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  • 31. Suska N, Beekman G, Monroe P, et al. Declawing position statement. American Association of Feline Practitioners website. Available at: www.catvets.com/guidelines/position-statements/declawing. Accessed Apr 21, 2015.

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Survey of practices and perceptions regarding feline onychectomy among private practitioners

Rebecca Ruch-GallieDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Peter W. HellyerDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Regina Schoenfeld-TacherDepartment of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607.

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Lori R. KoganDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Abstract

OBJECTIVE To estimate the proportion of veterinarians working with feline patients in private practices who do or do not perform onychectomy and assess attitudes regarding and practices related to onychectomy in a large population of veterinary practitioners.

DESIGN Anonymous online survey.

SAMPLE 3,441 veterinarians.

PROCEDURES An online survey was provided to members of the Veterinary Information Network from June 18, 2014, through July 9, 2014. Descriptive statistics and frequency distributions for applicable response types were calculated, and Mann-Whitney U tests were conducted to compare responses to onychectomy-related opinion questions between respondents who indicated they did or did not perform the procedure. Not all respondents answered every question.

RESULTS 2,503 of 3,441 (72.7%) survey respondents reported performing onychectomy, and 827 (24.0%) indicated they did not; 1,534 of 2,498 (61.4%) performing the procedure reported a frequency of < 1 onychectomy/month. Most (2,256/3,023 [74.6%]) respondents who performed onychectomy indicated that they recommended nonsurgical alternatives. Surgical techniques and approaches to analgesia varied, with use of a scalpel only (1,046/1,722 [60.7%]) and perioperative administration of injectable opioids (1,933/2,482 [77.9%]) most commonly reported. Responses to opinion questions in regard to the degree of pain associated with onychectomy and recovery; whether declawing is a form of mutilation, is necessary in some cats for behavioral reasons, or is a necessary alternative to euthanasia in some cats; and whether state organizations should support a legislative ban on onychectomy differed significantly between respondents who did and did not perform the procedure.

CONCLUSIONS AND CLINICAL RELEVANCE Onychectomy is a controversial topic, and this was reflected in survey results. In this sample, most veterinarians performing the procedure reported that they did so infrequently, and most offered nonsurgical alternatives to the procedure.

Abstract

OBJECTIVE To estimate the proportion of veterinarians working with feline patients in private practices who do or do not perform onychectomy and assess attitudes regarding and practices related to onychectomy in a large population of veterinary practitioners.

DESIGN Anonymous online survey.

SAMPLE 3,441 veterinarians.

PROCEDURES An online survey was provided to members of the Veterinary Information Network from June 18, 2014, through July 9, 2014. Descriptive statistics and frequency distributions for applicable response types were calculated, and Mann-Whitney U tests were conducted to compare responses to onychectomy-related opinion questions between respondents who indicated they did or did not perform the procedure. Not all respondents answered every question.

RESULTS 2,503 of 3,441 (72.7%) survey respondents reported performing onychectomy, and 827 (24.0%) indicated they did not; 1,534 of 2,498 (61.4%) performing the procedure reported a frequency of < 1 onychectomy/month. Most (2,256/3,023 [74.6%]) respondents who performed onychectomy indicated that they recommended nonsurgical alternatives. Surgical techniques and approaches to analgesia varied, with use of a scalpel only (1,046/1,722 [60.7%]) and perioperative administration of injectable opioids (1,933/2,482 [77.9%]) most commonly reported. Responses to opinion questions in regard to the degree of pain associated with onychectomy and recovery; whether declawing is a form of mutilation, is necessary in some cats for behavioral reasons, or is a necessary alternative to euthanasia in some cats; and whether state organizations should support a legislative ban on onychectomy differed significantly between respondents who did and did not perform the procedure.

CONCLUSIONS AND CLINICAL RELEVANCE Onychectomy is a controversial topic, and this was reflected in survey results. In this sample, most veterinarians performing the procedure reported that they did so infrequently, and most offered nonsurgical alternatives to the procedure.

Onychectomy, commonly referred to as declawing, is an elective procedure performed in cats that involves removal of the third phalanx using a guillotine-type nail clipper, surgical blade, or laser.1,2 The most commonly reported reason for performing onychectomy is unwanted scratching behavior that results in personal injury or property damage.1,3 Because there is no direct medical benefit to the cat, performing the procedure has become increasingly controversial. There is movement to ban the procedure in some states and jurisdictions,4 and this raises concern in a profession that has traditionally supported the procedure and requires a closer look at the associated benefits and risks. Some veterinarians consider elective onychectomy unethical and choose not to perform the procedure, recommending alternatives such as deep digital flexor tendonectomy or nonsurgical approaches such as environmental changes, behavior modification, and application of plastic nail coverings to prevent injury or damage associated with unwanted scratching.2,3 However, others believe that onychectomy is preferable to the possible negative consequences, such as euthanasia or abandonment, for cats that have undesirable scratching behaviors. Nevertheless, concerns about the procedure remain, in part because of the short- and long-term complications that have been attributed to onychectomy. Many veterinarians believe the procedure causes a substantial amount of pain, leading to concerns about appropriate anesthesia and analgesia.5 Other concerns include the belief that declawed cats are more likely to have other behavioral problems, including increased aggression, biting, and house soiling.3,6 It has also been suggested that onychectomy increases stress among cats because it prevents them from performing natural behaviors.3

In 2001, the National Council on Pet Population Study and Policy estimated that approximately 14.4 million of 59 million (24.4%) owned cats in the United States were onychectomized,3 whereas other, earlier estimates have varied substantially. In a survey of cat owners administered through an online bulletin board, 12 of 60 (20%) owners reported having cats that were declawed,7 and results of a telephone survey of 662 randomly selected cat-owning households in Indiana revealed that 298 (45.1%) of respondents indicated they owned declawed cats.8 One report9 from a private practice in New York indicated that 27.6% of cats underwent onychectomy at the time of neutering, whereas a survey of veterinary practices in Colorado found that a mean of 5.3 onychectomies was performed for every 23.7 feline neuter surgeries.10 More recently, a 2013 study11 found that approximately 374 of 1,794 (21%) cats seen in veterinary hospitals near Raleigh, North Carolina were onychectomized. Although the exact numbers are not clear, taken together, these studies suggest at least 1 in 5 owned cats in the United States has undergone onychectomy. The percentage of practicing veterinarians in the United States who currently perform the procedure and the techniques used by these practitioners are also unknown. Despite the interest and controversy that surrounds onychectomy, there is a dearth of data to help guide the field forward. The purpose of the study reported here was to estimate, through use of an online survey of VIN members, the proportion of veterinarians working with feline patients in private practices who do or do not perform onychectomy and to assess the attitudes and practices regarding onychectomy in this large population of practitioners.

Materials and Methods

Survey preparation and administration

An anonymous online survey was created in collaboration with the VIN. The survey was initially pilot tested by sending it to 6 veterinarians who were members of the Colorado Veterinary Medical Association as well as 28 VIN members who were asked to complete the survey multiple times to examine the branching and question flow aspects, as well as ambiguity and potentially missing or inappropriate response options. The veterinarians were chosen on the basis of their experience in survey development and testing or interest in the topic.

The final survey contained 35 questions, 34 of which were multiple choice.a Respondents were asked whether they performed onychectomies and, if not, whether anyone in their clinic did; they were also asked to indicate whether and how their clinic advertised that the procedure was done. Participants who reported performing onychectomy were asked several questions about the circumstances under which they performed the procedures and the frequency with which these were done, the techniques and equipment used, their approaches to perioperative and postoperative analgesia, and the perceived rate of complications. Respondents were also asked whether they performed deep digital flexor tendonectomies as an alternative to onychectomy. Those who reported they did not perform onychectomies and those who indicated they did not perform deep digital flexor tendonectomies were asked to indicate the reasons. All respondents were asked whether they discussed nonsurgical alternatives to onychectomy with clients, whether they offered or recommended such alteratives, and to specify which alternatives they routinely offered or recommended to clients. All participants were asked their opinions regarding the position their state organizations should take on legislation of a statewide ban on onychectomy. Lastly, they were asked to indicate their perceptions of the degree of pain involved in onychectomy and recovery from the procedure, whether they considered the procedure a form of mutilation, and whether the procedure is necessary in some cats for behavioral reasons or is a necessary alternative to euthanasia for some patients. One open-ended survey question allowed participants to offer any other thoughts on onychectomy in cats. For many of the multiple-choice questions, > 1 response was allowed. No demographic information was requested.

After the survey was approved by the Institutional Review Board of Colorado State University, an email invitation with a cover letter and a link to the electronic survey was sent to all VIN members (33,000 US veterinarians) from June 18, 2014, to July 9, 2014. An email reminder was sent 2 weeks after the opening of the survey. Respondents who reported seeing feline patients for routine medical and surgical care were included in the analysis.

Statistical analysis

Descriptive statistics and frequency distributions (reported in percentages) were calculated with commercially available software.a For questions with responses on a modified Likert scale, numerical values were assigned to the ratings for ease of comparison. Mann-Whitney U tests were conducted to compare onychectomy opinion question responses between veterinarians who indicated they performed the procedure and those who did not. For these analyses, values of P ≤ 0.05 were considered significant.

Results

The online survey distributed to 33,000 VIN members was completed by 3,441 respondents; the overall response rate was calculated as 10.4%. However, the number of survey recipients that worked in small animal–exclusive versus mixed animal practices was unknown, and response rates for different practice types were not calculable. Not all respondents answered every question, and several questions allowed multiple response options; thus, the total number of responses for each question varied.

Of the 3,441 participants, 2,503 (72.7%) indicated that they performed onychectomies, 827 (24.0%) indicated they did not, and 111 (3.2%) did not answer. In response to the question of whether anyone in the practice performed onychectomy, 424 of 827 (51.3%) respondents who stated they did not personally perform onychectomy replied no, and 403 (48.7%) replied yes. Among participants who did not perform onychectomy, the reasons given included that it was against their personal beliefs or ethics (670/818 [81.9%]), they never learned the procedure (158 [19.3%]), there was no client demand for the service (145 [17.7%]), it was prohibited by clinic policy (119 [14.5%]), it was prohibited by local or national laws (77 [9.4%]), and other (102 [12.5%]).

Onychectomy techniques

Respondents who reported that they performed onychectomies were asked to indicate the circumstances under which they did this. Most (1,571/2,488 [63.1%]) reported performing the procedure only when requested by an owner; 647 (26.0%) indicated they performed it only in certain situations (eg, failure of other methods to control scratching, or a person in the home at risk to cat scratches); 189 (7.6%) indicated that they offered the procedure to all owners; and 81 (3.3%) selected a response of other. The reported frequencies of performing onychectomy included less than monthly (1,534/2,498 [61.4%]), less than weekly but more than monthly (708 [28.3%]), weekly (181 [7.2%]), 2 to 3 times/wk (60 [2.4%]), and > 3 times/wk (15 [0.6%]). Most (2,274/2,496 [91.1%]) respondents reported performing onychectomy only on the forepaws. However, 222 of 2,496 (8.9%) participants indicated they routinely performed onychectomy on all 4 paws (190 [85.6%] for all 4 paws at the same time and 32 [14.4%] as 2 separate procedures).

Surgical preparation methods varied; 2,202 of 2,494 (88.3%) stated that they did not clip fur routinely, whereas 292 (11.7%) reported that they did. Of 2,493 respondents who provided information on preoperative disinfection of the paws, choices included chlorhexidine (1,609 [64.5%]), alcohol (1,036 [41.6%]), none (320 [12.8%]), iodine (284 [11.4%]), or other (40 [1.6%]). Routine application of tourniquets during onychectomy was reported by 1,976 of 2,503 (78.9%) respondents, whereas 527 (21.1%) indicated they did not routinely do this. Among 1,965 individuals who reported the locations in which they placed tourniquets relative to the stifle or elbow joints, selections included above the stifle or elbow joint (973 [49.5%]), below the stifle or elbow joint (766 [39.0%]), below the stifle but above the elbow joint (201 [10.2%]), and above the stifle but below the elbow joint (25 [1.3%]).

Respondents who stated that they performed onychectomies were provided a list of onychectomy methods and asked to indicate the frequency with which they used each approach (always, often, sometimes, rarely, never, and used in the past but not currently; Table 1). Use of a scalpel-only method was most frequently identified, followed by use of laser only and use of a guillotine-style nail trimmer only. The same respondents were asked whether they routinely removed the entire third phalanx (ie, disarticulation at the distal interphalangeal joint); 2,347 of 2,482 (94.6%) answered yes, and 135 (5.4%) answered no. Those who reported use of a scalpel were asked to indicate the size of blade they routinely used. Answers included No. 15 (687/1,522 [45.1%]), No. 11 (315 [20.7%]), No. 12 (315 [20.7%]), No. 10 (197 [12.9%]), and other (8 [0.5%]).

Table 1—

Frequency of use of various onychectomy methods as reported by respondents to an online survey on feline onychectomy.

MethodNo. of responsesAlwaysOftenSometimesRarelyNeverUsed in past but not currently
Guillotine-style nail trimmer only1,444424 (29.4%)105 (7.3%)16 (1.1%)20 (1.4%)628 (43.5%)251 (17.4%)
Guillotine-style nail trimmer and scalpel1,184122 (10.3%)70 (5.9%)57 (4.8%)72 (6.1%)755 (63.8%)108 (9.1%)
Scalpel only1,7221,046 (60.7%)77 (4.5%)76 (4.4%)73 (4.2%)261 (15.2%)189 (11.0%)
Laser only1,368489 (35.7%)67 (4.9%)30 (2.2%)21 (1.5%)621 (45.4%)140 (10.2%)
Other766147 (19.2%)14 (1.8%)9 (1.2%)3 (0.4%)565 (73.8%)28 (3.7%)

Frequencies are reported as number (%) of responses. Surveys were sent to 33,000 VIN members; 3,441 completed surveys were received from veterinarians who reported that they saw feline patients for routine medical and surgical procedures. Respondents who indicated that they personally performed onychectomy procedures (n = 2,503) were asked to answer questions regarding onychectomy methods. Not all respondents answered every question; some questions allowed multiple responses.

The most common method of skin closure reported was adhesive or tissue glue (1,747/2,487 [70.2%]), followed by suture (521 [20.9%]), none (163 [6.6%]), and other (56 [2.3%]). Asked whether they routinely bandaged paws after declawing procedures, 2,024 of 2,486 (81.4%) respondents responded yes, 276 (11.0%) responded no, and 186 (7.5%) indicated only if necessary. Among those who reported bandaging paws after onychectomy, most (1,871/2,206 [84.8%]) indicated that they tried to maintain the bandages overnight, with the remainder reporting this was done only perioperatively (on the day of the procedure; 164 [7.4%]), for 2 days (148 [6.7%]), or for > 2 days (23 [1.0%]).

Perioperative analgesics routinely administered for onychectomy procedures varied among the 2,482 respondents who performed the procedure and answered the question. The most commonly selected treatment was injectable opioids, followed by ring blocks and NSAIDs (Table 2). Participants were also asked to indicate the analgesics they routinely dispensed to the client for cats that underwent onychectomy. The analgesics most commonly selected by 2,465 respondents were transmucosally administered buprenorphine and NSAIDs (Table 3). Many individuals selected >1 perioperative or postdischarge analgesic choice. The duration for which analgesia was provided also varied, with 3 to 7 days most frequently reported (2,042/2,481 [82.3%]), followed by 48 hours (171 [6.9%]), > 1 week (163 [6.6%]), only perioperatively (in the hospital; 67 [2.7%]), and 24 hours (28 [1.1%]). Ten (0.4%) respondents indicated that they provided no analgesia. When asked whether they routinely hospitalized patients overnight after onychectomy, 1,616 of 2,479 (65.2%) respondents indicated that they did so for 1 night, 752 (30.3%) indicated that they did for > 1 night, and 111 (4.5%) reported that they did not.

Table 2—

Approaches to perioperative analgesia routinely used for treatment of cats undergoing onychectomy by 2,482 survey respondents.

TreatmentNo (%) of respondents
Injectable opioids1,933 (77.9%)
Ring block1,576 (63.5%)
NSAID1,535 (61.8%)
Transmucosal opioids516 (20.8%)
Fentanyl patch320 (12.9%)
Oral opioids237 (9.5%)
Splash block147 (5.9%)
Opioid-containing CRI83 (3.3%)
Other109 (4.4%)
None28 (1.1%)

CRI = Constant rate infusion.

See Table 1 for remainder of key.

Table 3—

Types of analgesics routinely dispensed to clients for administration to cats following onychectomy by 2,465 survey respondents.

TreatmentNo (%) of respondents
Transmucosal buprenorphine1,427 (57.9%)
NSAID1,298 (52.7%)
Fentanyl patch261 (10.6%)
Other opioid243 (9.9%)
Gabapentin109 (4.4%)
Other121 (4.9%)
None163 (6.6%)

See Table 1 for key.

Participants were asked to estimate the rates of minor (eg, minor bleeding or swelling or transient lameness) and major (major bleeding or swelling, protracted lameness, or infection) complications associated with onychectomy. Of 2,476 respondents who estimated minor complication rates, 1,549 (62.6%), 783 (316%), and 144 (5.8%) indicated these occurred in < 5%, 6 to 15%, and > 15% of cases, respectively. Fewer (2,267) respondents provided major complication rate estimates, with 2,240 (98.8%), 24 (1.1%), and 3 (0.1%) indicating these occurred in < 5%, 6 to 15%, and > 15% of cases, respectively.

Alternatives to onychectomy

All respondents, regardless of whether they performed onychectomies, were asked whether they performed deep digital flexor tendonectomies as an alternative to the procedure. Most (3,177/3,309 [96.0%]) respondents indicated that they did not, and 132 (4.0%) reported that they did. The most common reason selected by 3,095 individuals who did not perform this procedure was that they had never learned it (Table 4).

Table 4—

Summary of reasons given by 3,095 survey respondents for not performing deep digital flexor tendonectomies in cats.

ReasonNo. (%) of respondents
Never learned the procedure1,998 (64.6%)
Concerned about long-term complications1,244 (40.2%)
Against my personal beliefs or ethics975 (31.5%)
Concerned about immediate postsurgical complications305 (9.9%)
Prohibited by clinic policy141 (4.6%)
Prohibited by local or national laws49 (1.6%)
Other334 (10.8%)

All respondents (n = 3,441) were asked whether they performed deep digital flexor tendonectomies as an alternative to onychectomies; those who answered that they did not (3,177/3,309) were asked to indicate reasons.

See Table 1 for remainder of key.

All respondents were also asked whether they discussed nonsurgical alternatives to onychectomy with clients and, if so, whether they offered or recommended these alternatives. Of 3,023 respondents, 2,256 (74.6%) recommended nonsurgical alternatives, whereas 767 (25.4%) reported that they offered but did not recommend such alternatives. Specific alternatives offered or recommended by 3,016 respondents included appropriate scratching devices (eg, scratching posts; 2,942 [97.5%]), nail trimming (described as nail trimming demonstrations; 2,942 [97.5%]), nail covers (2,525 [83.7%]), deterrence materials (eg, double-sided tape, foil, or sprays; 1,953 [64.8%]), a synthetic appeasing feline facial pheromone spray (1,869 [62.0%]), behavior modification (1,612 [53.4%]), and prescription medications (260 [8.6%]). Forty-nine (1.6%) respondents indicated that they offered or recommended alternatives other than those listed.

Attitudes toward onychectomy

When asked what position they felt their state organization should take pertaining to legislation for a statewide ban on onychectomy, 1,638 of 3,354 (48.8%) respondents indicated the organization should oppose legislation, 920 (27.4%) indicated it should take no position, and 796 (23.7%) indicated it should support a legislative ban. Responses differed significantly (P < 0.001 for all comparisons) between veterinarians who reportedly performed onychectomy and those who did not; of 2,503 respondents who performed the procedures, 2,442 responded to the question on legislative banning. Out of these, 1,494 (61.2%) selected opposition to the statewide ban, 685 (28.1%) indicated no position should be taken, and 263 (10.8%) selected support of a legislative ban, whereas of 802 respondents who did not perform the procedure, 104 (13.0%) selected opposition, 193 (24.1%) selected no position, and 505 (63.0%) selected support of a legislative ban.

When asked to indicate the amount of pain they felt was involved with onychectomy and recovery, significant (P < 0.001 for all comparisons) differences were again identified among responses given by veterinarians who indicated they performed the procedure and those who stated they did not. Only 961 of 2,445 (39.3%) respondents who performed the procedure perceived it as involving a great deal or quite a bit of pain, compared with 664 of 807 (82.3%) who did not perform the procedure (Table 5).

Table 5—

Amount of pain involved with onychectomy procedures and recovery as reported by 3,362 survey respondents who reported that they did (n = 2,445) or did not (807) perform the procedure in cats.

 Perform onychectomies
ResponseYesNo
A great deal359 (14.7)418 (51.8)*
Quite a bit602 (24.6)246 (30.5)*
A fair amount790 (32.3)103 (12.8)*
A small amount581 (23.8)14 (1.7)*
None or minimal78 (3.2)1 (0.1)*
Unable to determine35 (1.4)25 (3.1)*

Data represent number (%) of respondents in each group that answered the question.

Value differs significantly (P < 0.001) from that for the group of veterinarians who performed onychectomy.

See Table 1 for remainder of key.

All participants were asked to indicate their level of agreement with 3 statements regarding onychectomy. Statements included the following: declawing is a form of mutilation (n = 3,369 respondents), declawing is necessary in some cats for behavioral reasons (3,366), and declawing is an unfortunate consequence of lifestyle issues but is a necessary alternative to euthanasia in some cats (3,372). Responses to each of these statements were significantly (P < 0.001 for all comparisons) different between veterinarians who reported performing onychectomy and those who reported they did not (Table 6). Whereas most respondents who performed onychectomies (1,307/2,453 [53.3%]) disagreed or strongly disagreed with the statement that the procedure was a form of mutilation, most of those who did not perform the procedure (633/806 [78.5%]) agreed or strongly agreed with the same statement. Similarly, most respondents who performed onychectomies agreed or strongly agreed that the procedure was necessary in some cats for behavioral reasons (1,741/2,448 [71.1%]), but most respondents who did not perform the procedure disagreed or strongly disagreed with this statement (534/808 [66.1%]). In response to the statement that the procedure was an unfortunate consequence of lifestyle issues but was a necessary alternative to euthanasia in some cats, the highest proportion of respondents in each group indicated agreement (2,156/2,454 [87.8%] and 326/808 [40.3%] who did and did not perform onychectomies, respectively).

Table 6—

Degree of agreement with statements regarding onychectomy as indicated by survey respondents who reported that they did or did not perform the procedure in cats

Statement and groupNo. of respondentsStrongly agreeAgreeNeutralDisagreeStrongly disagree
Declawing is a form of mutilation
 Perform onychectomies2,453 (100)130 (5.3)564 (23.0)452 (18.4)698 (28.5)609 (24.8)
 Do not perform onychectomies806 (100)318 (39.5)*315 (39.1)*59 (7.3)*46 (5.7)*68 (8.4)*
Declawing is necessary in some cats for behavioral reasons
 Perform onychectomies2,448 (100)535 (21.9)1,206 (49.3)343 (14.0)234 (9.6)130 (5.3)
 Do not perform onychectomies808 (100)20 (2.5)*153 (18.9)*101 (12.5)269 (33.3)*265 (32.8)*
Declawing is an unfortunate consequence of lifestyle issues but is a necessary alternative to euthanasia in some cats
 Perform onychectomies2,454 (100)980 (39.9)1,176 (47.9)128 (5.2)49 (2.0)121 (4.9)
 Do not perform onychectomies808 (100)62 (7.7)*264 (32.7)*115 (14.2)*197 (24.4)*170 (21.0)*

All respondents (n = 3,441) were asked to indicate their level of agreement with each statement. Within a row, data represent number (%) of the group that answered the question.

See Tables 1 and 5 for remainder of key.

Lastly, survey participants were given the opportunity to provide additional thoughts regarding onychectomy in an open-ended comment field. Of 1,248 recorded comments (897 from respondents who reported performing onychectomies and 351 from respondents who stated they did not), most (897/1,248 [71.9%]) were from the former group and were explanations of why they chose to perform onychectomy.

Discussion

In the present study, we sought to estimate the proportions of veterinarians working with feline patients who do or do not perform onychectomy and to evaluate attitudes and practices related to onychectomy by means of an electronic survey made available to members of the VIN. Most respondents in this study (2,503/3,441 [72.7%]) reported that they performed the procedure, and nearly half of those who indicated they did not perform the procedure (403/827 [48.7%]) reported that other members of their practices did. The calculated overall response rate of 10.4% was considered high for the survey venue. However, the number of small animal practitioners was not calculable from the VIN database, so the true response rate for the targeted population of practitioners working with cats could not be determined. Additionally, because participants volunteered to respond, self-selection bias may have influenced the results. Because of these study limitations, we could not assess how well the respondents represented the general population of veterinarians working with cats. However, this is the only study in recent years that has attempted to determine the number of veterinarians performing onychectomy and methods being used to perform the procedure.

Although the proportion of respondents who performed the procedure was high, more than half (1,534/2,498 [61.4%]) of those who reported a frequency indicated they performed < 1 onychectomy/mo. Most (2,256/3,023 [74.6%]) survey participants, regardless of whether they performed onychectomies, recommended a variety of nonsurgical alternatives, most commonly provision of appropriate scratching devices and nail trimming (with demonstrations). This study did not assess participants’ views on the effectiveness of such alternative measures.

When assessing practitioners’ attitudes about onychectomy, significant differences were found between those who performed the procedure and those who did not. Whereas 418 of 807 (51.8%) participating veterinarians who did not perform onychectomy perceived that the procedure and recovery involved a great deal of pain, only 359 of 2,445 (14.7%) of those who performed the procedure shared this perception. Similarly, the degree of agreement with various opinion statements (whether onychectomy is a form of mutilation, whether it is sometimes necessary for behavioral reasons, or whether it is an unfortunate consequence of lifestyle issues but a necessary alternative to euthanasia for some cats) differed between these 2 groups of practitioners. To the authors’ knowledge, there have been no other studies that examined attitudes toward onychectomy to this degree.

Numerous short-term and long-term complications have been attributed to onychectomy, with hemorrhaging and pain being the most common early postoperative complications.12–17 Complications that can occur later include claw regrowth, chronic draining tracts, radial nerve paralysis secondary to tourniquet use, infection, wound dehiscence or incomplete healing, protrusion or loss of the second phalanx, tissue necrosis from improper bandage placement, development of palmigrade stance, and persistent lameness.12–15 It has also been suggested that foot shaking, an unwillingness to jump, and a lack of hunting behavior after the procedure are indicative of neuropathic pain.16 Furthermore, the investigators of 1 study17 that included force plate analysis found abnormal gaits for ≥ 12 days after onychectomy in cats, regardless of the analgesic regimen used (topical administration of bupivacaine, IM administration of butorphanol, or transdermal administration of fentanyl).

Although most veterinarians who participated in the present study performed onychectomies, there are many veterinarians who feel strongly that this procedure is unethical and unnecessary. The lack of conclusive data on adverse long-term behavioral effects and short-term complications only fuels debate on this topic. Whereas most (670/818 [81.9%]) responding veterinarians in the present study who did not perform the procedure indicated that it was against their personal beliefs or ethics, others have taken the stance that onychectomy is not associated with adverse long-term behavioral effects and that short-term complications, particularly pain and hemorrhage, can be minimized or eliminated with proper surgical technique and use of analgesics.18 Additional studies are needed to assess short- and long-term effects of the procedure, particularly in regard to pain. Another argument against onychectomy is the concern of potential adverse effects stemming from depriving a cat of the use of its claws and the ability to engage in hardwired species-specific behaviors (eg, scratching and grooming).3 This frustration of natural behaviors has been proposed as a cause of chronic stress.3 Historically, those who support onychectomy have pointed out that scratching behaviors are a leading reason for cat relinquishment19,20 and directly impact the number of cats euthanized in veterinary clinics and animal shelters because of behavior problems21; however, this point has also been contested, with hypotheses proposing that declawed cats are actually at an increased risk of relinquishment and thereby euthanasia.22 However, many of these reports are currently > 10 years old, and whether this information holds true today is unknown as more recent studies, reflecting the change of the status of cats in society, have not been published.

The challenge with available studies is the lack of quality data about cat populations, cat ownership, and attitudes of cat owners in the United States in general. A 2012 survey of > 50,000 households identified a population of 74.1 million owned cats23 in the United States, and 1 older study24 estimated that there were 30 million to 60 million feral cats in the country. The proportion of truly feral versus free-roaming owned cats is difficult to assess.25 The reasons owners allow cats to roam are also not well-described, although personal beliefs about cat welfare and inappropriate or destructive behaviors, such as urine spraying and unwanted scratching, have been identified.22 Similar to the debate over onychectomy, views about the role of cats in our society and the acceptability of free roaming cats are divided; 1 study26 in Ohio found that cat owners were less likely to support laws against free-roaming cats than non–cat owners. Free-roaming cats are perceived to have a shorter life span owing to disease and accidents.26 Without appropriate population data, it is difficult to accurately assess any associations between onychectomy or destructive behaviors and shelter relinquishments, euthanasia, or free-roaming status of cats.

It is also difficult to assess the impact that a ban on onychectomy would have on overall cat welfare in the United States. Several countries have banned onychectomy27,28 for welfare reasons, yet there have been no published studies on the potential welfare-related outcomes of these bans. Owner attitudes about cats and cat ownership in other countries may also differ from those in the United States. In 2005, Hollywood, Calif, became the first city in the United States to prohibit onychectomy.4 A section in the city's animal cruelty statutes made it a misdemeanor for any person to perform, procure, or arrange for surgical claw removal, declawing, onychectomy, or tendonectomy on an exotic or native wild cat species.19 Seven more California cities followed suit by 2009.4 Other US cities have, or are considering, similar bans; however, the presence or absence of associations between such legal restrictions and welfare-related outcomes for cats is unknown and warrants further research.

A ban on onychectomy is not currently supported by the American Animal Hospital Association,29 the AVMA,30 or the American Association of Feline Practitioners.31 These organizations, as well as the Cat Fanciers’ Association,32 support the position that onychectomy should only be performed with careful consideration after alternative options have been explored. For example, the American Animal Hospital Association position statement indicates opposition to the declawing of domestic cats unless all other attempts have been made to prevent the cat from using its claws destructively or clawing presents a substantial health risk for people within the household.29 Similarly, the AVMA's policy indicates that onychectomy is an amputation and should be regarded as a major surgery, and includes a statement that declawing of domestic cats should be considered only after attempts have been made to prevent the cat from using its claws destructively or when its clawing presents an above normal health risk for its owner or owners.30 Current statements from the AVMA and the American Association of Feline Practitioners31 indicate that is it the obligation of veterinarians to provide cat owners with complete education with regard to feline onychectomy, which is not considered a medically necessary procedure in most cases.30,31 It is important to recognize the role of veterinarians and veterinary behaviorists in providing education as well as possible alternative solutions for unwanted scratching behaviors so that clients can make informed decisions. The Cat Fanciers’ Association also describes onychectomy and tendonectomy as elective surgical procedures without benefit to the cat, although indicating that in some situations, including high risk of injury or disease transmission to owners with bleeding disorders or compromised immune systems, the procedure might be justified to maintain the cat-human bond.32

Of the 3,023 respondents who answered questions about alternatives to onychectomy in the present study, 2,256 (74.6%) and 767 (25.4%) recommended or offered such alternatives, respectively. However, many individuals believe these policies do not go far enough and that a legislative ban is necessary. The results of the present study as well as the position statements by key organizations suggest that most veterinarians do not support a legislative ban. In this study, only 263 of 2,442 (10.8%) respondents who performed onychectomies indicated that their state organizations should support a ban. Although 505 of the 802 (63%) respondents who did not perform onychectomies indicated that such a ban should be supported, they comprised only 23% of the 3,441 survey participants and 24% of those who answered the question. A follow-up study to determine why veterinarians do or do not support a ban would provide additional useful information. As communities debate onychectomy bans, an analysis of the impact of the bans that have already been implemented, both in the United States and internationally, could help political leaders make informed decisions.

Onychectomy is often an emotional and divisive topic, and we found significant differences in the opinions between veterinarians who performed the procedure and those who did not. There appears to be a dearth of evidence-based medicine surrounding onychectomy and its impact on cat welfare. Additional studies are needed, including but not limited to current ban impacts, the long-term behavioral and physical impacts of onychectomy, current risks for relinquishment of cats to animal shelters, and a broader sampling of veterinary attitudes in the United States.

Acknowledgments

No third-party funding or support was received in connection with this study or the writing or publication of the manuscript. The authors declare that there were no conflicts of interest.

ABBREVIATIONS

VIN

Veterinary Information Network

Footnotes

a.

The survey instrument was an electronic document; copies of the survey questions are available from the corresponding author upon request.

b.

SPSS, version 21.0, IBM Corp, Armonk, NY.

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Contributor Notes

Address correspondence to Dr. Kogan (lori.kogan@colostate.edu).