Evaluation of short-term limb function following unilateral carbon dioxide laser or scalpel onychectomy in cats

OBJECTIVE: To evaluate short-term postoperative forelimb function after scalpel and laser onychectomy in cats. DESIGN: Randomized, prospective study. ANIMALS: 20 healthy adult cats. PROCEDURES: Cats were randomly assigned to the laser (n = 10) or scalpel (10) onychectomy group. Unilateral left forelimb onychectomy was performed. In the scalpel group, a tourniquet was used during surgery and a bandage was applied after surgery. Pressure platform gait analysis was performed prior to and 1, 2, 3, and 12 days after onychectomy. Peak vertical force (PVF), vertical impulse, and the ratio of the PVF of the left forelimb to the sum of the remaining limbs (PVF ratio) were used as outcome measures. RESULTS: The laser onychectomy group had significantly higher ground reaction forces on days 1 and 2 and significantly higher PVF ratio on day 12, compared with the scalpel group. Similarly, significant differences were found in change in ground reaction forces on days 1 and 2 and the PVF ratio on day 12, compared with day -1. No cats required rescue analgesia during the course of the study. One cat in the laser group had signs of depression and was reluctant to walk on day 2 after surgery, had physical examination findings consistent with cardiac insufficiency, and was euthanized. CONCLUSIONS AND CLINICAL RELEVANCE: Cats had improved limb function immediately after unilateral laser onychectomy, compared with onychectomy with a scalpel, tourniquet, and bandage. This improved limb function may result from decreased pain during the 48 hours following unilateral laser onychectomy.     

Use of pressure platform gait analysis in cats with and without bilateral onychectomy

OBJECTIVE: To determine peak vertical force (PVF) and vertical impulse (VI) in cats that had or had not undergone bilateral forelimb onychectomy. ANIMALS: 26 healthy adult cats. PROCEDURE: Onychectomized cats (n = 13) had undergone surgery more than 6 months prior to the study. The PVF and VI were collected from all limbs of each cat with a 2-m pressure platform walkway. Cats were allowed to walk at a comfortable velocity, and acceleration was restricted to +/- 0.5 m/s2. Five valid trials were recorded for each cat with all trials collected in a single 1-hour session. All forces were normalized to and expressed as a percentage of the cat's body weight. RESULTS: Gait data were successfully collected in all cats. No significant difference was found for PVF or VI between cats that had or had not had onychectomy. Limb loads were greater in forelimbs than hind limbs for all trials. Mean PVF and VI in the forelimbs of cats in the nononychectomy group were 56.41% and 18.85%, respectively. Mean PVF and VI in the hind limbs of cats in the nononychectomy group were 50.22% and 14.56%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Gait analysis was successfully performed in cats with a pressure platform walkway. The absence of differences in PVF and VI between the 2 groups of cats suggests that bilateral forelimb onychectomy did not result in altered vertical forces measured more than 6 months after surgery in cats.     

Use of the carbon dioxide laser for perianal and rectal surgery.

The skin of the perianal region is very thin and sensitive. The carbon dioxide laser is a very effective tool for removing tumors and treating conditions of this area. It offers a "no touch" method of treatment for conditions of the perianal region. There is less bleeding, less pain, less swelling with the use of the carbon dioxide laser. The carbon dioxide laser is an effective tool for excising perianal tumors, rectal tumors, performing anal sacculectomies and treating perianal fistulas.     

Evaluation of transdermal fentanyl patches for analgesia in cats undergoing onychectomy

OBJECTIVE: To evaluate efficacy and safety of using transdermal fentanyl patches (TFP) for analgesia in cats undergoing onychectomy. DESIGN: Randomized controlled clinical trial. ANIMALS: 45 client-owned cats weighing > or = 2.7 kg (5.9 lb) undergoing onychectomy, onychectomy and ovariohysterectomy, or onychectomy and castration. PROCEDURE: Cats were randomly assigned to be treated with a TFP (25 micrograms/h) or butorphanol; TFP were applied a minimum of 4 hours before surgery (approx 8 hours prior to extubation). Rectal temperature, heart rate, respiratory rate, force applied by the forelimbs, and serum fentanyl concentration were measured, and temperament, recovery, degree of sedation, severity of pain, severity of lameness, and appetite were scored before and periodically for up to 40 hours after surgery. RESULTS: Cats treated with a TFP had better recovery scores at 2 of 4 evaluation times, lower sedation scores at 2 of 8 evaluation times, and lower pain scores at 6 of 8 evaluation times, compared with cats treated with butorphanol. Use of a pressure-sensitive mat to evaluate force applied by the forelimbs did not reveal any differences between groups but did reveal a significant difference between preoperative and postoperative values. Mean +/- SD serum fentanyl concentrations were 1.56 +/- 1.08, 4.85 +/- 2.38, 4.87 +/- 1.56, and 4.35 +/- 2.97 ng/ml approximately 8, 24, 32, and 48 hours, respectively, after TFP placement. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that use of a TFP (25 micrograms/h) for postoperative analgesia in cats undergoing onychectomy with or without surgical sterilization is safe and effective.     

Attitudes of owners regarding tendonectomy and onychectomy in cats

OBJECTIVE: To compare the incidence of behavior problems following tendonectomy or onychectomy in cats, as well as attitudes of owners following these procedures. DESIGN: Nonrandomized clinical trial. ANIMALS: 18 cats that underwent tendonectomy and 39 cats that underwent onychectomy. PROCEDURE: Owners of cats that underwent tendonectomy or onychectomy between February 1993 and May 1998 were contacted by telephone and asked several questions regarding reasons for surgery as well as complications and behavioral changes in cats following surgery. RESULTS: The most common reason for considering tendonectomy or onychectomy was to avoid damage caused by the cat scratching household materials. Avoidance of injury to humans or animals was chosen more often by owners whose cats underwent onychectomy than those that underwent tendonectomy. Tendonectomy was more likely to have been recommended by veterinarians than onychectomy. Significantly more cats that underwent tendonectomy (67%) than onychectomy (44%) returned to normal activity within 3 days after surgery. Significant differences were not detected regarding behavior problems after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Although tendonectomy and onychectomy involved some medical complications and behavior changes following surgery, owners had positive attitudes regarding both surgeries after the immediate postoperative period. Tendonectomy may be a humane alternative to onychectomy, although owners need to be advised that nail trimming is still necessary in cats after surgery.     

Bilateral flexor tendon contracture following onychectomy in 2 cats

Two cats presented with bilateral flexor tendon contracture following onychectomy. This previously unreported complication proved to be painful and debilitating. Deep digital flexor tenectomy successfully resolved the problem. Twelve months after surgery, the first cat remains free of complications. The second cat recovered full limb function, but died of unrelated causes.     

Cardiopulmonary effects of using carbon dioxide for laparoscopic surgery in cats

The cardiopulmonary effects of capnoperitoneum were investigated in 8 spontaneously breathing, young adult female cats undergoing laparoscopic pancreatic biopsy (intra-abdominal pressure 12 mmHg). Cats were premedicated with acepromazine and hydromorphone, induced with ketamine and diazepam, and maintained using an end-tidal isoflurane concentration of 1.13% in 100% oxygen. Direct systemic arterial blood pressure, heart and respiratory rates, end-tidal carbon dioxide (CO(2)), and isoflurane were recorded every 5 min before insufflation (baseline), during insufflation of the abdomen with CO(2), and following desufflation. Arterial blood samples were drawn at baseline, at 10 and 30 min of insufflation, and 5 min after desufflation for blood gases. The significant findings (P < 0.05) were as follows: insufflation produced an increase in heart rate (5 to 15 min and at 30 min), mean arterial blood pressure (25 to 30 min), and diastolic arterial blood pressure (10 to 30 min). After desufflation, respiratory rate increased for 15 min. The changes were within physiologically acceptable limits in these healthy, anesthetized cats despite no artificial maintenance of minute ventilation.     

Comparison of the effects of buprenorphine,oxymorphone hydrochloride,and ketoprofen for postoperative analgesia after onychectomy or onychectomy and sterilization in cats

In this prospective, randomized, blinded study, 68 clinically healthy cats that had onychectomy (n = 20), onychectomy and castration (n = 20), or onychectomy and ovariohysterectomy (n = 28) were randomly assigned to one of four postoperative analgesic treatment groups: buprenorphine (0.01 mg/kg body weight, intramuscularly [IM]), oxymorphone hydrochloride (0.05 mg/kg body weight, IM), ketoprofen (2 mg/kg body weight, IM), and placebo (physiological saline). Sedation scores, visual analog pain scores, cumulative pain scores, serum cortisol concentration, and appetite were used to assess postoperative analgesic effect. Buprenorphine demonstrated the highest efficacy with the lowest cumulative pain scores and serum cortisol levels.     

Use of a carbon dioxide laser to treat ceruminous gland hyperplasia in a cat

This case report describes the skin condition ceruminous gland hyperplasia of the ears of a cat. The diagnosis was made through histopathology. Treatment consisted of carbon dioxide laser ablation of the cystic structures and postoperative care associated with the surgery, as well as a hydrolyzed protein diet, weekly ear cleaning and intermittent topical corticosteroid drops in the ears to minimize the reoccurrence of the cysts.     

Effect of postoperative analgesic protocol on limb function following onychectomy in cats

OBJECTIVE: To evaluate the analgesic effects of topical administration of bupivacaine, i.m. administration of butorphanol, and transdermal administration of fentanyl in cats undergoing onychectomy. DESIGN: Prospective study. ANIMALS: 27 healthy adult cats. PROCEDURE: Cats were randomly assigned to 1 of 3 treatment groups, and unilateral (left forefoot) onychectomy was performed. Gait analysis was performed before and 1, 2, 3, and 12 days after surgery. All forces were expressed as a percentage of the cat's body weight. RESULTS: On day 2, peak vertical force (PVF) was significantly decreased in cats treated with bupivacaine, compared with cats treated with butorphanol or fentanyl. The ratio of left forelimb PVF to PVF of the other 3 limbs was significantly lower on day 2 in cats treated with bupivacaine than in cats treated with fentanyl. No significant differences in vertical impulse (VI) were found between groups on any day. Values for PVF, VI, and the PVF ratio increased progressively following surgery. However, for all 3 groups, values were still significantly decreased, compared with baseline values, 12 days after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that limb function following onychectomy is significantly better in cats treated with fentanyl transdermally or butorphanol i.m. than in cats treated with bupivacaine topically. Regardless of the analgesic regimen, limb function was still significantly reduced 12 days after surgery, suggesting that long-term analgesic treatment should be considered for cats undergoing onychectomy. Irrigation of the surgical incisions with bupivacaine prior to wound closure cannot be recommended as the sole method for providing postoperative analgesia in cats undergoing onychectomy.     

Comparison of transdermal administration of fentanyl versus intramuscular administration of butorphanol for analgesia after onychectomy in cats

OBJECTIVE: To compare postoperative discomfort assessed by subjective pain score and plasma cortisol concentrations in cats undergoing onychectomy that received analgesia by use of transdermal fentanyl (TDF) patches or an i.m. injection of butorphanol. DESIGN: Randomized prospective clinical trial. ANIMALS: 22 client-owned cats weighing 2.2 to 5 kg (4.84 to 11 lb) undergoing onychectomy. PROCEDURE: Researchers were blinded to which cats received a TDF patch (25 microg/h) 18 to 24 hours prior to surgery or an i.m. injection of butorphanol (0.2 mg/kg (0.09 mg/lb]) at the time of sedation, immediately following extubation, and at 4-hour intervals thereafter for 12 hours. Clinical variables, plasma cortisol concentration, and pain scores were evaluated and recorded 24 hours prior to surgery, at extubation, and 2, 4, 8, 12, 24, 36, and 48 hours after surgery. RESULTS: The TDF group had a lower pain score than the butorphanol group only at 8 hours after surgery. Both groups had significantly lower mean plasma cortisol concentrations 0, 24, 36, and 48 hours after surgery, compared with mean plasma cortisol concentrations prior to surgery. No significant differences in appetite or response to handling the feet were observed between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE: Our data did not reveal a difference in pain relief between administration of TDF and butorphanol. Plasma cortisol concentrations were not different between groups. Fentanyl appeared to provide equivalent analgesia to butorphanol in cats undergoing onychectomy. The primary advantage of using a TDF patch is that repeated injections are not required.     

A prospective comparison of postoperative morbidity associated with the use of scalpel blades and lasers for onychectomy in cats

This study compared patient discomfort for 10 d following feline onychectomies performed using a CO2 surgical laser versus a scalpel blade. Both techniques appeared to result in discomfort of a similar duration, although the laser caused significantly less lameness than blade excision during the first 7 d.