Spay/Neuter in the COVID Era

Spay-neuter has been intricately woven into the fabric of animal lifesaving for more than 3 decades. And then suddenly, COVID-19 challenged every aspect of daily life and shelter operations, rewriting the book on what essential services are. The public was asked to stay #SaferAtHome to avoid overloading the healthcare system and that every exception to physical distancing would decrease its efficacy.

Essential procedures were defined as emergency treatment for conditions that are life-threatening, rapidly deteriorating, may cause permanent dysfunction, or for the relief of suffering. Conditions such as pyometra and dystocia are reproductive emergencies, but routine spay and neuter services for the public, shelter pets, and TNR are not. What did that mean for spay/neuter programs? Even if clinic personnel could distance themselves from the public with curbside intake and discharge, performing surgery would bring staff to work and into close proximity with each other.

Between mandated statewide stay-at-home orders and business decisions to close operations to protect staff, help slow the spread of infections, and preserve critically needed medical supplies, most spay-neuter clinics in the US and Canada shuttered their operations by mid-March, 2020.

Pausing spay-neuter was a blow to organizations across North America for whom HQHVSN was a critical component of population control and shelter lifesaving. It came at the beginning of kitten season, meaning that thousands of kittens would be born to community cats. In addition, staff were furloughed and business income plummeted, putting some clinics in jeopardy of bankruptcy. This clinic director explained how she came to the difficult decision to close her clinic:

“Our clinic is closing tomorrow.  Today is the last day of surgery.  I am the Executive Director and I agonized over this decision.  I agree 100% that our surgeries are essential, especially this time of year.  Initially, my goal was to stay open unless given an order by the government to close.  We enacted social distancing measures last Monday, March 16.  I felt good at that time that we were doing everything we needed to do.  As time has gone on and I have read more and more information from the CDC, AVMA, etc., I have come to the conclusion that there is no way that I can ensure my staff’s safety. I realized that I would not be able to live with myself if one of my employees or their family members contracted this virus. I don’t want to even think about if one lost their life.  When you add into account that anyone who gets admitted into the hospital (for any reason) will not be allowed to have their loves ones visit, that makes it even worse.  Then, on our HQHVSN Directors discussion group, someone made the comment that by keeping our clinics open we are encouraging people to break the quarantine and social distancing recommendations by coming to our clinic.  That was the final tipping point for me. I know that this is going to cause an increase in puppies and kittens in the shelters, but I have to take care of my staff and community first.”

Suspending spay-neuter had consequences for shelters too. In transitioning to essential services and reduction of sheltering capacity, they rapidly evacuated shelter animals to new adoptive and foster homes whether they were sterilized or not. This reversed decades of commitment to “neuter before adoption” and resurfaced the use of spay-neuter agreements to have surgery performed when routine procedures resumed.

As stay-at-home orders began to lift in May, 2020, clinics started operating again with new procedures to promote physical distancing from the public. Clients were told to wait in their cars outside, to use waiting list apps to know their turn, and to use cashless payment methods. It is proving more difficult to maintain physical distancing inside the clinic where room layouts have traditionally crowded office staff together and surgical staff are used to working side by side. To varying degrees, clinics have implemented masks for all personnel, additional personal protective equipment (PPE such as face shields, gloves and outerwear), daily pre-shift health assessments, paperless operations, rearranging workspaces, splitting teams, revisiting protocols to facilitate increasing distance among the surgery suite team, and a general reduction in patient number and personnel on site.

While many communities temporarily paused elective sterilization surgeries during the COVID pandemic, the placement of unsterilized animals in homes created some challenges. Spraying by male tom cats created a high risk for adoption/foster failure, so some programs considered castration to be a life-saving essential procedure and continued to neuter male cats. Fortunately, a cat can be anesthetized and castrated by a single veterinarian, so there was no need for personnel to come into close contact. Because COVID struck during the feline breeding season, many young female cats went into repeated estrous cycles, a risk factor for frustration and unintended pregnancy. Estrous suppression with megestrol acetate is an option for short-term contraception of female cats until spay/neuter services are restored. This drug is administered weekly in food and can be prescribed from compounding pharmacies. Megestrol acetate has also been fed to community cats pending trapping for TNR programs.