Hespeler Animal Hospital

The pros and cons of laser declaws for cats

We often get calls asking if we offer laser declaws.  We don’t, and here’s why:

 1/ Although an incision from a laser is less painful than an incision from a scalpel, studies show that only lasts 24 hours.  At Hespeler Animal Hospital, our pain management protocol offers 4 days of pain control (more below…).

 2/ It costs the pet owner more.  A surgical laser costs anywhere from $30,000 to $60,000.  That’s an expensive piece of equipment.  The hospital has to charge more for the surgery in order to pay for that.  Most clinics in the area charge $50 to $100 in addition to the usual surgery fee when they use their laser.

 3/ I think it’s a lot of hype.  The sales reps do a great job trying to convince doctors that this surgical tool is the latest and greatest thing since sliced bread.  I don’t know about you, but I usually take what sales people tell me with a large grain of salt.  I think the fact that most board-certified surgeons, including those at university hospitals, do NOT choose surgical lasers over a scalpel speaks volumes.  One specialist once told me “A cut is a cut, whether it’s made by a piece of steel or by laser”.

 4/ There’s some controversy about the thermal damage to the tissues as a result of the laser beam.

So what do we do at Hespeler Animal Hospital to ensure our feline declaws are as pain-free as possible?
 

1.  We give pain medication before we start the surgery.  That’s called pre-emptive analgesia.  Giving it early prevents wind-up pain, where the nerves get “angry” and therefore are more reactive post-op. It means we don’t need to give as high of a dose post-op, because the nerves never had a chance to get irritated.  Lower doses of drug translates into fewer side effects for the pet.  And, given pain meds pre-op means the patient wakes up with the medication already on board, so recovery is as comfortable as possible.
2. We use local anesthetics via nerve blocks to numb the area.  We choose bupivicaine because it lasts 6-8 hours. The cat wakes up with no sensation at all in the surgical area. 
3. We add a narcotic to the local, because studies in humans have shown this can extend the duration of analgesia to as long as 3 days.  It does not block muscle function, just the ability to feel pain. 
4. We administer a dose of hydromorphone immediately after anesthetic induction, before the patient is taken to surgery.  Some vets like to give the narcotic to an awake animal, but because it can make them vomit, we prefer to give it when it cannot cause this side effect.  (We thank Dr. Nancy Brock, a board-certified veterinary anesthesiologist, for that suggestion!)
5. We give an injection of Metacam, an anti-inflammatory, at the end of the surgery, if the cat’s blood pressure has been stable during the entire surgery.  Metacam can be hard on the kidneys if the patient experiences hypotension, so giving it at the end is safer because we’ve been monitoring the blood pressure through-out the entire procedure.  That’s another reason we highly recommend pre-anesthetic blood tests, to make sure it’s safe to give Metacam as a pain-killer.
6. We sent the cat home on two, not just one, pain medications.  Metacam for its pain-killing and anti-inflammatory properties, and buprenorpine because it is a narcotic that is 30 times as potent as morphine. 

                                             
What can you do to make sure your cat gets a pain-free declaw and no post-op complications?
 

1. Ask questions when you decide on who is going to operate on your baby!  What do they do for pain control while your kitty is in the hospital?  What do they prescribe for your kitty at home?
2. Make sure your cat is healthy.   Sick animals are more likely to develop more post-op inflammation.  Bring your kitty in for a physical exam before the surgery.  You want to meet the person who is going to operate on your cat, right?  And, a thorough check up means that you can feel sure your cat is a-ok for an anesthetic.
3. Make sure your cat is up to date on all of its inoculations. Kitty will be going into an environment where there may be patients hospitalized with infectious diseases! 
4. Say “yes” to pre-anesthetic blood tests that screen for silent diseases than can affect how your cat handles the anesthetic, and dictate what pain medications are safest.
5. Follow the surgeon’s post-op care instructions closely.  Some exercise restriction is in order after any surgery, to make sure the patient doesn’t hurt the incisions!
6. Don’t shop for the lowest price. There may be a reason it’s so low, and that might be because they’re not offering a good pain management protocol.
7. Choose a hospital that believes in pre-emptive analgesia.    Many veterinarians only give pain meds post-op.  By then it’s too late, the animal is already sore!  And, I know of a few older vets who choose not to give any pain medication at all.  No, I’m not kidding! They think that animals don’t feel pain like humans do, or they believe that being in pain means an animal won’t use the limb and hurt itself.  At Hespeler Animal Hospital, we strongly feel that animals do feel pain just like we do, and we believe there are better options than withholding pain medications to limit self-trauma after a surgery.

Here’s we you can read more about pain management for feline declaw surgery:

http://www.ehow.com/about_5379005_laser-surgery-better-traditional-declaw.html
http://avmajournals.avma.org/doi/abs/10.2460/javma.2002.221.651
http://www.avma.org/reference/backgrounders/declawing_bgnd.pdf

We’re located in Cambridge, Ontario and  your cat’s well-being is very important to us.  If you’re looking for a vet in the Cambridge, Kitchener and Guelph area, please give us a call!