High-quality, high-volume spay and neuter clinic guide
                     High-quality, high-volume 
spay and neuter clinic 
guide
 Holding a high-quality, high-volume (HQHV) spay and neuter clinic is one of the 
best ways to improve the lives of as many cats as possible. In assembly line 
fashion, stations help guide a cat from trap to anesthesia and through surgery to 
other necessary treatment areas. HQHV spay and neuter clinics are a critical part 
of Trap-Neuter-Return (TNR), the humane, effective approach to community cat 
populations.The following information outlines Alley Cat Allies’ tried-and-true 
approach to running a HQHV spay and neuter clinic. Keep in mind, though, that 
there are many different approaches to a successful spay and neuter clinic. Adjust 
this outline and its stations as necessary to fit your own resources and needs.
 See our general Spay and Neuter Protocol Considerations for Community Cats at 
alleycat.org/SpayNeuterProtocol and more resources at alleycat.org/
VeterinaryResourceCenter.
 Alley Cat Allies has decades of experience working with veterinary experts.
 Our goal is to ensure veterinary professionals have the accurate, current, and 
specialized information they need about cats from all walks of life and to bring 
their attention to the big issues impacting cats. Veterinary professionals have a 
uniquely powerful voice that is critical for advocating on cats’ behalf. Alley Cat 
Allies is here to help streamline that advocacy. Learn more at alleycat.org
/Veterinarian.
 Check-in/registration station
 When trappers or caregivers bring community cats to the clinic in humane box 
traps, assign each cat her own number and print that number on two tags. Secure 
one tag to the trap. The other, called the cat tag, will be tied to the cat’s paw (a 
rubber band works great) after she is anesthetized. Until that time, you can tape 
the cat tag to the trap to be used after anesthesia kicks in.
 Our Cat Clinic Tag can help ensure that both trappers or caregivers and clinic fully 
understand the expectations for this visit and the needs of each cat.
 At this time, cats should be scanned for a microchip. The microchip ID can be 
recorded on the cat tag, and the microchip can be scanned at each step of the 
spay and neuter process to ensure you are treating the right cat.
 Learn more at alleycat.org/PlanToScan including how to scan community cats for 
microchips.
 Anesthesia station
 Once a cat is deemed healthy enough for surgery based on their physical state, 
take them to the anesthesia station. Use an “isolator,” (see 
alleycat.org/Equipment) to guide her toward one end of the trap. This restricts the 
cat’s movement so that the licensed veterinary technician can inject an anesthesia 
combination called TKX (telazol, ketamine, and xylazine) directly into the muscle.
 After TKX has been administered, leave the cat in the trap and monitor her until she 
is fully unconscious. Then, carefully take her out of the trap and attach the cat tag 
to her paw.
 The cat tag must stay with the cat through every clinic station, and every 
medication administered to each cat must be recorded on the cat tag. Also record 
the amount of TKX administered in the Anesthesia Log.
 Express the cat’s bladder carefully and evaluate the sex and health of the cat. 
Check off “male” or “female” on the cat’s tag. The veterinarian will complete a 
full physical exam once the cat is under anesthesia.
 Prep station
 At the Prep Station, the veterinary technician injects Metacam, a pain killer, 
subcutaneously, just under the skin, and records the dose on the cat tag.
 Because cat’s eyes may dry out under anesthesia, apply a lubricant to keep them 
moist.
 One technique for holding female cats in place for surgery is the use of spay- 
boards. These are special boards that hold the female cats in the correct position 
for surgery. Learn how to build your own spay board using Alley Cat Allies’ spay 
board design instructions here at alleycat.org/SpayBoard.
 Shave the female cat’s surgical site and sterilize the area with betadine and 
alcohol. Administer betadine and alcohol alternately three times starting from the 
point where the incision will be made and moving out in a circular pattern, 
purposefully never doubling back over the incision site.
 Waiting area
 If the prep station gets ahead of the veterinarians completing surgeries, the cats 
wait in the order in which they were prepped for surgery until a veterinarian is 
available. This ensures that veterinarians are never waiting for patients and takes 
full advantage of the veterinarians’ time.
 In the waiting area, volunteers should closely monitor each cat’s breathing and 
level of sedation to ensure the cats are comfortable.
 Surgery station
 When the cat is on the operating table, the surgery assistant opens a sterile spay 
pack containing a gauze, drape, and instruments. A new sterile spay pack and 
materials should be used for each cat.
 HQHV clinics often utilize special surgery techniques that are faster and ensure a 
follow-up visit is unnecessary. These techniques include smaller incision, modified 
Miller’s knot (see our video how-to), and dissolvable sutures.
 Eartipping station
 Following surgery, the cat’s left ear is tipped by placing a straight hemostat 3/8″ 
from the tip of the left ear and removing the tip with a scalpel or straight edge. To 
reduce bleeding, the hemostat is left in place until the cat arrives at the vaccine 
station or is just about to be returned to her trap.
 See our eartipping protocol at alleycat.org/Eartip.
 All surgical information, particularly anything unusual that may have occurred, 
should have been recorded in the Veterinarian’s Surgery Log and on the cat tag 
by this time. Once that is done, transport the cat to the vaccine station.
 Post-op and vaccine station
 At the post-op and vaccine station, remove female cats from the spay boards and 
take the hemostat off their ears. If there is any bleeding from the eartip, apply 
styptic powder to stop it.
 The cat receives a subcutaneous rabies vaccination on the right hip. There is an 
extremely low occurrence of rabies in outdoor cats, but this vaccination will 
protect them if they happen to come in contact with a rabid animal.
 Other vaccinations can be administered at the discretion of the veterinarian and 
based on the caregiver’s ability to pay. For example, some clinics vaccinate for 
distemper using the FVRCP vaccine at this point in the clinic. Because there are 
parts of the United States which are not prone to distemper, some clinics choose 
not to vaccinate so they can spend that money to neuter more cats. It can cost 
$2-3 to vaccinate and when added up over the hundreds of cats a clinic neuters, 
the cost can multiply. One consideration may be to ask clients to shoulder the 
cost if they choose to have the vaccine administered.
 Alley Cat Allies does not recommend testing for FIV (Feline Immunodeficiency 
Virus) or FeLV (Feline Leukemia Virus) because the percentage of infected cats is 
low, sterilization contains the spread of these viruses, infected cats can be 
asymptomatic, there can be false positives, and testing is costly. Learn more at 
alleycat.org/TestingProtocols.
 Microchipping can also be done at this time. Alley Cat Allies encourages 
caregivers to have all the cats they care for microchipped. Learn more at 
alleycat.org/MicrochipsSaveLives.
 Record all medications administered on the cat tag.
 Grooming station
 Gently comb the cat for fleas and matted fur, and shave away any serious mats. 
Some clinics administer flea treatment at an added cost which is itemized for the 
client. Because flea treatments do not last long and will likely be the only one a 
community cat receives, the costs may outweigh the benefits of providing the 
treatment. With similar considerations, deworming and treatment for ear mites 
may be administered at this time.
 Do not cut the nails of community cats.
 Under certain circumstancescold weather, pregnancy or lactation, or by a 
veterinarian’s recommendation administer subcutaneous fluids.
 Record every treatment on the cat tag and then transport the cat to recovery.
 Recovery/discharge station
 When the cat arrives at the recovery station, remove the tag from her leg and 
record all information on it in both the Medical Record and Intake/Discharge Log.
 Compare the cat’s tag number with the tag number on the trap so that she is 
returned to the same trap she came to the clinic in, which should have been 
cleaned and lined with fresh newspaper or another trap liner. Cats who received 
fluids should be positioned in the traps so that as little fluid as possible leaks from 
the puncture site.
 At the recovery station, arrange the traps in numerical order and by colony for 
proper caregiver matching. Cover the traps so the cats have privacy but can still 
be seen from the front so trained observers can monitor them while they are 
waking up from anesthesia.