Harbour Veterinary Clinic (formerly known as the spay and neuter cruiser)

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High quality, high volume spay/neuter: an important and safe community service

By Dr. EMILIA WONG GORDON, DVM, DABVP  (SHELTER MEDICINE PRACTICE)

Spaying or neutering pet cats prevents pregnancy. It can also prevent some health and behaviour problems. The Canadian Veterinary Medical Association recommends that all cats and dogs have this surgery when they are young, unless they are going to be bred on purpose.1

Despite this recommendation, many cats do not get this surgery because their human caregivers cannot afford it. A recent study of 2,500 Canadian pet owners found that 18% could not access preventive care in the past year.2 The most common reason was cost, especially in Western Canada.2 Outdoor “community cats” also need spay/neuter surgery to prevent more kittens from being born. Often, kind people feed and care for these cats, but the cats may not get surgery because they do not have a true owner or regular veterinarian.

Cats in our community are loved. A recent survey found that 77-88% of British Columbians said pets helped them feel less lonely and supported their physical or mental health.3 Outdoor community cats may not belong to one person or family, but people care about them. Another Canadian study found that people believed the welfare of community cats is important, and that 86% believed that “accessible or low-cost spay/neuter” would help these cats.4

High quality, high volume spay/neuter (HQHVSN): an innovative model

In Canada, most spay/ neuter surgeries are done in regular full-service veterinary hospitals (general practice). A general practice needs to have many kinds of expensive supplies and equipment for different types of procedures. High quality, high volume spay/neuter (HQHVSN) clinics focus only on spay/neuter using safe and efficient systems.5 Most HQHVSN programs in Canada are run by charities. This unique model is helping more cats get the surgeries they need.

Important features of HQHVSN clinics include:5,6

  • Animals are generally young and healthy
  • Staff are highly trained and use proven checklists, protocols, forms, and systems
  • Vets use efficient techniques and repeat the same surgeries over and over
  • Each animal gets high-quality individual care including:
    • A veterinarian exam to make sure they are healthy for surgery
    • Drug doses based on their specific weight
    • Continuous anesthesia monitoring
    • Their own sterile surgery instruments and supplies
    • Pain medicine before and after surgery
  • Pets are scheduled in “blocks.” For example, several cat spays are done in a row before switching to cat neuters.
  • Supplies and equipment are high quality and limited to what is needed for spay/neuter

Strong teamwork, experience, and standardized protocols are important in HQHVSN. These lead to safe, high-quality, efficient care.

Differences between HQHVSN and full-service general practice

The protocols and practices in a HQHVSN clinic are designed for young, healthy animals. Animals who are older or have health problems that make anesthesia riskier should not come to a HQHVSN clinic. These animals should go to a full-service practice that has a variety of equipment and more time for each animal.

Bloodwork is not required

Pre-visit bloodwork is not required for healthy animals in a HQHVSN setting.6 Many caregivers who bring their cats to HQHVSN clinics have limited funds and the cat’s first and only visit is on the same day as surgery. Bloodwork is not practical for HQHVSN programs due to cost, time, and stress to the cat. Many HQHVSN programs have safely spayed and neutered tens of thousands of animals without pre-anesthetic bloodwork.7,8

Bloodwork is most important for animals who are older or have medical problems. The value of pre-operative bloodwork in young, healthy animals is controversial.9,10 It is extremely rare for bloodwork to show something that would change the plan to do surgery on a young animal who has been found to be healthy on a physical exam.9,10 If a cat caregiver would like to have bloodwork done prior to surgery, they should bring their cat to a full-service practice for bloodwork and surgery.

Specific surgery methods are used

HQHVSN surgeons use very efficient surgery techniques. These may include using less suture, making smaller incisions, and using absorbable suture under the skin. This way the cat does not have to come back for stitches or staples to be removed. These veterinarians often work with community cats as well as shelters and rescue groups who care for mom cats with kittens. Because of this, they are comfortable spaying young animals (as young as 8 weeks of age), animals who are pregnant or in-heat, and those who have recently given birth. This helps reduce cat overpopulation. Several studies have found that this is safe in HQHVSN settings.7,8

Costs are minimized

The cost of surgery at HQHVSN clinics tends to be lower than the cost at full-service hospitals. This is not because full-service facilities are “overcharging” or because HQHVSN clinics are “cutting corners.”5 It is simply because these clinics only do one type of streamlined surgery, so  they only have to buy and maintain certain supplies and equipment.

Controversies about HQHVSN … and what studies actually say

There may be some people who have doubts about this model of care, especially when a new program starts in a community. The two most common concerns are:

  • People worry that the surgeries are less safe than spay/neuter at a full-service hospital
  • Veterinary professionals are concerned that these clinics take away business from full-service hospitals

Let’s look at what studies have found about these two issues!

Safety

There are published standards of care for spay/neuter programs.6 These describe ways to keep animals safe before, during, and after surgery. They are from the Association of Shelter Veterinarians and American Veterinary Medical Association. These professional organizations represent over 100,000 veterinarians. HQHVSN programs, including the Spay/Neuter Cruiser, follow these proven guidelines.

Several studies show that surgeries done in HQHVSN clinics have very low complication rates.7,8,11 While rare, any surgery can have a chance of a complication such as bleeding, infection, or even death. A study of over 100,000 cats and dogs who had surgery at a HQHVSN clinic in the US found that the mortality (death) rate for this clinic was lower than average and so safe that it was similar to humans going through similar surgeries!8

Business concerns

Many families who come to HQHVSN clinics cannot afford care at a full-service hospital. Studies in the US have found that most cats who come to low-cost spay/neuter programs have never seen a veterinarian at a full-service clinic and are from families with annual incomes below $30,000 a year.12,13 Without a spay/neuter program, these cats would simply not get surgery.

A 2021 study that looked at different economic models for veterinary clinics found that low-cost clinics do not hurt full-service practices.14 If a community has both a low-cost and a full-service clinic, more pets overall can be served.14 In fact, lower prices at a low-cost clinic can actually lead to more profits for a full-service clinic.14 All of these studies together show that HQHVSN clinics do not “steal” profit from full-service clinics. Instead, everyone benefits when different types of clinics work together to serve the community!

The bottom line

All companion animals deserve healthcare. Spay/neuter surgery is a vital type of healthcare for cats, whether they live with a family or outdoors in the community. Yet, many cats cannot get this surgery due to cost.

Clinics that follow a HQHVSN model help fill a crucial gap in services. This model focuses only on spay/neuter and has been proven to be safe and efficient. HQHVSN clinics work collaboratively with full-service clinics as well as shelters, rescues, and other community organizations to expand access to veterinary care.

References

  1. Neutering of Dogs and Cats. Canadian Veterinary Medical Association. Accessed January 10, 2025. https://www.canadianveterinarians.net/policy-and-outreach/position-statements/statements/neutering-of-dogs-and-cats/
  2. Jacobson LS, Janke KJ, Probyn-Smith K, Stiefelmeyer K. Barriers and Lack of Access to Veterinary Care in Canada 2022. J Shelter Med Community Anim Health. 2024;3(1). doi:10.56771/jsmcah.v3.72
  3. Cant M, Gordon E. BC’s Housing Crisis: A Crisis for Pets Too. West Coast Vet. 2023;(52).
  4. Van Patter L, Flockhart T, Coe J, et al. Perceptions of community cats and preferences for their management in Guelph, Ontario. Part I: A quantitative analysis. Can Vet J. 2019;60(1):41-47.
  5. Bushby PA. High-quality, high-volume spay–neuter: Access to care and the challenge to private practitioners. J Feline Med Surg. 2020;22(3):208-215. doi:10.1177/1098612X20903600
  6. Griffin B, Bushby PA, McCobb E, et al. The Association of Shelter Veterinarians’ 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs. J Am Vet Med Assoc. 2016;249(2):165-188. doi:10.2460/javma.249.2.165
  7. Rigdon-Brestle K, Accornero VH, Amtower M, Slater MR. Retrospective review reveals few complications of ovarian pedicle tie in 15,927 cats undergoing ovariohysterectomy at a large HQHVSN clinic and training facility in the United States: 2017–2018. Published online June 1, 2022. doi:10.2460/javma.21.09.0405
  8. Levy JK, Bard KM, Tucker SJ, Diskant PD, Dingman PA. Perioperative mortality in cats and dogs undergoing spay or castration at a high-volume clinic. Vet J. 2017;224:11-15. doi:10.1016/j.tvjl.2017.05.013
  9. Mitchell K, Barletta M, Quandt J, Shepard M, Kleine S, Hofmeister E. Effect of routine pre-anesthetic laboratory screening on pre-operative anesthesia-related decision-making in healthy dogs. Can Vet J. 2018;59(7):773-778.
  10. Davies M, Kawaguchi S. Pregeneral anaesthetic blood screening of dogs and cats attending a UK practice. Vet Rec. 2014;174(20):506-506. doi:10.1136/vr.102211
  11. Miller KP, Rekers W, Ellis K, Ellingsen K, Milovancev M. Pedicle ties provide a rapid and safe method for feline ovariohysterectomy. J Feline Med Surg. 2016;18(2):160-164. doi:10.1177/1098612X15576589
  12. Benka VA, McCobb E. Characteristics of cats sterilized through a subsidized, reduced-cost spay-neuter program in Massachusetts and of owners who had cats sterilized through this program. J Am Vet Med Assoc. 2016;249(5):490-498. doi:10.2460/javma.249.5.490
  13. White SC, Scarlett JM, Levy JK. Characteristics of clients and animals served by high-volume, stationary, nonprofit spay-neuter clinics. J Am Vet Med Assoc. 2018;253(6):737-745. doi:10.2460/javma.253.6.737
  14. Haston RB, Pailler S. Simulation of the effect of low-cost companion animal clinics on the market for veterinary services. Am J Vet Res. 2021;82(12):996-1002. doi:10.2460/ajvr.21.08.0116