The difference is in a lot of things, anesthesia protocols, anesthetic monitoring, post op pain management, have multiple eyes on your pet and monitoring equipment. Getting a cat spayed is equivalent to a hysterectomy for us. Imagine doing that with only injectable sedation (yes I said sedation) if your lucking you get an endotracheal tube with gas anesthesia. You have no nurse or anesthesiologist, just the surgeon. And you don’t get hooked up to bp, ekg, spo2 or a capnograph. Oh and they send..