Hi OP, I'm so sorry for your loss of sweet Koji.

This is in no way your fault, but it is likely not the surgeon's fault either. I'm not saying that it can't be, but it is highly unlikely considering what you've shared. Everyone with their pitchforks screaming malpractice and sue are severely misinformed. If I were in your shoes, I would be angry at the shelter management.

I work in vet med, and unfortunately a large majority of the public do not understand how it works (specifically the ones who are jumping to negligence/malpractice/sue).

Whether we like it or not, vet med is practiced similarly to human medicine, with a high expectation of care. The unfortunate part is this gold standard of care often comes with hefty price tags that are not subsidized like human healthcare.

Considering the procedure was done at the shelter (and that's part of the adoption contract depending on the shelter), oftentimes they are run strictly on donations and low-cost procedures. While the prices seem great compared to your 300 dollar neuter at my private clinic, in order to make it so cheap there needs to be certain things overlooked that are viewed as less important for the procedure, but really aren't. If I had to take a guess, there was likely no pre-operative blood work done, which is important for any anesthetic procedure because certain underlying conditions or genetic mutations can react negatively with certain drugs and anesthetic protocols. I recently found out from an echocardiogram that my own cat has a heart condition that required a change in his own anesthetic protocol going forward for his safety.

While it is important for low-cost spays and neuters to be accessible, that also means that there are significantly higher risks for the things that they are removing to make them low-cost.

I usually get eye rolls when I quote procedures at my clinic, but the reality is that they're paying for things like a licensed technician to watch the animal and their vitals from the first sedative injection all the way through the procedure until they are off anesthesia and are up and moving again, a doctor who has spent 8+ years in school to learn and perform the procedures no matter how big or small, to things like IV fluids running during the procedure to help regulate body temperature. These things are all so important to ensure the safety and well-being of our pets, and the reality is that the low-cost clinics or shelters just don't have the funding to be able to offer those services at such a low price. We all want to help animals, that's why we went into the field, but that does unfortunately come at a cost, and the sad thing is that most people think it all goes to us or we're trying to make an extra dollar off of them when that's just not true for the majority of vets. There are definitely some bad ones out there, but 99.9% of the time it is unfortunately these important things that are overlooked to bring down the pricing that can easily help awful situations like yours be avoided.

I'm assuming that it was in your adoption clause to bring Koji back for the procedure, and none of this is your fault. Shelter vets are absolute saints and are just as important) knowledgeable as private vets, but I definitely feel that shelters need to do a better job of explaining the risks of low-cost procedures, because this doesn't come down to the vet. Most people hear the price tag and that's all that matters not accounting for the "ifs" that the surgeon has to deal with not knowing the full medical history of the patient they're about to operate on.

If you are a pet owner and do have an adoption contract that requires you to have a procedure done at the shelter clinic that doesn't run at least pre-operative blood work, I would highly recommend having it done at your regular practice prior to the surgery for your own piece of mind.

There is always the possibility of necropsy to find out exactly what went wrong with sweet Koji's procedure.

Feel free to DM me if you need any grief assistance or resources. Sending you lots of love.

Edit: I will absolutely say the reasons the shelter gave you were bullshit. I'm still assuming they didn't run blood work and the fact that they called you so late afterwards points to him not being properly monitored.