29. digit & tail amputation

non-elective indications for declawing

• digital neoplasia

• severe nail-bed infections

• forelimb deformities

non-surgical alternatives to declawing

• scheduled nail trims (gabapentin-assisted)

• behavior modifications

• vinyl nail caps (softpaws)

  • requires adhesive applications

  • takes time to acclimate cats

  • requires maintenance

proper tourniquet use

• place proximal to elbow

• 20 min time limit

onychectomy surgical prep

• ring block anesthesia

• examine all nails

• do not attempt to shave

• dilute chlorhex to clean all nails & paw pads

• place tournique proximal to elbow

  • not needed if using CO₂ laser

• sterile saline

  • keep fur wet & out of field

onychectomy: scalpel technique

• extrude P3 and grasp nail with forcep

• circumferential skin incision

• retract skin & palpate dorsal joint space at P2 / P3

• excise through common digital extensor tendon & enter joint space

• follow couture(?) of P3

• transect collateral ligaments

• transect deep digital flexor tendon

  • don’t cut pad!

• count claws removed

onychectomy: CO₂ laser technique

• same procedure as with scalpel but more expensive

• less hemorrhage; no need for tourniquet

• usually don’t need post-op bandaging

• user safety when using CO₂ laser

  • glasses

  • fume evacuation

onychectomy: guillotine technique

not recommended (basically do not use this method)

• e.g. rescoe nail trimmer method

• seat ring of instrument at dorsal joint space

• place blade just distal to digital pad

• deployment of blade results in complete removal of the ungual crest

  • flexor process remnant common — claw regrowth

onychectomy: incision closure

• best: 1-2 simple interrupted sutures

  • rapidly absorbable suture

  • chromic gut (4-0 or 5-0)

• cyanoacrylate glue

  • applied only to skin edges

  • can act as a foreign body; higher infection rate

onychectomy: post-op care

• bandage depending on method

• avoid clay litter for 7-10 days

• pain management is critical!

  • no well-defined universally accepted protocol

  • local block before surgery

  • NSAID for 5 days after surgery (off label — inform owner, document)

    • 0.1 mg/kg meloxicam day of surgery; 0.05 mg/kg SID post-op

  • opioids for at least 24h after surgery; consider continuing for 3 days

    • buprenorphine 0.02 mg/kg TID

deep digital flexor tendonectomy

• historic alternative to de-claws

  • prevents claw extrusion

  • requires regular nail trims

• cut deep digital flexor tendons under P2

• reported as salvage procedure for cats with chronic pain due to hyperflexion of proximal interphalangeal joints after declaws

indications for digit surgery

• digital neoplasia

• chronic infections with osteomyelitis

• trauma to phalanges

• lacerations of digital pads

• foreign body removal

• dewclaw removal

indications for caudal tail amputation

• neoplasia

• trauma

• tail docking for breed standard legal in USA

which vessel groups need to be ligated for caudal tail amputations?

• dorsal lateral caudal

• lateral caudal

• median caudal