Alternatives to Feline Declawing

Feline Declaw Alternatives

• Regular nail trims can be used instead of declawing
• Vinyl caps on claws, also known as soft paws, can be reapplied every 6-8 weeks
• A deep digital flexor tendonectomy is an alternative to declawing
• Pheromone sprays like Feliway can be used as an alternative

Onychectomy

• Surgically removes the third digital phalanx
• Usually performed on the front claws
• Best if done on younger cats, ideally between 3-12 months old
• Has fewer complications than other methods
• Owners need to keep cats indoors post-op

Anesthetic/Analgesic Considerations

• Multimodal analgesia should be used
• Use injectable opioid pre-meds with a sedative/tranquilizer like neuroleptanalgesia
• Injectable opioids should be used for 24-48 hours post-op
• Buprenorphine can be administered transbuccally to go home
• Can use an NSAID
• Consider nerve blocks

Surgical Preparation

• Check for polydactyly
• Clip hair around toes of long-haired cats
• Aseptically scrub the paw, digits, and nails
• Apply a tourniquet distally to the elbow

Equipment Based on Technique

• Rescoe technique uses a guillotine type nail clipper, a tourniquet, tissue glue, and bandage material
• Blade technique uses a small scalpel blade (no. 12), a tourniquet, tissue glue, and bandage material
• Laser technique uses saline-soaked sponges, and there is no tourniquet required, with nadaging post-op being optional

Procedure Steps

• Extend the claw
• Make an incision at the junction of haired and hairless skin between the 2nd and 3rd
• Avoid the digital pad
• The entire third phalanx should be removed
• If using guillotine clippers, remaining bone must be dissected out to prevent growth
• Count to ensure all 10 are removed
• Choices for closure include tissue glue, suture, leaving it open to heal by second intention, or bandaging the paw with a tourniquet in place

Post-Op

• Bandages should stay on for up to 24 hours
• Cats will try to shake off bandages, so use tape stirrups
• If bleeding occurs through, bandage over the first bandage

Discharge Instructions

• Do not use clay litter for 10-14 days
• Use shredded paper or pelleted litter that consists of yesterdays news
• Restrict activity
• Avoid excessive grooming, use e-collar

Complications

• Hemorrhage
• Claw regrowth because of incomplete removal of P3 or draining tract
• Chronic pain including lameness
• Ischemic necrosis of paw caused by a tight bandage
• Neurapraxia and tissue necrosis caused by improper tourniquet placement

Endoscopy

• A technique used to examine the internal body structures using specialized optical instruments
• Considered a high-yield, noninvasive, or minimally invasive procedure
• The body is entered through an orifice, or a small incision, to enter the body
• Used to examine tissue directly, obtain biopsy samples, or perform therapeutic procedures like removal of foreign bodies
• Proper fasting and general anesthesia are required

Endoscopy Types

• Cystoscopy evaluates the bladder and lower urinary tract through the urethra
• Esophagostomy examines the esophagus by way of the mouth
• Gastroscopy examines the stomach and upper small intestine
• Colonoscopy examines the colon by way of anus
• Rhinoscopy examines the nasal passage through the nares
• Tracheobronchoscopy evaluates the trachea and bronchi by way of the mouth
• Laparoscopy examines abdominal organs
• Arthroscopy examines the joint
• Thoracoscopy examines inside the thoracic cavity

Flexible Endoscopes

• Used for procedures that require bending or flexing to examine
• Have either a 2-way (up/down) or 4-way (up/down/left/right) distal tip deflection
• Deflections are controlled by an angulation knob mounted on the control system of the endoscope

Rigid Endoscopes

• Used for procedures involving a direct pathway that is better viewed by a direct line of sight, like ears, nose, urinary bladder, joint spaces, abdominal or thoracic viscera
• Used for noninvasive to moderately invasive procedures that involve tissues that lie relatively close to the body surface and can be visualized with a direct line of sight

Preparation

• Patient prep
• Equipment setup includes biopsy forceps, oral speculum, lube, gauze squares, formalin containers/slides, and a histo request form
• Insufflation needles and biopsy equipment
• Patient monitoring
• Obtaining biopsy samples
• Freezing, capturing, and storing images

Equipment Breakdown

• Store in a hanging position, not coiled, in a padded case
• Allows residual moisture in the insertion tube to drain to help prevent bacteria and fungal growth
• The control section of the endoscope is the only area designed to bear weight
• During transport, hold the control section with one hand and the insertion tube and umbilical cable in the other

Equipment Cleaning

• Perform a leak test
• Aspirate approved detergent through biopsy channels
• Brush biopsy channels and re-aspirate
• Aspirate distilled water and then alcohol through biopsy channels
• Aspirate air until biopsy channels are dry
• Clean air-water and suction valves
• Flush all water out of the air-water channel
• Clean the exterior of the scope with approved detergent and water
• Hand to dry

Procedure Setup

• Perform file backups
• Maintain order of the endoscopy
• Order supplies
• Have the endoscope choice hooked up to the endoscopy machine with appropriate valves and biopsy channel covers
• Have patient data entered into the computer
• Ensure machine is turned on when the endoscope is attached, and the light source is checked

Biopsy Sampling

• Endoscopic biopsies are made with flexible forceps
• Handle any biopsy sample carefully to minimize artifacts and distortion, and do not allow to dry out
• Remove tissue samples from biopsy forceps with a 25-gauge needle
• Place tissue samples from different locations in different formalin jars and label them, generally taking 6-8+ biopsies per site to help with diagnosis

Suction Machine

• Removes fluid or air from the surgical site and is a mechanical device
• Very helpful piece of equipment in certain surgical procedures
• May have its own electric motor or run on a central vacuum line
• Require a receptacle to collect the suctioned matter
• Needs aid with a float or safety valve to prevent fluid from entering the motor or vacuum line

Disposable Suction Hose

• Sterile single-use tubing and a suction tip to collect fluid or air from the surgical site
• The tubing and tip are aseptically placed in the sterile field, with one end of tubing dropped for the technician to attach to the suction pump

Suction Tips and Plastic Tubing Connector

• Poole is a two-piece instrument used to remove large volumes of fluid and has an inner cannula that can be used alone or inside the outer basket, which has many holes for quick removal of fluid without suction to the tissue
• Frazier/Adson consists of a single tube with a small opening that is commonly used in orthopedic and neurologic procedures and may have a thumb hole to help control the amount of vacuum
• Yankauer is a general-purpose suction tube similar to the frazier but bulkier
• An Argyle bubble connect is an efficient and lightweight plastic tubing connector and is ideal for orthopedic surgeries