Good evening, everybody, and welcome to this Tuesday night's webinar. My name is Bruce Stevenson, and I have the honour and privilege of chairing tonight's webinar. A huge big thank you to our two sponsors for tonight, the one being Cat's protection and the other one being Boringa Engelheim.

Bringer Ingelheim Animal Health is always working on first in class innovations for the prediction, prevention and treatment of disease in animals. Metacam is the original veterinary meloxicam, supporting vets and nurses in delivering high quality pain management solutions. And it has been the go to brand for the last 30 years.

Metaam has a broad range of formulations and has wide indications for dogs, cats, and guinea pigs for both acute and chronic pain. Metacam is very proud to be partnering with Cats protection, supporting cats to recover from neutering pain-free. For more information on Metacam, please visit Bohringer's website.

Little bit of housekeeping before I, introduce our speakers tonight. For those of you that are new to our webinars, if you have a question, please move your mouse over the screen. You'll see a little control bar pop up at the bottom, normally a little black bar.

And there's a Q&A box on that. Just click on that, type in your questions. They will all come through to me, and we will hold them over to the end.

We also have a poll question. So, be awake, be ready for that. I'll explain a bit more when we get to that of what we want you to do.

Our two speakers tonight, the first one is Jane Clements, and she is the head of neutering for cats protection, where she is responsible for their neutering programme. Jane is an RVN and completed a master's degree in human behaviour change in 2020. She work, her work involves developing targeted collaborative neutering campaigns, promoting pre-pubertal neutering, and working on research projects to monitor the impact of the neutering initiatives.

Our second speaker taking over from Jane is Alison Richards, who qualified as a vet from Bristol Veterinary School in 2010 and spent her first eight years in clinical veterinary practise. In that time, Alison developed a real passion for the feline side of small animal practise. Regularly being the cat advocate in her team, and she started educational volunteering for cats protection.

In 2018, she joined Cats protection veterinary team and now works as the head of clinical services. In her role, she enjoys the opportunity to promote a feline-focused, holistic approach to the veterinary treatment of cats, and is a big believer in the value of pragmatic, contextual care. Outside of work, Alison has a rescue cat called Smarty.

I love that, and two dogs called Benji and Ted, who she loves to be walking with in the outdoors. First of all, Ali, Jane and Alison, welcome to the webinar vet. And, Jane, it's over to you.

Thank you, Bruce. I'm just gonna turn my camera off while I'm, while I'm presenting everyone, but thank you for joining us tonight. So I'm going to first of all, kick us off tonight talking about our new subsidised neutering scheme, and then we're gonna move on to talk about the benefits of pre-pubertal neutering, which is closely associated with our neutering schemes and is really important.

I'm just trying to move the presentation on, sorry. Just click on the slide. And then your arrow should move it.

Oh, yeah, it's just got a bit stuck, sorry. OK. So in terms of, how we do subsidised neutering at the moment at cats protection, you're probably all fairly familiar with, with the way we do it across the board, and that can be quite different, across regions, and, and certainly across different towns and cities as well.

Coming out of the pandemic at the end of 2021 and and sort of coming into 2022, we really wanted to make sure that we were doing our best to make subsidised neutering available to as many cat owners who needed it and and obviously reaching those cats, but also to make it as attractive as we could, to our private vets that we work with, and we really appreciate those partnerships because we couldn't neuter the cats that we neuter without them. So, in that vein, what we did at the beginning of 2022, in spring, was we ran a consultation with vet practises, and as I say, we really just wanted to understand how we could improve subsidised neutering, and therefore, our research question was just that really, how can we improve subsidised neutering and microchipping in order to better support veterinary practises to participate. And we also were very interested in what else we could learn.

From, from those discussions. So we wanted really deep insights and therefore we used a methodology of surveys in the first instance, and then, taking from those surveys some participants onto focus groups where we had some real in-depth conversations and we also completed some structured interviews with some participants as well. We learned a lot from, from that process, so I won't go through all of it tonight.

But what I am going to go through is, is the key things that came out of that consultation, which has basically formulated the recommendations, for our new subsidised neutering scheme. And, due to those recommendations being put into place, as most of you will probably be aware, that scheme, formally goes live in a couple of days' time, in the, on the first of June. So the things that came up in the consultation and, and what vets were telling us across the board was that what they felt would be really helpful would be one UK wide scheme, and that would mean a scheme that was the same wherever you were in the UK.

So that it's more equitable both for veterinary practises and also for the general public and the cat owners that need it. Alongside that, we, not, unsurprisingly and absolutely appreciate the fact that we needed to increase our standard voucher value, again, to make it a little bit more standardised across the board. What was also important, to the vets we spoke to was post-op analgesia, take home post-op analgesia, and for the voucher to include that, so that there was no cost of that, to the practise or the cat owner.

And alongside post-op analgesia, to also include a microchip. And obviously that's especially important with the, legislation that's now in place and, and will come into play next June. And, and some vets also asked for a buster collar to be included.

We know that's not necessarily across the board, but it was one of those things that was asked for. And so it did go into the recommendations and is therefore now part of of the new scheme. And I'll go into a little bit more detail in a second.

The other thing that we talked a lot about in the consultation was about digitization. So I'm sure again, you're all aware that at the moment we work with paper vouchers, which is certainly not ideal. And we, we have really been wanting to look at digitization for some time.

And what this new scheme enables us to do is to move forward with that. It is obviously a slightly bigger piece of work, than just adding the new parts to subsidise neutering. So we expect that to to happen next year in 2024, as early as we can make that happen in 2024.

But essentially what we're aiming for that to look like is a full digital platform, which will give practises direct access. The vouchers would then also be able to come through the portal, and they would be digital vouchers and not paper vouchers, and it would also have the function, to do more direct invoicing, which again, I'm sure, you know, is it will be a really positive thing in terms of making payment faster as well. But that, that piece is to come in 2024.

So before I talk a little bit more about the detail, kind of in broad summary, we consulted with vets across the UK from different regions of the UK, from different types of practise as well. And, also with decision makers in those practises. And what was broadly said was that at the moment, there are too many campaigns and too many voucher types, that the voucher values across the UK were inequitable because it, it is at the moment a bit of a postcode lottery.

And that a wider welfare package was needed. So what's meant by that were the key things, that were asked for. So that's the microchip, the postop analgesia, which will be available in the form of MetaCam and a buster collar, where you want to give it.

And then the digital voucher scheme would also be desirable, and we'll be moving, forward into that next year. So that's what Beth said, in the consultation last year. And that's really what we've done.

We've just packaged all of that up. So it means that the new neutering scheme is one UK wide scheme. So whatever type of cat you are, whether you're a pet cat or a feral cat, or a cat in care in our care, that voucher will be used to neuter any type of cat.

What we did last year was we looked at the average cost of neutering across the UK both from the perspective of the research we did, the vets we talked to, but also the Society of practising Veterinary Surgeons annual report. At that time, the voucher was coming out at 60 pounds for a male and 80 pounds for a female, which aligned with the, the average voucher, sorry, the average neuter value. Across the UK.

Now, we do obviously accept that the average never captures everything and, and there are always different ends, different extremes, and we are committed to reviewing that voucher value at least on a, on a yearly basis. The voucher will also include a 3 mL bottle of Metacan for the owner to take home, a microchip and a buster collar for for female cats, primarily where where you want to give one. So what does that look like in terms of the kind of bit of small print around it?

So the voucher value includes the 10 pounds owner contribution. Obviously we are in a cost of living crisis at the moment, and our subsidised neutering schemes are there for the purpose of helping people, cat owners who are most financially constrained. So, therefore, we are asking, that the 10 pounds is the maximum that an owner contributes and the rest of the amount comes from the voucher itself, which cats protection pays.

It's worth noting at this point that we do have, regional schemes across the UK which currently operate like this. And, and at the moment, obviously the, the voucher values are actually much less than than the new one, but they, they are now going to go up in line with the new scheme. Where there isn't a cat owner, so where a cat being neutered is one of our cats in care or a feral cat or a stray cat, then we will cover that 10 pounds, so that the practise always receives the full voucher value.

It may also be the case that some cat owners who are not strictly speaking eligible to use the scheme, we might want to authorise their access to it. Obviously on our helpline and also our volunteers across the UK are always having 1 to 1 conversations with people, and we're taking into account their different circumstances and situations all the time, and obviously particularly at the moment. So it might be the case that we will also cover the 10 homes, for some of those cat owners.

The practise will know about that, because you will receive authorization, either direct from Cats protection neutering team at head office or from one of our volunteer cats protection branches across the UK. We, you might also be aware that sometimes the public help us to neuter ferals and stray cats, which we do really appreciate and obviously is really important for us to be able to reach as many of those cats as possible. So they would also, be authorised to use the scheme, and you will, as I say, get, get notification of that too.

The scheme is means tested by self-declaration, so there is no need for practises to check proof of eligibility at all. I know that in some cases, currently or historically, you may have been asked to do that, but, but that will not, that will not be the case going forward. You will see on the voucher that the cat owner needs to sign a self-declaration, which allows us to audit that information going forward into the future.

So that's how we would mitigate, to some extent people who might be trying to use the scheme when they shouldn't. Our experience is that that really doesn't happen that often, but that's there as a bit of a safety net. A slight difference as well for many practises will be that instead of a cat owner coming along with the voucher for their neuter, or instead of you being given the vouchers by one of our volunteer branches, the vouchers will actually be held in practise.

So we would send those out to you from our neuring support team, and we can replace those when you need more. This means that cat owners can access the scheme by coming direct to participating practises, but obviously they will still be directed to participating practises by our local branches as well, and our national helplines and our website, because there will be a find a vet tool on the website where people can see where their nearest participating practises are. To clarify, this doesn't mean that you have to issue vouchers and post them out to the public.

It just means that when somebody comes to use the scheme with their cat on the day of neutering, and that's where you present a voucher to them and the onus is on them to complete it, so you're not having to complete it for them either. The way that you would receive the products that we've included in the package is via a cat's protection wholesaler account. Our wholesaler is Cavetros, and we appreciate that for many of you, that won't be your normal wholesaler.

But just to stress that the, the account is a cat's protection account, so it's not actually your own account. It doesn't affect any agreements you have with your own wholesalers. And the account is just in place, for, for the purposes of you being able to order that stock at no cost to the practise or the client.

And it means that we can then pay the wholesaler direct, so there's no financial element for you. We do ask the practise to register microchip details in order to ensure registration does happen. We do know that sometimes cat owners find it difficult even when when they're told to go away and register the cat.

That doesn't necessarily happen. And on our current regional schemes, we do, we do ask practises to register the microchip details just to make sure that that gets done. There's lots more information on the website and you should have hopefully by now received the direct communication which we sent to all practises either by email or by letter or some, in some cases both.

And all of the links on this slide, will give you all of the information you need, and also the forms that you need to actually register for the new scheme. And hopefully, the feedback we've had is that it's been quite simple to do the registration process. There's lots of detail there and there's also a sort of quick guide too because we do appreciate that.

You know, don't necessarily have time to wade through lots of detail. At the end, I'll also, give an email address, and if you have any queries at all, it's absolutely no problem to get in touch at any point. We're also very happy to organise a 1 to 1 chat, just to talk through the more detailed elements of the scheme, where you might have more questions.

I'm now just gonna play a short video, and this is David, who is one of the vets currently helping us. He's been a partner with us since 2017 on our regional neutering scheme in Liverpool. And as I say, that the new scheme runs very much like, this new scheme does.

So hopefully this works well and you'll be able to listen to David instead of me for a bit. The new cancer protection nutrient scheme has been designed to make the process easier for practise colleagues. The new scheme involves one type of nutrient voucher.

This means there will only be one set of instructions and information for the team to understand and convey to clients, such as a single set payment required from the client regardless of the reason for the client's eligibility to use the scheme. The voucher itself has been simplified with advice and feedback from practise teams. This simplification should increase the ease of completion and reduce administration when processing the voucher.

The requirement of the practise to view eligibility criteria, such as proof of benefits, has also been removed to reduce the burden on the practise team. The wholesaler process to order consumer balls for use for cat protection uterine is very easy. There's one simple form to complete and submit, and the consumer is supposed to deliver it shortly after.

There's no requirement for the practise to routinely use this wholesaler as your main provider of medication. And why is this new scheme good for cancers? The hope is that more practicers will opt to be involved with this new simplified nutrient scheme.

More accessible veterinary care will mean that more cats will be neutered to reduce the increasing numbers of unplanned litters. This will improve the welfare of all cats by working to reduce the number of unwanted or abandoned pets. Cattle also have more access to benefits of neutering, such as reduced roaming, with the risks associated with that of road traffic accidents and car fighting.

All right, I'm just My brain is sticking again. Down the bottom left of your screen. Yeah, yeah, thanks.

Sorry about that. It's just. Sticking.

OK. So thank you for listening to me around the new Nutrient scheme. There will be an opportunity to ask questions, of course, and as I say, I will give more information on, on how to contact us, to, to ask any questions and to arrange a 1 to 1 chat if you would like that.

We're now gonna move on to talk a little bit about prepubil neutering. So we're gonna start with a bit of a poll. And if we could ask you, for pet kittens, what age does your practise routinely neuter at the moment?

So, 4 months or younger, 5 months, 6 months, or maybe over 6 months? Right, folks, I have launched the poll. A lot of you already know what to do.

Just simply click on the answer which best represents what you do in your practise. And, please remember that these answers are anonymous. So, don't feel like your answer might be wrong or you, you might be divulging practise secrets or something.

As I say, they are completely anonymous, and, we want to get as many people voting as what we can. It'll give all of us on the webinar a great indication. But it's also good feedback, to cats protection so that they are getting, more information, which obviously helps them to know what's going on out there.

So, I'm going to give you another 10 seconds to click on the answer, which most appropriately represents, your practise and the age at which your practise is neutering kittens. Right. Let's stop that poll and share those results.

There you go, Jane. Thank you. Thank you.

That's really interesting and and thank you to everyone for completing that poll for us. It's really great that 25%, are neutering at 4 months or younger, and 37%, are neutering at 5 months. So we're really capturing.

Quite a lot of cats pre-pubertily. And then we've got 30% of people, neutering at 6 months, which is, of course, historically, the recommended, time, and then very few, as we would expect, neutering at over 6 months, just, just 7%. So that's great.

So it's really heartening to see so many, neutering at 5 months or younger. So now we're just gonna move on to talk a little bit about the research, around prepubertal neutering. And some of the benefits and some of the tips as well around surgery, and anaesthesia.

So why do we feel that timely neutering is important? Well, we know from consistent research done in the area that there's kind of a lot of problems with people leaving it too late. And so we know that cats can become pregnant as early as 4 months old.

We also know that many cat owners are unaware of the reproductive capacity of cats. Many owners also believe that that a cat should have a litter of kittens before being neutered. That's still quite entrenched, despite best efforts to, to sort of bust that, that myth.

Research shows that 16% of female cats had kittens before being neutered, and 80% of owned cat litters were accidental, which is, is obviously massive, you know, really, really high. We know also that vet professionals identified the lack of neutering as one of the top issues relating to the well-being of cats, and again, that's, that's consistent, a consistent message that we hear. And we know that as many as 68% of vets are currently neutering at 4 months of age, or they would if if the practise policy permitted.

So this is what the research shows us. What we know anecdotally is that we do see so many accidental litters of kittens, and that inevitably leads to more stray cats on the street, or more cats in shelter care. And we know also that sometimes even the best prepared, most responsible owners can accidentally let let a cat out, and because if they, if they're thinking that the age is 6 months, then quite often it can perhaps be towards the end of 6 months or 7 months before actually neutering is happening.

And by that time, definitely the queen could have had a litter of kittens. So timely neutering is the only effective way that we can really reduce the number of accidental litters and unwanted kittens born in the UK. Some of the reasons we know why owners choose not to neuter or or don't neuter, it's not always a choice actually.

And, and again, some of this is in the research and some of it, we hear anecdotally all the time, both in our community work and over our helplines, is. The, the sort of myth or ignorance factor, things like brother and sisters won't mate. Like I say, every cat should have a litter, and also some, indoor cats as well.

Although you kind of struggle to, to, to wonder how people manage to, to live with an indoor cat that isn't neutered. Often the cost, is obviously a problem, and, and that's the reason for our subsidised neuring schemes. But sometimes it's just the apprehension of the cost.

So people sometimes have a much higher perception of what nuuturing costs than it actually does. And sometimes it's just that people don't know that the help is available, which again is the reason for raising more awareness around our subsidised nuturing scheme. From a practicality point of view, we, we're always amazed at how many people just don't have a cat carrier or how many people haven't acclimatised their cat to the carrier.

So obviously the first time they try and get their cat to the vet, that's a little bit of a of a nightmare for them, because the cat doesn't react well. And transportation can be an issue as well if they don't have access to a car and the nearest vet practise is a little while away. Obviously, kittens, you know, people will always want kittens, to some extent, sometimes they have them to sell, and unfortunately, sometimes that's not done in a responsible way.

Obviously people want kittens because they're cute, and some people will have them as an educational reason for their children. There are also cultural reasons sometimes, why, people don't neuter. And sometimes it's just a general lack of motivation, to get it done, or it's just sort of non-choice.

They haven't thought about it, so they're just not, they're just not making the choice. And that's why we really feel that those conversations early on about neutering, are really important. So we have some more findings on why owners don't neuter from our 2022 cats report, and that showed us that 20% of cat owners didn't neuter because the cat didn't go outside.

14% actually wanted the cat to have kittens. 13% felt that the cat was too young to be neutered. 11% didn't agree with neutering.

And 11% have just sort of just not got round to it, so they've been meaning to do it, but they haven't got round to it. So there's some quite interesting reasons there as well in terms of the breakdown of those percentages. But overall, 1.3 million million cats were not neutered, which equates to about 12% of owned cats in the UK.

So you may have heard of the Cat Kind Group, and our aim is to increase public awareness and intention towards timely neuturing to improve cat welfare. We are a collaboration of lots of different charities and organisations that do cat work in the UK. We were formed actually back in 2013, and we aim to have aligned messaging and policies on neutering.

And we also developed 4 key workstreams, and we are still true to those work streams. So they are around public awareness and marketing, engaging with the veterinary profession, engaging with harder to reach audiences. So typically, those are people in areas of the UK which suffer from multiple deprivation, where obviously financial constraints are a problem, or where other reasons may be a factor.

And we also try to support smaller charities around, neuturing in a timely way. The cat kind website, sorry, also features our kitten neutering database. So if you are a practise neutering routinely at 4 months or younger, you can register the practise on that database and the public will be able to find you.

So you can see along the bottom there, all of the logos of the organisations involved with Cat Kind. I really just wanted to highlight here as well, the positions of the BSAVA and the BVA, both supporting pre-pubertal neutering, in terms of population reasons and also cat welfare reasons. And I'm now gonna hand over to Alison.

Thanks Jane. So I'm gonna talk a bit more about the detail of creepyvertal neutering. And I think we've essentially established that the key to effective population control is to get them neutered before sexual maturity.

So many cats are, going to reach puberty by 5 to 6 months. And as we've just seen, groups like the BSABA and BBA, and the cat group recommend neutering at around 4 months, for those domestic owned cats. And we define kitten neutering as that neutering that takes place at 4 months or younger.

And I think it's really, really important to highlight that there really is no evidence, for health concerns, such as issues with growth, or bone development. And often, people kind of are concerned about risks of, like, urinary tract disease, particularly in male cats. But the evidence, just isn't out there for those links, and, and vets should be kind of reassured by that.

Next slide, please. And there are loads of advantages of kitten neutering. I'm going to, probably spend the next 1015 minutes, hopefully selling kitten neutering to you.

It's something I absolutely love, and was so happy to start neutering kittens, at sort of 4 months or younger. What we're gonna see is an advantage. You're gonna get fewer unwanted kittens, which is, I think, super important.

And we can get, sort of thinking about that shelter perspective. If you've got cats, being neutered before rehoming from a rescue centre, it takes a lot of the onus, off the owner when they're taking that cat on, to make sure they are neutered. Breeders can neuter those cats that they might, sort of not see as suitable for, for further breeding before they can re.

Own those cats. And it also, when we're thinking about doing TNR work, really, improves our, a capacity to, you know, get all cats neutered or when they're doing a TNR project. If we've, trapped a, a sort of a younger kitten, and we're concerned about, kind of, then trying to retrap that cat, if we can, sort of neuter them.

At that sort of younger age, it's going to, really improve the, the success, the chance of success of the TNR project. It's obvious, it's also, going to reduce the chance, of lots of health problems, things like pyometras, mammary tumours, mammary hyperplasia. And we're gonna be, having fewer pregnant or in-season spaces, which, in my opinion, is a massive tick because they are never the spaces that you want to be doing.

There is a much quicker recovery for the cats, and if you haven't done kitten neutering before, you will be astounded if you, you know, following this session, do get involved in it by just how quickly those guys are up and about and are behaving as if nothing has happened. It's incredible, surgical recovery that we see. And, it's a much nicer surgery.

We'll talk about this in a bit more detail, but we've got a much lower blood supply to those immature organs. So that risk of bleeding, becomes, much less. So, it's, it's a much safer surgery, and we have got evidence out there to show that it's actually less, painful.

And it's also good for those poorly compliant owners. You know, those owners that you maybe see for those 2 vaccinations, and you tell them to come back in a few. Months for that pre-op check to talk about neutering, and they just sort of, you don't really see them again until a year's time, and then you need to have a conversation again about getting the cat neutered or the cat's maybe presented, having had kittens.

If you can get that neutering sort of booked in at the time of that second vaccination and, and keep that kind of conversation fresh in their minds, then the chance of it kind of, following through is, is, is much improved. Next slide, please. And just a little reminder of just some pictures of some pyometer in cats.

It's not something we see every day, but it can really be quite dramatic, and needs some really quite dramatic significant surgery that we wanna avoid. Next slide please. And as I touched on earlier, one of the questions that we get when we're talking to vets about pre-pubertal neutering is around safety.

So, and it's just that reassurance that numerous studies have shown that there is no evidence to show that, neutering pre-pubertally has any negative developmental or behavioural consequences. And the other sort of safety area that we talk about is sort of, you know, how is the surgery riskier? Is the anaesthesia riskier?

Obviously, these are smaller kittens that we're doing all of this on. But I think, it's, and I'm gonna talk about this in a bit more detail, but hopefully it can offer some reassurance that that risk is considerably reduced, by the published information out there and the improved techniques and agents. And there is, I think, sort of certain things that kind of come inherently with the procedure that do actually make it a, a safer procedure.

Next slide, please. So, what do we want to be thinking about with these guys? It's always worth having those, kittens having had a general health check before surgery and being vaccinated prior to surgery.

Like I say, I think if you kind of consider those sort of getting those vaccinations done and then thinking about getting that surgery booked in, following on from those vaccinations, you do need a minimum weight of 400 grammes. And it's that physical size that's a lot more relevant than the actual age of the kitten. There are a few times where we might postpone.

One of those would be if we have got a crypt orchid, particularly if it's abdominal. And the, when it comes to sort of planning your day list, the first surgeries you want to be doing are your kitten neuters, because they are, gonna have the slightly more naive immune systems, and you want to reduce the risk, of them, of them catching anything whilst, you know, and, getting any infectious disease. And when it comes to housing them, you want a warm and quiet environment that they can sort of recover in.

And there are two conditions that you really need to think about, in particular to kitten neutering, next slide please. And those two conditions are hypothermia and hypoglycemia. And because these, these, guys are gonna be a bit smaller, they are more, those are the two risks that we really need to consider, but there is a lot that we can put in place to avoid them.

So by, by warming our theatre, keeping our theatre about 20 degrees BC, having a heat source on the table, having, using that sort of insulating, reflective material for patients, trying to kind of keep the area as dry as is possible during the, surgical prepping and keeping that surgical time really short, that's hopefully going to, avoid as much as possible hypothermia. And, we can avoid hypoglycemia by fasting for less than 3 hours prior to the surgery. So that's quite a shift in mindset, to, so we aren't gonna ask them to be starved completely overnight.

It's only 3 hours prior to surgery, and we want to get them fed as soon as possible on recovery. And like I said, it's quite impressive. I always find how quickly they are up and about and eating.

Next slide, please. And we want to keep kittens together. So, litter mates can recover in the same cage.

This is gonna help with, inpatient, efficiency. It's also gonna decrease stress for the kittens. They can, you know, snuggle up together.

It's gonna help, with that kind of recovery. And so that's not something you should be afraid to do. Next slide, please.

Now, Anastasia is something we get asked about a lot, and I think your approach might be a bit different, for, prevertal neutering. So you're gonna want to use a combination of it, agents, so you're able to minimise that risk of overdose and, and kind of reduce that, that risk of, reduce that dose of each of those, agents. And you ideally want to be going for something that's reversible.

Because, these guys are a little bit ddy, IV access isn't gonna necessarily be the easiest. So something that you can give intramuscular is always going to be preferred. And we want something that's gonna be, quite rapid in terms of induction.

So, they, these, kittens are gonna have less body fat and higher metabolic rate. So. They are going to be sort of, you know, slightly more susceptible, to that.

They are, we want to be able to provide a rapid recovery, so they are going to, kind of recover really quite quickly from this surgery. And to kind of allow for, those kind of, a safe anaesthetic. We wanna make sure we get really accurate weights, and we really also want to, instead of using weight, use body surface area for calculating dose rates.

So this, because they are much smaller, using body surface area means that our dosing becomes a lot more accurate. Next slide please. Now, we do have, some anaesthetic protocols, that we can recommend.

We've got, some details on the cat Kind website. And useful combinations would include, for example, meatomidine and ketamine, meatomidine, ketamine and butterphenil, or the kitten quad, which is probably our preferred, dosing at Cats protection, which is meatomidine, ketamine, buprenorphine, and midazolam. And that can be given in a single intramus single intramuscular injection.

Next slide, please. And, so I've just got the doses here. When you, for the metaomidine, ketamine, buprenorphine, and midazolam, you'll find that it ends up working out, as sort of the equal, volume of each, when you're drawing it up in the syringe.

And we've got a, . Kitten quad, table that's available on our, Caine website. And it's also available in the veterinary guide.

If any of you have got a copy of the Cats protection veterinary guide, you can find it there. So, this is a really useful thing to just have, sort of stuck on, one of your, kind of, cupboards in prep room, just so you can really easily refer to it. But it is a really, You, you know, really, really straightforward way, of, of, kind of dosing them.

You've got, a lot of benefits, comes from the midazolam. So, it's a muscle relaxant, it's, angiolytic and amnesic. So that first, generally, first experience of surgery that like cat's had, is gonna be less stressful.

And it does really help reduce the requirements for other drugs. It's, it's a, it's a really nice drug, To use. And we wanna make sure we don't forget pain relief.

So, meloxicam, at 0.2 MB per gig is licenced from 6 weeks of age and from 2 kg in weight. We do have doses on the kitten quad, chart for, meloxicam under that weight range, and it's just worth sort of highlighting that that is off licence.

So you'll just need to get in your consent for that. Next slide, please. Thinking about the surgery, we want to make sure we lubricate in the eyes.

We don't necessarily need to tube males, and we'll use an uncuffed tube for females. And we want to do what we can to keep surgery time to a minimum. Next slide please.

For the boys, you can do a standard open or closed castration. The, tissues are obviously gonna be a bit smaller and they are going to be a bit more fragile. So this is where you're gonna need to take a little bit of extra care, and in terms of technique.

I mean, you can auto ligate, you can use forceps, or you can ligate with a cat. And the technique can, you know, essentially be the same as what you would do in a in an older cat, but it's just being, just ever so slightly more cautious because of the fragility of the tissues. Next slide, please.

Spaying females. So, in preparation for a, female kittens spa, we are going to, gently express the bladder, once anaesthetized. It's gonna really improve our exposure and our visibility.

You can approach it with a midline or a flank incision. Flank is what we generally recommend with ferals, because, they are going to be. Released fairly shortly after, we've neutered them.

And in terms of landmarks, for the flank space, it's gonna be pretty much the same as if you were a a flank spaying an older cat. For midline incisions, we, use the umbilicus and the pubic brim. And I have to say, my go to is, is to go for a flank, when I'm doing, hidden spades.

Next slide, please. And there are some surgical differences, and this is where I get quite excited and, sing the praises of kittens spaces. The, skin is quite thin.

You've got minimal subcut flat, sub-cut fat. So that means that your visibility is vastly improved. And I always find when I'm kitten spraying that, like, locating, the organs is the, you know, so much easier.

One thing to be aware of is you might see a bit of abdominal fluid, and that will be. Different, to neutering cats at that older age. It's, it's generally clear abdominal fluid, and it can sometimes be alarming if it's not something you're used to, but that is, that is normal to see that in, in, in these kittens.

You're gonna get a lot less, fat internally. So, like I say, your visibility is, is much better, and your blood vessels are much smaller. So you've got less likelihood of haemorrhage, and you can do very simple hemostasis, at the ovary and the cervix.

Next slide, please. And just some images here of the surgery, as you can see, we're talking about very small incision, very small, organs, yeah, and it's a really, really nice surgery. Next slide please.

In terms of recovery, like I say, this is generally really, really rapid, so much faster than adults, and you will be slightly bit amused the first time, you, do kiss and neutering by just how quickly they seem to kind of recover. You want to be keeping them nice and warm, you wanna be recovering litter mates together, and you want to feed them on standing. And as soon as they've eaten, they can go home.

They're probably, you know, once they're up and about and eating, they are better being at home than being in the clinic. So, those are probably like your key things to consider when you're thinking about recovery for these guys. Next slide, please.

So we've got, that was a sort of really quick run through in terms of the practicalities of creepy ertal neutering. We've got a really nice video. Online, which, gives us, gives you a bit more of a step by step guide to that pre-pubertal neutering.

So I definitely recommend, hopping onto YouTube and, just checking that out if you're interested in learning more. And the other thing to say is, if you are kind of a practise that are keen to, sort of learn more about kit and neutering, then, yeah, definitely, you know, check out the Cali website. But I think at Cats Protection, we're always, you know, kind of happy to sort of hear from you and, and, and talk to you if you, if it's something that you're kind of considering and not sure about.

Next slide, please. And now I'm gonna hand over back over to Jane. Thanks, Alison.

So I'm just going to round up, and I'm gonna start the roundup with, a video from Martha Cannon and her colleague at the Oxford Cat Clinic. And Martha's gonna talk again a little bit more and summarise, the benefits of pre-pubertal neuter. Hello, I'm Martha Cannon.

I'm a Royal College specialist in feline medicine and co-owner of the Oxford Cat Clinic. And about 4 or 5 years ago now, we adopted a policy of neutering cats at 4 months rather than 6 months. And so I'm here today to talk about that and to introduce my colleague Eleanor, who is neutering cats every day for us and who is a real champion of pre-pubertal neutering.

So, you joined us in 2013 and already had experience of prepubertal neutering, so, so you were kind of an advocate then. What do you see as the main benefits of neating at 4 months rather than 6? It's a very quick surgery and the recovery time is very, very quick.

Cats are usually awake and eating in 20 to 30 minutes, and because it's such a small incision, the discomfort postoperatively is. Almost nonexistent, and so cats go home without a collar, which is a great advantage to to both the cat and the owner. But it must come as quite a shock to owners sometimes when you start talking about nutrients, I mean, we start at the first time we meet the kitten, so you know we usually have first vaccine when it's already, you know, only 9 weeks old, but we tell why we do this, you know, we discuss the surgery with them, the benefits for the cat.

But also the benefit for them and getting pregnant and once they're aware of those things, then it's, you know, something that they're very willing to do. So it's it's not a hard sell, but looking at the bigger picture, it must have a bigger impact on reducing unwanted litters. Yes, without a doubt, I think that owners underestimate the reproductive capacity of their cat.

Many owners don't realise that their kitten can get pregnant at 4 months when it's still a kitten. And so by neutering them at 4 months, we eliminate that possibility that that cat will get pregnant. So if you've got an owner who is worried about prepubertal neutering, what do you say to them to encourage them?

Well, we discussed the benefits of the surgery for the cat, so how quick it is, how easy it is at that age, you know, these cats, they don't have well developed blood vessels. Which makes the surgery quite easy. It makes it quite safe for them.

There's less chance of any bleeding, so that's good for the cat. It's also a shorter surgery time, which is good for the cat, and we discussed with them all of the precautions we take in, anaesthetizing young cats. So making sure that the cat hasn't eaten that morning, making sure there's only a 2 or 3 hour period of time where they've not eaten.

We very carefully, measuring drugs very carefully monitoring them. There is a nurse with them at all times, monitoring them from from the minute we pre-med them until they're awake and eating. Yeah, I guess if we're confident that we're doing is the right thing, it's easy.

I mean, if this translate that, yes, exactly. So if it was our cats, we've been 4 months and recognise that. And what about vets?

How do you find when you're talking to new vets coming to the practise, how do you find they take to the idea? Yeah, funnily enough, vets can be more resistant than owners, and I think the longer you've been neutering cats at 6 months or older, then the more difficult it is. But once they do the surgery, they see how easy it is, how quickly they recover, they come round to us, yeah.

You know, smaller cats doing an aesthetics on these small cats can be daunting, but you know, we make sure we weigh them very carefully. These are not cats that are fasted overnight. We only fast them 2 or 3 hours and that's a big change, isn't it?

It's a big change. And I think a lot of vets are worried about the long term consequences of pre-proportional neutering for which there is absolutely no evidence that neutering at 4 months. Any adverse effects compared to 6 months.

So as far as you know, the educational establishments at schools and nursing colleges, are they supporting the idea of pre-pubertal ne? As far as I'm aware, yes, most new grads coming out have been introduced to the idea that ne should start at 4 months. Yeah, so ultimately it will become the new norm.

So as you can see, we see big benefits for the individual and indeed for the owners when we recommend neutering at 4 months rather than 6, but it does really have bigger impact than that across the country and UK wide if vets adopt this as a normal practise, it would have a huge impact. On the number of unwanted kittens and unexpected litters with all the welfare issues that go with that, and particularly it would reduce the number of cats that end up in shelters needing rehoming because if we don't produce those unwanted litters in the first place, we don't have that oversupply of cats. If you'd like further information, you can visit this website.

It's got a wealth of information about the practicalities of the technique and the anaesthetic, but also a summary of all the evidence supporting this change. So to conclude, we would say that kitten neutering is simple and it's quick with a rapid recovery. Morbidity is lower than conventional neutering.

There's no increase in long term physical or behavioural problems, according to the current evidence, and neutering at 4 months should be the norm and not really considered early, which is why we tend to use the term kitten neutering, and it's really important to stop kittens having kittens. These are all the references that I referred to earlier, when I was talking about all of the research around pre-biblical neutering and owners' attitudes and opinions. So it's just really for us to say thank you very much now for listening to us.

I hope you find that really useful and really informative. If you would like to drop us a line about the new neutering scheme, please don't hesitate to use that, email address, vet neutering support at cats.org.uk, and we will get back to you as soon as possible.

Both my personal email and Alison's personal email is also on that slide. So thank you once again, and over to you for any questions, I think. Thank you very much to both Jane and Allison for their very insightful presentations and for bringing the latest in the RSPCA and cat protection, shall I say, schemes to our attention.

Big thank you also to Bohringer Engelheim for their, sponsorship of tonight. We really do appreciate it. Guys, we've had a whole lot of, of questions about, The sedations and the drugs and the choice of opiates and everything else and those tables you were showing were great.

Personally for me, I like the kitten quad app that's on the phone because it's really, really simple and it does all the work for you. Right, let's get. Yeah, carry on, Jane.

I was just, I just wondered whether I had anything to add on the, on the drug side of things at all. Cause I know you like the quad as well, don't you, Alice? Yeah, no, I, I would definitely go with the quad, and it's just super easy in terms of, you basically are drawing up the same volume of each of the medications, so you don't have to do too much thinking, and like you say, the app is, is really, really easy to, to use.

Yeah, everybody's got their phone in their pocket and it saves you making calculations and double and triple checking yourself and doubting because the volume seems so weird. It's, it's all just there for you, which is fantastic. Jane, I think the first, set of questions that have come through were for you.

And Joy wants to know, if we are in Wales, do we still need to register for the new scheme? You do, please, Joy, yeah, just because as much as anything else, you will need to register for the Cavetros account as well. So part of the, you'll see on the registration form, part of it is registering to us as a participating practise, and the other part is making sure we can set you up with that Cavetrous account.

Fantastic. She's got two other questions as well. One is, do CP provide the microchips?

And the second one, I think you've covered that. The second one is also, are feral cats to be microchipped? Brilliant.

Good questions. So if yes, if you are on the current well scheme, you'll be used to ordering your microchips directly from us and then you getting them directly by delivery. They might, you, we still provide the microchips, but on the new scheme, we provide them under the wholesaler account.

So you just order them, as I say, free of charge to you, on the wholesaler order form, and then they are delivered to you in the same way as your, your normal wholesaler, provides your, your drugs and consumables. Feral cats, we, sorry, was a question about chipping feral cats, Bruce, sorry, yeah. So no, we wouldn't, advise, chipping a feral cat.

Feral cats or unowned cats aren't included in the new legislation. So we would always ask for feral cats to be ear tipped. And that's really because, it means that it's an internationally recognised symbol.

So if anyone else further down the line should try and re-trap in that area, then they're gonna know that that cat is already neutered, because it's obviously hugely stressful for a cat really, to be trapped. And that helps avoid that situation happening. And it saved somebody's skin trying to get a scanner close to.

Question, Alison, I think, which is, it came through, I think you've answered this already. And certainly the last video, I think, answered it for us. But, there's a question about cat behaviour, later on in life when they're neutered pre-puberly or afterwards.

The comment is, do they stay more kitten-like for longer? Yeah. I mean, there's definitely no sort of negative evidence, of any sort of behavioural change, in cats that are neutered prepubvertally.

So, there's, there's nothing that we, are kind of aware of in terms of differences in behaviour between, prepubertal, prepubertally neutered cats and cats that are neutered, later on. I mean, there may be sort of anecdotal, reports, but it's, it's not something that we've got any evidence on. Not scientific, which is great.

Another one for you. Joy wants to know, you said to do the kitten neuterings first. You're doing about a 3-hour fast.

And if their Oli starts at 8 a.m., your owners are not gonna be too happy when you ask them to feed them between 2 and 3 a.m.

Yeah. So, yeah. It's, it can be a bit of a challenge.

So I guess it's thinking, is there a particular day that you want to, so it's kind of that balance between, starting them first and also them having the kind of the correct fast time. I mean, I think it's, it's having a look at what else you've got on, that day. I think if you've got another very clean, very low risk surgery, you, and, and you think you're going to struggle to get the owner to, sort of feed them ahead of them coming into the, With that 3 hour window, then, you know, you've got a bit of, you might have a bit of flexibility around that.

So it's, it's kind of trying to be sort of mindful about if you are going to, sort of veer away from, them coming in first, what is it that you're putting on your ops list to do before them. And, is there, you know, would your owners make that exception for, for their kittens? I think I'm always, you know, I think you'd be quite surprised by how many owners will be kind of, sort of willing to do that, I would imagine.

So in terms of sort of feeding them, getting up early and feeding them. So, I think it's, it's just a conversation to have and see if there's any sort of flexibility, and any flexibility around, sort of, your start times in your, on your upstairs. Yeah, discussions and drawing the owner into the conversation, which is always a good idea regardless of what you're talking about.

Yeah, absolutely. Here's another one for you, Allison. Can you do just an ovarectomy on a kitten, or should we always be going for ovarian hysterectomies?

Yeah. So, I mean, I would say so. I think when, I mean, when I do the surgery, I won't necessarily go all the way down, to the cervix.

So I think you are, you are kind of OK to, leave some, leave some, Remnant of uterine tissue behind. We know that as long as we've got all of the ovary out, then the risk of, things like pyometra and, obviously pregnancy are completely reduced. So, yeah, I think, it's the thing I would say, though, is, is once you, have had experience of doing the surgery, it is so quick that you might not see the need to actually do a, an ovarectomy, if that makes sense, because it's, everything is so Accessible.

And, yeah, it's just, it's, it's a very, very easy, kind of quick procedure. So, yeah, the, I would say, I would say to, the, ask that question to, to have a go and see whether they actually feel they still need to do an ovarectomy, if, if that makes sense. I'm sitting here smiling, and you took the words out of my mouth because my answer was gonna be, just try it.

The whole thing falls out. It's so easy. It's it.

It's ridiculous. In fact, it's probably harder to only do an ovarectomy than an ovarian hysterectomy because these pre-pubertal ops are fantastic. They are just the best.

Yeah, I totally agree. I can do them all day. Here's another one for you.

I think this is a, a real, hot potato, but I think you'll have a clearer answer on it. Daniela wants to know at what point do you inject Metacam? I think we do it around the time of the pre-med, if I remember correctly.

So, yeah, I don't think we would have any kind of concern, sort of doing it at the time of the pre-med, so. Yeah. It is, I think that, that question always comes up as to whether you, should do it sort of after, on sort of recovery, but I think you want that pain relief on board, sort of from the time of, surgery, really.

Yeah, I think so. And, and I think with using the quad for the kittens, the advantage that you've got is that you've got so much pain relief on, but you still need time for the metacam to kick in. So, I mean, I've been a vet for a long time and I've been doing pre-pubertal neuterss also for a very long time.

And, the arguments of at pre-med or as they go into surgery or as they're recovering from surgery. I think that, it doesn't make that much difference if you're using a quad, you know, because you've got such good anaesthesia and analgesia, on, on board that, that 10-minute difference between a pre-med and, and at the surgery or 12 minutes for after the surgery doesn't really make much difference. Yeah, that's the thing you were talking about, like you say, kind of minutes of time.

So I think in reality, the impact that that's gonna have on, you know, the concern is around the impact on the kidneys. So, I, it's, I just don't think it's going to have that, that, that much of an impact, whether, what time you do it. But, yeah.

And watching these kittens sort of sit up and fall into the food bowl and just scoff their way out is fantastic. You know, you just know that, that the risk on the kidneys is just not there. When do you normally get them back for post-op checks?

So, I mean, the, we probably would see them back about 222 to 3 days. And then, depending on how, kind of, you, it's, it's, it's kind of practise policy, but some practises will then see them sort of for a final check off at 10 days. But the recovery.

Is, is like, pretty incredible, because you're talking about so much smaller a wound. As, sort of Martha was saying in the video, often they won't send them home. They don't necessarily need a buster collar because they're so unaffected by the wounds, they're not gonna be turning around and, sort of trying to nibble at it.

They just are completely unaware that anything's happened, really. So, Yeah, that's yeah. Excellent.

We have loads and loads of questions coming through. We are not going to be able to get to all of them tonight. But I promise you, if you're listening and you've asked a question, we don't get to it.

Dawn will get these over to Alison and Jane and ask them, pretty, pretty please, if they would answer them back to you if we don't get to them tonight. Jane, couple coming in for you here. One says if we're already on the cat protection scheme, do we need to register for the, the new scheme?

Do we need to re-register? Sorry, is the word they used. Yes, please.

Yeah, you do, just because we need to sort of be really clear which practises are, are on the, new neutering scheme, and because, you know, there is, there will be a rolling transition period as we register practises onto the new scheme. But when all the old existing vouchers stop to to exist, if you like, we need to be really clear, which vet practises are on the new scheme. OK, that leads me into the next anonymous question, which says, we have verbally been told on the phone that we will receive vouchers and that until we receive vouchers and our COVERs account is set up and the current scheme will continue.

Is this correct? And we are based in London and currently using the C4 scheme. Yes, that is absolutely correct.

So, as soon as you are registered, as soon as you've received, your welcome pack, which includes the neutering vouchers and the, access to the Cavetros wholesaler account, then You are good to go. And at that point you can just use the new scheme. However, we do appreciate that obviously some of the older existing vouchers will still be in the system.

So they will still be honoured for payment, until the end of this year. Fantastic. Last question for tonight.

Allison goes to you. What is the best advice to give to owners regarding queens that are still feeding their kittens when you want to have them neutered? So, I guess, so, this is a, a, a non prepubertal, neutering question.

So, I would say it's probably worth, waiting for sort of, sort of 6 to 8 weeks. So the wing kittens are starting to wean. So this is presumably like an owned cat.

And you haven't got any sort of, any of the pressures that you might have in like a shelter environment, or, in a TR, the trap needs to return sort of situation. So, yeah, I think I would probably wait until, the kittens are weaned. You have sometimes got the risks that you, you kind of wanna avoid, mom going out and getting pregnant again.

If there is like a real urgency for her to be neutered, I mean, with our ferals, we will sometimes, neuter, and one of the advantages of doing a flank spray at that point is that the kittens can still get to the, the mammary glands and still feed. So it's not that it It's a complete no. But I think if there is no, if there's no pressure on the situation, probably your priority is to get those kittens, kind of, sort of weaned and, and, and, and sort of to the point where it's a bit safer for mom to be taken away.

So, that would be my approach. I hope that, does that answer the question, Bruce? Yep.

Jane, anything you want to add? No, I don't think so. Thanks.

Fantastic. Well, ladies, thank you for attending tonight and thank you for sharing your knowledge with us. And, there, there's some really great, advances happening in the, the cat protection scheme.

And hopefully, that will translate into a much bigger benefit for our, our furry little feline friends and, stop all the overpopulation problems that we have. So, a huge big thank you to Jane and Alison. As well as to Cats protection and our other main sponsor, Boringa Engelheim.

Another thank you to everybody who attended tonight. If we didn't get your questions, I'm really sorry, as I say, Dawn will work her magic with Alison and Jane, and we will try and get answers to you as soon as what we can. But thank you for your time tonight.

I do hope you enjoyed the webinar as much as I did. And last but not least, thanks to Dawn, my controller in the background for making everything happen nice and seamlessly. From myself, Bruce Stevenson, it's goodnight.