Abstract
The American Association of Feline Practitioners (AAFP) strongly opposes declawing (onychectomy) as an elective procedure. It is the obligation of veterinarians to provide cat owners with alternatives to declawing. If owners are considering declawing, they must be provided with complete education about feline declawing, including the anatomic details of what a declaw entails (ie, amputation of the third phalanx [P3]) and the importance of proper pain management. In addition, alternatives to surgery and the risks and benefits of surgery need to be discussed.
It is important that owners understand that scratching is a normal feline behavior; it is both inherited and learned. 1 The primary reason for scratching is to maintain the necessary claw motion used in hunting and climbing. 2 In addition, it is done to re-establish claw sharpness via ‘husk’ (or ‘sheath’) removal and to stretch the body. Finally, it is an important means of visual and olfactory communication. Scratching can be directed to areas that owners consider appropriate. The following steps should be taken to prevent destructive scratching and are alternatives to declawing.
The surgical alternative of deep digital flexor tendonectomy can cause deleterious results due to the overgrowth of nails, the need for more extensive claw care required of the owner, and the development of chronic discomfort in some patients. Consequently, deep digital flexor tendonectomy is not recommended.
Onychectomy is not a medically necessary procedure for the cat in most instances. There are inherent risks and complications with this surgical procedure that increase with age. 10 These include, but are not limited to, the following: acute pain, hemorrhage, swelling, infection and nerve trauma. 11 Long-term complications include lameness, chronic draining tracts, retained P3 material leading to claw regrowth, development of palmigrade stance, behavioral problems 11 and chronic neuropathic pain. Fewer than half of veterinary schools in the USA include a mandatory lecture or laboratory to teach this surgery. Lack of formal training in the procedure could lead to inferior surgical technique, thereby increasing the likelihood of both long- and short-term complications. 10
Regardless of the method used, onychectomy causes a significant level of pain. Patients may experience both adaptive and maladaptive pain. In addition to inflammatory pain, the cat may develop long-term neuropathic or central pain if its pain is inadequately managed during the perioperative and healing periods.
In human medicine, the reasons for phalanx amputation include ‘tumors, malformations that affect function, infection, severe post-traumatic vascular damage or gangrene. Removal of the nail is done for ingrown toenail or paronychia’ (A Hugo, 2014, personal communication). Similar medical conditions in a cat might indicate the need for a specific phalanx to be removed. This would not support the amputation of normal digits.10,12
While it has been suggested that onychectomy is acceptable to prevent spread of zoonotic disease(s) to immune-compromised people, 10 current research demonstrates the greater value of proper hygiene and parasite control in the prevention of most common zoonoses. In households where cats come into contact with immune-compromised individuals, extensive education about zoonotic disease potential should be discussed and documented in the medical record. Of note, the Centers for Disease Control and Prevention does not advise declawing cats owned by HIV-infected persons; rather, these individuals ‘should avoid rough play with cats and situations in which scratches are likely.’ 13
Because property destruction and human injury occur less commonly from the claws on the rear feet, four-paw declaws are not recommended.
There is no current peer-reviewed data definitively proving that cats with destructive behavior are more likely to be euthanized, abandoned or relinquished. The decision of whether or not to declaw should not be impacted by these considerations.
If surgical onychectomy must be performed for a medical purpose, anesthetic agents and perioperative analgesic medications is imperative. The AAFP believes that a multimodal pain management strategy of sufficient dose (potency) and duration is required for feline onychectomy. Such a protocol will lead to reduced patient stress, less pain, and reduced patient morbidity and mortality.14,15 Because one of their primary means of defense has been removed, declawed cats should be housed indoors and properly supervised for their protection when outside.
The AAFP reviews scientific data and supports controlled scientific studies that provide insight into all aspects of feline medicine. The AAFP recognizes that feline onychectomy is an ethically controversial procedure. It has been considered for prohibition in some US states and cities and Canadian provinces. It is currently prohibited in the European Union (including the United Kingdom), 16 Australia, Brazil, Israel and some other countries, as well as several cities in California.
