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Pain and adverse behavior in declawed cats
Abstract
Objectives
The aim of this study was to assess the impact of onychectomy (declawing) upon subsequent development of back pain and unwanted behavior in cohorts of treated and control cats housed in two different locations.
Methods
This was a retrospective cohort study. In total, there was 137 declawed and 137 non-declawed cats, of which 176 were owned cats (88 declawed, 88 non-declawed) and 98 were shelter cats (49 declawed and 49 non-declawed). All cats were physically examined for signs of pain and barbering. The previous 2 years of medical history were reviewed for documented unwanted behavior such as inappropriate elimination and biting with minimal provocation and aggression. All declawed cats were radiographed for distal limb abnormalities, including P3 (third phalanx) bone fragments. The associations of declaw surgery with the outcomes of interest were examined using χ ² analysis, two sample t-tests and manual, backwards, stepwise logistic regression.
Results
Significant increases in the odds of back pain (odds ratio [OR] 2.9), periuria/perichezia (OR 7.2), biting (OR 4.5) and barbering (OR 3.06) occurred in declawed compared with control cats. Of the 137 declawed cats, 86 (63%) showed radiographic evidence of residual P3 fragments. The odds of back pain (OR 2.66), periuria/perichezia (OR 2.52) and aggression (OR 8.9) were significantly increased in declawed cats with retained P3 fragments compared with those declawed cats without. Optimal surgical technique, with removal of P3 in its entirety, was associated with fewer adverse outcomes and lower odds of these outcomes, but operated animals remained at increased odds of biting (OR 3.0) and undesirable habits of elimination (OR 4.0) compared with non-surgical controls.
Conclusions and relevance
Declawing cats increases the risk of unwanted behaviors and may increase risk for developing back pain. Evidence of inadequate surgical technique was common in the study population. Among declawed cats, retained P3 fragments further increased the risk of developing back pain and adverse behaviors. The use of optimal surgical technique does not eliminate the risk of adverse behavior subsequent to onychectomy.
... These same reports are recognized as key diagnostic features of inflammatory LBP described in a validated clinical prediction rule for inflammatory LBP. [32][33][34][35] For patients in the Constrained Posture Sensitive symptom pattern, self-management interventions should emphasize frequent movement, including scheduled walking breaks. Furniture prescription should facilitate motion (eg, a task chair with a spring-loaded rocking feature or a rocking chair) and encourage postural change (eg, sitstand work surface) without interfering with function. ...
... 17,[19][20][21]27 Many dancers perceive that pain is mostly unavoidable in dance 17,19 and do not readily consult with health care practitioners when injured. 31,32 Many avoid communicating pain to dance instructors or choreographers. Some dancers interviewed described the fear of losing their job and performance roles. ...
... Results from this study corroborate with previous authors that found dancers routinely continue performing through pain. 6,16,[18][19][20][21][22][23][24][25]27,30,32,33,35 Nearly 94% of ballet dancers (n=123) reported experiencing dance-related pain and only 72% of ballet dance instructors (n=51) reported having taught dancers who experienced a dance-related injury or pain. Thus, comparing the perception of dancerelated pain between groups was significantly different, with dancers reporting greater levels of pain than what dance instructors perceived. ...
The purpose of this case report is to outline the residency trained physical therapy clinical reasoning process behind the evaluation, treatment, and urgent referral of a patient resenting with repeated falls and gait instability despite having been referred by his primary care physician (PCP) to physical therapy with a diagnosis of LBP.
... [1][2][3] However, evidence suggests elective onychectomy can be associated with lameness, acute and chronic pain, as well as an increased risk of back pain, house-soiling, increased biting behavior and barbering in cats. 2,[4][5][6] Pain, lameness and changes in behavior can also be present in cats regardless of the method of amputation or anesthetic and analgesic protocols. 7,8 Scratching is a natural behavior that is inherited and learned in cats that allows them to deposit pheromones, stretch and sharpen their claws. ...
... House-soiling and aggressive behavior have been reported as two of the most common behavioral surrender reasons in cats, 29 and in a 2018 cohort study onychectomy was associated with a 7.2-times higher odds of periuria/perichezia and 4.5-times higher odds of biting behaviors. 4 However, even with this information, it would be difficult to infer a direct causative relationship owing to the multifactorial etiology of both conditions. Systematic tracking of the onychectomy status of individual cats could have helped narrow down this population and determine if the ban could have had a protective or negative effect on relinquishment for these different subsets of cats. ...
Objectives
The aim of this study was to determine whether there was an increase in cat relinquishment for destructive scratching behavior, a change in overall feline surrender intake and euthanasia, or a change in average length of stay in a British Columbia shelter system after provincial legislation banning elective onychectomy.
Methods
Records of cats admitted to the British Columbia Society for the Prevention of Cruelty to Animals in the 36 months prior to (1 May 2015–30 April 2018, n = 41,157) and after (1 May 2018–30 April 2021, n = 33,430) the provincial ban on elective onychectomy were reviewed. Total intake numbers, euthanasia and length of stay were descriptively compared between periods. Proportions of cats and kittens surrendered for destructive scratching, as well as the proportion of cats and kittens surrendered with an owner request for euthanasia, were compared using two-sample z-tests of proportions.
Results
Destructive behavior was found to be an uncommon reason for surrender (0.18% of surrendered cats) during the study period. There was no statistically significant difference in the number of cats surrendered for destructive scratching behavior ( z = −1.89, P >0.05) after the provincial ban on elective onychectomy. On the contrary, the proportion of owner-requested euthanasias decreased after the ban ( z = 3.90, P <0.001). The total number of cats surrendered, the shelter live release rate and average length of stay all remained stable or improved following the ban, though causation could not be determined.
Conclusions and relevance
The findings in this study suggest that legislation banning elective onychectomy does not increase the risk of feline shelter relinquishment – for destructive behavior or overall – and is unlikely to have a significant effect on shelter euthanasia or length of stay.
... It should come as no surprise that evidence shows declawing causes pain in cats, in part due to a number of surgical sequelae including retained bone fragments, osteomyelitis, excessive tissue handling during surgery, and complications from bandaging (124). While pain is an expected outcome of any surgery and should be ameliorated appropriately, there is evidence that there is short-and long-term pain due to onychectomy (124)(125)(126)(127)(128)(129). Behaviors indicative of pain, such as forepaw shaking and laying on their side, were seen in cats that were declawed compared to those having a sham procedure performed (125). ...
... Surgical methods and adherence to appropriate technique affect the outcome for declawing, as with all surgeries. A recent study demonstrated that 63% of cats had radiographic evidence of P3 remnants, and this was most highly correlated with back pain, periuria, and aggression (128). These results were seen far out from the surgery date. ...
Veterinarians perform surgery for a number of reasons, from treating a problem to preventing future problems. There is an inextricable link between the physical and psychological aspects of an animal's health, and surgery is often a conduit to bridge that gap. Some surgical procedures can affect an animal's behavior, such as castration, and some pose an ethical dilemma, such as ear cropping and declawing. Ameliorating pain, decreasing stressful experiences for the animal, and identifying and treating concurrent problem behaviors are hallmarks of improving animal welfare. The purpose of this article is to outline some of these interrelationships and ethical dilemmas, providing evidence-based verification as applicable.
... Even stronger negative effects of declawing were identified in a retrospective study published in 2018, 26 which provides a useful overview of the impact of the procedure, as well as of the effects of different surgical techniques. Cats that had been declawed experienced significant increases in the risk of back pain, undesirable elimination, biting and problem licking/grooming. ...
... Nonetheless, as the authors pointed out, 'The use of optimal surgical technique does not eliminate the risk of adverse behavior subsequent to onychectomy'. 26 An ancillary finding in a study by one of the present authors (TD) on resolution of conflict between housemate cats was the unexpectedly high percentage of declawed cats involved in such conflicts. 27 As noted earlier, the overall proportion of declawed cats in the USA is estimated to be between 20.8% and 25%. ...
Practical relevance:
While scratching is a normal, beneficial behavior for cats, it can create problems when cats scratch objects owners deem as inappropriate. However, if veterinarians make suitable recommendations from the first veterinary visit, owners will be able to implement effective preventive strategies to develop good scratching patterns for life. Educating owners as to why cats scratch, how to guide cats to scratch only on desirable surfaces (ie, a scratching post), which types of scratching posts are preferred by most cats, the benefits of pheromone products, as well as other strategies to avoid destructive scratching, helps to preserve the cat-owner bond and reduces the risk of relinquishment.
Clinical challenges:
Clients may not directly ask veterinarians for their assistance regarding their cat's destructive scratching, and may not be aware that anything can be done except for declawing their cat.
Evidence base:
Published studies on scratching are limited. Destructive scratching has been documented as a reason for the relinquishment of cats to shelters and the negative effects of declaw surgeries are being increasingly discovered. Among recent scientific publications are studies assessing kitten and cat preferences for scratching substrates, and the use of pheromones to encourage appropriate scratching behavior. This review draws on these studies, among other resources, as well as the authors' personal experiences.
... Although indoor vs. outdoor access was not a significant predictor of pARBs in this study, declaw status was the strongest predictor of these behaviors in the multiple regression model. Numerous recent studies have reported welfare concerns surrounding the practice of declawing (onychectomy), and associations between declawing and behavior problems, with behavior problems more common in declawed companion cats (e.g., Grigg & Kogan, 2019;Martell-Moran, Solano, & Townsend, 2018). This proportion of declawed cats is in sharp contrast to the earlier study, in which the majority (93.5%) of cats were not declawed. ...
One common form of play between companion cat guardians and cats involves the use of laser light pointers (LLPs). Although viewed by many as an enjoyable shared interaction, experts have suggested that it may increase the risk of compulsive behaviors. Our earlier study recruited participants through social media to examine the relationship between LLPs and potential abnormal repetitive behaviors (pARBs). Because of possible biases in this form of recruitment, this study was conducted utilizing Amazon Mechanical Turk. A total of 468 responses (54.5% female, 44.0% male, 1.5% nonbinary) were analyzed. Significant associations between the frequency of LLPs and the occurrence of spins or tail chases, chasing lights or shadows, staring "obsessively" at lights or reflections, and fixating on a specific toy were found. Additional associations for these pARBs included declaw status, cat age, and number of cats in the household. Despite differences in recruitment method, the primary conclusions of the two studies were the same: guardians frequently using LLPs with their cats reported significantly more pARBs. These results suggest that LLPs may be associated with compulsive behaviors in cats.
... It is estimated that about 21-24% of owned cats in the United States are declawed (Lockhart, Motsinger-Reif, Simpson, & Posner, 2014;Patronek, 2001). This is an important welfare issue, as it has been demonstrated that declawing causes back pain, undesirable habits of elimination and even aggression in cats (Martell-Moran, Solano, & Townsend, 2018). Moreover, declawed cats stay longer at shelters before being adopted (Fritscher & Ha, 2016), which also impacts their welfare conditions. ...
Preference responses of cats for scratching fabrics commonly used on furniture were evaluated during four consecutive days in three Non-Governmental Organizations (NGOs) that rescue companion animals. Cats were grouped and their choices were registered at a group level (no individual identification). Daily choices for chenille, suede, synthetic leather, or waterproof grosgrain fabrics were evaluated for the cats' groups. A preference for chenille and non-preference for synthetic leather and waterproof grosgrain was found, independent of the NGO. In conclusion, although not using chenille does not assure that cats stop scratching furniture-especially if no other option to scratch is available-synthetic leather and waterproof grosgrain seem to be less attractive fabrics for these animals. Further studies are needed to investigate whether these findings apply to cats in a home scenario, when just one or a few individuals are usually present and only one type of fabric covering furniture is commonly available. Although we did not investigate the effect of providing scratching posts for these animals, we recommend such posts are available in the environment as scratching behavior is important to cats.
... Proposed theories for the transition to chronic pain include persistent noxious signalling from the periphery and a maladaptive response in the central nervous system, which includes descending inhibitory and facilitatory modulation dysfunction (13). There is currently insufficient evidence in veterinary medicine to establish the prevalence of this problem, though surveys of postoperative human patients suggest that prevalence may be as high as 40% in certain surgical populations and a recent feline study suggested an increased risk of chronic pain and adverse behaviors in cats that had been declawed (13,14). The timescale over which acute pain may establish the biological foundations required for the development of chronic pain syndromes is measured in hours to days (13). ...
A prospective, observational, cross-sectional study documenting the prevalence of pain in dogs presented to the emergency service of a veterinary teaching hospital and their handling (times to triage, examination, treatment) was conducted. Pain was assessed and compared using a validated and an unvalidated pain assessment scale. Sedation was monitored using a validated scale. A first evaluation was completed in 109 dogs. A second evaluation was completed for 95 dogs: 36 (38%) were identified as painful and 53% (19/36) were provided analgesia in the clinic. The remainder either did not receive analgesia (6/36, 17%) or were prescribed an analgesic for administration at home (11/36, 31%). Of dogs receiving analgesia in the clinic, most showed a decrease in pain score (15/19, 79%). Pain assessment scales were positively correlated (r = 0.69, P < 0.0001) but the unvalidated scale was insensitive in discriminating changes. Between painful and non-painful dogs, progression did not differ: admission to treatment [P = 0.96, 95% confidence interval (CI): -23 to 22 minutes] and examination to treatment (P = 0.73, 95% CI: 14 to 20 minutes). Suboptimal analgesic use suggests focused training in pain assessment and analgesic use guided by a validated pain assessment scale, is warranted.
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
... Specific reports of similar chronic pain related problem aggression in cats appear to be missing in the literature, but such responses are believed to occur in relation to both arthritis and dental disease [11][12][13][14] and typically manifest as poorer mood [13] and defensiveness in relation to interaction [13,15,16] but also increased fearfulness in some cases [13]. A retrospective cohort study of 137 declawed cats indicated that declawed cats were at increased risk (odds ratio of 2.66) of having back pain and nearly nine times more likely to show signs of aggression [17]. Central sensitization (sometimes called "wind-up pain"), in which there is increased sensitivity towards pain in body regions not initially affected by a painful lesion, is also believed to occur in the cat, resulting in aggression when touched in this non-painful region [18]; the absence of a lesion associated with the area may lead to the mistaken supposition that the cat's problem is "behavioral" rather than pain-related. ...
We argue that there is currently an under-reporting of the ways in which pain can be associated with problem behavior, which is seriously limiting the recognition of this welfare problem. A review of the caseloads of 100 recent dog cases of several authors indicates that a conservative estimate of around a third of referred cases involve some form of painful condition, and in some instances, the figure may be nearly 80%. The relationship is often complex but always logical. Musculoskeletal but also painful gastro-intestinal and dermatological conditions are commonly recognized as significant to the animal’s problem behavior. The potential importance of clinical abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed by clinicians in general practice, even when they are common within a given breed. In general, it is argued that clinicians should err on the side of caution when there is a suspicion that a patient could be in pain by carefully evaluating the patient’s response to trial analgesia, even if a specific physical lesion has not been identified.
... In addition, some owners in the present study (12.3%) had had their own cats declawed, and an additional 11.2% of cats had been declawed prior to being obtained by the present owner. This practice continues despite concerns about the welfare impact of declawing, and the link documented in a number of recent studies between declawing and behavior problems (e.g., reference [30]). Behavior problems were significantly more prevalent in declawed cats in the current study, supporting these findings. ...
Available research on the link between domestic cats’ environment and welfare has primarily been conducted in animal shelters or research facilities; a better understanding of the welfare of cats living in homes is needed. This study measured the attitudes of current U.S.-based cat owners towards cats as pets; owner knowledge about normal cat behavior and environmental needs; current trends in cat care; cats’ behavior in the home; and the human-animal bond. The primary hypothesis was that owners with a more accurate understanding of cat behavior and a stronger reported bond with their cats would report fewer behavior problems. Data from an online, anonymous, cross-sectional survey of 547 cat owners supported the primary hypothesis: owner knowledge, along with two measures of the human-animal bond (owner-pet interactions, and perceptions of affordability of cat ownership), were significant predictors of the number of reported behavior problems. In addition to fewer reported behavior problems, greater owner knowledge about cats was correlated with less use of positive-punishment-based responses to misbehavior, and increased tolerance of potential behavior problems when present. Owners’ agreement with certain misconceptions about cats and perception of high costs of care were correlated with the use of positive punishment in response to misbehavior. Based on the survey results, many cats living in private homes may be receiving only minimal environmental enrichment. Collectively, these results suggest the need for better education of cat owners. Topics could include: understanding normal cat behavior and correcting misconceptions; enrichment needs (particularly of indoor-only cats) and the risk of behavior problems when cats’ needs are not met; welfare risks associated with declawing; and the importance of sufficient resources to minimize social and territorial conflict.
... In addition, some owners in the present study (12.3%) had had their own cats declawed, and an additional 11.2% of cats had been declawed prior to being obtained by the present owner. This practice continues despite concerns about the welfare impact of declawing, and the link documented in a number of recent studies between declawing and behavior problems (e.g., reference [30]). Behavior problems were significantly more prevalent in declawed cats in the current study, supporting these findings. ...
... Clinical signs of PPP can be observed in onychectomized cats and include lameness, back pain, inappropriate elimination habits, licking and chewing at the digits, aversion to the feet being touched, and altered weightbearing, among others. 53 These signs lead to suffering, disability and reduced QoL, and are a major burden on these cats. Veterinary authorities in regions where onychectomy is performed (including the USA and Canada) should be calling for legislation to prohibit this nontherapeutic surgical procedure. ...
Practical relevance
Chronic pain is a feline health and welfare issue. It has a negative impact on quality of life and impairs the owner–cat bond. Chronic pain can exist by itself or may be associated with disease and/or injury, including osteoarthritis (OA), cancer, and oral and periodontal disease, among others.
Clinical challenges
Chronic pain assessment is a fundamental part of feline practice, but can be challenging due to differences in pain mechanisms underlying different conditions, and the cat’s natural behavior. It relies mostly on owner-assessed behavioral changes and time-consuming veterinary consultations. Beyond OA – for which disease-specific clinical signs have been described – little is known regarding other feline conditions that produce chronic pain.
Recent advances
Knowledge of the subject has, however, greatly improved in the past few years, informed by study of the mechanisms of pain in cats with OA and the development of pain scales that can be used by owners or veterinarians. Pain scales may facilitate the diagnosis and follow-up evaluation of chronic painful conditions, providing a basis for therapeutic decision-making. Assessment of quality of life is also recommended in cats with chronic pain, and its improvement can be used as a positive outcome in response to therapy.
Aims
This article reviews recent advances and presents the challenges and some future perspectives on clinical chronic pain assessment. The most common feline chronic conditions associated with pain are also described.
... 12 Moreover, a recent retrospective study also identified that onychectomy (declawing) could affect feline behavior, with significantly increased odds of aggression in declawed cats with radiographic evidence of residual P3 fragments, and even cats with no evidence of residual P3 had an increased odds of biting (odds ratio 3.0). 13 Kittens will form strong social relationships during the 'sensitive period' or the window of optimal socialization that occurs between 2 and 7 weeks of age. 14 Curiously, during these first few weeks of age is the time of natural cat-appeasing pheromone release by the queen; coincidentally or causally at a time when kittens are living in groups with very few conflicts and competition. ...
Objectives
Aggression and social tension among housemate cats is common and puts cats at risk of injury or relinquishment. The aim of this study was to evaluate the effectiveness of a new pheromone product in reducing aggression between housemate cats.
Methods
A new pheromone product (Feliway Friends) containing a proprietary cat-appeasing pheromone was evaluated for efficacy in reducing aggression between housemate cats via a randomized, double-blind, placebo-controlled pilot trial of 45 multi-cat households (pheromone [n = 20], placebo [n = 25]) reporting aggression for at least 2 weeks. Each household had 2–5 cats. Participants attended an educational training meeting on day (D) –7 and the veterinary behaviorist described behaviors to be monitored for 7 weeks using the Oakland Feline Social Interaction Scale (OFSIS), which assessed the frequency and intensity of 12 representative aggressive interactions. Participants were also provided with instructions for handling aggressive events, including classical conditioning, redirection by positive reinforcement and not punishing or startling the cat for aggressive displays. Punishment techniques were strongly discouraged. Plug-in diffusers with the pheromone product or placebo were utilized from D0–D28. Participants completed a daily diary of aggressive events and weekly OFSIS assessments through to D42.
Results
Evolution of the OFSIS–Aggression score according to treatment group in the full analysis set population revealed a significant effect on time and treatment group. The OFSIS–Aggression score decreased over time from D0–D28 in both groups (time factor P = 0.0001) with a significant difference in favor of the verum P = 0.06); similar results were found considering the D0–D42 period (time factor P = 0.0001 [D0] and P = 0.04 [D42]).
Conclusions and relevance
The OFSIS provided a quantifiable measure of the frequency and intensity of 12 intercat interactions reflecting conflict between cats. The cat-appeasing pheromone is a promising treatment for the management of aggression between housemate cats in multi-cat households.
... However, in multi-cat households declawing doubles the risk of house-soiling, possibly because these cats are less able to defend themselves against other cats, so potentially replacing one problem with another while at the same time threatening the cat's welfare. 43,44 There appears to be a considerable mismatch between the occurrence of potentially problematic behaviour in the pet cat population, and its prevalence in terms of numbers of enquiries to advice services and cases presented to practitioners ( Figure 5). Behaviour that causes inconvenience or embarrassment to owners, especially urination and defecation in undesired locations, is over-represented in clinical surveys; behaviour that may be perceived as 'just what cats do', such as aggression between cats living in neighbouring households, is under-represented, even though these may be different expressions of the same underlying issue. ...
Practical relevance
Cats are descended from a solitary, territorial ancestor, and while domestication has reduced their inherited tendency to be antagonistic towards all animals larger than their typical prey, they still place more reliance on the security of their territory than on psychological attachments to people or other cats, the exact opposite to dogs. Many feline problem behaviours stem from perceived threats to this security, often due to conflicts with other cats. Others are more developmental in origin, often caused by inadequate exposure to crucial stimuli, especially people, during the socialisation period. Strongly aversive events experienced at any age can also contribute. A third category comprises normal behaviour that owners deem unacceptable, such as scratching of furniture.
Evidence base
This review identifies three areas in which basic research is inadequate to support widely employed concepts and practices in feline behavioural medicine. First, classification of cats’ problem behaviours relies heavily on approaches derived from studies of their behavioural ecology and, to some extent, extrapolation from canine studies. Few studies have focused on cats in the home, the environment in which most behavioural disorders are expressed. Secondly, cats’ chemical senses (olfactory and vomeronasal) are far more sensitive than our own, making it difficult for owners or clinicians to fully comprehend the sensory information upon which they base their behaviour. Thirdly, although the concept of psychological distress is widely invoked as an intervening variable in behavioural disorders, there are still no reliable measures of distress for pet cats in the home.
Global importance
Psychological distress of some kind is the primary cause of many of the behavioural problems presented to clinicians, but surveys indicate that many more cats display the same clinical signs without their owners ever seeking help. The welfare of this ‘invisible’ group could be improved by veterinarians taking a more proactive approach to educating their clients about the behavioural needs of pet cats.
... Clinical signs of PPP can be observed in onychectomized cats and include lameness, back pain, inappropriate elimination habits, licking and chewing at the digits, aversion to the feet being touched, and altered weightbearing, among others. 53 These signs lead to suffering, disability and reduced QoL, and are a major burden on these cats. Veterinary authorities in regions where onychectomy is performed (including the USA and Canada) should be calling for legislation to prohibit this nontherapeutic surgical procedure. ...
This chapter discusses the recognition and assessment of acute (adaptive) and chronic (maladaptive) pain in cats. Cats express their pain-induced behavior in a unique manner. In this chapter, we will address the most common causes and behavioral signs of acute and chronic pain in this species. A user-friendly, dynamic and interactive approach for assessment of pain in cats is described including the use of validated pain scoring systems. Factors that may influence recognition of pain are discussed.
Practical relevance
The ‘2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques’ (hereafter the ‘Cat Friendly Veterinary Interaction Guidelines’) support veterinary professionals with feline interactions and handling to reduce the impact of fear and other protective (negative) emotions, in so doing enhancing feline welfare and In implementing these Guidelines, team satisfaction and cat caregiver confidence in the veterinary team will increase as the result of efficient examinations, better experience, more reliable diagnostic testing and improved feline wellbeing. Veterinary professionals will learn the importance of understanding and appropriately responding to the current emotional state of the cat and tailoring each visit to the individual.
Clinical challenges
Cats have evolved with emotions and behaviors that are necessary for their survival as both a predator and prey species. A clinical setting and the required examinations and procedures to meet their physical health needs can result in behavioral responses to protective emotions. Cat friendly interactions require understanding, interpreting and appropriately responding to cats’ emotional states and giving them a perceived sense of control while performing the required assessment.
Evidence base
These Guidelines have been created by a Task Force of experts convened by the American Association of Feline Practitioners and the International Society of Feline Medicine, based on an extensive literature review and, where evidence is lacking, the authors’ experience.
Endorsements
These Guidelines have been endorsed by a number of groups and organizations, as detailed on page 1127 and at catvets.com/interactions and icatcare.org/cat-friendly-guidelines .
This chapter addresses ethical concerns in companion animal practice including shelter medicine, outdoor cats, overpopulation, neutering/gonadectomy, conformational disorders/brachycephaly, convenience surgeries/declawing/onychectomy, behavioral medicine, referrals, futile intervention, obesity, and access to veterinary care. Modern animal shelters provide an array of services with population control and animal welfare at the forefront. Sterilization programs have been an integral part of shelter missions to control overpopulation and stop the influx of unwanted animals into shelters. Some shelters have stopped taking in unsocialized cats and euthanizing them. Instead, these cats are now being sterilized, vaccinated, and returned to field. The dog and cat overpopulation crisis in the 1970s coincided with surgical sterilizations becoming routine in private clinics. Neutering involves the surgical removal of gonads. It is performed primarily to prevent companion animal overpopulation. Conformational disorders occur when an animal's shape and structure negatively impact its health and welfare.
The concept of veterinary professionalism and how it relates to veterinary ethics is receiving increasing focus within educational and practice contexts. This chapter explores the concept of veterinary professionalism, considering what the term means and how this relates to veterinary ethics. The veterinary profession has gone through extensive changes as it adapts to societal needs and the evolving roles animals play in our lives. Changes in human–animal relationships and the perception of animals in society have led to extensive evolution to the veterinary role as the gatekeepers to animal health. Regulation of veterinarians and veterinary technicians in the United States is at the state level, via organizations called veterinary medical boards. The regulation of the veterinary profession is carried out through codes of conduct with misconduct cases managed formally and potentially resulting in the loss of a license to practice.
Cats are unique amongst domestic species in that they have evolved from a solitary ancestral species to become one of the most beloved household pets today. Interestingly the cat's physical appearance and sensory systems remain almost identical to their wild counterparts. Recognition of the perceptual parameters allows us to better understand how the domestic cat responds to environment and communicates with social partners. Sociality is unequivocally the aspect of feline life most affected by the domestication process. Cats can display a wide range of social behaviors, and evidence indicates that early exposure to a variety of social and environmental stimuli is the most important postnatal factor for a well‐adjusted life in a domestic setting and resiliency to basic stressors. By gaining an understanding of feline natural behavior, communication, learning, and cognition, shelter staff can provide cats with an ideal environment, change unwanted behaviors, and improve the welfare of our cats.
This chapter presents a concise description of the pathophysiology, diagnosis, and treatment of the most relevant canine and feline skin and musculoskeletal diseases. An emphasis is given to the impact of these diseases on anesthetic and analgesic management of patients. In some instances, skin and musculoskeletal disease is presented as a secondary complication rather than the main clinical concern. Skin burns are a result of thermal, chemical, electrical, or radiation injury. The prevalence of acute neuropathic pain in humans with burns can be up to 52% for years after the injury and is associated with an increased extent/percentage of body surface burns at presentation. These patients are at high risk of developing chronic pain syndromes following healing. Auricular diseases can be particularly painful, especially in the presence of chronic inflammation and neoplasia. Malignant hyperthermia episodes may occur in healthy animals without a previous history of anesthetic problems.
Este trabalho tem como objetivo realizar uma revisão sobre as principais alterações comportamentais do gato, discorrendo de forma objetiva e clara sobre suas possíveis causas, formas de prevenção e de tratamento, além de um breve resumo sobre as necessidades básicas para o bem-estar do felino doméstico. Realizou-se uma revisão narrativa, utilizando artigos científicos, monografias, teses e dissertações publicadas e disponíveis nas bases de dados online: Periódico Capes (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), SciELO (Scientific Electronic Library Online) e Google Acadêmico, além de livros específicos do tema. A agressividade foi a alteração relacionada ao comportamento do gato mais estudada e discutida na literatura consultada, seguida da arranhadura em locais inaceitáveis e da eliminação em locais inapropriados. Observou-se que a negligência das necessidades básicas dos felinos é a principal causa das alterações comportamentais e que os tutores devem ser conscientizados sobre as necessidades alimentares, de manejo e ambientais dos gatos de estimação. Ressalta-se que a abordagem proativa do médico veterinário é de fundamental importância, notadamente no processo de conscientização do tutor, no ensinamento sobre o manejo adequado, sobre o enriquecimento ambiental e na busca por enfermidades não diagnosticadas, de forma a minimizar os transtornos relacionados ao comportamento no felino, o abandono e a eutanásia.
Our own experiences and scientific evidence demonstrate the significant positive impact therapy animals have on us, including our physical and emotional well-being. For the safety of all animals involved in animal-assisted interventions (AAI), and the humans they interact with, the well-being of therapy animals must also be carefully evaluated. The physical well-being of a therapy animal is paramount for its welfare, as well as the welfare of the humans that benefit from the animal interaction. Appropriate preventative and wellness care can reduce the occurrence of disease in animals and allow for a longer, better quality of life.
Practical relevance:
Aggression towards owners is a common behavioural problem in cats, particularly in cats that have been obtained from pet shops or other sources where there has been inadequate socialisation with people, and in those kept only indoors. Very often aggression is associated with a stress response and it may potentially lead to relinquishment and euthanasia of the cat. Therefore, preventing and treating owner-directed aggression has significant benefits for the welfare of the cat and the quality of the cat-owner bond.
Aim:
The objectives of this article are to highlight the characteristics of the most common types of feline aggression towards human family members and to describe, in a very practical way, the main treatment strategies. The article is aimed at general practitioners; for severe cases of aggression and/or cases involving feral cats, referral to a specialist behaviourist is recommended.
Clinical challenges:
Veterinarians and behaviourists are not always able to witness the aggressive behaviour of the cat and therefore a detailed and accurate interview, as well as the use of complementary tools such as video recording, is essential to reach a diagnosis.
Evidence base:
This review draws on evidence from an extensive body of published literature as well as the authors' clinical experience and own research.
Comprehensive in scope and exclusively devoted to feline medical care, Dr. Susan Little's The Cat: Clinical Medicine and Management is an essential resource for anyone who provides complete, state-of-the-art care to cats. In one convenient volume, you'll find authoritative, clinically-focused information enhanced by full-color illustrations, tables, boxes, algorithms, key points, and much more — all in a format designed for quick access. Dr. Little and her expert contributors address the unique concerns and challenges facing the feline practitioner, including the latest advances in feline medical diagnosis and management and their clinical applications to everyday practice. User-friendly and complete, The Cat is also available as an e-book, giving you easy access to the complete, fully-searchable contents online.
A survey of a computer group interested in pets was conducted to determine the incidence of behavior problems in cats and whether it varied with the sex of the cat, with declawing, or with the number of cats in the household. In addition, information on the brand of cat food and litter was obtained, along with details of litter hygiene. Sixty owners of a mean of two cats responded. The percentages of cats exhibiting behavior problems were: jumping on counters or tables, 60%; scratching furniture, 42%; eating house plants, 36%; acting aggressively toward other cats, 25%; stealing food, 25%; house soiling, 16%; inappropriate vocalizing, 16%; acting aggressively toward people, 12%; chewing fabric, 7%; hissing at people, 5%. A significantly greater percentage of declawed cats, as compared to intact cats, was reported to jump on counters or tables. There was significantly more meowing and also more jumping on counters among cats in single-cat homes than among those in multiple-cat homes. There was no difference between the sexes in the proportion exhibiting the various behaviors. This information can be used to advise owners as to the type of misbehaviors cats may display. It also indicates that declawed cats are not prone to have more problems than do clawed cats.
To compare the incidence of behavior problems following tendonectomy or onychectomy in cats, as well as attitudes of owners following these procedures.
Nonrandomized clinical trial.
18 cats that underwent tendonectomy and 39 cats that underwent onychectomy.
Owners of cats that underwent tendonectomy or onychectomy between February 1993 and May 1998 were contacted by telephone and asked several questions regarding reasons for surgery as well as complications and behavioral changes in cats following surgery.
The most common reason for considering tendonectomy or onychectomy was to avoid damage caused by the cat scratching household materials. Avoidance of injury to humans or animals was chosen more often by owners whose cats underwent onychectomy than those that underwent tendonectomy. Tendonectomy was more likely to have been recommended by veterinarians than onychectomy. Significantly more cats that underwent tendonectomy (67%) than onychectomy (44%) returned to normal activity within 3 days after surgery. Significant differences were not detected regarding behavior problems after surgery.
Although tendonectomy and onychectomy involved some medical complications and behavior changes following surgery, owners had positive attitudes regarding both surgeries after the immediate postoperative period. Tendonectomy may be a humane alternative to onychectomy, although owners need to be advised that nail trimming is still necessary in cats after surgery.
This study compared patient discomfort for 10 d following feline onychectomies performed using a CO2 surgical laser versus a scalpel blade. Both techniques appeared to result in discomfort of a similar duration, although the laser caused significantly less lameness than blade excision during the first 7 d.
Objectives:
To systematically review published studies evaluating pain associated with onychectomy in cats, and to assess the efficacy of the analgesic therapies applied.
Databases used:
Four sources were used to identify manuscripts for review. Databases searched were those of the National Library of Medicine, EMBASE and CAB International. In addition, pertinent references in the bibliographies of included articles were retrieved.
Results:
Twenty manuscripts published in refereed journals were reviewed. These included papers reporting 18 clinical trials and two studies conducted in conditioned research cats. Twelve analgesics were evaluated, including seven opioids, four non-steroidal anti-inflammatory drugs and one local anesthetic. Nine studies involved a direct comparison of analgesic agents. Limb use was abnormal when measured at 2 and 12 days following onychectomy, and neither fentanyl patch nor butorphanol administration resulted in normal use of the surgical limb. In another study, cats evaluated at 6 months after this surgery were not lame. Differing surgical techniques were compared in six studies; the results indicated that pain scores were lower after laser surgery than after scalpel surgery. The difficulties associated with assessing pain in cats and the lack of sensitivity of the evaluation systems utilized were highlighted in many of the studies. Huge variations in dose and dosing strategies had significant impacts on drug efficacy. Statistically significant differences among treatments were found in most studies; however, no clearly superior analgesic treatment was identified. A combination of meloxicam or robenacoxib with an opioid may provide more effective analgesia and should be evaluated.
Study objective: In the last ten years, many emergency medicine specialists have studied animal bite wounds. The majority of these studies have addressed the controversies of prescribing prophylactic antibiotics or suturing wounds. This study was undertaken to determine risk factors for cat bite wound infections. Design: Prospective survey. Setting: Community hospital emergency medicine residency program. Type of participants: One hundred eighty-six consecutive patients with 216 cat bite/scratch wounds over a two-year period. Interventions: A standardized wound cleaning protocol with debridement and suturing, if indicated, was used. Variables analyzed included patient age and gender; wound age, type, number, location, and depth; prehospital therapy; emergency department therapy; and antibiotics used. Results: The mean patient age was 19.5 +/- 15.9 years. The mean time interval from wounding to ED treatment was 10.2 +/- 39.2 hours. By anatomical sites, there were 33 (15%) head/neck, 48 (22%) arm, 97 (45%) hand, ten (5%) truncal, and 28 (13%) lower extremity wounds. By wound type, there were 122 (56%) punctures, 54 (25%) abrasions, 37 (17%) lacerations, and two (1%) avulsions. One hundred fifty (71%) of the wounds were partial thickness, and 62 (29%) were full thickness. Twenty-four (12.9%) of the patients had clinical evidence of wound infection on arrival to the ED. Five (2.7%) developed clinical evidence of infection despite ED treatment. None of the 14 (7.5%) patients with only "claw" injuries developed infection. The overall patient infection rate for those with cat "bites" was 15.6%. Factors associated with wound infections included older age (P < .001), longer time intervals until ED treatment (P < .0001), wounds inflicted by "pet" cats (P = .001), attempting wound care at home (P = .0004), having a more severe wound (P = .01), and having a deeper wound (P = .0001). Data from 148 patients who had only "bite" wounds and did not have clinical evidence of infection on initial presentation to the ED also were analyzed for wound infection risk factors. Wound infections were more likely to develop in patients with lower extremity wounds who did not receive prophylactic oral antibiotics (P = .071) and those with puncture wounds who did not receive prophylactic oral antibiotics (P = .085). Conclusion: In this study, wound type and wound depth were the most important factors in determining the likelihood of developing wound infection regardless of whether the patient was prescribed prophylactic oral antibiotics.
The frequency of claw regrowth, bony remnants, and complications in cats that underwent forelimb onychectomy using laser, scalpel, or guillotine techniques were evaluated. Eighty-seven client-owned cats were recruited from 27 veterinary clinics in the Canadian Atlantic provinces. At least 1 year after onychectomy the cats underwent a physical examination, gait analysis, and radiographic evaluation by 1 of 2 authors. There was no significant difference in the frequency of claw regrowth among the 3 methods (P = 0.283). Significantly more cats had bony remnants following guillotine onychectomy (P < 0.001). Bony remnants were significantly associated with claw regrowth (P = 0.001). Cats that underwent laser onychectomy had significantly less post-operative complications (P = 0.023). The long-term outcome was not significantly different among the 3 methods. We conclude that leaving remnants of the third phalanx in situ is associated with an increased frequency of claw regrowth. Laser onychectomy may be preferred to reduce the risk of post-operative complications, bony remnants, and claw regrowth.
The morphology of cornified structures is notoriously difficult to analyse because of the extreme range of hardness of their component tissues. Hence, a correlative approach using light microscopy, scanning electron microscopy, three-dimensional reconstructions based on x-ray computed tomography data, and graphic modeling was applied to study the morphology of the cornified claw sheath of the domesticated cat as a model for cornified digital end organs. The highly complex architecture of the cornified claw sheath is generated by the living epidermis that is supported by the dermis and distal phalanx. The latter is characterized by an ossified unguicular hood, which overhangs the bony articular base and unguicular process of the distal phalanx and creates an unguicular recess. The dermis covers the complex surface of the bony distal phalanx but also creates special structures, such as a dorsal dermal papilla that points distally and a curved ledge on the medial and lateral sides of the unguicular process. The hard-cornified external coronary horn and proximal cone horn form the root of the cornified claw sheath within the unguicular recess, which is deeper on the dorsal side than on the medial and lateral sides. As a consequence, their rate of horn production is greater dorsally, which contributes to the overall palmo-apical curvature of the cornified claw sheath. The external coronary and proximal cone horn is worn down through normal use as it is pushed apically. The hard-cornified apical cone horn is generated by the living epidermis enveloping the base and free part of the dorsal dermal papilla. It forms nested horn cones that eventually form the core of the hardened tip of the cornified claw. The sides of the cornified claw sheath are formed by the newly described hard-cornified blade horn, which originates from the living epidermis located on the slanted face of the curved ledge. As the blade horn is moved apically, it entrains and integrates the hard-cornified parietal horn on its internal side. It is covered by the external coronary and proximal cone horn on its external side. The soft-cornified terminal horn extends distally from the parietal horn and covers the dermal claw bed at the tip of the uniguicular process, thereby filling the space created by the converging apical cone and blade horn. The soft-cornified sole horn fills the space between the cutting edges of blade horn on the palmar side of the cornified claw sheath. The superficial soft-cornified perioplic horn is produced on the internal side of the unguicular pleat, which surrounds the root of the cornified claw sheath. The shedding of apical horn caps is made possible by the appearance of microcracks in the superficial layers of the external coronary and proximal cone horn in the course of deformations of the cornified claw sheath, which is subjected to tensile forces during climbing or prey catching. These microcracks propagate tangentially through the coronary horn and do not injure the underlying living epidermal and dermal tissues. This built-in shedding mechanism maintains sharp claw tips and ensures the freeing of the claws from the substrate.
The etiology of feline hyperesthesia syndrome can be difficult to determine. Behavior modification and medications may help in treatment.
To determine the characteristics of phantom limb sensation, phantom limb pain, and residual limb pain, and to evaluate pain-related disability associated with phantom limb pain.
Retrospective, cross-sectional survey. Six or more months after lower limb amputation, participants (n = 255) completed an amputation pain questionnaire that included several standardized pain measures.
Community-based survey from clinical databases.
A community-based sample of persons with lower limb amputations.
Frequency, duration, intensity, and quality of phantom limb and residual limb pain, and pain-related disability as measured by the Chronic Pain Grade.
Of the respondents, 79% reported phantom limb sensations, 72% reported phantom limb pain, and 74% reported residual limb pain. Many described their phantom limb and residual limb pain as episodic and not particularly bothersome. Most participants with phantom limb pain were classified into the two low pain-related disability categories: grade I, low disability/low pain intensity (47%) or grade II, low disability/high pain intensity (28%). Many participants reported having pain in other anatomic locations, including the back (52%).
Phantom limb and residual limb pain are common after a lower limb amputation. For most, the pain is episodic and not particularly disabling. However, for a notable subset, the pain may be quite disabling. Pain after amputation should be viewed from a broad perspective that considers other anatomic sites as well as the impact of pain on functioning.
To evaluate the frequency, duration, intensity, and interference of back pain in a sample of persons with lower limb amputations.
Retrospective, cross-sectional survey.
Community-based survey from clinical databases.
Participants who were 6 or more months post lower limb amputation (n = 255).
An amputation pain survey that included several standardized pain measures.
Frequency, duration, intensity, and interference of back pain.
Of the participants who completed the survey (return rate, 56%), 52% reported experiencing persistent, bothersome back pain. Of these, 43% reported average back pain intensity in the mild range (1-4 on 0-10 rating scale) and 25% reported pain of moderate intensity (5-6 on 0-10 scale). Most respondents with back pain rated the interference of their pain on function as none to minimal. However, nearly 25% of those with back pain described it as frequent, of severe intensity (>or=7 on 0-10 scale), and as severely interfering with daily activities including social, recreational, family, and work activities.
Back pain may be surprisingly common in persons with lower limb amputations, and, for some who experience it, may greatly interfere with function.
To compare postoperative signs of discomfort and complications associated with use of CO2 laser for onychectomy with those of the scalpel technique in cats.
Prospective, randomized, masked clinical trial.
20 client-owned cats.
Forelimb feet (right, left) were randomly assigned to laser and scalpel treatment groups. Signs of discomfort (lameness and signs of pain) and complications (hemorrhage, swelling, and discharge) were assessed on days 0, 1, and 7. Surgeries were performed by 1 experienced surgeon. Evaluations were performed by 2 individuals without knowledge of treatment group. Signs of discomfort and complications were scored on scales of 0 to 8 and 0 to 9, respectively.
Onychectomy did not result in high discomfort or complication scores 1 day after surgery, regardless of technique used, although the laser-treated group had significantly lower scores for signs of discomfort and complications. Seven days after surgery, significant differences were not detected between groups for signs of discomfort or complications.
The CO2 laser can be an excellent tool for onychectomy in cats, with excellent hemostasis and minimal postoperative discomfort and complications. Differences in discomfort and complications between groups treated via scalpel versus CO2 laser were not clinically relevant and were only observed 1 day after surgery.
To determine analgesic efficacy and adverse effects of preemptive administration of meloxicam or butorphanol in cats undergoing onychectomy or onychectomy and neutering.
Randomized controlled study.
64 female and 74 male cats that were 4 to 192 months old and weighed 1.09 to 705 kg (2.4 to 15.5 lb).
Cats received meloxicam (0.3 mg/kg [0.14 mg/lb], s.c.) or butorphanol (0.4 mg/kg [0.18 mg/lb], s.c.) 15 minutes after premedication and prior to anesthesia. A single blinded observer measured physiologic variables, assigned analgesia and lameness scores, and withdrew blood samples for each cat at baseline and throughout the 24 hours after surgery. Rescue analgesia (butorphanol, 0.4 mg/kg, i.v. or s.c.) or administration of acepromazine (0.025 to 0.05 mg/kg [0.011 to 0.023 mg/lb], i.v.) was allowed.
Meloxicam-treated cats were less lame and had lower pain scores. Cortisol concentration was higher at extubation and lower at 1, 5, and 12 hours in the meloxicam-treated cats. Fewer meloxicam-treated cats required rescue analgesia at 3, 5, 12, and 24 hours after extubation. General impression scores were excellent or good in 75% of meloxicam-treated cats and 44% of butorphanol-treated cats. There was no treatment effect on buccal bleeding time; PCV and BUN concentration decreased in both groups, and glucose concentration decreased in meloxicam-treated cats.
Preoperative administration of meloxicam improved analgesia for 24 hours without clinically relevant adverse effects in cats that underwent onychectomy or onychectomy and neutering and provided safe, extended analgesia, compared with butorphanol.
The medical practice of declawing has received much political debate over the past few years. Yet, empirical and theoretical research on how this practice is maintained and the ethical positions of those who actually participate in this work is lacking. Drawing from 9 months of ethnographic fieldwork in a feline-specific veterinary hospital and open-ended interviews with veterinarians and staff, this study examines veterinary staff members' attitudes toward, and strategies for, dealing with the medical practice of declawing. Specifically, findings show that a number of staff felt uncomfortable with their participation in onychectomy (declawing) and relied heavily on organizational support structures to cope both with these feelings and the moral ambiguity about the practice. Relying on these structures, the veterinarians and their staff are able simultaneously to define felines as subjects worthy of respect for their quality of life, protect their own self-identity as people who work toward the best interest of animals, and paradoxically support action toward felines that they find morally objectionable.
To evaluate signs of postoperative pain and complications after forelimb onychectomy in cats receiving buprenorphine alone or with bupivacaine administered as a 4-point regional nerve block.
Prospective, randomized, double-blind clinical trial.
20 cats.
All cats received buprenorphine (0.01 mg/kg [0.004 mg/lb], IM) preoperatively. One forelimb of each cat also received bupivacaine (1 mg/kg [0.45 mg/lb] of a 0.75% solution) administered as a 4-point regional nerve block. After onychectomy, discomfort (lameness, foot reaction, and pain) scores were evaluated by 2 experienced observers 2, 4, 6, 8, 24, and 168 hours postoperatively. Complication (hemorrhage, swelling, and infection) scores were evaluated 24 and 168 hours postoperatively. Surgeries were performed by 1 experienced veterinary surgeon. Rescue analgesia was provided if needed.
6 cats required rescue analgesia postoperatively. There was no difference in discomfort or complication scores between control limbs and limbs in which a nerve block was administered. Additionally, there was no difference in discomfort and complication scores between cats that did or did not require rescue analgesia.
Bupivacaine administered as a 4-point regional nerve block in addition to a systemic analgesic did not decrease discomfort or complication scores in cats undergoing forelimb onychectomy.
To evaluate short-term postoperative forelimb function after scalpel and laser onychectomy in cats.
Randomized, prospective study.
20 healthy adult cats.
Cats were randomly assigned to the laser (n = 10) or scalpel (10) onychectomy group. Unilateral left forelimb onychectomy was performed. In the scalpel group, a tourniquet was used during surgery and a bandage was applied after surgery. Pressure platform gait analysis was performed prior to and 1, 2, 3, and 12 days after onychectomy. Peak vertical force (PVF), vertical impulse, and the ratio of the PVF of the left forelimb to the sum of the remaining limbs (PVF ratio) were used as outcome measures.
The laser onychectomy group had significantly higher ground reaction forces on days 1 and 2 and significantly higher PVF ratio on day 12, compared with the scalpel group. Similarly, significant differences were found in change in ground reaction forces on days 1 and 2 and the PVF ratio on day 12, compared with day -1. No cats required rescue analgesia during the course of the study. One cat in the laser group had signs of depression and was reluctant to walk on day 2 after surgery, had physical examination findings consistent with cardiac insufficiency, and was euthanized.
Cats had improved limb function immediately after unilateral laser onychectomy, compared with onychectomy with a scalpel, tourniquet, and bandage. This improved limb function may result from decreased pain during the 48 hours following unilateral laser onychectomy.
Pain management in dogs and cats has undergone a dramatic evolution in the past decade. Current approaches focus on anticipation and prevention of pain, as well as both pharmacologic and non-pharmacologic management techniques. The veterinary team plays an essential role in educating pet owners about recognizing and managing pain in their pets.
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