Monday, September 17, 2012

Hey, want to get rid of those ovaries, cheap?

A few months ago I was watching a general practice veterinarian perform a dog spay. And I was surprised by how slow he was. He seemed hesitant, not confident in his technique, and he took a good forty minutes to finish the surgery. He commented to me, “I only do about one spay a month. Most of the animals we see these days were spayed before they left the animal shelter.” This made me wonder: if I had a dog that I wanted to have spayed, where would I take her? To someone who only performed this complicated surgery once a month? Or would I actually rather have her spayed at a shelter, by someone who does multiple surgeries a day, even though she is less likely to have high quality anesthesia management and individual attention there?

The answer to the question of how to offer high quality, high volume spay and neuter services to the general public is veterinary clinics focusing entirely on spay and neuter, and not offering general health care. One model clinic of this type is Humane Alliance in Asheville, NC. This sucessful non-profit clinic was founded in 1994, before much of the rest of the shelter community had woken up to the fact that high volume spay/neuter is an important component of reducing pet overpopulation. Today, 25% of the animals they surgerize are privately owned and come in on appointment. The other 75% come from shelters, rescues, and feral cat trap-neuter-return operations within a sixty mile radius of the clinic (transportation is provided by the clinic). On any given day they may have 100-125 animals in the building receiving surgery.

The Humane Alliance model was so successful that other clinics began coming to them for help. In 2005, Humane Alliance began accepting applications for National Spay/Neuter Response Team (NSNRT) members, member clinics designed on the Humane Alliance high volume model. They define “high volume” as at least 5,000 surgeries per year, though they note that most clinics perform at least 7,000. With a profit margin of about $2-3/surgery, this nets the clinics a profit of about $10,000/year, which is enough to keep them afloat. Today, there are 110 NSNRT clinics, and five more are expected to be operational before the end of the year. Humane Alliance helps the clinics every step of the way, from the design of their business plan, to the list of medications to have on hand on opening day, to sending staff members out to work on site at the new clinic for the first week.

Do these clinics provide spay/neuter surgery in the style of shelter surgeons? In some ways, yes, because their protocols are very much oriented to high volume, with the expectation that one surgeon will handle up to dozens of animals a day. But the quality of the care is extremely high. Arguably the most dangerous part of surgery is going under general anesthesia, and these clinics do not skimp on their management of this aspect of surgery, down to the details of keeping the animals extra warm on a heating blanket while they wake up.

I like this vision of the future: veterinarians who are specialists in spay/neuter surgery, working in clinics that are focused on this one complicated procedure, providing services of higher quality and for lower cost. Making spay/neuter more affordable and more accessible can only be a good thing for pet overpopulation. Unfortunately, the reaction of many general practice veterinarians is not so enthusiastic. Because these types of clinics charge much less for surgeries (often well under $100), veterinarians at full service clinics often fear that their clients will be stolen from them by clinics offering less expensive services.

Is it a realistic fear? I don’t think so. Full service veterinarians offer full service: wellness care, and management of sick animals. Spay/neuter clinics offer a one-time interaction with the client. Full service veterinarians may indeed lose spay/neuter business, but I contend that those services don’t comprise a large part of their income to begin with. The rest of their services aren’t threatened.

I think these clinics are going to continue to expand, and become an accepted part of the way veterinary medicine is practiced. The old adage “good, cheap, fast: pick two” is disproven here. This is the place I would take a beloved animal to have surgery.


  1. How dangerous is it for the vet who is performing all these surgeries on feral animals? Are you well protected?

  2. It's safe. In the case of Humane Alliance, not very many of the animals are feral. But good feral cat handling is very safe. The animal is anesthetized with an injection while it is still in its cage and only handled while asleep.

  3. If it were as simple as high-volume = lower cost, with the same quality of material used (like anaesthetic, pre-anaesthetic) and same options like pre-anaesthetic bloodwork, then absolutely. Letting specialist surgeons do the job would be ideal for all. Certainly their sharper skills save time, reduce problems and result in a better experience for the dog and the owner. Especially the dog.

    However, it is not that simple. Many cut-rate spay/neuter only shops are driven as much by profit as anything, and so corners are cut-no PA bloodwork, cheap anaesthetic, etc. Yes, it is understood that cutting these corners might be the only way that some animals get spayed. But that is not the only reason those type of cut-rate procedures/practices are used.

    All vets are not created equal, and not all veterinary business models take a "no compromise" course on their vet care offerings. As with anything, caveat emptor.

  4. Female dog spayed at vet's=easy recovery, sent home with pain meds. Male dog neutered at local animal services (high volume) = no pain meds to take home, dog groggy and out of it for three days. I'll take the vet next time. Yes, it will cost at least 2x as much.

  5. You guys are right, I should have covered in my post the issues with finding a place that's really good. Yes, there is good care and bad care in both general practices and low-cost spay/neuter practices. Pain medication is ESSENTIAL before and after surgery and should never be cut. Checking out a place before you use it is also essential -- finding someone else who's used it, getting a recommendation! Humane Alliance, which I visited, is a really good clinic and I'd vouch for them, having seen them behind the scenes. I can't vouch for all of them!

    Anoymous @May 9, I'm really sorry your dog had a bad experience.