in mortality rates between students and SEVs could not be definitively determined owing to low numbers of nonsurviving patients. CONCLUSIONS AND CLINICAL RELEVANCE With judicious case selection and as a part of a surgical training program, complication rates for veterinary student-performed gonadectomy procedures for dogs and cats were no different from those for SEV-performed gonadectomy procedures. We believe such information regarding patient outcomes will allow shelter staff to make informed decisions and help them in discussions with stakeholders who may have concerns about student participation.

Effect of transmucosal corn syrup application on postoperative blood glucose concentrations in kittens.

Objectives The aim of the study was to determine the effect of a common clinical practice, the transmucosal (TM) application of corn syrup, on postoperative blood glucose concentrations in kittens. Methods This study was designed as a randomized controlled trial. Seventy-five kittens between the age of 8 and 16 weeks scheduled for surgical sterilization by gonadectomy at an animal shelter were enrolled. Kittens were randomly assigned to either a routine treatment group that received the shelter's typical postoperative application of corn syrup immediately following gonadectomy or to a control group that did not receive typical treatment. Three blood glucose measurements were obtained per kitten: baseline reading prior to preoperative examination, immediately postoperatively and 20 mins postoperatively. The median values of the 20 min postoperative blood glucose reading for the control and treatment groups were compared using the Wilcoxon rank-sum test. Results Postoperative application of corn syrup to the oral mucosa of kittens did not result in significant elevations in blood glucose compared with controls. No kitten was hypoglycemic (⩽60 mg/dl) at any point during the study. Conclusions and relevance TM application of corn syrup did not affect postoperative blood glucose concentrations in kittens. Protocols that use routine TM administration of corn syrup in kittens should be re-evaluated.

Perioperative blood glucose concentrations in kittens following overnight fasting and gonadectomy.

Objectives The objective of this study was to determine if hypoglycemia is an effect of overnight fasting and gonadectomy in kittens, as well as to determine predictors of baseline and postoperative blood glucose. Methods This was a prospective observational study. Seventy-five kittens between the age of 8 and 16 weeks undergoing routine castration or ovariohysterectomy at an animal shelter were included. Two blood glucose measurements were analyzed per kitten after an overnight fast: a baseline reading prior to preoperative examination, and a reading immediately postoperatively. Predictors of the baseline and postoperative blood glucose levels were determined using multi-level mixed-effects linear regression. Results Kittens, when fasted overnight, were not hypoglycemic (<60 mg/dl). No kittens exhibited clinical signs consistent with hypoglycemia. No kittens had a blood glucose <70 mg/dl postoperatively. Postoperative hyperglycemia (>150 mg/dl) was observed in 44% of kittens. The only predictor of fasted blood glucose levels was body condition score. The only predictor of postoperative blood glucose levels was the fasting blood glucose value. Conclusions and relevance Overnight fasting prior to elective sterilization in 8- to 16-week-old kittens did not result in hypoglycemia. Concern regarding hypoglycemia after a prolonged fast in kittens may be unwarranted for short procedures in healthy animals.