Ron Hines DVM PhD
I have nothing to sell you. I see my job as providing you with unbiased information regarding your cat’s health. Take that for what it’s worth. Let me start by telling you that I am not suggesting that you declaw your cat. What I am suggesting is that you not be bullied, too judgmental, or too quick to castigate cat owners who decide to do so. Sometimes, it is the elderly, the frail, the disabled, and the lonely who need a feline companion the most. Sometimes its a maladjusted quirky cat that needs a human companion and protector the most.
I spent much of my career at the NIH working for the Surgeon General. Like the CDC, our mission is to protect your health. That imbued in me a mindset that I needed to look out for your health interests as well as those of your cat. You probably arrived here through my article on declawing of cats. If not, you can get there here.
There I told you in that I estimated that problems associated with a cat’s clawing could be solved without surgery in perhaps 85% of cat households. I told you that my cat, Oreo, was not declawed because I did not find it necessary. I just clipped and filed his front claws from time to time.
This article is about the other – perhaps 15%, the cats for whom that surgery might still be the most humane solution. I get punished now and then for the things I write. Generally it is led by the AVMA for answering your questions online; or by militant groups who do not agree with me. ( read here ) I catch the same flack from all of them for suggesting that it is not in your cat’s best interest for you to have it spayed or neutered too young. ( read here )
By virtue of their large war chests and confrontational techniques, militant cat interest groups have a disproportionate influence over American society. They disseminate and lobby for simplistic, eye-catching solutions to complex, difficult-to-solve problems. I will always tell you what I believe to be true – but it won’t always be what you or they want to hear. Here are some things about a cat’s claws that those folks are not going to tell you about:
Cat-scratch Disease / Bartonella henselae
Cat-scratch disease (CSD) is caused by a little bacteria (a coccobacillus) named Bartonella henselae. This bacteria generally makes its home in the cells that line the blood vessels (the endothelium) of your cat’s body; but they appear free in the cat’s blood from time to time as well. Veterinarians a physicians used to believe that when a cat or a human was infected with Bartonella, it caused a disease that was quite mild and only lasted a short time (benign). That opinion is changing. The most common way one becomes infected with Bartonella henselae is through the scratch of a cat.
In many ways, cat scratch disease is similar to Lyme disease. They both have the ability to produce a tremendous variety of symptoms or no symptoms at all. They both involve the complex interplay between animals, parasites and humans. They are both quite difficult to diagnose because they produce signs that mimic so many other diseases. Both can produce lingering illnesses that are very hard to treat. In both diseases, the upswing in cases are due to changing human lifestyles, changing demographics and better tests to identify those that are infected. (read here) Neither organism is easily eliminated with antibiotics. Neither have effective vaccines.
When a cat harbors Bartonella anywhere in its body; you can assume that at points in its life it will harbor the organism on its claws as well. ( read here ) It is estimated that more than half of cats residing in areas where fleas are common harbor Bartonella at some point in their lives. (read here)
You can also assume that at some point the owner of a cat will get scratched. Most often but not always, that scratch was inadvertent. Perhaps the cat was held or petted longer than it wanted to be or held incorrectly. Perhaps the cat was startled. Perhaps you stepped on its tail. Perhaps a young child pursued it. Perhaps it was play pouncing or kneading. (read here & here )
Physicians still believe that most people who contract cat scratch fever recover with no lasting damage. But they are also realizing that a host of health problems that were not previously recognized as being related to bartonellosis, the cat scratch organism was the underlying cause. Those situations occur most commonly in the elderly, the very young and folks whose health is tenuous for a variety of reasons. However it can occur in anyone and from year to year it is being diagnosed more frequently in people. ( read here , here , here , here & here )
What People Need To Be Particularly Cautious About This Disease?
People With Heart Issues:
Heart valve problems and heart murmurs are quite common in us humans as we age. ( read here ) Some cases need no treatment, some can be treated conservatively with medication, and in some, heart valves needs to be replaced. In other cases, the thin lining layers of the heart become inflamed (endocarditis). Cat owners in all those situations are more susceptible to severe complications of cat scratch fever should they be exposed to it. ( read here ,here ,here , here & here) Sometimes blood tests for bartonella remain negative and the diagnosis can only be made by removing a small biopsy specimen (snippet of tissue) from the patient’s heart valve itself. ( read here )
Weakened Immune Systems Of The Elderly
When a human is inadvertently scratched and develops cat scratch fever, it is their immune system that must battle and defeat it. During our middle adult lives, most of us have a robust combative immune system. But as we age, our ability to fight infections decreases. There are other people who are born with defects in their immune systems that make them less able to combat infections. Still others loose their ability to fight infections like Bartonella because of conditions such as AIDS (read here ) or cancer treatment medications. Still others become more susceptible to Bartonella due to a joint replacement or various forms of Lupus. ( read here & here ) Anything that lowers a cat-owner’s CD4+ T cell count is likely to make that person more susceptible to bartonella infections. (read here) That can be no more than a person having to battling two infections at the same time. (read here)
Not only are people with weakened immune systems more susceptible to bartonellosis, it appears that cats with immune systems weakened by feline leukemia virus might be more susceptible to bartonellosis as well. ( read here )
Less Documented But Claimed By Some Physicians
Bartonella has the ability to cause chronic inflammation in just about any part of the body. Generally, it is persistent fever and enlarged lymph nodes that lead physicians to test for bartonella involvement. ( read here ) Just because a person tests positive for bartonella or improves when given an antibiotic known to cure bartonellosis is not proof that whatever symptoms that person experienced were caused by bartonella. Read some articles that suggest as link between the presence of bartonella and psychiatric issues, the worsening of those issues and other bizarre syndromes (read here, here ,here & here )
Bartonella As A Threat To Your Veterinarian
Who is most likely to be scratched by a cat? Of course, it is your veterinarian and his or her employees. So it should come as no surprise that veterinarians and folks that work with lots of cats lead the list when it comes to Bartonella henselae exposure. ( read here , here & here ) Veterinary medicine is one of the high stress professions; so a lot of the symptoms seen in these studies could have had causes unrelated to or only partially related to their exposure to cat scratch fever. Another of the failings of our professional associations, the AVMA and the BVA , is that this has never been adequately explored.
What Are Some Of The Possible Symptoms If I Were To Catch Cat Scratch Fever?
A few days to about two weeks after the scratch or bite of an infected cat, the wound area often appears reddened – perhaps something like this. Its not unusual for a cat scratch to look like that for a day or two after the incident – but not for it to persist or for warmth or pain to persist at the spot. It is common for people who have contracted Bartonella to then experience headache, chills and fever. A tell tale sign that sometimes occurs soon after is tenderness and, perhaps, swelling of the lymph node closest to the scratch or bite. It it was on the arm, then the axillary lymph nodes . Perhaps similar to a stylized diagram you can see here. If the scratch or bite was on the leg, it would probably be the lymph nodes of the groin. However, some people experience none of those symptoms when infected with Bartonella. One frustrating characteristic of Bartonella is that its initial symptoms, if any, are so unpredictable. The majority of people – those with a robust immune system and no compounding health problems – recover without treatment. However, some will go on to have more serious, long lasting side effects. Many cases are initially misdiagnosed and current tests to confirm Bartonella infection are not particularly sensitive. (read here)
I mentions heart complications earlier. Here are some others that have been reported:
Scratches To The Eye
It is not uncommon for an annoyed or playful cat to take a swat at a cat owner, a family member or household guest. Some folks can read a cat’s mood accurately. But others are oblivious to the warning signals cats gives when they are disturbed or frightened. When the Bartonella organism enters by that rout, the results can be extremely serious. ( read here ,here & here )
Occasional serious complications of cat scratch fever involve the nervous system. How they progress is highly dependent on the vigor of a person’s immune system. Most recover or get better with time. ( read here , here , here & here )
Are There Other Diseases That Cats Can Transmit Through Their Claws?
Yes. There are many
Rickettsia felis is the latest candidate. But as to proven transmission through a scratch, we really do not know one way or the other yet. ( read here ) Like Bartonella, R. felis can also catch a ride to humans and other cats on cat fleas. When Rickettsia felis infects people, the fever, rash and headache it produces are indistinguishable from cat scratch fever. Occasion it affects on people are considerably more severe. In some areas of the world, this organism has become even more common than Bartonella. R. felis wasn’t recognized as a threat to humans until 1991. Again, it is your veterinarian who is at the front of the line for exposure risk. (read here) In my experience, veterinarians are considerably more likely to be scratched by a cat than bitten by a cat flea. Diagnostic tests (including PCR) for exposure to this organism are not particularly sensitive. ( read here ) Although there is more awareness among the medical community than there once was, we still know quite little about the many ways Rickettsia felis it is transmitted.
Antibiotic Resistant Bacteria
When your cat must receive antibiotics frequently or for extended periods time, strains of antibiotic-resistant bacteria are always a danger. ( read here ). Should those resistant bacteria gain entrance to you, such as through a scratch or bite, there can be very few treatment options left for your physician. (read here) That occurred to one of my clients subsequent to a stubborn ear infection in her cat. Since then, I am less reluctant to recommend otoplasty. Certain cat breeds, such as sphinx and devon rex , are more prone to skin infections that other cat breeds. That sometimes requires repeated antibiotic treatments. Among the ominous antibiotic-resistant bacteria such treatments generate, dwell the MRSA staph. ( read here & here)
All can be passed to humans through the claw of a cat. When they do, it is the elderly or those with imperfect immune systems who suffer the most fatalities. ( read here ) Lets say, just for example, that you are a member of a group that takes your house cats to nursing homes and long-term care facilities to keep the resident’s spirits up. People confined to those facilities long for interaction with pets and people. Volunteering to visit with your pet is a very compassionate thing for you to do. Or what if it were your mother, your father or your dearest friend who was scratched when they came to visit your home? ( read here & here)
Enough About People! – Are There Cats Whose Health Might Improve If They Were Declawed?
A few of those cats exit too:
It is a more common problem in dogs, but some cats have very itchy allergies. ( read here , here, & here )Those cat can literally tear their skin to pieces scratching. If its just a flea allergy that can be corrected. Others might be controlled with special diets. Desensitization is rarely successful. ( read here ) Antihistamines do not provide much help for these cats. What does bring them relief are corticosteroids and powerful medications such as cyclosporin that produce severe life-shortening side effects themselves. ( read here ) Are long term corticosteroids ( read here ), tranquilizers, cytotoxic drug and Elizabethan collars more humane than declawing some of these cats? Are this cats just out of luck?
Eosinophilic Granulomas Complex
You can read about this baffling disease here. Veterinarians are still unsure why some cats develop it or what triggers the intense scratching and self-trauma that some forms of this disease produce. ( read here ) Flea control must be scrupulous. Claws can be blunted and smoothed weekly; claws can be capped. But unattended to, one way or the other, claws will do damage. Is declawing some of these cats off the table because of rigid philosophies?
Cats With Unusually Fragile Skin
Some cats have genetically fragile skin – skin that is easily torn by claws. Cat breeders are to blamed for the suffering of these unfortunate designer cats. If you go to the ncbi index in 2021 and search for Devon Rex & Spinx cat, you will find over 30 articles regarding the rare diseases these unfortunate creatures suffer from. Animal cruelty is one of the prices of human vanity. Both breeds are highly susceptible to skin disease. Animal militants the AVMA and the CFA remain hush hush about that. Get your cat at your local shelter and, as H.E. Peterson once remarked, follow the money.
In other cats, fragile skin is due to adrenal gland over-activity – something similar to the Cushing’s disease that occurs in dogs. ( read here ) In some of these cats, their skin fragility was due to high doses of corticosteroids given to address their other health issues. In other instances, fragile skin appears to be the result of disease processes elsewhere in their body. (read here, here , here & here ) In still others, inborn genetic defects are thought to be the problem. (read here) Dealing with secondary bacterial infections in all of these pets can require periodic antibiotics. With time, those bacteria will become antibiotic-resistant – a threat to the cat and to you. Cats with autoimmune skin disease ( pemphigus ) also develop unhealthy skin – just as humans sometimes do. (read here ) They too might require periodic antibiotic and other immunosupressive treatment. Tissue surrounding the claws (the nail beds) often harbors those infections as well. ( read here and ask me for Manning1982)
I do not believe that people in imperfect health should be denied the companionship of a cat. Loneliness is epidemic in America today. I do not believe that a cat should be denied the companionship of a loving and willing cat owner. Wretched cat colonies are no substitute for loving owners. I do not believe that a cat should be denied any procedure that is to its benefit. I have no ethical problem recommending that cats belonging to a client of mine with any of these health concerns be front declawed the way I performed the surgery. The procedure got its bad reputation from ham-handed veterinarians who removed far too much. I would also inform the cat owner that a cat bite or perhaps even a flea bite could poses a similar danger.
Perhaps you will be successful in solving your cat-claw-related issues in less drastic ways. I hope so. Perhaps you feel that declaw surgery is not appropriate for your cat facing any of these issues. Perhaps you are by nature or inclination dead set against it. That is fine. But family decision like these should be yours to make without duress and bullying. I think your cat would agree.