Calcium Chloride A New Tool for Chronic Poverty Ruth Steinberger, Co-CEO Spay FIRST! www.spayfirst.org

Thank you to Elaine Lissner, Director of Parsemus Foundation for making our work with calcium chloride possible. Thank you to researchers and visionaries Billy Clay, DVM, HW Haney, DVM and Charles Helwig, DVM for making it possible to collect data with the goal of helping animals in chronic poverty and to Peter Denooij, DVM for his vision of delivering services to animals where it has previously been difficult to do so.

Worldwide dogs and cats exist within a broad spectrum of care… Some dogs and cats get all necessary veterinary care; Many get some veterinary care; Most get none. 75% of dogs worldwide receive no veterinary care

Main roadblocks to traditional services… Extreme poverty, little to no funds for supplies, equipment or appropriate space. Massive numbers of animals need spay/neuter in order to have an effect on population. Shortage of human resources (veterinary services to meet the needs). Remote locations, difficult logistics.

Why new tools? Provide greater volume. Maximize the use of surgeons, time and money.

Our goal is not to replace what works well, but instead to expand capacity to prevent unwanted litters born to animals that will not otherwise be altered. In order to do all that, we need to dramatically decrease costs and eliminate roadblocks to getting animals altered in high-risk circumstances.

The overwhelming numbers of animals requires cost effective programs.

Temporary space and the high cost for surgical supplies can limit the numbers.

Calcium chloride provides a large volume of sterilizations of male dogs and cats at a fraction of the cost, and without the necessary equipment, of surgery and it can even be used in very challenging settings.

In the case of chronic poverty, remote areas, long distances and other challenges, we must meet the issues with easy, low cost, non-surgical options that have benefits equal to castration.

Costs: Calcium Chloride in Ethyl Alcohol A separate needle and syringe used for each testicle Sedation and pain medication used Chlorhexidine Gauze Exam gloves Total under US $ 1.00

HOW DOES IT WORK? BILLY CLAY MS, DVM, DIPLOMATE AMERICAN BOARD OF VETERINARY TOXICOLOGY STILLWATER, OK USA

CALCIUM CHLORIDE DIHYDRATE A 20 % SOLUTION PREPARED WITH STERILE ETHYL ALCOHOL INJECTED INTO THE CENTER OF EACH TESTICLE WITH SUFFICIENT PRESSURE TO AVOID LEAKAGE INTO THE SCROTUM THE HYPERTONIC SOLUTION EXERTS OSMOTIC PRESSURE ACROSS CELLULAR MEMBRANES

CALCIUM CHLORIDE DIHYDRATE FLUID TRAVERSES THE MEMBRANES OF CELLS AS WELL AS EXTRAVASCULARLY RESULTING IN SWELLING OF EXTRACELLULAR TISSUES. THE INTEGRITY OF CELLS ARE LOST RESULTING IN DEATH AND NECROSIS- AND FINALLY FIBROSIS

Left Testicle measured 32 mm Right Testicle measured 25 mm

Scrotum is 1.5x TO 2.0x NORMAL

Left Testicle measured 26 mm (-6) Right Testicle measured 20 mm (-5)

Castration after 30 days

Study in Collaboration with Spay First Pathology by Keith Bailey (OSU Lab) Testicular and Epididymis pathology was performed on 14 dogs 3-30 days post injection Testes showed inflammatory response with mineralization, fibrosis and tubular degeneration. Epididymides showed similar inflammation, mineralization and fibroplasia.

Leakage into the Scrotum? A similar necrosis will occur with erosion to the skin surface in some. Those lesions will heal in about 30 days.

Calcium Chloride A New Tool for Underserved Areas Presenter H. W. Haney, DVM, Cache, Oklahoma, USA

What are “intratesticular injections of calcium chloride?” Calcium chloride for this purpose contains 4 grams calcium chloride dihydrate in 20 ml of ethyl alcohol. It is made of pharmaceutical grade products. It reduces testosterone significantly and the testicles atrophy. .

Our trials Existing data since 1978 on dogs, in-depth publications in 2007, 2011 Confirmed by HCG challenged testosterone tests funded by Spay FIRST! through generous grants from Parsemus Foundation. Pathology continuing on samples.

Dogs injected and challenged with HCG at 30 days. Below 0 Dogs injected and challenged with HCG at 30 days. Below 0.5 ng/ml of testosterone is a castrated dog. Up to 9.0 ng/ml is within the normal range. Testicles atrophied. Injected on Jan 31, 2014 30 day HCG challenge Feb 28, 2014 Dog 1 0.004 Dog 2 Dog 3 0.594

Outcomes Testosterone near or below the level of a castrated dog. Eliminated libido (major safety factor). Reduced costs dramatically Permanent atrophy of testicles

Supplies

Tool for measurement Gauze and soap Syringes and extra 23 g needles in 1’ and 1.5” Calcium chloride Ethyl alcohol

Measuring each testicle

Write the size of the testicle for measuring the correct dose.

It is vital that no calcium chloride enter the scrotum It is vital that no calcium chloride enter the scrotum. Use of separate, clean needle for each testicle is necessary. Insert clean needle into bottle

Pull correct dose into sterile syringe

Replace sterile needle on the syringe with calcium chloride and repeat for second testicle.

You will have two syringes with the correct dose of calcium chloride in each. A sterile needle will be attached to each syringe before injection. Any needle that has been in the calcium chloride will be discarded.

One wipe with chlorhexidine solution.

Use the correct length needle to reach center of testicle Use the correct length needle to reach center of testicle. Have 1” and 1.5 “ needles on hand.

Remove needle very slowly and pinch off testicle

Identification Tattoo each dog Ear tattoo if appropriate Microchip if desired Use a system that works in your area

Calcium Chloride Distribution Peter P. Denooij, DVM www.calciumchloridecastration.com

Calcium Chloride Distribution Bottle contains 4 grams of Calcium Chloride Dihydrate Sterile Add 20 ml of 95% Ethyl Alcohol Results in 20 ml of 20% solution of CaCl2

Calcium Chloride Distribution

Calcium Chloride Distribution 1 box contains enough CaCl2 to produce 1000 ml of 20% calcium chloride solution

Calcium Chloride Distribution Veterinarians only

Calcium Chloride Distribution Ordering Process Place order with CaClCa Inc. Receive Paypal Invoice Includes cost of bottles, packing, handling, shipping and service charges Pay invoice through Paypal Shipping via DHL Express You will receive shipping progress by e-mail

For information: info@spayfirst.org info@calciumchloridecastration.com All veterinary inquiries regarding CaCl will be answered by a licensed veterinarian.