More Than One Way to Neuter a Cat

Prepubertal gonadectomy (PPG) is used in shelters to ensure that cats are neutered before adoption. In this study, PPG in male and female kittens (8–12 weeks of age) was compared with traditional age gonadectomy (TAG; 6–8 months of age). Kittens were recruited from shelters and were randomly assigned to 1 of 2 groups: PPG ( n = 380) or TAG ( n  = 68). One of 3 anesthetic protocols was used: (1) IM or (2) oral transmucosal administration of premedication (dexmedetomidine and buprenorphine) followed by ketamine, or (3) IM injection of medetomidine-buprenorphine-ketamine. Ovarian pedicle hemostasis for the PPG group was performed by ligature ( n  = 47), vascular clips ( n  = 50), electrocautery ( n  = 50), or pedicle tie ( n  = 50); ligatures were used in the TAG group ( n  = 34). For male kittens, PPG consisted of a closed castration by spermatic cord knot ( n  = 92) or ligature ( n  = 91); male kittens in the TAG group were neutered via open castration spermatic cord knot ( n  = 34). All of the PPG techniques were found to be safe. PPG was faster compared to TAG. For female PPG, clips and coagulation were the fastest techniques, and ligatures the most time consuming. Creating the skin incision relatively more caudally was important. One kitten died in a pilot study when a spay hook inadvertently damaged the spleen; a spay hook was used to locate the right ovary in all subsequent surgeries with no additional complications. In male kittens, creation of a knot in the spermatic cord significantly shortened surgical time. Postoperative wound complications were rare.

Global Commentary

Population control is one of the most important goals of sterilization in dogs and cats all over the world. This study demonstrates that PPG is a good choice for males and females, and complications are the same as that for TAG—this is the most important point for owners. In my opinion, surgical time is not an issue with this type of surgery; an experienced surgeon can perform it with the technique of his or her choice (clips, coagulation, ligatures) in an acceptable period of time and at a relatively low cost. I usually use the spermatic cord knot technique in male cats and coagulation or ligatures in female cats, but this surgery permits many variations with the same results. For shelters and foundations, I think that we need to recommend PPG for population control.— Esteban Pujol, DVM, DECVS

This capsule is part of the WSAVA Global Edition of Clinician’s Brief.