High-Volume Techniques are methods of increasing speed and utilizing a group setting in order to decrease costs associated with spaying and neutering pets. Some of these techniques are helpful to pets, some are irrelevant to pet care and others are less than ideal. High volume clinics aim to streamline drop off and pick up, safely speed surgery, and eliminate veterinarian down time between surgeries. The following list provides some insight into some of their techniques:
Surgery: Experienced high-volume veterinarians are adept at making small incisions and manipulating the tissues to provide the least trauma associated with the operation. As with anything else, repetition increases both speed and skill. It is important for a client to know the experience of both the organization offering the services AND the veterinarian working on their personal pet. Ace of Spays only hires experienced spay neuter veterinarians. These veterinarians are paid to slow down and put safety and comfort over volume.
Paperwork: Streamlining paperwork speeds drop off and pick up. It also minimizes record keeping and filing time. Some of this is great: it helps clients. And some is not so great: communication can suffer and one-size-fits-all records are often short on detail. At Ace of Spays, paperwork is streamlined and intake and release are fast. But client communication is given priority. And each individual record has written notations.
Distribution of Work: Any job that does not require the veterinarian’s immediate attention is done by trained staff. The veterinarian is kept busy with veterinary chores from arrival time through the completion of surgery. This is common procedure at all well-run veterinary hospitals and as long as staff is appropriately trained for the jobs given them, has no ill effect on the pet.
Arrival Times: All pets arrive before the veterinarian. In this way, the veterinarian can proceed without interruptions. This is slightly detrimental to pets as it lengthens hospital time. This can be avoided at Ace of Spays by choosing private service.
Departure Times: All pets stay in the building until the end of the last surgery. This allows staff to focus on surgery and recovery without interuptions for pet release. Again, this is slightly detrimental to pets as it increases hospital stay. This can be avoided at Ace of Spays by choosing private service.
Drug Choices: Many high-volume techniques involve drug choices that allow clinics to run smoothly. Ace of Spays rejects these.
- One-drug-fits-all: Using one drug for all dogs or for all cats regardless of breed, age, or health conditions allows ease of administration, easy staff training, less need for storage, less drug wastage, and more reliable prediction of the best time to administer the medication for seamlessness in moving pets on and off the surgery table. This works out okay for the average healthy pet. But what happens with a bull dog who has a flat face and does better with a much shorter acting anesthetic agent? Or an older pet who could benefit from a different drug? At Ace of Spays, drug choices are made based on age, breed, health status and temperament.
- Estimating weight instead of using a scale is very common for cats at clinics because cats are not always cooperative and the process of weighing is time-consuming. But what happens when a seven pound cat is estimated to be 8 pounds? Drugs are given to induce anesthesia in an 8 lb cat resulting in an overdose. This is not likely to kill the cat but it is not in the cat’s best interest, either. At Ace of Spays, all cats that can be handled are weighed and all feral cats are given an approximate weight in pounds. When not weighed, anesthesia is given in an amount suited for a cat smaller than the estimated weight because it is easy to give more drugs when needed but impossible to take away what has already been administered. This is a slow process but safer. Ace of Spays optimizes safety over affordability.
- One-size-fits-all: Administering the same volume of drug for pets in a relatively large range of weights saves time.
- Cats are estimated to be in one of three or four weight catagories: young kitten, small, medium or large. It is faster. And drugs can be drawn up in advance of the clinic for 4 sizes. But what about the cat? A medium cat might be 5-9 lbs. The 5 lb cat is going to be deeper under anesthesia than the 9 lb cat. The goal of anesthesia is to provide unconsciousness without death. The line between these two stages is not vast. Dr. Cobb opts to administer drugs according to exact weight, aiming for the least amount of the drug needed to provide adequate anesthesia.
- Many clinics group dogs into small, medium and large on intake and administer one of three basic doses of pre-operative medications based on these weight estimates. The medication is usually a fairly heavy sedative. Anesthesia is then given based on the dog’s actual weight. At Ace of Spays, all dogs are weighed at the time of intake for appropriate dosing of pre-operative pain and anxiety-relief medications.
- Long-Acting Drugs: The best way to decrease pricing and increased the number of pets served in clinics is to eliminate “down-time” of staff. Drugs that remain in the system for a fairly long period of time given at doses that provide a fairly deep level of unconsciousness are very helpful. This technique eliminates time delays that occur when the veterinarian’s speed at one particular surgery is altered in either direction. The next pet is ready before the veterinarian finishes the prior surgery and remains ready for a long time in the event of delays. Often, the pet doesn’t need the anesthesia machine at all. At Ace of Spays, this technique is rejected in favor of short-acting anesthetics and heavy reliance on the anesthesia machine. The machine allows the most rapid changes in the state of consciousness so that pets can be kept unconscious in a safer manner.
- Less Expensive Drugs: Using less expensive drugs saves money. At Ace of Spays, drug cost is not considered. For example, one of the main drugs used for cats is very expensive but can be reversed after surgery allowing faster recovery, less loss of body temperature and safer anesthesia.
Services: Another place to save time and money is by decreasing services.
- Pre-surgical exams are important for detecting diseases that may increase the risks of anesthesia. Few shelters provide these exams. Dr. Cobb finds numerous pets each year with heart murmurs and even more with upper respiratory conditions. When called, some clients opt to continue with surgery but many others opt for further testing or for treatment.
- Client communications take time at intake, after exams and at discharge. Ace of Spays embraces opportunities to help clients.
- Comfort during recovery helps speed recovery. Animals lose body heat from anesthesia. Shorter acting drugs and short surgeries prevent much of this loss but Ace of Spays also pays attention to these details providing dryer-warmed blankets for pets in need of extra heat.
- Veterinarian on Premise during all phases of recovery is safest. Pets are not out of the anesthetic risk time until they are fully recovered. At Ace of Spays, the veterinarian is on the premise until all pets are fully awake, and usually far beyond that time. This is an expense many high volume clinics avoid.
- Intubating takes time. Placing a tube into the airway prevents aspiration in case a pet vomits and also maintains the airway for emergency procedures when needed. Some shelters avoid “tubes” using face masks and/or longer acting injectable drugs instead.
- Post-operative Care is expensive. Most high volume clinics hire veterinarians “piecework,” meaning they are paid a set rate for each type of surgery. They are not expected to be on call nor to answer phones. Ace of Spays provides veterinary cell phone numbers for after hours concerns and a veterinarian is available to see pets during business hours when needed.
Avoiding change: Change means new paperwork, new training of staff, a new learning curve; all of which are expensive and time consuming. At Ace of Spays you will never hear “If it ain’t broke, don’t fix it” or, “It’s been working fine just like this for 20 years, why change?” Dr. Cobb embraces change. Ongoing research and developments in drug safety are regularly incorporated at Ace of Spays. Technicians returning after a few months away often need new training.