The Recovery Monitor observes the cats closely as they wake from anesthesia and alerts a veterinarian if a cat exhibits any problems that need medical attention. This position does not require a rabies vaccination.
Most perioperative deaths occur during the first 3 hours after surgery. Recovery is the most dangerous period for cats undergoing surgery. Cats must be monitored continuously during this very risky period:
- Visually monitor the cats closely. If the cat is moving, blinking or licking, then it is recovering normally. If the cat is fully sedated, watch the chest for movement. Breathing can be very shallow and difficult to see. A normal respiratory rate is 6 or more breaths per minute. If breathing is less frequent or isn’t visible at all, alert the Vaccinations Technician to do a hands-on assessment immediately.
- Notify a veterinarian immediately, if a cat is in distress. Never remove a conscious cat from a trap. A cat should only be removed from a trap, if it is unconscious.
- Infectious cats are segregated from healthy cats in the Recovery Station. Change gloves and wash hands after handling any infectious cat.
- Continually “walk the line,” pacing back and forth along the rows of cats to provide constant monitoring.
- Keep the traps uncovered until the cats are completely awake and no longer need close monitoring.
Recovery Monitor Instructions
The Recovery Station has two phases. One supervisor oversees each phase.
- Cats stay in the main post-op area immediately after surgery for assessment and monitoring. They will be on their sides, head facing the rear of the trap, and ear-tipped (left) side up, unless there is an amputation, enucleation, or other wound on a cat’s right side, in which case they will be placed right side up. Particular attention must be paid to breathing, bleeding from incision and ear tip, and temperature regulation. Supplemental heat is provided with heat lamps. Once a cat can 1) become and remain sternal, 2) hold its head up, and 3) right itself if it falls over, it can then be transferred to Phase 2 Recovery in the hallway.
Do not cover traps in Phase 1 Recovery.
Cats are transported to the Phase 2 Recovery area in the hallway for additional monitoring once they become sternal. Particular attention must be paid to the cat’s level of consciousness, especially if it becomes more sedate as time passes. This can indicate hypothermia, internal bleeding, or other emergent complications, and a veterinarian should be swiftly notified. Close attention to the incision is important as cats wake up and move around more. The back 1/3 of the trap may be covered with a small cloth trap cover to give the cat a place to hide while it recovers, but monitors must be very attentive to the hiding cats and able to still see them without difficulty. Once the cat is coordinated, not thrashing or banging, is steadily sternal or standing and alert, then it may be transferred to the Discharge Station.
Monitoring in Recovery Station Phases 1 and 2
Check the position of the cats in the traps,tilting the traps if needed to reposition the cats in order to extend their neck to breathe freely or to view their incision sites.
Monitor the cats continuously as they recover in the Recovery Station. Some cats may have more difficult recoveries than others:
- Any blood on the clean newspaper in a cat’s trap should be investigated. If a cat is bleeding from its neuter site, have a veterinarian make an assessment in case it requires further surgical repair.
- Tipped ears may bleed a lot, especially if the cat is thrashing about hitting the ear on the cage and preventing clot formation. This bleeding will eventually stop on its own. Notify a supervisor, if there is active hemorrhage (i.e. uninterrupted blood flow) from the ear.
- Respiration may be slow, if the cat is still under anesthetic influence.
- Thrashing around is considered normal as long as the cat’s limbs or body are not stiff or convulsing. Cover the front, back, and sides of a thrashing cat’s cage with its trap cover to calm it. Be sure you can still observe its recovery through an uncovered portion of the top of the trap.
- Vomiting and heaving are not considered normal. If you notice a cat retching or attempting to vomit, call a supervisor immediately.
Advise a Medications Technician if a cat is not waking up in Phase 1 Recovery. Record the times of cats’ arrivals to the Recovery Station, and notify a supervisor of any cat who has been unconscious for an hour or more. These cats will receive a supplemental dose of Yohimbine (0.3 ml SC or IV) to further reverse the effects of anesthesia.
Monitors should continually “walk the line” checking on each and every cat in their phase of recovery. Make note of which cats aren’t becoming progressively more awake as time passes, or cats who lose consciousness after having been responsive earlier, and alert a supervisor.
When cats are completely awake, the rear third of the trap should be covered with their trap coverto reduce stress, and the cat may be moved to Phase 2 Recovery. Traps in recovery should never be completely covered, as visual observation is required until discharge.
- Do not fully cover cats unless they did not receive anesthesia (i.e., vaccine-only cats, or cats who were determined not candidates for surgery), or until they are completely recovered and are being discharged.
Continue to monitor the cats in Phase 2, checking their recovery until they are returned to their caregivers.
Monitors should not take breaks unless they have transferred their responsibilities to another monitor who can keep a close eye on all cats. The cats should never be left unmonitored.
All Station Images
Station Closing and Cleanup
When the clinic is concluded:
- Inventory the remaining supplies and repack the supply kit.
- Return the kit, station instructions and any remaining items to storage.
- Clean the area and dispose of all trash.
- Wash all tables, including the central trough, and wipe down the entire base of the table.
- Remove any tape from the undersides of the tables.
- Sweep or vacuum and mop the floor.