Idea Exchange: Three steps to less painful declaws

For feline onychectomy, we use three levels of preemptive pain management:

1. Admit the patient the night before the surgery and apply a fentanyl patch.

2. Once anesthesia is induced, administer a simple subcutaneous lidocaine-bupivacaine nerve block just distal to the carpus on each paw.

3. Just before starting the surgery, administer meloxicam subcutaneously.

With this protocol, patients have a high comfort level after surgery and rarely need additional pain medication. Bandages can be removed 24 hours after surgery, and the fentanyl patch can be removed 48 hours after surgery, before discharge.

Dr. Curtis Cianci, MS

Tinton Falls, N.J.