The Truth About Spays and Neuters: Not All Are Created Equal

When it comes to spaying or neutering your pet, the old adage "you get what you pay for" often holds true. While it's tempting to choose the lowest-cost option, it's crucial to understand that not all spay and neuter procedures are created equal. Your pet's health and well-being before, during, and after the surgery can vary significantly based on several factors. To ensure your furry friend receives the best possible care, here are some critical questions to ask when comparing veterinary services.

Do they use pre-medication?

Pre-medication or pre-emptive pain management refers to the administration of medication before the start of general anesthesia. These medications are not part of the anesthetic. They are given to reduce anxiety, control pain, decrease the risk of aspiration pneumonia, and lower the incidence of postoperative nausea and vomiting. Anxiety levels are typically high for patients presenting for surgery. Anxiety not only interferes with patient comfort, but also increases stress hormone production, gastric secretions, initial anesthetic requirements, and preoperative procedure difficulty (ie, intravenous catheter placement). For your pets comfort and safety, it is imperative that your veterinary professional utilize a balanced anesthetic protocol, which includes anticipating and using certain medications to prevent pain and anxiety well before any procedure begins.

What is their sterilization process for surgical instruments?

Sterilization is a very important process in any surgical procedure. It is a method of killing all possible contaminants. The contaminants are living organisms like bacteria, which includes spores that may have been harbored by a particular instrument. All instruments that come in direct contact with body surfaces and tissues need to be sterilized before use. A surgical ‘pack’ refers to a set of sterile surgical instruments used during the procedure. Ensuring that your veterinarian uses a fresh, sterile pack for each surgery is paramount. Reusing packs without proper sterilization or between multiple patients in a day is not acceptable. Additionally, using instruments that have just been in ‘cold sterile’ (soaking the instruments in a tray of chemicals) and not a full autoclave/steam sterilization process can also increase the risk of infection and other complications. Cold sterile use for spay and neuter procedures would be considered below the basic standard of care as there can be contamination of the chemicals which leads to contaminated or unclean instruments. When calling around for prices, don't be afraid to ask if they use a fresh pack for every surgery.

Do they use local or regional blocks?

A local or regional block is a method of utilizing a numbing medication in and around the area in which the incision is going to be made. Most of these medications have a number of hours of duration, and this practice can significantly reduce pain both during and after the surgery. This promotes faster recovery and greater comfort for your pet. Veterinarians who use local blocks demonstrate a commitment to pain management and the overall well-being of your pet.

Do they place an intravenous catheter?

Intravenous catheters (or IV’s) are very small flexible tubes placed directly into a vein and secured in place temporarily which allow the veterinary team reliable and immediate access to the blood supply for giving medications quickly or administering injectable anesthetics or IV fluids. In some cases, this step may be skipped, either to save time or cost. However, it is absolutely vital in the rare case that your pet requires emergency or stabilizing medications during an anesthetic procedure. Having a catheter in place for the duration of surgery and recovery allows your pets team to act quickly where seconds count. Overall, an IV catheter is essential for maintaining patient stability and addressing any intraoperative needs promptly.

Do they include intravenous fluids?

Surgery can lead to significant fluid loss so IV fluids help maintain blood pressure and hydration. Patients are often required to fast before surgery (to prevent nausea and vomiting perioperatively), but this can lead to mild dehydration. IV fluids ensure that proper hydration levels are maintained. They can also maintain blood pressure, and therefore have a more stable anesthetic procedure, by maintaining adequate blood volume. This in turn can ensure stable circulation and oxygen delivery to all tissues. The fluids that are used are also balanced in terms of the electrolytes required by the body – this is crucial for normal cell function and metabolism (and therefore patient healing!) The proper fluid balance also helps remove waste products and supports kidney function during and after surgery. Using IV fluids is essential for maintaining physiological stability and supporting the patients overall condition during the surgical procedure. Many hospitals feel that young healthy patients should be able to handle an anesthesia without fluids and use this as a way to save money. It is important to make sure your veterinary team is making your pets health a priority by including this vital item for their procedure.

What is their approach to post-operative pain management?

Pain management is a critical component of any surgical procedure. Both spays and neuters are painful procedures and should be treated as such. Ask your veterinarian what pain management protocols they have in place. A balanced or comprehensive post-operative pain management protocol should include the use of both a narcotic, and a non-steroidal anti-inflammatory. Certain post-operative pain medications are certainly cheaper for some vets to use, but they often lack comparable efficacy or duration. Medications like methadone or hydromorphone would be far superior in terms of the level of pain control provided, but they also come at a slightly higher price point. Some postoperative patients may also benefit from physical therapy modalities such as therapeutic laser to reduce pain and inflammation. Each surgical patient is unique, so each pain management strategy must cater to the needs of the individual. A well-rounded pain management plan can make a significant difference in your pet's recovery experience.

What type of anesthesia do they use?

The type of anesthesia and pain medication used can have a significant impact on your pet's safety and comfort. There are various types of anesthesia, including injectable anesthetics and inhalant anesthetics (such as isoflurane or sevoflurane). Inhalant anesthetics are generally considered safer and more easily controlled, allowing for a quicker recovery. Ask your veterinarian what type of anesthesia they use and why they prefer it. Additionally, inquire if they use monitoring equipment to track your pet’s vital signs such as heart rate, respiratory rate, blood pressure, ECG, oxygen saturation, carbon dioxide output, et cetera during the procedure, which is crucial for ensuring your pet's safety under anesthesia.

Do they have a Registered Veterinary Technician?

The roles of a Registered Veterinary Technicians (RVTs) and a veterinary assistant differ significantly in terms of education, responsibilities and professional credentials. RVT’s have a broader scope of practice with legal authority to perform more advanced and invasive procedures, with their role being regulated by provincial laws, similar to nurses in the human field. Veterinary assistants have less stringent education requirements or may only receive “on-the-job” training. A RVTs role (amongst many others) is to assist veterinarians during surgeries and provide crucial care to your pet. They work side-by-side with the veterinarian to develop and execute a safe and balanced anesthetic and pain management protocol for your pet, they perform anesthetic monitoring all of your pets vital parameters and are trained on how to intervene in case of an emergency. They are also the person who ensures your pet has a smooth recovery from anesthesia and in the hours after. Having an RVT on staff during your pet's spay or neuter procedure can enhance the quality of care your pet receives. RVTs are crucial to ensuring that your pet is in good hands throughout the process.

What is included in the estimate?

When comparing costs, make sure to ask what all is included in the estimate. Some clinics may offer a low initial price but later add on fees for necessary or required services like pre-surgical blood work, anesthesia, pain medications, and follow-up visits. It is also important to understand that not every hospital has the same requirements for services, so just because one clinic includes or requires something, doesn’t mean that all hospitals will require this. Understanding the full scope of what’s included will help you make a more accurate comparison and avoid unexpected expenses.

What is the skill and experience of the Veterinarian performing the procedure?

The skill and experience of the veterinarian performing the surgery are crucial factors in the success of the procedure and the safety of your pet. Ask about the veterinarian's qualifications, how many spay or neuter surgeries they have performed, and their track record. While many newly-graduated veterinarians have had surgical exposure during their clinical training, they are understandably going to be slower and require more guidance during surgical procedures. This could lead to unnecessarily long (and therefore less safe) anesthetic procedures for your pet. A more experienced veterinarian is likely to handle complications better and ensure a smoother procedure and recovery for your pet.

Why These Questions Matter

Choosing a veterinarian for your pet's spay or neuter procedure isn't just about finding the lowest price; it's about ensuring that your pet receives the highest standard of care. Here's why these questions matter:

Infection Control: Using a fresh pack for each surgery reduces the risk of infections, which can be serious and costly to treat.

Comfort and Recovery: Techniques like line blocks and comprehensive pain management protocols help ensure your pet experiences minimal discomfort and recovers more quickly.

Quality of Care: Having an RVT involved in the procedure means your pet is being cared for by someone with specialized training and expertise.

Transparency in Costs: Knowing what’s included in the estimate helps you understand the full cost of the procedure and ensures there are no surprise expenses.

Veterinarian Expertise: The experience and skill of the veterinarian are key to minimizing risks and ensuring a successful outcome.

Spaying and neutering are routine procedures, but the quality of care can vary widely. By asking the right questions, you can ensure that your pet receives the best possible care. Don’t be afraid to discuss these points with your veterinarian—they should be open to addressing your concerns and explaining their practices. Remember, investing in higher quality care can lead to better outcomes and a healthier, happier pet.

Your pet deserves the best, so take the time to make an informed decision. It’s not just about the cost; it’s about the care!