Summary f Articles Studying Surgical Declawing f Dmestic Cats The Washingtn State Veterinary Medical Assciatin frmed the Feline Declawing Task Frce t examine the issue f surgically declawing dmestic cats. The task frce reviewed the available scientific literature studying the subject and has summarized the mst salient pints f pertinent articles belw. Members f the veterinary prfessin and public are encuraged t read these articles in full. Additinal studies specific t evaluating pain management strategies were nt included in this summary due t their narrw area f fcus, which was utside the scpe f the task frce s charge. It is imprtant t emphasize that verall, little research studying the issue f declawing utside the realm f pain management has been cnducted. The articles belw are listed in chrnlgical rder frm date f publishing. Kaplan, J., Bensn, C., Hlmes, K., Brks, J., Pau, A., Masur, H. Guidelines fr preventin and treatment f pprtunistic infectins in HIV-infected adults and adlescents. Recmmendatins frm CDC, the Natinal Institutes f Health, and the HIV Medicine Assciatin f the Infectius Diseases Sciety f America. MMWR 2009; 58:1-198. HIV-infected persns are at high risk fr severe disease caused by B. henselae. The majr risk factrs fr acquisitin f B. henselae are cntact with cats infested with fleas and receiving cat scratches. Persns wh acquire a cat shuld acquire an animal aged >1 year and in gd health. Cats shuld be acquired frm a knwn envirnment, have a dcumented health histry, and be free f fleas. Stray cats and cats with flea infestatin shuld be avided. Patients shuld avid cntact with fleas, flea feces ("flea dirt"), and any cat-assciated wund shuld be washed prmptly. Care f cats shuld include a cmprehensive, nging fleacntrl prgram under the supervisin f a veterinarian. Declawing is nt advised, but HIV-infected persns shuld avid rugh play with cats and situatins in which scratches are likely. Hlmberg, D., Brissn, B. A prspective cmparisn f pstperative mrbidity assciated with the use f scalpel blades and lasers fr nychectmy in cats. Can Vet J 2006; 47:162-163. This study cmpared the pstperative pain f 9 healthy cats wh underwent declaw surgery using a scalpel blade n ne frelimb and a CO2 surgical laser n the cntralateral limb. Pain was subjectively evaluated twice daily fr the 10 days fllwing surgery.
Significant imprvement in pain was fund fr bth grups until pstperative day 8. Differences in pain scres between the tw grups were nt significant when cmpared n individual days, and neither treatment grup shwed an bservable lameness by day 9. Cper, M., Laverty, P., Siderer, E. Bilateral flexr tendn cntracture fllwing nychectmy in 2 cats. Can Vet J 2005; 46:244-246. The early pstperative cmplicatin rate fllwing nychectmy is apprximately 50%. Cmplicatins include pain, hemrrhage, laceratin f the digital pad, swelling, reluctance t bear weight n the affected limbs, neurpraxia frm imprper turniquet use, and lameness. The late cmplicatin rate fllwing surgery is apprximately 19.8%. Cmplicatins infectin, tissue necrsis frm imprper bandaging, wund dehiscence r incmplete healing with prtrusin f P2, regrwth frm the ungual prcess f P3, scars (prductin f defrmed claw segment frm epithelial cells f the ungual crest), retentin f flexr prcess f P3, chrnic draining tracts, palmigrade stance, and chrnic intermittent lameness. This is a case reprt f tw individual cats wh presented fr chrnic pain, lameness, and fixatin f frelimb digits in flexin fllwing nychectmy. One cat was evaluated 6 weeks after nychectmy. The ther was evaluated 3 mnths after nychectmy. That cat als had hyperstsis f the distal half f P2 in essentially all digits and minimal sft tissue cverage ver the distal ends f P2. Bth cats were treated with staged tenectmies f the deep digital flexr tendn and recvered. The etilgy f the tendn cntracture is unknwn, but hypthesized t be a result f pstperative inflammatin due t excessive/rugh tissue manipulatin, a dull scalpel blade, imprper use f tissue adhesives, r pr aseptic technique. Gaynr, J. Chrnic pain syndrme f feline nychectmy. NAVC Clinician s Brief 2005; 11-13. Pain and behaviral prblems secndary t pain may arise within days t years after declawing. The authr speculates that chrnic pain syndrme is attributed t inadequate analgesia in the immediate pst-perative. Chrnic pain may be due t anatmical issues (bne remnants, claw regrwth) r windup phenmenn. The authr recmmends a specific multimdal apprach t preventing and acute and chrnic declaw pain. It includes pre and pst-perative pain cntrl extending days past the surgery. The authr als recmmends a specific multimdal treatment prtcl t alleviate chrnic pain. This prtcl successfully treated 12 f 12 cats that presented t the authr s hspital. Rmans, C., Grdn, W., Rbinsn, D., Evans, R., Cnzemius, M. Effects f pstperative analgesic prtcl n limb functin fllwing nychectmy in cats. JAVMA 2005; 227:89-93. 2
Onychectmy is a painful surgery. Untreated pain can result in cmplicatins. This study used pressure-platfrm gait analysis t cmpare the analgesic effects f three different pain management prtcls: pst-perative tpical bupivacaine, pstperative intramuscular butrphanl, and pre-perative transdermal fentanyl t alleviate the pain f unilateral nychectmy. It included 27 healthy cats. N cntrl grup was included due t humane cnsideratins. Gait analysis was perfrmed 1, 2, 3, and 12 days pst-peratively. One cat in the bupivacaine grup was remved frm the study due t severe pstperative pain that required rescue analgesia. Fr all 3 grups, peak vertical frce and vertical impulse were significantly decreased the day after surgery, cmpared t baseline. Values increased prgressively during the subsequent days. The piids prvided similar analgesia and better analgesia than bupivacaine. Hwever, the values fr all 3 grups were still significantly decreased cmpared t baseline at 12 days pst-p when the study cncluded. Therefre, the authrs recmmend cntinuing pst-perative pain cntrl at least thrugh 12 days pst-peratively. Chmel, B., Buluis, H., Breitschwerdt, E. Cat scratch disease and ther zntic Bartnella infectins. JAVMA 2004; 224:1270-1279. Cat scratch disease is mre cmmnly seen in yung cats with fleas. Peple wh want t avid transmissin, particularly immuncmprmised peple, shuld seek an adult cat frm a flea-cntrlled envirnment. Flea cntrl is the best methd f preventing cat scratch disease transmissin. Onychectmy is f limited use in preventing cat scratch disease as the infectin is als transmitted via flea bites. Therefre, flea cntrl, persnal hygiene (hand washing, especially f any cuts, bites, r scratches) and behaviral mdificatin t avid biting r scratching are cnsidered the mst effective cntrl measures. Rmans, C., Cnzemius, M., Hrstman, C., Grdn, W., Evans, R. Use f pressure platfrm gait analysis in cats with and withut bilateral nychectmy. AJVR 2004; 65:1276-1278. The purpses f the study were t determine whether limb functin culd be measured in cats by use f pressure platfrm gait analysis, describe the vertical frces fund in clinically nrmal cats, and cmpare thse frces with thse f cats that underwent nychectmy mre than 6 mnths prir t the study. There were 13 healthy cats in each grup. Gait analysis was successfully perfrmed. There were n significant differences in mean gait velcity, acceleratin, peak vertical frce, r vertical impulse between grups. Misn, M., Bhart, G., Walshaw, R., Winters, C., Hauptman, J. Use f carbn dixide laser fr nychectmy in cats. JAVMA 2002; 221:651-653. 3
This study cmpared the use f CO2 laser with the scalpel technique fr nychectmy with regard t pstperative signs f discmfrt and cmplicatins. 20 healthy cats participated in the study. Each cat had bth techniques perfrmed, ne per limb. Lameness, pain, swelling, hemrrhage, and discharge was assessed fr 24 hurs and again at a re-check 7 days after surgery. The laser technique resulted in lwer discmfrt and cmplicatin scres n the first day, but there were n differences between the grups at the ne week re-check. The authrs did nt believe the differences bserved were clinically imprtant. Patrnek, G. Assessment f claims f shrt and lng term cmplicatins assciated with nychectmy in cats. JAVMA 2001; 219:932-937. This paper reviewed 19 articles which studied medical r behaviral cmplicatins assciated with nychectmy. Overall, little research has been cnducted t assess cmplicatins assciated with declawing. Feline nychectmy is an elective surgical prcedure primarily perfrmed t prevent prperty damage r persnal injury frm scratching. Apprximately 24.4% f wned cats in the United States are declawed. The mst cmmn early pstperative cmplicatins are hemrrhage and pain. Later pstperative cmplicatins may include claw regrwth, radial nerve paralysis secndary t turniquet use, chrnic draining tracts, infectin, wund dehiscence r incmplete healing, prtrusin r lss f the secnd phalanx, tissue necrsis frm imprper bandage placement, develpment f a palmagrade stance, persistent lameness, cystitis, asthma, skin disrders, husesiling, and increase in frequency r severity f biting. The medical r shrt term cmplicatin rates in the reviewed literature ranged frm 0 t 40%. The lng term cmplicatin rate in the reviewed literature was apprximately 20%, but nly five studies assessed lng term cmplicatins. There is very little research available n behaviral cmplicatins and includes 3 retrspective studies, ne internet survey f cat wners, and ne mail survey f veterinarians. The behaviral cmplicatin (husesiling, increase in frequency f severity f biting) rate ranged frm apprximately 4 t 33% f declawed cats. Yen, S., Flanders, J., Scarlett, J., Ayers, S., Hupt, K. Attitudes f wners regarding tendnectmy and nychectmy in cats. JAVMA 2001; 218:43-47. This study cmpared wners reasns fr surgery and changes in the cats behavir fllwing surgery. It als assessed wners impressins f recvery time, benefits and cncerns regarding each surgical prcedure, and verall attitude regarding surgery. Scratching is an inherited nrmal behavir in cats. Mst undesirable scratching can be prevented r eliminated with envirnmental manipulatin and behavir mdificatin. 4
Owners wh are unwilling r unable t use these methds may elect fr surgery t cntrl the undesirable scratching. The mst cmmn surgical cmplicatins fllwing nychectmy r tendnectmy are pain, bleeding, swelling, and dehiscence. Tendnectmy als leads t rugh claws that grw excessively and require regular trimming. Owners f 57 frm 98 cats wh underwent the surgeries during a 5 year perid respnded t the study. 39 f these cats underwent nychectmy, while 18 underwent tendnectmy. The fllw-up perid ranged frm 2 mnths t 5.4 years pst-p. Reasns fr electing surgery included: scratching husehld materials (69% f nychectmy and 78% f tendnectmy patients), cncern fr injury t humans (49% f nychectmy and 17% f tendnectmy patients), cncern fr injury t ther husehld pets (26% f nychectmy and 6% f tendnectmy patients), desire t keep the cat indrs (90% f nychectmy and 67% f tendnectmy patients), and recmmendatin by anther persn (15% f nychectmy and 78% f tendnectmy patients). 13 (33%) f the nychectmy (6 huse siling, 2 refusing t cver feces, and 7 biting) and 3 (17%) f the tendnectmy (2 huse siling, 1 biting) patients develped behaviral prblems fllwing surgery. Statistical differences were nt bserved between the tw surgical prcedure grups. Benefits f surgery as reprted by wners included a decreased perceived risk f injury t humans (77% f nychectmy and 28% f tendnectmy patients) and a better relatinship between the cat and ther animals (46% f nychectmy and 11% f tendnectmy patients). Significant differences were nt detected in wner perceptins between the 2 surgical grups regarding the benefits f decreased damage t husehld materials, better relatinships between wner and pet, r the need fr less discipline f the cat fllwing either prcedure. 80% f nychectmy and 61% f tendnectmy patients had mre than 1 immediate medical cmplicatin fllwing surgery. 1 cat wh was declawed had regrwth f P3. 1 cat wh had tendnectmy had prlnged lameness (nt further described in the text). Mst wners perceived a return t nrmalcy fr their cats within 14 days after surgery. 10% f nychectmy patients tk mre than 14 days t fully recver, as reprted by their wners. 94% f tendnectmy and 87% f nychectmy patients wners reprted a psitive attitude tward the surgery. Jankwski, A., Brwn, D., Duval, J., Gregr, T., Strine, L., Ksiazek, L., Ott, A. Cmparisn f effects f elective tenectmy r nychectmy in cats. JAVMA 1998; 213:370-373. This study prspectively cmpared the cmplicatin rates and wner satisfactin fr nychectmized and tenectmized cats. It included 38 healthy cats. Bilateral frelimb nychectmy and tenectmy f the tendn f the deep digital flexr muscle are cmmnly perfrmed n cats in the United States t prevent use f claws. Pstperative cmplicatins include pain, lameness, bleeding, swelling, incisinal dehiscence, nerve trauma secndary t use f a turniquet, and tissue necrsis resulting 5
frm imprper bandaging. These cmplicatins develp in up t 50% f nychectmized cats. Lng term cmplicatins include lameness, infectin, regrwth f claws, develpment f chrnic draining tracts frm remnants f the distal phalanx, prtrusin f the secnd phalanx, and develpment f palmagrade stance. These cmplicatins develp in up t 20% f nychectmized cats. Cats were examined by clinicians until discharge the day fllwing surgery, then rechecked within 14 days pst-peratively t assess shrt-term cmplicatins. Clients were cntacted by telephne survey at least 5 mnths after surgery t assess lng-term cmplicatins. The shrt-term cmplicatin rate in this study was 24%. Cmplicatins included hemrrhage, infectin, persistence f sutures causing lameness, and behaviral changes. Lng-term cmplicatins in this study included chrnic lameness. N claw regrwth ccurred in any f the cats. 2 f 18 wners whse cats underwent nychectmy were dissatisfied with the results. One cat had signs f extreme pain and inapprpriate urinatin fr 2 days after discharge. The ther cat had lng-term lameness and did nt walk nrmally fr 300 days after surgery. 6 f 20 wners whse cats underwent tenectmy were dissatisfied with the results. Dissatisfactin was related t ability t scratch smewhat after surgery (11 f 20), wner difficulty with trimming claws (6 f 20), excessively thick claws n the frelimbs that seemed t irritate cats, r lng-term lameness (1 cat did nt walk nrmally fr 180 days after surgery). Tw cats in the tenectmy grup were disqualified frm the study because their wners later admitted the cats fr nychectmy due t dissatisfactin with tenectmy results. Cats wh underwent tenectmy appeared t have significantly less pain than cats wh underwent nychectmy. Patrnek, G., Glickman, L., Beck, A., McCabe, G., Ecker, C. Risk factrs fr relinquishment f cats t an animal shelter. JAVMA 1996; 209:482-588. This study examined the rle f varius risk factrs fr relinquishment f cats t an animal shelter. The study was cnducted via telephne survey and included 624 catwning husehlds and 218 husehlds that relinquished a cat t the Humane Sciety f St. Jseph Cunty during the study perid. Euthanasia f healthy but unwanted pets by animal shelters is believed t be the leading cause f death in cats, claiming apprximately 4 millin lives annually. Increased risk factrs fr relinquishment included being declawed, having behaviral prblems, husehlds with a specific expectatin abut the cat s rle in the husehld, inapprpriate care expectatins, wners wh had never read a bk abut feline behavir, age < 6 mnths, being sexually intact, being a mixed-breed, being acquired at n cst frm the previus wner, spending mst f the day in a basement r garage, having access t the utdrs, never receiving veterinary care, wners wh did nt carry r display a picture f the cat, wners wh had nt previusly wned a cat since childhd, annual family incme < $40,000, renting r living in an apartment r mbile hme, and wners wh lived in their current hme fr < 5 years. 6
Cats that were fund as strays, cared fr by the entire family, viewed as family members, r unexpectedly acquired had a decreased risk f relinquishment. There was n statistical difference in incidence f behaviral prblems between declawed and nn-declawed cats. Tbias, K. Feline nychectmy at a teaching institutin: a retrspective study f 163 cases. Vet Surg 1994; 23:274-280. This study assessed the frequency f cmplicatins with nychectmy and any crrelatins with patient age, weight, r surgical technique. It studied 163 healthy cats wh underwent nychectmy at a teaching hspital ver a perid f 7 years. At least ne early cmplicatin was nted in 50% f patients. Early cmplicatins included pain, hemrrhage, swelling, lameness, and nn-weight-bearing. Early cmplicatins ccurred mre frequently in patients wh underwent scalpel vs Resce declaw. Late cmplicatins were nted in 19.8% f patients. Late cmplicatins included infectin, regrwth f claws, P2 prtrustin, palmagrade stance, and lameness. Late cmplicatins ccurred mre frequently in patients wh underwent Resce vs scalpel declaw. Martinez, S., Hauptman, J., Walshaw, R. Cmparing tw techniques fr nychectmy in cats and tw adhesives fr wund clsure. Veterinary Medicine 1993; 88:516-525. This study cmpared wund healing using disarticulatin amputatin via scalpel r bny amputatin with Resc nail trimmers and tw brands f surgical glue fr clsure. The study included 252 healthy cats. Cats were discharged the day after surgery and returned fr re-check 7 days and 6 mnths after surgery. Cmplicatins assciated with nychectmy include claw regrwth, chrnic draining tracts, hemrrhage, and radial nerve paralysis. At the 1 week re-check, 11% f patients were lame (16% f scalpel and 5% f Resc declaws), 17% had dehiscence (22% f scalpel and 12% f Resc declaws). N differences were bserved between tissue glue grups. At the 6 mnth re-check, 10% f patients had claw regrwth. These patients had all been in the Resc nail trimmer grup. At bth re-check visits, P3 remnants were nted in patients. The number f patients affected was nt discussed. N clinical cmplicatins assciated with these remnants were bserved. 7