High-quality, high-volume spay–neuter: Access to care and the challenge to private practitioners

Abstract

Impact: Low-cost spay–neuter clinics were first established nearly 50 years ago in response to the numbers of dogs and cats euthanized in animal shelters. Since then, high-quality, high-volume spay–neuter (HQHVSN) clinics have been established throughout the USA and have contributed to a significant reduction in animal euthanasia in shelters. These clinics, specializing in efficient systems and surgical techniques, provide an avenue for clients who cannot afford surgery to sterilize their pets. These clinics have also helped animal shelters with limited financial resources implement spay–neuter prior to adoption policies. Response: The veterinary profession’s reaction to HQHVSN clinics has been mixed; some practitioners question the quality of care provided or fear the loss of clientele, while others recognize the need for such clinics and support their development. Challenges: As veterinary education has become more expensive and veterinary care more sophisticated, the cost of veterinary care, including spay–neuter surgery, has risen. With increasing costs, the numbers of pets that receive little or no veterinary care has increased. Indeed, a 2018 survey by the Access to Veterinary Care Coalition documented that more than 25% of pet-owning households in the USA experienced difficulties obtaining veterinary care for their pets and the most frequent barrier was financial. Aim: This review looks at the reality of HQHVSN clinics and what this means for the private practitioner. By adopting similar systems and techniques that lower the cost of spay–neuter surgery, practitioners could potentially pass on cost savings to clients. Moreover, the same principles may be applied to other aspects of basic care to further address access to care issues.

Measuring Changes in Perceptions of Access to Pet Support Care in Underserved Communities

“…In contrast, PFL engages in their work with historically underserved communities through a social justice perspective that asserts that pet ownership should be available to anyone who wishes to access the benefits of the human-animal bond (53). This program philosophy aligns with more recent research that has discussed other problematic systemic factors contributing to high costs of veterinary care, such as an increase in veterinary education program costs (54), an increased demand for veterinary healthcare services that mimic those offered in the human healthcare field (20), the disproportionate growth between cost and pet owners' perceived worth of services (20), and economic downturns (24). Within this framework that recognizes the broader community-level factors driving the lack of affordability of services, some animal welfare programs are advocating for, and modeling, a shift in the definitions of "minimum acceptable level of caretaking" and "upmost level of medicine and surgery" in the veterinary medicine profession (24).…”

“…Other programs being piloted to address the affordability of pet support services by offering alternative payment options include "Pet Health Care Credit Cards" (20), "pay what you can" models (20,57), or subsidizing basic preventive care (e.g., spay/neuter, vaccinations). While there are some concerns that these alternate payment systems could negatively impact the revenue of private veterinarians, initial research indicates that many of the clients who utilize these alternate payment options were not previously utilizing any veterinary care services (54).…”

COVID-19 associated reduction in elective spay-neuter surgeries for dogs and cats

“…Clinics performed a similar reduction in spays compared to neuters during the pandemic, even though female sterilization is most important for preventing unintended reproduction. The prolonged delay in return to normal spay-neuter operations is especially concerning for female cats as they can become pregnant as early of 5 months of age, which underpins the recommendation that cats be sterilized before 5 months of age ( 27 ).…”

Fix by Five – an ethical responsibility?

“…An insight into that world, and the challenges and opportunities presented to private practitioners by HQHVSN, is provided by one of the current editorialists (PB) in a review article in this issue of JFMS . 1…”

“…An insight into that world, and the challenges and opportunities presented to private practitioners by HQHVSN, is provided by one of the current editorialists (PB) in a review article in this issue of JFMS. 1 Things began to change in 2016. A small organization in the US, Marian's Dream, with the assistance of Joan Miller of the Cat Fanciers' Association, convened a task force at the North American Veterinary Conference to discuss guidelines for best practice for feline spay-neuter.…”