What is there for private sector vets to get involved in high-volume spay/neuter work?
BY | February 20, 2025
India faces a significant challenge with its roaming dog population and the associated threat of rabies. This issue has received a lot of attention at all governmental levels, leading to the development of a national rabies control program (NRCP). A critical aspect of this plan is the canine component, which primarily involves sterilizing and vaccinating stray dogs at approved Animal Birth Control (ABC) centers. I refer to this initiative as the ‘traditional ABC program’ approach.
My Two Pennies (decades) for the Spay/Neuter Field
For the past twenty years, I have been advocating for a humane dog population management strategy that prioritizes ensuring a substantial proportion of the roaming dog population is sterilized. This approach emphasizes maintaining sterilization coverage over the years through sustained efforts. The focus is on the overall population—concepts, such as sterilization coverage and herd immunity.
Ideally, such a large-scale, continuous spay/neuter work is designed not only to meet a specific target number of dogs operated within a set timeframe after which the program is allowed to stop, but to provide ongoing spay/neuter surgery service, year after year. Roaming dogs do not exist in isolation; rather, they belong to an open population where breeding, births, and deaths occur continuously. New dogs also join the population through the abandonment of unwanted puppies or because of health issues of older dogs that owners can’t manage. Therefore, surgical sterilization of owned dogs is essential to mitigate unwanted pregnancies and limit the number of unwanted puppies.
Changing Focus Over Time
After these years, I still believe that traditional ABC programs are vital, and appreciate the incredible work being done across India by different organisations and municipality centers to sterilize stray dogs. However, I have noticed my perspective evolving, my views are shifting—an inevitable result of growing older and having more experience. And having experienced more, I suppose.
Across various fields, the tides are changing.
I no longer believe that the contributions from animal charities and municipality or corporation-run ABC centers to operate ownerless stray dogs are sufficient ALONE to create lasting impacts on humane dog population management and rabies control. With this I don’t mean to imply that ABC programs are ineffective; they can be very successful when executed continuously and with a proper grasp of dog population dynamics and the role of responsible ownership.
However, I have begun to advocate for the significant involvement of private clinics and government hospital veterinarians in spay/neuter services, focusing on owned dogs that frequently become unwantedly pregnant, because the traditional straydog ABC programs simply cannot do it all. I have previously discussed the importance of addressing owned dogs in blog posts on the Hill View Farm Animal Refuge blog.
Addressing a Common Question
One common inquiry we receive from international program donors concerns how we ensure that veterinarians who attend surgical experience programs will continue using those skills to operate on stray dogs in charity clinics or government-funded ABC centers. I have always been ready to answer this crucial question. However, the answer is not an easy or short one but requires some amount of patience to listen to and learn about the veterinary sector, the animal charity field, and the rules and regulations in India that concern stray dog sterilization programs (the traditional ABC program approach).
Reality check no 1 – no judgment here, just stating the realities
Well-functioning ABC centers recognized by the Animal Welfare Board of India (AWBI), which possess the necessary approvals and have access to consistent funding to maintain operations, are not widely available across the country. In fact, such facilities are quite rare, especially in smaller towns. Where they do exist, they often rely on additional funding sources—whether domestic or international—to function continuously. And yes, there are differences across the states.
Reality check no 2 – no judgment here either. Just stating realities.
Furthermore, there aren’t enough ABC centers focused on stray dogs to guarantee long-term employment for all veterinarians interested in this field. Additionally, working at an ABC center often requires vets to relocate from their hometowns and districts. This is Ok early in your career, when you are driven by the desire for surgical experience or just any kind of work experience. However, after a couple of years, these centers may not offer the career growth prospects that young veterinarians seek, which include not just salary but meaningful work and opportunities for professional development. Opportunities to develop as a clinician and surgeon.
Therefore, as years go by, and it becomes time to get married or move to post-graduate studies in India or abroad, or to look for more challenging clinical roles, early career vets leave these jobs. Those who move back to their home towns/districts/states may then look for other available employment opportunities either from the government or from the private sector.
Critical questions
To fully answer the common question, we need to answer first couple of other critical questions:
1. What happens to the surgical skills at the time when the employment sector changes from an ABC charity to private or government for those who began in the ABC center-field?
2. What happens to the surgical skills of those who never had an opportunity to work in an ABC program simply because such job was not available for them?
3. What needs to be done to make spay/neuter surgery something that is done at any kind of clinic; government, private, or NGO?
Do we have enough models to showcase that low-cost high-volume spay/neuter work is not only something for stray dogs and ABC centers? Do private-sector vets understand the financial benefits of getting into high-volume spay/neuter campaigns? Do they get enough spay/neuter cases to provide surgical opportunities for their junior vets? Do we understand the amazing existing facilities for surgery campaign clinics that the vast government veterinary hospital and dispensary network provides across the country? Are we ready to utilize all possible existing resources; human as well as infrastructure, to improve the humane dog population management strategies? Are we ready to look outside the box of the ‘traditional ABC program’ -approach?
Access to care and the challenge as well as opportunities to private practitioners
Philip Bushby, in his article HIGH-QUALITY, High-volume–NEUTER Access to Care and the Challenge to Private Practitioners, explores the benefits that private vet clinics would have if they would engage more into high volume spay/neuter work.
The scenario in the US is of course different from India in that the veterinary service providers there are mainly private clinics and as these are getting more and more expensive, more and more pets are in danger of not being able to receive the basic care they need; vaccinations, deworming and spay/neuter, because of owner’s financial constraints. This has led to the establishment of specific high-quality – high-volume – spay/neuter (HQHVSN) clinics that often work along with animal shelters to help get animals sterilized before adoption. These clinics also provide low-cost spay/neuter surgery services for financially fragile people.
Private clinics in the US do not always see eye to eye with the HQHVSN -concept, fearing that such clinics take away their business, and I have heard of similar concerns also from some private practice vets in India. However, according to Bushby’s article, there is no evidence to either prove or disprove this perception. Instead, he encourages private clinics to learn from the HQHVSN models to adopt some of their cost-efficiency methods and boost their business by bringing in clients via spay/neuter surgery campaigns. Some of the key principles are:
✜ Do it when they are young. Spay–neutering of cats prior to 5 months of age is easier, faster, and safer than delaying surgery to 6 months of age or older. The concept has been endorsed by numerous humane organizations. Read more about this from Feline Fix By Five.
✜ Adopt efficient surgical techniques. For ovariohysterectomy small, appropriately placed abdominal incisions, the use of a spay hook, and stretching of the suspensory ligaments can significantly reduce surgery time and therefore enable more surgeries to be performed in a shorter time.
As Bushby puts it; “either the private practices begin to do this or the owners go elsewhere….”
In India, I would say “Either the private practices and government vet dispensaries begin to do this, or we continue to have millions of pet owners not having access to spay/neuter of their pets, which continue to cause unwanted pregnancies and puppies left on the streets to become more stray dogs.”
Available options for owned dog spay/neuter in India
Unlike in the US, in India, there is a vast network of government veterinary clinics and dispensaries that exist to provide free or subsidized veterinary services. However, spay/neuter surgery is not usually readily available in most government dispensaries and hospitals, though exceptions do also exist, mostly based on the hospital’s senior vet’s personal interest and investment in surgery. I am lucky to have met several such great personalities over the years!
Private full-service veterinary clinics mainly function in bigger towns and cities and while they often provide spay/neuter surgery services, the price of an appointment surgery in a private veterinary hospital may well be half or more of a laborer’s monthly income and therefore inaccessible for many pet owners.
Animal charities have been trying to bridge this gap by running free or low-cost consultation clinics and operating owned dogs for subsidized fees. To be able to have a well-funded charity program, you need to be around people who can donate for its activities and this means often big cities rather than small towns and rural areas. Moreover, many charities focus mainly on stray dogs and rescue of abandoned and roaming dogs as well as shelter work, rather than addressing the access to care issues of dogs that still have owners.
The matter is urgent
Along with the problems caused by the large roaming dog population that we read in the news every so often, and the criticism that the traditional ABC-center approach is receiving, the urgency to develop more ways to humanely control the overpopulation of dogs and cats is increasing in India. Both in the US as well as in India millions of pet dog owners cannot afford the current costs of spay-neuter surgery at private full-service veterinary clinics. Furthermore, limitations in accessing transport might prevent many owners from taking their pets to a charity spay/neuter program even if an HQHVSN clinic existed in a nearby town.
In this scenario, the private clinic can embrace the challenge and play an increased role.
- Designate a specific block of time for HQHVSN
Key principles in developing efficiency that help to keep costs down include designating a block of time devoted to high-volume spay-neuter surgery, performing the surgeries at an earlier age, adopting efficient surgical techniques, and training veterinary assistants in routine anesthesia and surgical preparation. The HQHVSN work could happen one specific day a week, every week – or it could be one weekend a month or one week every two months. Whichever works best for the clinic schedules. If the private clinics do not strive to reach to these potential clients via innovative ways to set up HQHVSN campaigns, the result will be an ever-continuing number of pet dogs getting unwantedly pregnant, giving birth to unwanted puppies that eventually get abandoned on the streets, to breed more stray dogs.
- Positive publicity for the private clinic
Adopting routine HQHVSN campaigns can also be an effective way for a private clinic to gain positive publicity within the community (social media!!!), bring in new clients, and also help in internal veterinary team surgical skills preparedness development. Increased skills and confidence in surgical and anesthesia can result in the clinic being able to handle other surgical patients better. Such cases as GDV or large tumors – cases that do not need to come under the low-cost campaign -heading but are charged according to the proper private full-service clinic rates.
- Retention and development of talent
It might also help to improve veterinary staff retention if junior vets get more opportunities to perform surgeries and develop their skills. I have come across many occasions where a young vet working in a full-service private vet clinic is considering leaving the job and applying for work in a spay/neuter charity because of the lack of sufficient surgical exposure in the private clinic. They have been ready to do this even though it had meant a lower salary. In full-service private vet hospitals senior vets are given the more complex surgeries to perform while routine spay/neuter cases might not be many. This does not leave much opportunities for the aspiring young vets to develop their surgical skills.
According to Bushby, “Private practitioners can and must address the access to care issues, or someone else will.” In India, I would put it “Private practitioners and government hospitals can and must address the access to spay/neuter issues because the NGO sector alone can not do it all.”
The second part of the common question
The common question from the program donors often has a second part to it. “How do you know that the vets won’t just use their skills to make money when working in private practice?” This question is even more critical to answer and understand.
For the sake of the overall objective of improving the welfare of dogs and humane dog population management by surgically sterilizing dogs, it should not matter whether the vet earns his/her salary through a government ABC grant, foreign donor, by being employed by a private clinic, or by being self-employed in his/her clinic and charging the owners for the surgery performed.
Why would surgical sterilization be more valuable as an animal welfare activity for the individual dog if the vet’s salary was paid by a donor instead of from fees collected from the owner? Why do we keep maintaining the idea that only free spay/neuter surgery work is valuable for animal welfare? The surgery is never free. If the owner does not cover the expenses; medicine, materials, and salaries of the vet and assistant, someone else is doing it.
Why would we not – for the sake of sustainability – encourage creativity and develop more concepts where owners are involved and included in expecting small fees to be paid by them while at the same time making sure that expenses are kept low by utilizing targeted high-volume campaign models? Engage, encourage, and involve – every vets’ input is needed for this work!
And then there are also options for public-private partnerships to have municipalities subsidize spay/neutering at private clinics for financially fragile dog owners. More about this next time.
Happy spaying – just keep doing it! (and if you don’t yet have surgical instruments or you need to update your stocks, check out the Access to Vet Care – online instrument store).