The Spay Neuter Textbook is Here!

Those of you who have spent any time with me during the past 2 years have probably heard about my work as the editor of the long-awaited Spay Neuter Textbook. Well, it’s finally here! The e-book version has been available for a few months, but the print copies just arrived at the publisher’s this week.

Want to order a copy? This link will take you to Wiley’s page for the book with links to various sellers. And when you receive your copy, let everyone know what you think by reviewing the book on Amazon.

This book is the product of the dreams and hard work of a lot of people: there are dozens of contributing authors with a variety of areas of expertise, and I have been honored and humbled to work with them all.

So what’s in the book? Who is it for?

I could write a long blog post on this from scratch, but I realized that I already answered these questions when I wrote the book’s preface and acknowledgements. So I’ve included these two sections here to answer these questions and to provide a sense of the history, context, and organization of the book.

I hope that this is the book you’ve been looking for — enjoy!

Why do we need a spay-neuter textbook?

Spaying and neutering are often the first (and in some cases, the only) surgeries that students learn in veterinary school, and are expected skills for every new graduate in general small- or mixed-animal practice. It can be tempting to dismiss them as “beginner surgeries,” the easily trivialized but sometimes terrifying rites of passage into the veterinary profession. Perhaps because spaying and neutering are skills learned so early and repeated so often in a general practitioner’s veterinary career, they are rarely the subject of continuing education seminars and articles, and general practitioners may go their entire career without modifying or even questioning the techniques for spaying and neutering that they learned as third-year veterinary students. 

At the same time, spaying and neutering have been central to efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs. The spay-neuter clinics and programs that arose over the past several decades recognized the need for minimally invasive, efficient techniques that would shorten surgical times and improve patient recovery. This textbook pulls together many of the surgical, anesthetic, perioperative, and operational techniques discovered, developed, and popularized over the decades by these innovative spay-neuter pioneers. 

As the field of spay-neuter developed, practitioners recognized the need for greater acceptance and clarity. In 2006, a task force was convened that developed the first guidelines for medical care in spay neuter programs; this document was published in JAVMA in 2008 as The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs (Looney et al., 2008). The goals of these guidelines were to promote acceptance of spay-neuter practice by the veterinary profession and the public, as well as to provide guidance for veterinarians and spay-neuter programs regarding standards of care and practices based on scientific evidence and expert opinion. The ASV Spay Neuter Task Force reconvened in 2014 to update and expand the document, resulting in The Association of Shelter Veterinarians’ 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs (Griffin et al., 2016).

High-Quality, High Volume Spay Neuter (or HQHVSN, the awkward but now widely used acronym adopted by the first Spay Neuter Task Force) is the field of veterinary medicine that began with the efforts of spay-neuter pioneers in the 1970s through 1990s and became firmly established and advanced by the publication of the 2008 and 2016 spay-neuter guidelines. HQHVSN is defined as “efficient surgical initiatives that meet or exceed veterinary medical standards of care in providing accessible, targeted sterilization of large numbers of cats and dogs to reduce their overpopulation and subsequent euthanasia”(Griffin et al., 2016). 

Until now, practitioners new to HQHVSN or isolated in their practice have had no single place to turn to find out about HQHVSN techniques and protocols and the evidence supporting them, or about spay-neuter program types, their implementation and staffing, and their effects on animal populations and individual animal health. Many of the techniques used in HQHVSN have been taught at conferences and mentorship programs and shared and spread between practitioners, and many have been subjects of peer reviewed research; however, few appear in textbooks. Nevertheless, the medical, surgical, and perioperative care described in this book need not be limited to high-volume or shelter settings—they are applicable wherever veterinary surgery is performed.

This book is divided into two parts, and each of those parts divided into several sections. Part 1, Clinical Techniques and Patient Care, is concerned with evidence-based clinical knowledge and skills including perioperative, anesthetic, and surgical techniques. Part 2, Fundamentals of HQHVSN, introduces the high-volume surgical setting and the special organizational, logistical, and epidemiologic challenges that arise when striving to optimize the clinic’s operations and impact.

The book is intended for a range of audiences: from the veterinary student to the experienced HQHVSN practitioner, and from the veterinary technician to the aspiring spay-neuter clinic founder. Part 1 begins with chapters on determination of patient sex and neuter status, reproductive anomalies and pathologies, the selection of surgical instruments and suture, infectious disease control, asepsis, and stress reduction in the clinic. The sections on anesthesia and surgery cover general principles as well as specific techniques and protocols, including chapters on avoiding and managing both anesthetic and surgical complications, and a chapter on anesthetic and surgical techniques in rabbits and other small mammals.

While many of the techniques covered in Part 1 are well known to experienced HQHVSN surgeons, some of the anomalies, complications, and complicated presentations are unusual and may be once-in-a-lifetime cases for some. Experienced practitioners may also learn of useful variations on or alternatives to their accustomed techniques, or learn new ways of preventing or addressing frustrating complications. 

Part 1 concludes with a section on other common shelter surgeries and associated anesthetic procedures, and can serve as a reference for shelter surgeons with a variety of levels of experience. This section includes amputations, eye surgeries, vulvar or rectal prolapse treatment, and dental extractions.

Part 2 of this book moves away from the clinical care of individual patients and into the structures and systems fundamental to HQHVSN, with sections on population medicine, human resources and wellbeing, and HQHVSN program models. Optimizing the potential of HQHVSN requires more than just proficiency in the clinical care (anesthesia and surgery) of individual patients. Effective HQHVSN programs must understand the effects of their interventions on animal populations and individuals; they must combine their clinical skills with appropriate staffing and facilities to allow an efficient and streamlined workflow; they must institute systems that are financially, physically, and emotionally sustainable. Chapter 23 serves as an introduction and roadmap to the second half of this book. The material in this second half of the book should be of interest to anyone seeking to establish a new HQHVSN program or improve an existing one.

Acknowledgements and Deepest Thanks…

First, I want to thank the original four editors of the book: Brenda Griffin, Karla Brestle, Philip Bushby, and Mark Bohling. These four veterinarians have been instrumental in establishing and promoting the field of HQHVSN; this book would not have existed without them. I have had the privilege of working with all four of these people in different capacities over the past decade and a half: as teammates on the ASV spay neuter task force and co-authors on the 2008 and 2016 Guidelines, as co-teachers in pediatric spay neuter wet labs, and finally as contributing authors to this textbook. Thank you for being my mentors and colleagues, and for believing I could do this. Thanks especially to Brenda, who during my editorship has been my cheerleader and sounding board, my informant and historian, and a bridge between the original vision for this book and its evolution and re/vision. The encouragement, context, and friendship you have offered throughout this process has supported and inspired me.

I also want to thank all the HQHVSN and shelter veterinarians I have met over the years in person and online. My early teachers in this field were all virtual (but real!) colleagues who took the time to explain and describe surgical techniques in words, back in the days of dial-up internet, before YouTube. From the sheltervet electronic mailing list that I joined in 2001 to today’s shelter veterinary and spay neuter Facebook communities and hqhvsnvets online group, you have been and continue to be my mentors and my inspiration. Thank you also to my online colleagues who contributed photos for this textbook—your eagerness, openness, and surgical and photographic skills have made this book better.

And a huge thank you to all the authors who have contributed chapters to this textbook. It is your expertise that has driven the field of HQHVSN forward and that makes this book all that it is. This book is a first edition, but it is also a revision: by the time I signed on as editor in early 2018, many of the submitted manuscripts had become dated. I want to thank the authors for their patience and willingness to revise or even overhaul these chapters in order to make the materials as relevant, timely, and useful as possible.

And finally, thanks to my wife Tina, who kept the refrigerator full and the woodstove stoked during my many long hours of writing and editing. 

Want to order a copy? This link will take you to Wiley’s page for the book with links to various sellers. And when you receive your copy, let everyone know what you think by reviewing the book on Amazon.