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are transferred to a colleague's office several miles away from the expected impact zone, and the clients are notified of the transfers. The practice manager confirms that all insurance policies are current and that the medical records are backed up offsite. The practice owner secures dangerous drugs and controlled substances. The staff secure valuable equipment, such as anesthesia monitors and lab equipment, at an elevated height. Two staff members volunteer to stay overnight to monitor the situation. Supplies, such as food and bottled water, as well as a couple of sleeping bags and air mattresses, are provided. Because the clinic does not have a generator, the practice manager acquires a portable one and several tanks of extra propane to use if the clinic ends up without power following the flood event. A communication plan is put into place.

       Make sure all doctors and staff have their personal needs taken care of – family, pets, property – so then they can focus on the veterinary practice.

       Have a disaster plan for a localized event – building fire, water damage from burst pipe, etc.

       Have a disaster plan for a regional event – earthquake, hurricane, massive fire, chemical spill, etc.

       Keep supplies ready for evacuation, shelter‐in‐place orders, and postdisaster needs.

       Maintain all necessary documents for medical records, practice management, and insurance needs.

      2.17.4 Cautions

      Some disasters come without warning. Having a plan in place and using practice drills on a regular basis will help mitigate the effects. Identify leaders ahead of time who can stay calm and think on their feet to help the practice survive the disaster and its aftermath.

      1 American Red Cross Pet Disaster Preparedness: www.redcross.org/get‐help/how‐to‐prepare‐for‐emergencies/pet‐disaster‐preparedness.html

      2 AVMA Disaster Resource Center: www.avma.org/KB/Resources/Reference/disaster/Pages/default.aspx

      3 AVMA Professional Liability Insurance Trust, Disaster Planning for Veterinary Practices: www.avmaplit.com/education‐center/library/disaster‐planning

       Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)

       College of Veterinary Medicine, University of Arizona, Oro Valley, AZ, USA

      2.18.1 Summary

      The need to reproductively manage owned and feral dogs and cats is the driving force behind gonadectomy. Excision of sex organs (neutering, desexing) prevents procreation, which is of particular importance when considering the sheer numbers of animals that are relinquished to animal shelters annually. There is only so much room to accommodate new arrivals, and traditional shelters are often forced to euthanize otherwise healthy patients in the face of space constraints. Sterilization surgery is considered the norm in North American dogs and cats, and is increasingly performed at young ages to (i) prevent breeding of adopted dogs, and (ii) potentially reduce behaviors that may lead to relinquishment. Early‐age gonadectomy is not without risk, which has led to increasing interest in reversible contraception, as opposed to the traditional ovariohysterectomy (OVH) and castration. These methods run the gamut from extra‐label use of human contraceptives to intratesticular injections.

      2.18.2 Terms Defined

      Gonadectomy: Technically, surgical removal of an ovary or testis; colloquially, this term often refers to excision of the reproductive tract and is therefore synonymous with ovariohysterectomy or castration.

      Orchiectomy: Surgical excision of both testicles; synonymous with the term castration

      Ovariectomy (OVE): Surgical removal of one or both ovaries, leaving the uterus intact.

      Ovariohysterectomy: Surgical excision of the ovaries and uterus.

      Reversible Contraception: A method of preventing pregnancy that does not result in permanent sterilization, such that if pregnancy is desired at a later point, removal of this method makes this physiological state possible.

      2.18.3 The Reason for Sterilization

      The primary purpose of gonadectomy is to manage canine and feline populations [1]. American animal shelters collectively report an estimated intake of 6.5 million companion animals annually [2]. Permanent sterilization prevents unplanned pregnancies that yield unwanted litters, which ultimately end up at shelters [3–7].

      The majority of American veterinarians advocate for elective sterilization surgery [8]. Most American dogs and cats undergo elective OVH or castration within their first year of life. The recommended age for such surgeries often varies with breed, stage of growth, and underlying risks for potential medicals conditions, such as inherited orthopedic problems.

      Gonadectomy reduces the risk for mammary neoplasia, particularly if females are spayed before the first heat cycle [6, 9–14]. Male dogs that are castrated are less likely to develop hormone‐dependent benign prostatic hypertrophy (BPH) [9].

      Neutering also curbs unfavorable behaviors: castrated male dogs roam, mount, and urine‐mark less frequently, and male cats are less likely to spray [9, 15].

      2.18.4 The Rise of Pediatric Neutering

      Waiting to sterilize patients until they are 6 months of age or older runs the risk that they will reach sexual maturity and procreate. Because of this concern, pediatric neutering is on the rise. Shelters also do not wish to adopt out intact patients that then may reproduce, particularly since unwanted litters are often relinquished back to shelters [1, 7, 9].

      In an effort to break this cycle, OVH and castration are now routinely performed at 6–16 weeks of age [4, 6, 8, 9]. Safe anesthetic protocols have

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