Reproductive status and abnormal clinical signs after surgery are positively associated with hemoabdomen and autotransfusion in cats after ovariohysterectomy

Objective To identify the frequency and factors associated with hemoabdomen and the need for autotransfusion in cats undergoing spay surgery in the high-quality, high-volume spay/neuter context. Methods Licensed veterinary technicians recorded information about clinical signs and other variables of interest during and after spay surgery of queens at least 5 months of age that were spayed in ASPCA Community Medicine spay/neuter clinics between March 30, 2022, and January 9, 2024. These data were matched with additional medical data extracted from the medical records and analyzed with bivariate statistics for significant relationships. Results The analysis included 9,513 queens; 970 queens (10.6%) experienced intraoperative bleeding, and 77 queens (0.8%) experienced a major intraoperative bleed. Twenty-eight queens (0.3%) received an autotransfusion; 2 of those received an autotransfusion during the surgery, and the remaining 26 queens received an autotransfusion postoperatively. A higher proportion of queens in heat, in late-stage pregnancy, and after pregnancy experienced abdominal bleeding. A higher proportion of pregnant queens required an autotransfusion. Capillary refill time > 2 seconds, pale mucous membranes, and extended recovery time after surgery were significantly positively related to intraoperative bleeding and requiring an autotransfusion. Conclusions Major bleeds and autotransfusions were rare. Reproductive status was associated with abdominal bleeding. Delayed recovery and signs of anemia and/or poor peripheral perfusion after surgery can be an indicator of postoperative bleeding requiring autotransfusion. Clinical Relevance While severe hemoabdomen from ovariohysterectomy is rare, clinicians can use this information to promptly identify and manage abdominal bleeding from ovariohysterectomy.