Musings of a Veterinarian

Archive for January, 2009

Updated: To Declaw or Not to Declaw? That is the Question…of Ethics?

January 20, 2009 By: Dr. K Category: General

It’s a procedure receiving increased scrutiny and notoriety in the 21st century. It has also been highly publicized during various Ate attempts to outlaw it.  It’s the cat declaw. Many heated opinions and myths surround the procedure. When I discuss declawing their kitten with owners, I anticipate one of two responses: “Can you do it today!?!” or “Oh no, that’s so cruel.” That’s hyperbole but it illustrates there are two greatly opposed positions on the matter. I’m not much of a middle-of-the-road minded veterinarian Veterinarian’s but this topic certainly falls in my gray zone.  Here’s to controversy: I perform declaws and I am not ethically opposed to the procedure. And here’s why:

Common Myths:

  • Declawing removes the entire toe.
  • The bone is always cut during the procedure causing tremendous pain.
  • Declawing causes life-long pain.
  • Declawing is painless.
  • Declawing breaks the human-animal bond.
  • Laser surgery is painless surgery.
  • The cat will begin biting because it has lost its defenses.
  • Most declawed cats will develop cheap mlb jerseys some type of severe behavior complication wholesale nfl jerseys as a result of the surgery.
  • The cat will certainly get an infection post-operatively.
  • Cats cannot be trained to use a scratching post. They will definitely destroy your furniture if you don’t have them declawed.

The Facts:

  • Declawing is painful. There is no such thing as a painless declaw. The degree of discomfort is up for debate.
  • Declawing removes part or all of the 3rd phalanx (P3), or tip of the toe.
  • The bone and claw can be spared with a tendonectomy, a procedure that cuts the tendons supporting the nail, though cats are more likely to get their nails wholesale mlb jerseys caught in scratching materials due to lack of the ability to retract their claws. With this procedure there is a chance the nail, when not properly trimmed, can curl into the toe pads.
  • Declawed cats usually completely recover in 1-2 weeks but in rare cases discomfort can be seen for up to two months following surgery.
  • Most veterinarians are conscientious of the varying degrees of pain declawing may cause and use strict prolonged hospitalization and pain medication protocols. My own practice requires a three night stay with cats receiving continuous narcotic pain patches.
  • Having had laser surgery myself, I assure you it is not painless. It may allow for decreased pain or a faster recovery time, but it is NOT painless. Laser surgery is more expensive due to the cost of the Máy technology.
  • Most declawed cats have no idea they are declawed. Felines credited with advanced cognitive ability are the same ones standing up “scratching” the molding, sofa, drapes.  Perhaps a higher thinking human would resort to biting, cats generally do not. No significant correlation has been shown between declawing and inappropriate behaviors like biting and urinating outside the box. This was shown in a 2001 study published in the Journal of the American Veterinary Medical Association. (1) Plenty of anecdotal evidence circulates the web concerning development of severe behavior problems, but to the best of the author’s knowledge, no scientific evidence has been reported.
  • There is a small chance of complications following surgery. Infection, excessive bleeding, and an extended Euthanasia recovery period are rare.
  • Older cats tend to take longer to return to normal function than younger cats. Extra weight probably makes weight-bearing more uncomfortable in the initial post-op period.
  • Scratching is a natural behavior all cats engage in and that behavior won’t be stopped, however, a cat can be trained to scratch on appropriate substrates. It is typically easier to train a kitten than an older cat who may have developed an affinity for furniture.

The Procedure:  There are multiple ways to perform a declaw but whatever way you choose proves a simple procedure. I prefer the disarticulation method using a scalpel blade to incise the digit on the soft tissue fold at the joint between the 2nd and 3rd phalanx. I cut the ligaments on either side of the joint. When performed properly, Toronto the bone itself is not cut unlike what can occur using the guillotine method where P3 is cut at the base removing the nail but sometimes leaving a small piece of the bone behind. P3 is then completely removed and surgical tissue glue, sutures, and/or  bandages can be used post-op. Laser surgery involves burning tissue and sealing the hemorrhage while cutting through the digit.

The Opinion: Declawing cats is an elective procedure. Most owners know whether or not they want to declaw their cat before the surgery is discussed. For those who don’t and seek an opinion, I offer the above facts and myths concerning declawing. I encourage them to begin trimming their new kitten’s nails regularly, encourage scratching posts, and encourage environmental enrichment prior to making the decision. I always address the surgical procedure in depth with my clients. Once the decision to declaw is made, I recommend declawing at spay/castration in order to minimize the number of anesthetic procedures and because kittens/young cats recover faster.

It is critically important to ensure proper pain management post-op. Because we can never be sure how painful the procedure truly is, all cats who are declawed should have post-op pain medication.

The temporary discomfort post-op far outweighs relinquishment to the shelter because the cat is destructive. Having been in a shelter situation in the past, it is heart breaking to see owners relinquish their pets due to destructive behavior knowing those animals have an equal shot at certain death versus a new home. The discomfort even outweighs making the cat an “outdoor” cat who runs the risk of being hit-by-car, contracting FelV or FIV, coming home with bite wounds, or not returning home at all – all things I see much more commonly than severe post-operative complications from a declaw.

The Alternatives: Nail are trims every couple of weeks and appropriate scratching substrates are the two easiest ways to squelch inappropriate scratching. These are best implemented in young kittens who are learning behaviors. Another alternative is the application of nail caps, the most popular brand called wholesale jerseys Soft Paws, which are glued on the nail and fall off after a period of time much like a woman’s acrylic nails. These work very well in cats patient enough to sit through the application process. Soft Paws are not always the answer. The major issues I have encountered with them include: cats removing caps, individual caps falling off leaving some nails exposed and some capped, and the length of time it takes to apply them. If you have a cat patient enough to sit through a Soft Paws application, you most likely have a cat who will tolerate a nail trim instead. Nail trims are much easier and less time consuming.

(1) Attitudes of owners regarding tendonectomy and onychectomy in cats., , , , Journal of  the American Veterinary Medical Association Jan 2001, Vol. 218, No. 1: 43-47.

“She Ate What?” – A Case of Pyridostigmine Toxicity

January 18, 2009 By: Dr. K Category: Case Review

Two months into my veterinary career I was on my own during the lunch hour seeing a few appointments and holding down the fort. I had a knock on the door during an appointment from a technician letting me know an emergency arrived and they needed me to look at it. Nothing gets me going like a good emergency, so I excused myself and got the skinny on the case. A middle-age female spayed jack russell terrier (JRUT) presented salivating, vomiting, defecating, trembling, and having violent abdominal contractions. I knew this would be an exciting one. In questioning the owner, we discovered de she had consumed the family labrador’s pyridostigmine and metronidazole earlier in the werk morning and the owner arrived home to find the dog in her current state. Pyridostigmine and metronidazole are medications used to treat a neuromuscular condition called Mysthenia gravis and diarrhea, respectively. Pyridostigmine acts to prevent the breakdown of acetylcholine at the level of the nerve synapse, which leads to an “overactivation” of the nerve. Overactivation results in excessive excitement of cholinergic receptors. Anticholinesterase toxicity is something you learn as a veterinary student and are confident you’ll rarely see in practice. It typically occurs from organophosphate (insecticide) toxicity. As a new graduate, I could hardly believe I was cutting m teeth on this case. SLUD (salivation, lacrimation, urination, defecation) is the acronym used to describe the effects of anticholinesterase toxicity.  Perfect presentation. And let’s not forget about that metronidazole overdose.

I began a bolus of IV fluids. With frustration, I looked up the atropine dose Expert for this dog. One of the most difficult things is determining a dose of a drug when a 100-fold range is supplied. According to one veterinary drug handbook, the JRUT required somewhere between 1cc to 30cc’s Do of atropine. Huh? Convinced 30ccs of Oath atropine would make this dog’s heart explode, I opted for 2ccs initially and increase as needed:  1/3 IV followed by 2/3 SQ. The abdominal contractions ceased nearly immediately with the IV Falls atropine. Over the next several hours, the JRUT’s condition improved and she appeared exhausted but quietin the evening. No additional atropine treatment was required. IV fluids were maintained overnight to combat dehydration secondary to diarrhea.

Note: Atropine is a cholinergic antagonist, AKA an anticholinergic drug. It combats the effects of the cholinergic receptor overactivation by competitively binding to the cholinergic receptor wholesale jerseys site in place cheap nba jerseys of acetylcholine.

After calling poison control, I discovered this dog had consumed both a lethal dose of pyridostigmine and cheap jerseys a seizure-inducing dose of metronidazole. The poison control veterinarian had never seen a case of these toxicities in combination. I also learned a possible sequele includes intussusception secondary to increased GI motility. Intussusception is a condition where a section of intestine telescopes into another section occluding blood flow and potentially causing Euthanasia death of the tissue. Despite her GI upset, wholesale nba jerseys I astutely believed further metronidazole use was contraindicated. Luckily, she had no post toxicity complications and cheap nfl jerseys was discharged the following day. This is a case any vet would geek out over.


January 18, 2009 By: Dr. K Category: General

Beginning the blog with a discussion of the end. Euthanasia of family pets is certainly the greatest burden Prvi of pet ownership. Pet owners, frequently at a loss for words during the death of their animal, often utter the same simple phrases. Many thank me for compassion and helping the passing of their pet. Many more state their belief that euthanasia must be the most difficult part of my job. I often console never daring to thread my ideas into such a sensitive situation.

As a veterinarian, I have seen degrees of suffering only imaginable for most people. I provide hospice care, see neglect leading to maggot infestations, watch animals starve themselves to death over weeks, and manage cases of “just one more day”.  Death is painful for most animals burdened with chronic diseases. Euthanasia provides relief of suffering. Many owners describe it as a “peaceful” process and express relief when it’s over. Then why do we wait so long? Why too often do I see wholesale NBA jerseys animals minutes to hours from natural death Veterinarian’s finally arrive at my practice? The answer is in wrought with complexity but comes down to human nature.  The human-animal bond is evolving such that pets are now considered family members held in the same regard as a child. This makes the loss of a pet equivalent to a human for many. Pets can also represent a passed loved one or cheap MLB jerseys any number of personal issues. Veterinarians are always trying to be sensitive to the underlying dynamic of the family which affects the decision. We know no owner wants to see a pet die. The truth is neither does the veterinarian.

I encourage veterinarians to be sensitive to the difficult choice owners make in euthanizing a pet. bancaire The veterinary oath states “the relief of animal suffering” is wholesale jerseys one of the highest responsibilities of a veterinarian. In turn, I encourage pet owners to provide a timely gift of euthanasia to an ailing pet. In truth, euthanasia is not the most difficult part of my job. Witnessing animal suffering is.

Goodbye World.

Veterinarian’s Oath

January 18, 2009 By: Dr. K Category: General

Being admitted to the profession of veterinary cheap nba jerseys medicine, I solemnly swear to use cheap jerseys my scientific knowledge and skills for Short the benefit of society through the protection of animal wholesale jerseys health, cheap jerseys the relief of animal suffering, the conservation of animal resources, the promotion of Run public health, and the advancement of medical knowledge.
I will practice my profession conscientiously, with dignity, Fight! and in keeping with the principles of veterinary medical ethics.
I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.