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Elizabethan collars for cats
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An Elizabethan collar is often used when a cat is itchy, but they can also be detrimental to an animal’s wellbeing; this short paper considers the pros and cons of the “plastic cone”.
Anne Quain
BA, BScVet, BVSc, MVetStud, GradCertEdStud (HigherEd), Dip. ECAWBM (AWSEL)
Dr. Quain graduated from the University of Sydney in 2005 and currently splits her time between working in private companion animal practice and teaching at the Sydney School of Veterinary Science. She is a member of the Australian and New Zealand College of Veterinary Scientists Animal Welfare Chapter and is a Diplomate of the European College of Animal Welfare and Behaviour Medicine in Animal Welfare Science, Ethics and Law. She recently co-authored the textbook Veterinary Ethics: Navigating Tough Cases.
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Key points
- Elizabethan collars are an important non-pharmacological means of preventing self-trauma in feline patients, but they may negatively impact a cat’s behavior and welfare.
- Suitable alternative or adjunctive interventions may be an option for some cats, but comprehensive communication with the owners can help mitigate a collar’s negative effects.
Introduction
Elizabethan collars are a commonly used, non-pharmacological intervention employed to prevent self-trauma and overgrooming in feline patients. However, they may also cause distress to both cats and their owners (1); understanding the potential negative impacts of such collars may help veterinarians minimize this distress while maximizing the benefits of the collars when they are used.
What are the benefits?
Because cats are fastidious groomers, they are prone to removing sutures and traumatizing surgical sites, particularly on the body, limbs and tail. Moreover, the presence of pruritus because of a dermatological problem can lead to self-trauma and exacerbation of the condition (Figure 1). A well-fitted Elizabethan collar can often help, by allowing skin lesions to heal, wounds to repair and preventing the need for additional surgery; Box 1 offers a detailed list of indications for their use. In addition, the collars are inexpensive and may be applied by owners at home as well as members of the veterinary team at the clinic.
Indications for Elizabethan collars in cats.
- Prevention of removal of topical medication or patches
- Prevention of over-grooming or self-trauma due to pruritis or anxiety
- Prevention of suture removal following surgery
- Protection of wounds to facilitate healing
- Protection of catheters, dressings or bandages
What are the downsides?
Many owners, and cat owners in particular, report that their pet dislikes wearing an Elizabethan collar. This was confirmed in a recent global survey involving the owners of dogs and cats that had worn an Elizabethan collar during the previous 12 months (n=434), with 77% of owners reporting that their companion animal had a worse quality of life when wearing the collar (2). To compound the problem, some pets may be required to wear a collar for extended periods of time. In a case series of 13 cats medically managed for deep ulcerative keratitis, the mean duration of Elizabethan collar use was 28 days, with a range of 13 to 73 days (3). Owners reported that some animals seemed to acclimatize to the collar over time, while others apparently did not.
It can be challenging to determine whether the behavioral changes seen in cats wearing Elizabethan collars are due to the collars themselves, or the underlying reasons for cats being required to wear them. For example, in one study looking at behavioral changes and severity of pain in cats recovering from elective neutering, wearing an Elizabethan collar significantly affected the overall extent of behavior changes in female cats (4). The most commonly reported alterations in this study included overall activity level, amount of time sleeping, playfulness and movement, but it can be argued that major surgery such as neutering could directly lead to these changes in behavior anyway.
Although many cats will wear Elizabethan collars without any apparent adverse effects, the welfare of some individuals can be negatively impacted by the collars. Another study noted that owners reported Elizabethan collars interfered with various daily feline activities including drinking (60.2%), playing (67.5%), and other actions such as toileting, grooming and being fitted for a harness or lead (2). Some owners also noted dramatic changes in their cat’s behavior, including agitation, altered posture or gait, or “freezing”. Other problems have also been reported; in some cases, the Elizabethan collar increased antagonism between cats in multi-cat households, and a collar may prohibit a cat from entering or leaving their house via the cat flap, interfering with their normal routine. Indeed, collars can interfere with an animal’s mobility in general, which may increase the risks to cats that have outdoor access while wearing one.
Elizabethan collars should therefore be the smallest size needed to shield the site requiring protection in order to minimize the impact on movement and daily activities.
Importantly, if the underlying cause of self-trauma is not addressed (for example, if a dermatological problem is not resolved) the cat may continue to suffer from the negative feelings of pruritus or pain, with self-trauma recurring once the collar is removed (5). [...]
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