Tag Archives: stress reduction

Has your cat or dog ever had to wear a “cone of shame”? Also known as an Elizabethan collar (or an E-collar), and resembling more of a lampshade, these devices are routinely prescribed by veterinarians to prevent our pets from scratching themselves, biting at sutures, or otherwise harming themselves.

Apparently the term “cone of shame” was popularized by the movie “Up” – perhaps referring to the fact that it likely feels like a punishment to the wearer. It’s no walk in the park for the pet owner either – turns out that owners are reluctant to use them on their pets, and do not use them for the full length of time recommended by their vet. Cones may even be dangerous, with at least two dogs dying due to getting tangled in plastic bags while wearing the collar.

A recent open-access study out of Australia (“The Cone of Shame”: Welfare Implications of Elizabethan Collar Use on Dogs and Cats as Reported by their Owners) surveyed pet owners with cats or dogs who had needed an E-collar in the last year, asking several questions about why the collar had been recommended, how long the pet had to wear the collar, and whether the owner had observed problems or signs of stress in their pet. There were 434 participants, primarily from Australia. They reported that their pet had a wear the collar for anywhere from 3-7 days.

More than half of owners reported welfare concerns related to the use of the collar: 60.2% said the collar interfered with drinking, and 67.5% reported that their pet was unable to play while wearing the collar. A quarter of pets experienced (mostly minor) injuries from wearing the collar such as itching, trauma, or bumping into walls or objects. Almost of quarter of animals were able to remove the collar on their own, but their owners were helping them out too: over half of owners just took the collar off their pet when they were supervising them.

My cat, "depressed" and coned.

The majority of owners reported that their pet had a worse quality of life while wearing the cone, and reported that their pet was “depressed”, had difficulties eating, and that the distress was worse than the behavior it was supposed to prevent. In some cases, the cone didn’t fit well, and some animals could not jump or walk normally when wearing them.

On the plus side, owners did feel that the cone of shame was effective at preventing the behavioral responses such as licking or biting. It is possible that some cats and dogs could be trained to habituate to and accept wearing a collar, but that is not the approach that most owners can take – the collar needs to go on NOW, not after the pet has been sensitized to it.

I had my own experience a few years ago with the cone and my cat. She was limping, so we took her to the emergency vet. She was diagnosed with “lameness” (okay, it still makes me chuckle) – just a soft tissue injury -- and sent home with pain killers and a cone. Why the cone? I still don’t know. She hated it, and like many pet owners, we did not comply, and we took it off her after just a few hours of her misery. She recovered just fine.

So is the cone of shame a necessary evil? Is it necessary at all? Are there other options? I decided to throw some questions at one of my favorite experts when it comes to medical care for cats, Ellen Carozza, LVT, who works at the Nova Cat Clinic in the DC area. She has specialized in feline medicine for almost two decades, and trust me, this woman knows her sh*t. But I also knew from previous conversations with her that she shared some of my concerns about the routine use of the cone of shame.

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Why did your clinic stop the routine use of e-collars?

EC: We noticed it caused more stress to the patient when they wear them.  When a patient is properly pain managed using a multimodal method, we have found they will not pick or groom the suture area. We barely have external sutures – we do internal and subcutaneous or subcuticular to minimize the picking as well.

 The main complaints we get from clients on e-collars is that the cats won’t eat, they bonk into the walls, become depressed and overly groom the e-collar (that is a indication of pain…they just can’t get to the spot but trying to groom it sure does help!). These cats may also not rest well due to the collar propping their head and face up, so that adds to the discomfort and now the animal can’t get comfortable and sleep. And sleep and rest is very important with the healing process. 

Using a local block, opiates, Gabapentin and NSAIDS (if the kidneys will allow it) along with complimentary therapies such as laser and the Assisi Loop aid in healing because the pet is kept comfortable and the acute and chronic pain is diminished and kept to a minimum. 

Why do most veterinary clinics continue to rely on the “cone of shame”? 

EC: They believe they really do help. What we should be focusing on is pain management to prevent them from wanting to pick at the first place. It is also taught that this is the standard of medicine: just stop the behavior. You also have the " We've always done it *insert excuse of the day here.* 

You can't always trust the owners to keep the area clean and dry.  Most clients don't even check incision sites daily.  So putting a collar on the animal prevents the client from having to do an extra job as a pet parent and pay attention. 

What are the alternatives? Is it time to end this "shameful" practice?

EC: There are lots of alternatives. Some of the newer "cloud or balloon collars" allow the animal to eat more freely, but don't allow the head to rest properly either as it’s an inflatable ring. The "No Bite" collars are neck braces that prevent the neck from bending back to function normally. Some companies go as far as making ridiculous, yet cute e-collars that resemble flowers or lion manes so something so "shameful" isn't (clever marketing). OR the best thing ever is to PROPERLY PAIN MANAGE!!! and address any underlying obsessive behaviors with mood modifying drugs and environmental changes (especially the cats who just clean obsessively and you can't find the reason why medically).

Do I think it's time to end the "shameful" practice? I think it's time for better pain management, behavior and environmental modifications to be done to limit the routine use of them in practice. Understanding the feline pain body scoring allows you to stay ahead of the issue at hand and not have to rely on a cone to suddenly halt a behavior. 

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Hopefully this research will help increase awareness that e-collars are not necessarily necessary or helpful to maintaining companion animal welfare while helping them heal. People hate ‘em, our pets hate ‘em, it’s time to start taking the alternatives seriously!

References

Shenoda, Y., Ward, M. P., McKeegan, D., & Fawcett, A. (2020). “The Cone of Shame”: Welfare Implications of Elizabethan Collar Use on Dogs and Cats as Reported by their Owners. Animals, 10(2), 333.

Shumaker, A. K. (2019). Diagnosis and treatment of canine acral lick dermatitis. Veterinary Clinics: Small Animal Practice, 49(1), 105-123.

Wilson, S. (1993). Elizabethan collars and plastic bags. The Veterinary record, 132(26), 664-664.

Did you know that cats should see their veterinarian at least once a year? That’s right, even if they are indoors only and seem healthy, it’s good to have a check-up. A big reason that people do not take their cat in for regular care (aside from money) is the stress they perceive that their cat experiences. A survey found that 38% of cat owners reported that they get stressed out just thinking about taking their cat to the vet, and 58% say their cat hates going to the vet. I’ve previously written about how training your cat to love a carrier can make this whole process a LOT easier. But what about what happens AT the vet?

Passive versus full-body restraint. Image from Moody et al., 2019

Researchers at the Ontario Veterinary College have published two studies exploring how the way cats are handled at the vet might effect their behavior.  The premise of both studies was comparing responses to what the authors call “passive restraint” (defined as handling the cat lightly in a position of the cat’s choosing) and “full-body restraint” (holding the cat on their side, while grabbing the cat’s legs, preventing movement of the head, body and limbs).

 

 

Both studies included (I think the same) 51 healthy adult shelter cats. All cats were first categorized as either friendly or unfriendly according to an “Unfamiliar Person” test. Each cat was individually placed in a room in a carrier. The carrier door was opened and the cat was given two minutes to choose to exit the carrier, explore the room, and approach the experimenter (an unfamiliar person). If at the end of two minutes, the cat was still in the carrier, the experimenter removed the top of the carrier and left the room, and the cat was given another minute to explore. At that point, the experimenter approached and attempted to pet the cat. Friendly cats had to leave the carrier, approach the experimenter within about a foot and a half, and allow petting. Twenty-four cats were categorized as friendly, and 23 as unfriendly.

Next, all cats were given a two-minute “mock” physical exam using either passive or full-body restraint. The experimenters measured how long it took to restrain the cat, as well as the presence of ear movements, tail lashing, lip licking, respiratory rate, and amount of pupil dilation to assess stress responses to both types of handling. Two cats in each condition were not able to be examined due to aggressive behavior.

Lip licking can be a sign of stress. Photo via Public Domain Pictures.

Now for the results of the first study “Can you handle it? Validating negative responses to restraint in cats”: it took longer to get cats into full-body restraint than passive restraint. Full-body restraint also resulted in a higher respiratory rate and more lip licking. Cats who had been subjected to full-body restraint were quicker to jump off the examination table. The authors concluded that the full-body restraint increases the activation of a cat’s stress system, and the attempts to escape the exam table suggest that those cats found the experience more aversive than the cats in the passive restraint condition.

Image from Moody et al., 2019

Fast-forward to 2019. The second study that was just published earlier this year in Applied Animal Behaviour Science, titled “Testing two behavioural paradigms for measuring post-handling cat aversion behavior,” looked at whether cats found the handler threatening AFTER being placed in either full-body or passive restraint. After the two-minute exam, cats were given two tests to assess how they felt about the person who did the exam. For the first, cats had previously been trained to walk down a runway for treats. Only 38 of the shelter cats were able to be trained to complete this task. The cat was placed on the runway, with the handler at the other end, and the experimenters recorded whether the cat approached or moved away from the handler.

There were no differences in the time it took cats to approach the handler, regardless of whether they had been subjected to passive or full-body restraint. Because no differences were found, and because a sizeable number of cats could not be trained to use the walkway, it appears that this is not a good measure of aversion responses in cats.

The apparatus used to test location preference. From Moody et al., 2019.

But wait, there’s more! The researchers next tested whether cats would form negative associations with a LOCATION after full-body restraint compared to passive. This study included 45 shelter cats and 10 adult laboratory cats who were group housed. All cats were subjected to BOTH restraint methods for one full minute, but in two different, visually distinct compartments of an enclosure. After the cat had been restrained, they were allowed to choose which side of the compartment they wanted to stay in – the one they had been passively restrained in, or the one in which they received full-body restraint. All laboratory cats, and the “friendly” shelter cats spent more time in the passive compartment; the “unfriendly” shelter cats were equally torn between compartments, perhaps finding both types of handling aversive.

From these studies, we can conclude that overall, cats have fewer stress-responses to passive restraint. For some cats, particularly the friendly ones, those stress-responses carried over to preferring the location that they had received passive restraint in compared to full-body restraint. However, the cats subjected to full-body restraint were no more or less likely to approach the person who had restrained her compared to the passively restrained cats, so to answer my original question, it doesn’t appear that cats hold much of a grudge if any.

Cat handling is a hot topic for a lot of reasons, and the trend of “less is more” can be found in several movements to help make the veterinary experience better for cats (e.g., Cat Friendly Practice, Fear Free and Low-Stress Handling programs). I feel like I should mention that “scruffing” or the restraint of cats by holding the skin of their neck is NOT what was tested in this study. I bring this up because scruffing is a commonly used method of restraint that is considered outdated and a bit  controversial, and unfortunately I know of no research to condemn or condone its use. Two studies (here and here) did not find strong evidence for aversive responses to a handling technique called “clipnosis” or pinch-induced behavioral inhibition in cats, which is sort of similar to scruffing. Regardless, the consensus is that cats should never be LIFTED by their scruff.

And, when we teach cat handling at the veterinary school, the messages that we try to leave in the student’s minds are, “do you automatically default to heavy handed techniques, and if so – why?"  and “EBYs (Even Better Yets)” – what can we do better next time?

References

Moody, C. M., Picketts, V. A., Mason, G. J., Dewey, C. E., & Niel, L. (2018). Can you handle it? Validating negative responses to restraint in cats. Applied Animal Behaviour Science204, 94-100.

Moody, C. M., Mason, G. J., Dewey, C. E., Landsberg, G. M., & Niel, L. (2019). Testing two behavioural paradigms for measuring post-handling cat aversion behaviour. Applied Animal Behaviour Science210, 73-80.

Nuti, V., Cantile, C., Gazzano, A., Sighieri, C., & Mariti, C. (2016). Pinch-induced behavioural inhibition (clipthesia) as a restraint method for cats during veterinary examinations: preliminary results on cat susceptibility and welfare. Animal Welfare25(1), 115-123.

Pozza, M. E., Stella, J. L., Chappuis-Gagnon, A. C., Wagner, S. O., & Buffington, C. T. (2008). Pinch-induced behavioral inhibition (‘clipnosis’) in domestic cats. Journal of Feline Medicine and Surgery10(1), 82-87.

Dogs + Humping: Match made in heaven

Leave it to two of my science-blogging faves, DogSpies and BuzzHootRoar to bring us the top reasons that dogs hump, complete with animated GIFs. We can all just go home now, science journalism is done.

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