The clinic is held on the second Sunday of the month, but occasionally others can be scheduled (we did one every week in October). It is held at PACCA's (Philadelphia Animal Control and Care Assiociation) facilities--the O.R. is donated but we do pay a fee for the anasthesia. The surgery is performed by veterinary students under the supervision of a licensed veterinarian; all other functions are handled by volunteers. This is potentially good publicity for PACCA--too many people still think Animal Control will round up and euthanize feral cats, despite PACCA's stated refusal to do so. More about that at another time and another post.
The volunteers arrive at about 8:00AM and begin organizing the clinic. The trappers begin arriving shortly thereafter; some, like me, are also volunteers and will remain for most or all of the clinic. The trappers fill out forms specifying whether the cat is to be released or fostered, and whether or not it is to be tested for FIV/FELV; they also leave instructions as to whether or not positive animals are to be euthanized. A volunteer logs the cats in, lables and numbers the paperwork and trap/carrier, and places them in a holding area--at no time is the cat to be separated from the paperwork. Dana was assigned #10.
While the cats are being logged in other volunteers set up various stations: a refreshment table with coffee and food (usually bagels and other baked goods and spreads), an immunization table, a recovery area, and a trap/carrier cleaning station. Other volunteers are assigned to wash and dry towels and blankets or to serve as runners (volunteers often double up on functions--cleaners and laundry workers are usually also runners, but others pitch in as well where needed). At about 9:00 the vets and students arrive and begin to set up in the O.R. Experienced volunteers are often on hand to assist them there by assembling surgical instrument packets and prepping the cats.
The traps and carriers that have been marked are lined up in the corridor leading to the O.R.--males on the left, females and "unknowns" (some cats, especially ferals, cannot be accurately identified as male or female until they're unconscious for any number or reasons) on the right. When the O.R. crew is ready, runners begin bringing the cats in.
If a cat has been determined to be friendly and able to be safely handled it is removed from the carrier and given an injection to tranquilize it; it is then returned to the carrier until it is unconscious. A feral cat who cannot be safely handled (most are in traps) is handled differently. As Dana is a feral, she was in a trap when brought to the O.R. The trap was upended and a volunteer used an isolator--a kind of comb-like device--to pin her to the bottom of the trap; she was then injected through the bars. Once she was unconscious she was removed and a student drew a small amount of blood from her inner thigh. The blood sample was used to test for FIV/FELV; Dana was negative for both so the operation could proceed. Her belly was shaved and she was taken to an operating table, where she was secured in a spread-eagle fashion with light ropes and a gas mask was placed on her muzzle--thus prepared, the student or vet assigned to her performed the surgery.
Males require less prep work; their surgery is pretty simple and quick, although there are more often issues in recovery.
Once the cats have been removed from their carriers or traps, a runner takes the latter to the cleaning station. Food, feces and other dirt is removed (sometimes a power-wash is required) and the carrier/trap is lined with newspaper for males and absorbent padding for females and then placed in waiting near the recovery area.
The recovery area is a section of floor covered in cardboard (the general clinic area is PACCA's indoor loading area); an L-shaped layer of sleeping bags, blankets and quilts is set up on the outer edge. A bin with various supplies and equipment and a baby scale is placed in the center. On the L; electric heating pads are placed and covered with quilts.
When Dana's surgery was complete, a runner took her and her annotated paperwork to the immunization table; she was wrapped in a soft blanket and placed upon the table. The O.R. staff placed a strip of tape with her number on her head. An experienced volunteer--usually but not always a veterinary technician--then administered three injections. FVRCP vaccine was injected subcutaneously into her right leg, a rabies vaccine was injected into similarly into her left leg, and a post-surgical antibiotic was injected subcutaneously into her upper shoulder (I actually got to do those injections on other cats today!). As a feral who is to be released, her left eartip was cut off and the wound was electrically cauterized. Her paperwork was annotated and she was rewrapped and carried with her papers to the recovery area.
The procedure is the same for males, but they do not get the antibiotic injection unless the O.R. staff recommends it.
The cat is weighed on the baby scale and then placed upon a heating pad still wrapped in its blanket. Anasthesia causes a cat's body temperature to drop considerably; so as it recovers external heating is often required. During the recovery volunteers monitor heartrate and temperature. The heartrate is monitored by stethoscope placed under the cat's forepaw (it's not easy to find an unconscious cat's heartrate, but unmistakeable once you do). Heartrate should be about 200 beats per minute; the listener counts for fifteen seconds, multiplies by four and then notes the figure and time on the paperwork. Temperature is taken rectally and should be as close as possible to 100 degrees Farenheit; this is similarly notated. The cat's ears are then cleaned; when needed medication for ear mites and eye infections are administered. If a cat is to be fostered its claws are trimmed.
Recovery workers watch for any distress signs from the cat and respond accodingly. The most common ones are shivering (the cat needs more direct heating) and excessive bleeding from the surgical wounds (the cat may need pressure applied or may even need to be returned to the O.R.--males seem paricularly prone to this and one today went back twice). They also watch for signs of consciousness. As a cat comes out from under anasthesia it will be groggy and disoriented--there's often a "bobble-head" effect. Some also stay under for a longer than usual time and need to have temperature and heartrate rechecked. Once a cat begins moving around, the tape is removed from the head and it is placed in its prepared carrier. Dana was originally brought in a trap, but a carrier was brought for her for recovery purposes--more about that later.
The students and volunteers operate the clinic like an assembly line; senior volunteers (many of whom have medical or veterinary credentials and experience) supervise the operation and handle complications as they arise. They rely upon other volunteers to spot and report those complications, and unless a clinic is especially busy they also train volunteers to perform more complicated tasks. Today was a light day, so I received training in both immunization and recovery.
As the surgeries are completed and the cats begin fully recovering, medical certificates are created for each cat and the trapper/owner is contacted to pick up the cat. As the cats are removed the clinic is systematically dismantled and supplies/equipment are packed away for the next clinic.
Dana returned home with me in a small carrier. For at least the next 72 hours she will be in recovery with me prior to release. Details of her recovery will be described in the next post--I'm tired, my feet are sore and I'm just about ready for bed--tomorrow's a work day....