I was asked recently what would be considered an acceptable complication rate for a high-quality-high-volume spay and neuter (HQHVSN) clinic. That’s an excellent question and it’s important that we have benchmarks for these rates. The complication that keeps us awake at night is, of course, perioperative mortality.
A new article reports mortality rates in 113,906 clinically healthy dogs and cats at a HQHVSN clinic in Florida.
- The overall mortality rate was 0.03% (3.3/10,000)
- The rate for female dogs and cats was 0.05%, versus 0.02% for males
- The rate for cats (0.05%; 5/10,000) was five times as high as for dogs (0.009%; 0.9/10,000)
Of the cats that died or were euthanized due to poor recovery, 76% were community cats admitted for TNR. Most deaths (58%) were postoperative, 26% were preoperative, and 8% each were intraoperative or post-discharge.
How do these rates stack up against others? The rates reported here were very low indeed – approximately 1/10th the rate commonly reported for private low-volume veterinary practices and approaching the 1/10,000 mortality for hysterectomies in women with benign conditions.
In the human literature, mortality and complication rates are lower if surgeons and hospitals perform the same procedures frequently and at high volumes. (Read “The Checklist Manifesto” for more on this.)
There’s no reasonable argument against HVHQSN – as the article points out, “approximately 3 million unwanted dogs and cats are still euthanized in shelters each year, of which 80% are believed to be healthy and treatable”, and millions of pet owners are unable to afford SN at private rates. Spay and neuter is demonstrably the single best way to reduce shelter euthanasia. This article also provides the assurance that, properly done, and with the HQ firmly in place, HVSN can also be incredibly safe.
How does your clinic compare? If you don’t have the numbers, now would be a good time to start collecting them.
- Levy et al 2017. Postoperative mortality in cats and dogs undergoing spay or castration at a high-volume clinic. The Veterinary Journal 224:11-15.