Friday, July 19, 2013

Facts and Myths about Feline Spaying and Neutering

Spaying and neutering are probably the two most common surgical procedures performed in veterinary practice.  The primary purpose of these procedures is to take away the ability of cats to reproduce.We use the term “spay” to describe the surgery performed on a female cat.  The proper medical term for the surgery is an ovariohysterectomy – the removal of the ovaries and uterus.  “Neutering” is the term we use to describe the surgery performed on males.  The medical term is orchiectomy, the removal of the testicles.  Another synonym would be castration.  Frankly, neuter sounds less, um, aggressive.

Reducing feline overpopulation is not the only benefit to spaying and neutering.  If you spay a female cat before they ever come into heat, they will almost never develop mammary tumors in the future.  After one heat, spaying still significantly reduces the risk.  After two heats, there is no mammary tumor-sparing effect.  Spaying also reduces the risk of developing ovarian and uterine cancer.  Pyometra is a uterine infection that is potentially life-threatening.  Spaying a cat removes the uterus, thus eliminating the risk of pyometra development.  Neutering a male cat obviously eliminates the possibility of developing testicular cancer.  Dogs that aren’t neutered are at significantly increased risk of developing prostate disorders.  Male cats, for some reason, almost never develop prostate disease, regardless of whether they’re neutered or not. 

Despite the health benefits listed above, some cat owners still harbor fears about neutering and spaying. 

Friday, July 5, 2013

Type B, or Not Type B - Henry Saves a Life

Last Tuesday, at our hospital, Manhattan Cat Specialists, we were scheduled to perform surgery on Galet, a 6 year old domestic longhair.  Galet is a challenging case.  She is FIV positive.

As most of you know, FIV is the feline equivalent of HIV.  Cats acquire this infection usually though the bite of another infected cat.  Initially, cats may show a little fever and possibly some swollen lymph nodes upon infection, but they rapidly recover, and then continue with life as if nothing has ever happened to them.  However, over the years, the T-cell count continues to drop, until there are too few T-cells to protect the cat against illness, and opportunistic illnesses and infections start to occur.

Galet has a mass at the back of her throat.  It is a soft mass, and at the moment, food is able to pass around the mass, enabling her to eat.  Our concern is that as the mass grows, it will obstruct her ability to swallow, and she will no longer be able to eat.  The mass looks to be removable surgically, so that was our plan.  We performed pre-surgical bloodwork and were surprised to discover that Galet had become significantly anemic since the last time we tested her blood.  Although she still had enough red blood cells to be safely anesthetized, she was on the cusp.  We needed to find the cause of her anemia and treat it, so that she would be a better candidate for surgery.

There are many causes of anemia, and to list them all and explain how to figure them out is probably beyond the scope of this blog post.  Because Galet is FIV positive, and FIV suppresses the immune system, an infectious cause should be high on our list.

There is an organism called Mycoplasma (formerly known as Hemobartonella) that is an infectious cause of anemia.  It is a red blood cell parasite.  When this parasite attaches itself to the red blood cells, it makes the cells look different.  The immune system’s job is to recognize what is “you” and what is “not you”.  When it sees something that is not you, it tries to destroy it.  We tested Galet for this organism, and lo and behold, she tested positive.  Fortunately, Mycoplasma is treatable, and treatment was begun with the antibiotic doxycycline (which kills the organism) and dexamethasone (an anti-inflammatory drug that tells the immune system to stop attacking these different-looking red blood cells.)  Galet was to come back in a few days for her surgery, on the presumption that her red blood cell count would be improved and she would be stable for surgery.

Tuesday morning, I received a call from Galet’s owners.  They wanted to postpone the surgery because Galet was much weaker.  She could barely stand or walk, and they felt that she wouldn’t make it through the anesthesia.  They wanted to give the antibiotics and other medicines a few more days to kick in, so that she’d be a stronger candidate for surgery.

I was worried.  A cat too weak to stand or walk is in trouble.  Certainly we should postpone the surgery, but I suggested that they bring her in anyway, for me to evaluate.  They agreed.   On examination, she was indeed very weak.  I looked at her gums and could see they were pale, confirming the anemia.  The last time we saw Galet, her hematocrit (the percentage of her blood that is comprised of red blood cells) was 17.  The normal value is between 29 and 48%.  Our quick in-house test confirmed my fears.  Galet’s red blood cell count was a shockingly low 9%!  This is barely enough red blood cells to keep a cat alive.  While waiting for her medications to kick in, Galet’s anemia worsened, to a life-threateningly low level.   If Galet was going to survive this, she needed a blood transfusion.
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