By Dr. Becker
Today, I have a very special guest I'm interviewing by phone, Dr. Jean Hofve, and we're going to discuss the distressing topic of declawing.
Dr. Jean earned her Doctor of Veterinary Medicine (DVM) at Colorado State University in 1994. She took further training in homeopathy, homotoxicology (a system of bioenergetic medicine similar to homeopathy), reiki, and flower essences, and went on to practice veterinary medicine in Denver for many years.
Now retired from practice, Dr. Jean is an author and consultant. She has written for many online and print publications, including the Whole Dog Journal, the Journal of the American Holistic Veterinary Medical Association, Let's Live, Amazing Wellness, and Animal Wellness Magazine. She co-authored The Complete Guide to Holistic Cat Care: An Illustrated Handbook with nutritionist Dr. Celeste Yarnall, and they also recently published a second book, Paleo Dog: Give Your Best Friend a Long Life, Healthy Weight, and Freedom from Illness by Nurturing His Inner Wolf.
Dr. Jean also runs an award-winning website Little Big Cat, which she founded in 2003 with the wonderful Jackson Galaxy. Little Big Cat is a respected source of information on feline health, nutrition, and behavior.
Veterinary students aren't adequately informed about the consequences of declawing.
The topic Dr. Jean and I are going to discuss today is emotionally painful for us, and certainly physically painful for the kitties who have endured it.
I grew up with cats, but none of them were declawed. I never gave declawing much thought until I attended veterinary school and had to learn how to do it. I found the procedure shocking and overwhelming. In 1997, the year I graduated, vet students were not adequately informed about the consequences of declawing or how to perform the procedure in a way that might help mitigate the chances of a poor outcome.
I asked Dr. Jean to share her thoughts on whether veterinary students get adequate instruction in school on this very important topic. She answered that when she was a veterinary student in the early 1990s, declawing was very common. These days, there are two schools that no longer even teach the procedure – Tufts University and Louisiana State. At most other vet schools, it has become an elective. Large animal vet students obviously don't need the information, and increasingly, small animal vet students aren't taking the class either. But according to Dr. Jean, there was a survey done recently that revealed that new vet school graduates are expected to perform declaws on their first day at work, which is just shocking.
Dr. Jean agrees it's appalling, and she says to this day, there is little if any information given to vet students about the consequences of declawing – side effects, complications, aftercare. She has talked to the students at a few different veterinary schools, and they say they have raised the issue with faculty, but faculty apparently doesn't agree with them.
Dr. Jean's first exposure to a declawing procedure on video made her physically sick.
I asked Dr. Jean what her personal experience has been with regard to declawing. She said she had a rather abrupt "evolution." The night before she was scheduled to perform a declawing in her surgical rotation, she had to watch a video of how the procedure was done. That's true of training for most veterinary surgical procedures – students watch a video, and the next day they do the procedure themselves.
Dr. Jean said she was horrified by the declawing video. She remembers sitting there thinking, "This is the most barbaric thing I've ever seen. Vets are supposed to be the good guys. What are we doing?" And the longer she sat there, the sicker she became. Eventually, she had to leave the room to run to the restroom to throw up. She says it was pretty horrible. But on her first day of work at the clinic, she was required to declaw, so she did. There she was, practicing a procedure she had no desire to perform, on an animal that certainly had no desire to have it done.
Her boss at the time believed – and still believes today – that declawing finds more homes for homeless cats. She believes more cats will be adopted, and stay adopted, if we declaw. But Dr. Jean says the facts don't support that theory.
Unfortunately, we know that veterinarians today remain inadequately trained on the procedure. Most don't give adequate pain medication. There's a very high rate of complications – something around 80 percent for vet students. So there's the question of why veterinary schools aren't doing a better job of teaching the procedure. And then there's the more important question of why we're still doing the procedure at all.
Declawing: the gory details.
I asked Dr. Jean to help listeners and readers here today who may be first-time cat parents, or who don't know a lot about the declawing procedure, to explain exactly what happens when a kitty is declawed. Many people assume it's just a permanent nail trim, but nothing could be further from the truth.
Dr. Jean explained that cats have three bones in each of their toes, just as we have three bones in each of our fingers – two joints and three bones. A kitty's claw actually grows out of the last bone. This is very different from human fingernails, which grow out of flesh. Since a cat's nail grows from the bone, it is the bone that must be removed – amputated – in order to prevent the claw from growing back.
The procedure involves cutting between the second and third bones, and amputating the last bone that contains the claw. This of course severs everything in the way – nerves, tendons, and blood vessels. A front-paw declaw requires 10 separate amputations. If the hind paws are also done, that's 8 more separate amputations. Fortunately, hind paw declawing is much less common, but also considerably more painful for the cat.
There are three different methods used for declawing – the Resco, which uses nail trimmers that are also referred to as guillotine trimmers; scalpel; and laser. Resco is by far the most common method used. According to Dr. Jean, the way the Resco procedure is taught in vet school, it's optional whether the veterinarian leaves a little piece of bone behind. The trimmers only cut in a straight line, and since there's no straight line in the joint, the bone must be cut.
There's a long-running debate as to whether a piece of bone should be left or removed. Left in, it can feel sort of like a permanent pebble in a shoe, which is darned uncomfortable. But if the piece of bone is removed, the tendons will contract even further and can cause severe malpositioning of the toes, which changes how the paws bear weight.
Some veterinarians believe using a laser causes less pain, but according to Dr. Jean there isn't a shred of scientific evidence that it's less painful. It does cause less bleeding, but that's it. It looks "prettier" than the result from other methods, but it still involves burning the tissue, and there are many complications from use of a laser.
Any of the three methods -- scalpel, laser or Resco -- changes the cat's anatomy and physiology. The procedure changes everything about the way a cat walks. Some veterinarians bandage, some don't. When they do, they apply the bandages very tightly to control bleeding, so you can imagine those incredibly painful paws swelling up inside a rigid bandage. According to Dr. Jean, there have been many cases of cats ultimately losing a limb because a bandage was put on too tight, or a tourniquet was misapplied.
Declawing is so painful, it is the procedure of choice in veterinary medicine to test new pain medications on cats.
Dr. Jean points out that declawing is so painful it is the procedure of choice to test new pain medications for cats. Everyone in the veterinary community understands it's a more painful procedure than spaying or neutering. "Cats do not walk on their uterus," as she puts it.
Surgery on the hands and feet are known to be some of the most painful procedures a human can endure. Dr. Jean explains that she had a partial "declaw" on one of her own toes a few years ago, and it STILL hurts.
In addition to the mutilation of their toes, cats must use their paws to bear weight, which makes sitting up, and especially standing and walking, torturous. And many DVMs who still perform declaws send patients home with just two or three days of pain medication. How can anyone think this kind of excruciating pain will subside in 48 hours? I asked Dr. Jean where this ridiculous, not to mention heartless idea came from.
She replied that it actually came from cats themselves. Felines are extremely stoic creatures, as anyone owned by a cat knows. They don't show signs of pain if they can possibly avoid it. Cats are predators, of course, but they are also prey for bigger animals like coyotes, foxes, and great-horned owls. If a cat shows weakness – signs of pain – it may quickly become someone's lunch. So they hide pain exceptionally well. They seem fine, but as Dr. Jean so aptly puts it, "absence of evidence isn't evidence of absence." The pain of the declawing is still present – the cat just works hard not to make it obvious.
In a study done a few years ago, researchers measured the weight cats were putting on their paws after being declawed. The study only ran for 12 days, and the kitties were still painful at the end of the 12 days based on how they were moving and trying to avoid putting weight on their feet. So we know pain medication should be given for at least two weeks, but Dr. Jean says she doesn't know anyone who does that. And I agree – it's certainly not the standard of care after a declawing, which is horrific when you think about it.
In addition to the serious issue of pain, when a kitty's ability to bear weight is shifted, as it is with declawing, it changes how the toes, paws, and wrists function. It impacts the elbow joint and stresses the spine. The compensatory changes that occur to accommodate compromised front limb function alter the cat's locomotion and can lead to arthritis. Kitties with front AND hind paw declaws literally don't have a comfortable leg to stand on, which sets the stage for chronic pain.
Frequently, behavioral changes occur in declawed cats.
I asked Dr. Jean to discuss some of the emotional or personality changes that can occur with declawing. Because the fact is, when someone has a cat declawed to save her sofa, she is risking significant and permanent behavioral side effects in her pet as a result of the procedure.
Dr. Jean replied that changes in behavior flow from the pain the cat is experiencing. She says the veterinary community is very careful about discussing behavior problems after declawing. They talk about a lack of evidence of behavior problems when declawed cats are compared to control groups. But according to Dr. Jean, almost none of the studies actually used control groups. The reality is, we should be measuring a cat's behavior before the procedure against his behavior after the procedure.
Using that measure, when you look at the statistics, about 33 percent of cats develop a behavior problem, for example, biting, or urinating outside the litterbox. Both of those behaviors are pain-related.
And now, of course, you've also changed the cat's ability to walk naturally. Normally, kitties carry 60 percent of their body weight on their front feet. If the front paws are damaged, even temporarily, the problems flow upstream to the wrist, elbow, and shoulder, and down the spine to the tail.
The weight equalizes after about six months according to studies, but that's weight-bearing across four legs. Within the declawed paws, a cat continues to shift his weight backwards, which can lead to collapse of the wrists. Declawed cats have ended up walking on their ankles or wrists, which is painful.
Sometimes when a small piece of bone is left in, something regrows from it, even as much as 15 years after a declaw. This also causes significant pain.
The tendons contract when they're severed in the declawing procedure, which pulls the toes back. This changes the angle at which the foot connects with the ground, which can cause severe pain.
Declawing can also cause permanent emotional changes in cats.
So declawing can create chronic, severe pain in a number of ways, and cats, being stoic, deal with it. They appear normal. They may even get back to playing. They may "pretend" to scratch with their missing front claws. They may climb and jump, but none of it is normal movement because their entire physiology has been altered by declawing. Their biomechanics have changed, and down the road, behavioral problems can arise.
As Dr. Jean explains, there are immediate and obvious behavior changes in about a third of declawed cats, like biting and eliminating outside the box. But there are also mental and emotional problems that can develop. Lots of owners of declawed cats have reported that their pet has become morose, withdrawn, irritable, and even aggressive. This of course should be expected if every step a cat takes causes pain. And while owners may not associate the behavior change with pain because cats are stoic, pain is usually the cause of it.
According to Dr. Jean, a pain recognition tool getting some attention of late is called the Grimace Scale. There are subtle signs of pain that can be seen in the faces of animals, including declawed cats, if you're looking for them. They include the ears and whiskers pulled back; squinting of the eyes; and a "bunched up" face with a wrinkled nose and puffed out cheeks due to the jaw being clenched. There's a grimace scale for several different animals, but not yet for cats. The mouse grimace scale looks like this. Left to right, the images are of a mouse in no pain, in moderate pain, and in severe pain.
Dr. Jean feels that when certain animals are in pain, like cats, there's a desire not to know about it for many people, which is probably why there is no grimace scale for cats.
Many vet school students graduate with the belief that declawing is an acceptable procedure, and many practicing DVMs don't want to give up the income stream from declawing.
Next, I asked Dr. Jean why, in her opinion, there are still veterinarians willing to perform declaw procedures. I mean, I knew upon graduation from veterinary school that I would never offer cosmetic or "convenience" declawing, tail docking, ear cropping, or any procedure that mutilates or maims.
Dr. Jean responded that surprisingly, there are old-school vets that have seen the light, yet plenty of students coming out of vet school still believe what their professors tell them about these procedures. They graduate with the belief that declawing and other such procedures aren't a problem. In fact, the American Veterinary Medical Association's (AVMA) view is that if the surgery is done correctly and adequate pain management is used, declawing is no big deal.
However, as we've discussed, the majority of DVMs don't do the procedure properly and don't provide adequate pain relief. Which means the majority of vets should not be performing the procedure. But Dr. Jean believes it's a matter of education. It's a matter of "beating people over the head a little bit… in a nice way," to educate them about the realities of the procedure.
Dr. Jean was very involved in getting anti-declawing laws passed in some of the largest cities in California, including San Francisco, Berkeley, Los Angeles, and Santa Monica. Given the size of those cities, she figures about 4 million cats have been saved from declawing. She says it was interesting to watch the city council members and city supervisors, once they understood what a declawing entails say, "Oh my God, that's cruel!"
Dr. Jean says that unfortunately, her group had a lot of opposition from the California Veterinary Medical Association (CVMA) and local veterinarians -- some actually got irate about the ban. The reason? According to Dr. Jean, it's because their income from declawing procedures was being threatened. In fact, the backlash was so severe that the CVMA got a law passed that prohibits individual cities in the state from banning veterinary procedures of any kind.
There are at least a dozen alternatives to declawing.
Next, I wanted to talk with Dr. Jean about alternatives to declawing, and how to combat the popular but misguided notion that cats without claws are more adoptable. In fact, the humane society I worked for years ago offered declawing as a "bonus" procedure.
I asked Dr. Jean how we can educate people about the realities of declawing. How can we respond to people who say, "My cat is destroying my house with his claws. I'm this close to dumping him at the pound. Help!"
Dr. Jean answered that there are at least a dozen alternatives to declawing. You can find them listed at Little Big Cat. The number one solution is to provide your cat with an alternative scratching surface. Cats are hardwired to scratch. Even declawed kitties who may still be in pain from the procedure will continue to try to scratch with their front claws – that's how deep the instinct is. In a survey from just two years ago, 48 percent of cat guardians didn't know they should provide their pet with a scratching post. That's just amazing. Obviously, pet owners aren't paying enough attention, but in addition, veterinarians must be doing a really lousy job of educating their cat owning clients.
So the first order of business for anyone with a cat is to get a scratching post. Then watch where kitty scratches. Does she head for your carpet? If so, get her a horizontal scratching surface that sits on the floor.
Is he going after the couch? If so, get him a tall, sturdy scratching tree. Cats seem to especially like the kind with sisal rope. And you can even replace the rope when it gets ratty (although your cat may prefer it ratty).
Another alternative is to use nail caps for kitties called Soft Paws. Get some guidance from a groomer or your vet on how to apply them. The nail caps are designed to prevent damage from scratching.
Dr. Jean makes the excellent point that dogs also have claws, and they can scratch you or your furniture with them. Yet we don't declaw dogs, and the reason, according to one of her veterinary school professors, is because "Dogs scream bloody murder if they're declawed." Sadly, cats do not. Thanks to their stoic nature, cats just deal with it, which is probably one of the biggest reasons the barbaric procedure continues.
More alternatives to declawing.
Dr. Jean wonders aloud how it is that every civilized nation on the planet no longer declaws, with the exception of the U.S. and Canada. Throughout the entire European Union, it is illegal to declaw. And all those countries have young people, old people, people taking blood thinners, people who are immunocompromised, people on corticosteroids, people with organ transplants, and people with immune-related diseases. Those countries have the same level of risk as we do here in the U.S., yet over there, everyone seems to be doing fine leaving cats with their claws intact.
There is no reason for declawing. There are non-surgical alternatives to every reason given for declawing a cat. In addition to the ones mentioned above, there are also rotary nail trimmers like the Dremel that many people have good luck with.
And you can also create barriers in places where kitty likes to scratch. For example, if she's fond of sharpening her nails on your couch, place a plastic carpet runner, spiky side up, on the floor in front of or behind your sofa. Put aluminum foil on inappropriate scratching spots. Also consider two-sided tape. There's a product called Sticky Paws that won't damage fabric surfaces.
The idea is to prevent your cat from digging into inappropriate surfaces and getting a nice backstretch in the bargain. You want to make it awkward for her to scratch and stretch in the wrong spot.
As Dr. Jean points out, you don't have to live with barriers forever. You will have to put up with a little inconvenience for the few weeks it takes to train your cat to use her own scratching surfaces, but cats do learn. They're not as easy to train as dogs, but it's not impossible. It goes much quicker if you can find THE treat your cat will work for.
And it's always best to start when the cat is a kitten, if possible. You can teach a kitten to let you clip her claws. Alternatively, you can have a groomer or your vet do it. Nail clips typically don't cost a lot.
We actually call it "a nail at day" at my practice when we're helping new pet owners learn how to perform basic grooming chores. Just clip one nail a day, and by the time your kitty realizes what's happening, it's done. (If you'd like to watch me demonstrate a kitty nail clip, have a look here). In fact, all three of my cats lay on their backs now and we can do all their nails in one session. But that's because they've been conditioned to realize it doesn't hurt. And we clip nails every week without fail. We keep them nice and short, so there are never any issues.
Unfortunately, not enough veterinarians take this kind of proactive approach with their clients. In my practice, it's something we do with every new puppy and kitten owner. Taking the time to show clients how to perform routine grooming chores like nail trims on new pets can mean the difference between a cat that finds a forever home, and one that is relinquished or returned to the animal shelter.
Many people are catching on to the realities of declawing. Sadly, many still are not.
I asked Dr. Jean how cat owners respond when she explains the drawbacks to declawing. Do they decide against it? She replied that as soon as she explains that the procedure is not a painless "permanent nail trim" but actually involves multiple amputations, 75 percent of people decide immediately to cancel the procedure. She doesn't even have to talk about side effects or long-term outcomes with those cat owners – all she has to do is clarify for them what the procedure involves.
Unfortunately, the remaining 25 percent usually go ahead with the procedure. And at the vet practice she worked for years ago, she was expected to do it. But she worked there just five years, and the day she left, she never declawed another cat.
So most people are willing to listen, especially when they're told that a third of declawed cats develop a behavior problem like biting. Often the problems a cat owner hopes to fix by declawing aren't nearly as troublesome as the problems that develop after the declawing.
According to Dr. Jean, landlords are also learning that a declawed cat is just as capable of doing damage as a non-declawed cat. In fact, California passed a law that prohibits landlords from requiring declawing as a condition of rental. Dr. Jean says that should be done around the country. It's not the case in Denver, for example, where she lives. She says she turned down a beautiful apartment that was perfect for her because the landlord wanted her to declaw her 15 and 18 year-old cats. Needless to say, she refused.
My hope is that everyone listening and reading here today will visit Dr. Jean's website, Little Big Cat, and learn more about declawing and the alternatives. I hope more cat owners will think twice before declawing. And I hope few if any veterinarians continue to recommend it as a "bonus" procedure to go along with spaying or neutering. The word needs to spread that declawing causes permanent physiological, emotional, and personality changes that cannot be reversed.
I think the more we talk about it and get the word out, the more people will realize that declawing is an archaic, barbaric procedure that simply should not be done. The only reason a cat should ever have even one claw removed is in the case of perhaps a tumor on a toe, or a toe amputation for some other reason.
As Dr. Jean puts it, declawing is not a medical treatment, "It's an irreversible surgical solution to a behavior problem." Veterinarians aren't real good at dealing with behavioral problems, but they do know how to do surgery. And as the old saying goes, "To a man with a hammer, everything looks like a nail."
One thing we haven't covered is the issue of phantom pain, which as Dr. Jean points out, isn't even recognized in veterinary medicine. She feels it's inevitable that cats experience intermittent to perhaps even constant phantom pain from the severed portions of their toes. So if the solution to a cat's behavior problem is to perform a procedure that could cause the animal pain for the rest of his life, it is incumbent upon us to find alternatives. Dr. Jean feels that if a cat owner can't make any of the alternatives work, he or she should re-home the cat with someone who can.
Many thanks to my good friend, Dr. Jean Hofve!
I want to sincerely thank Dr. Jean for her time today and for sharing her knowledge on the whole painful and emotional topic of declawing. It's always wonderful to have her as a guest expert here at Healthy Pets.
I'm hopeful that the more we educate people about declawing, the more people will make wiser choices for the cats in their care.