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Feline Toe Amputation Statement
Robin Downing, DVM
MS, Clinical Bioethics
Diplomate, Academy of Integrative Pain Management
Diplomate, American College of Veterinary Sports Medicine and Rehabilitation Certified Veterinary Pain Practitioner
Certified Canine Rehabilitation Practitioner
Hospital Director, The Downing Center for Animal Pain Management, LLC
Amputating the last phalanx (P3) of the toes of cats was once considered a “commodity” procedure, commonly performed by well-intentioned veterinarians. As time has passed and our understanding of feline pain, biomechanics, and quality of life has evolved, we now recognize many downsides to this procedure and truly NO upside.
For the purpose of this position statement, there are three distinct perspectives within which the issue of feline toe amputation shall be considered:
Clinical bioethical perspective Pain perspective Biomechanics perspective
Clinical Bioethical Perspective
Cats are sentient beings with moral agency who, it has been recently argued (Andrews 2011; Copp 2011; Downing 2016; Nussbaum 2015; Panskeep 2012), should be approached with the same consideration as nonverbal children. As beings with moral agency, it behooves us to consider them within the context of the foundational principles of clinical bioethics.
The four cornerstone principles of clinical bioethics have been described and defined by Beauchamp and Childress as:
Respect for autonomy
Justice (Beauchamp & Childress, 2012)
Let us consider each of these in turn as we examine the clinical bioethics of feline toe amputation.
To respect the autonomy of cats, we must consider their preferences. Given a choice between being subjected to multiple toe amputation versus maintaining intact feet, one can easily make the case that they would prefer intact toes and feet, avoiding the pain and disfigurement associated with multiple toe amputation.
Feline Toe Amputation Robin Downing, DVM, MS, DAIPM,
DACVSMR, CVPP, CCRP Page 1
Nonmaleficence means “do no harm” or “avoid harm”. Considering feline toe amputation, the question then becomes, “Does amputating all of a cat’s front toes (P-3) cause harm?” Amputation is painful, potentially for the rest of the cat’s life, it forever alters the way a cat walks, it prevents natural (scratching) behavior, and it forever prevents the cat from being able to defend itself by escaping (climbing) or fighting. Clearly toe amputation causes harm.
Beneficence means to act in a being’s best interest. Can we truly argue that amputating all of any cat’s third phalanges of the front toes is ever in that cat’s best interest? It appears that the answer to this question is a self-evident ‘no”.
Finally, the fourth cornerstone principle of clinical bioethics is justice. Translating this for application in veterinary medicine focuses on fairness. The relevant question to ask is if amputating the third phalanx of each a cat’s front toes could ever constitute fairness to the cat within the context of its life and lifestyle. Considering all of the compromise that toe amputation creates, I respectfully submit this does not reflect fairness.
Considering feline toe amputation from a pain perspective, multiple studies have demonstrated that most cats receive woefully inadequate pain prevention and management for procedures like spays and neuters – – procedures far less traumatic than multiple toe amputations. The pain literature clearly demonstrates that acute pain poorly managed at the time of the trauma often leads to the establishment of permanent pain states. This means ongoing, perpetual, self-sustaining chronic maladaptive pain that constitutes lifelong torture (AAHA/AAFP 2007; WSAVA 2014; Costigan 2009; Dahl 2011)
The few studies that have evaluated either the presence of leftover bone fragments following toe amputation, or the regrowth of sharp bone spurs following amputation, demonstrate that an embarrassingly large number of cats suffer from this extra boney tissue. These sharp shards perpetually poke at the underside of the skin at the end of each toe stump, making every single step like walking on needles or nails.
Finally, we know from pain physiology that when we sever a nerve there is a very high risk of creating an ongoing, self-perpetuating pain state called “neuropathic pain”. Humans most commonly develop neuropathic pain as a result of conditions such as amputation, direct nerve trauma, shingles, and diabetes. People who develop neuropathic pain can describe how it feels, so we know quite well the unremitting torture they endure each and every day – – tingling, burning, electric-like pulsed pain, pins and needles. We also know quite well that once chronic, maladaptive, neuropathic pain is in place, these people report ongoing challenges to relieving pain (Sandkuhler 2006; Woolf 2006; Woolf 2004).
We know from pain and neurology research that companion animals are “wired” precisely as we are. When nerves are cut – – as they are in feline toe amputation – – the probability that the cat will develop neuropathic pain is exquisitely high. These cats can go on to develop many different aberrant behaviors. These may include:
reluctance to walk on certain surfaces
reluctance to jump onto or off furniture, window ledges, etc. over-grooming of feet and/or legs
Feline Toe Amputation Robin Downing, DVM, MS, DAIPM, DACVSMR, CVPP, CCRP
These cats must walk on their painful feet!
The third context within which to consider feline toe amputation is the forever altered biomechanics of the patient.
When a cat is subjected to toe amputation, in addition to having the last bony phalanx removed, all of the surrounding tendons and ligaments that attach to that bone are severed. This changes the architecture of the feet, thus changing the biomechanics of how the feet work. Because approximately 60% of the cat’s body weight is carried on the front feet, altered biomechanics changes the way the entire body moves. If we superimpose chronic, maladaptive, neuropathic pain in the feet onto altered front foot biomechanics, we amplify the downstream implications of the cat moving in an abnormal fashion. The altered biomechanics can significantly interfere with the cat’s ability to exhibit normal cat behaviors.
We also know that the vast majority of cats 10 years of age and older suffer from degenerative osteoarthritis (OA) in at least one joint (Kerwin 2010; Lascelles 2010). The majority of cats who develop OA in later life have it occur in their equivalent of the human lower back – – where the spine and pelvis come together. When the biomechanics of movement are altered, so are the forces generated throughout the body’s joints – – in particular the joints of the spine. The repetition of ergonomically unsound movements creates over time micro-traumas to these joints which can contribute to the development and progression of OA. OA, then, provides these cats with ongoing chronic maladaptive pain.
The bottom line is that amputating the last phalanx of the toes of cats violates those cats on many levels – – bioethically, from an acute pain perspective, from a neuropathic pain perspective, from a biomechanical, movement, and lifestyle perspective, and from an OA/chronic maladaptive pain perspective.
Andrews K. 2011. Beyond anthropomorphism: Attributing psychological properties to animals. In: Beauchamp TL, Frey RG (eds). The Oxford Handbook of Animal Ethics. New York. Oxford University Press.
Beauchamp TL, Childress JF. 2012. Principles of Biomedical Ethics, 7th ed. New York. Oxford University Press.
Copp D. 2011. Animals, fundamental moral standing, and speciesism. In: Beauchamp TL, Frey RG (eds). The Oxford Handbook of Animal Ethics. New York. Oxford University Press.
Costigan M, Scholz J, Woolf CJ. 2009. Neuropathic pain: A maladaptive response of the nervous system to damage. Annu Rev Neurosci. 32: 1-32
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Dahl JB, Kehlet H. 2011. Preventive analgesia. Curr Opin Anaesthesiol. 24: 331-338.
Downing R; They do not deserve to hurt: Closing the gap between what we know and what we do for
companion animal acute pain; Master’s Thesis; Union Graduate College; 2016.
Lascelles BDX. 2010. Feline degenerative joint disease. Vet Surg 39: 2-13.
Nussbaum M. 2011. The capabilities approach and animal entitlements. In: Beauchamp TL, Frey RG
(eds). The Oxford Handbook of Animal Ethics. New York. Oxford University Press.
Panskeep J, et al (eds). 2012. Low P. Cambridge declaration of consciousness. Presented at the Frances Crick Memorial Conference on Consciousness in Human and non-Human Animals at Churchill College, University of Cambridge, Cambridge, UK, July 2012.
Sandkuhler J. 2006. Spinal cord plasticity and pain. In: McMahon SB, Koltzenburg M (eds). Wall and Melzack’s Textbook of Pain, 5th ed (e-book). London. Elsevier.
Woolf CJ, Salter MW. 2006. Plasticity and pain: Role of the dorsal horn. In: McMahon SB, Koltzenburg M (eds). Wall and Melzack’s Textbook of Pain, 5th ed (e-book). London. Elsevier.
Woolf, CJ. 2004. Pain: Moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 140:441 – 451.
Kerwin SC. 2010. Osteoarthritis in cats. Topics in Companion Animal Medicine. 25; 4; 218-223. DOI: http://dx.doi.org/10.1053/j.tcam.2010.09.004
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X-Rays Tell the Story !! What Really Happens to a Declawed Cat!!
Shelters all over the country are seeing more older owner surrender declawed cats coming their way. Some of these cats have behavior problems and/or litter box issues which are likely reasons for their surrender in the first place.
I volunteer at KC Pet Project, one of the largest no-kill open admissions shelters in the country. It’s located in Kansas City, MO. They looked for reasons behind that behavior and found that many of these cats had bone fragments in their paws as leftovers from declaw procedures that were causing t hem extensive pain. Can you imagine walking every step on shards of glass? That’s what these cats were feeling. KCPP now routinely X-rays the paws of all declawed cats. If the damage is severe, they do reconstructive surgery on the paws of the cat.
Bone fragments are often left as the result of a declaw procedure making it difficult and painful for the cat to walk, use the litter box, and just be a cat! At KCPP, there is a small bulletin board display that contains an X-ray of a declawed cat and some informational material. Counselors helping adopters select a cat, can lead them by the display and discuss why they shouldn’t declaw their cat. The X-ray is the focal point for an educational discussion that isn’t judgemental. In a previous post Rick Andrius requested that X-ray so here it is and I’ll try to explain it.
X-rays look beyond the fluffy paw of a cat to reveal the devastating damage this is underneath in the paws of some declawed cats.
IMAGE 1: This is the X-ray that is on display. It shows the paws of Precious, a KCPP cat. Those little triangular pieces at the ends of the toes are P3 remnants. P3 is the bone the claw grows out of that is cut out when declawing. These are the bone fragments that are causing such pain for the declawed cat.
IMAGE 2: shows (on the right) a normal paw with claws, and (on the left) a declaw with no P3 remnants.
WHY IS DECLAWING LEGAL? Good question and many have asked. It’s illegal in these countries: England, Scotland, Wales, Northern Ireland, Ireland, Italy, France, Germany, Austria, Switzerland, Norway, Sweden, Netherlands, Denmark, Finland, Slovenia, Portugal, Belgium, Spain, Brazil, Australia, New Zealand, Serbia, Montenegro, Macedonia, Bosnia, Malta, and Israel.
WHAT ABOUT THE US? Declawing is now prohibited in eight California cities: West Hollywood, Los Angeles, San Francisco, Burbank, Santa Monica, Berkeley, Beverly Hills and Culver City. There are bills proposed in 4 states trying to ban declawing: New York, New Jersey, Rhode Island, and West Virginia.
HOW YOU CAN HELP: Spread the word that shelters receiving declawed cats should X-ray their paws. If reconstruction surgery is needed, work to help raise funds for the procedure. It’s an investment in the life of the cat!! Work with a compassionate local veterinarian who will perhaps donate one such surgery per month.
IMAGES 3 & 4: Things to look for in your declawed cat. Meet Candy Corn, another KCPP cat. Her paws had become bent and sort of deformed due to being declawed. Also, when she sat, she’d often held one paw up.
IMAGE 5: Meet Beauford. This story has a happy ending but wow!! It breaks my heart! Beauford was a declawed cat resident at a local animal shelter and I believe he was owner surrendered. He bit people!! After being on multiple bite holds for 10 days each, he was going to be put down for his bad behavior. A wonderful good samaritan stepped in and took him to HELP Humane Society – A True No Kill Animal Shelter, in Belton, MO. They immediately accessed the situation and thought that bone fragments could be in his paws causing great pain and hence his biting behavior. He soon went to the vet for X-rays which confirmed the need for reconstruction surgery. He received the procedure and it was life changing for Beauford. He no longer bit people!! He purred his heart out!! After a period of recovery, he was adopted by a loving family.
IMAGE 6: This is the little bulletin board in the KC Pet Project cat adoption area. It contains the X-rays and other information about cat declawing. It provides adopters with a focal point that counselors can use to discuss declawing in an educational and non-judgmental way.
MESSAGE TO SHELTERS EVERYWHERE: Please X-ray the paws of your declawed cats especially those who are having behavior or litter box issues. Get them the life saving reconstruction surgery if needed.
SPECIAL THANKS to Sally McCampbell for the X-rays and research information for this post.
My name is Penny and I’m a very pretty blue Snowshoe kitty and I’m about 3 1/2 – 4 years old but I have a really awful history. Despite that, I’m a sweet girl and I am quite affectionate.
My previous caretaker chose to have me declawed on my front feet and it was done very badly. My poor front feet hurt so badly ALL THE TIME so I don’t like the litter box. Hey it feels like walking on sharp pieces of glass! It turns out I am totally faithful to a pee pad in or out of a litter box (I have never missed at my foster home).
My caretaker passed away recently and her daughter decided that since I am not good with the litter box and she didn’t really want to be bothered with me, so she took me to the shelter and ask that they put me to sleep.
Instead, since I am such a young kitty, the shelter had her sign me over as an owner-surrender. That’s when Austin Siamese Rescue came to my aid and I came to Killeen to stay with my new foster family.
At the vet I had an x-ray of my feet which showed shards of bone were left in three toes of my left paw and one in the right paw. If you watch me I am constantly lifting my paws due to the pain and sometimes I even lick them because they hurt. I was immediately put on some anti-inflammatory pain meds to make me more comfortable but I need surgery to take out those shards so I’ll be more comfortable.
Austin Siamese Rescue is asking for help to fund my surgery and in the meantime foster mom is making me as comfortable as possible and loving on me a million times a day (I’m in the bathroom ).
If you can donate to help me get my surgery to fix the bad declaw please either use the “PayPal Donate” button on the ASR home page and note that it is for Penny’s surgery http://www.austinsiameserescue.org/ OR you can donate directly to the vet clinic by calling Firehouse Animal Health Center in Leander, TX, at (512) 980-2080 (you can use a credit or debit card with both) or you can mail a check or money order to Austin Siamese Rescue, P. O. Box 13474. Austin, TX 78711-3474.
Please make sure to mark your donation for Penny’s Surgery. We are looking to gather around $500 which will cover the surgery and aftercare.