Why this vet hates the in-hospital toenail trim
OK so here’s where I confess: I don’t like to trim toenails––nor do I relish delegating claw detail to my staff. And no, it’s not because we’ve got better things to do and can’t be bothered with the lowly pedicure. It’s more that I can’t stand the stress of the event.
The problem: By and large, my canine patients hate having their claws clipped. Though a few of my owners have trained their dogs to accept the manipulation of their paws and have mastered the art of proper toenail submission, many still rely on the vet for the dubiously-helpful, once-a-year trim.
So you know, shots, blood draws and even the fecal rod are far more readily accepted by the average dog than a nail trim. The majority of these patients shake and cower as we trim their nails. A sizable percentage must be forcefully restrained. And for what?
Let’s be honest: a dog that gets a nail trim once a year is receiving an all-but-useless service that only serves to make him more afraid of the veterinarian’s office. After all, they’ll have grown out within a month or two––or less in some cases. And some dogs really don’t need trimming at all as long as they walk on surfaces that sufficiently file their toenails.
That’s why I’ve begun a campaign to reduce nail trims at my workplace. Unless the animal is easily amenable or under anesthesia, annual or semi-annual nail trims are counterproductive when conducted by a veterinarian or her staff. You want his nails trimmed? Go to the groomer. Go to PetSmart. Go anywhere else but the place where stress should be minimized for medical reasons.
Here's a happy toenail trim at a groomer's:
But you may ask: Isn’t nail trimming medically indicated? Isn’t it an integral part of my pet’s health? In that case, nail trimming is well within the veterinarian’s purview.
My rejoinder: I don’t bathe, brush or walk your dog, right? And they’re all necessary for optimal health. Why single out the nail trim when that’s every bit as basic as these home care fundamentals?
The exception: There are always exceptions. As when pets require sedation or anesthesia for a trim. But even this is questionable if you consider the risks of anesthesia vs. the health rewards of nail trimming.
Which brings me to the more obvious exception: Puppies!
IMO a veterinarian should go out of his way to explain the importance of nail trimming to pet health. Primarily, nail trimming reduces injuries such as claw and toe fractures, prevents ingrown curved nails, and minimizes orthopedic problems that can result from poor claw positioning.
Puppy nail trim training is easily undertaken by providing positive stimulus while manipulating feet and clipping the claws. Because puppy claws are especially easy to trim, an owner who complies with directions and clips claws weekly can adapt easily to the procedure and fall into the habit with a minimum of human stress.
Clients who neglect to trim their puppy’s toenails and expect the veterinarian to do it on a subsequent well-puppy visit should be gently informed of their responsibility. After all, the puppy visits will end and they’ll soon be on their own. Clients who fear clipping claws too short should be instructed in the use of a Dremel-like drill or PediPaws-style product as an alternative approach.
So you know, I’m not the only veterinarian who hates the forced nail trim at the hospital. Here’s applied animal behaviorist and veterinarian Dr. Sophia Yin on the nail trim in her excellent book, “Low Stress Handling, Restraint and Behavior modification of Dogs and Cats: Techniques for Developing Patients Who Love Their Visits”:
“A toenail trim is not an emergency procedure. Do not perform one forcibly if the patient is unwilling to hold still. Doing so can train the dog to be more fearful of people, hate the veterinary hospital, and can even escalate to aggression immediately or in the future. Consequently, forced restraint is likely to cause the dogs to become behaviorally worse than when they entered. Instead, if the dog will not hold still, inform the owner that you are concerned about the dog’s behavioral health and ability to be treated in the future.”
Dr. Yin then offers a host of counterconditioning techniques that veterinarians and technicians can teach their clients to perform at home. Treats and petting and gradual approach to feet (and later, claws)––all through positive, gentle interactions. Here's a video to illustrate (though I would likely have used a muzzle, initially, for this pet, the techniques work).
Sure, it’s our job to make sure your pet gets that nail trim. But that doesn’t mean it should be happening at the hospital––especially if it trebles the stress of an already stressful visit. After all, if your dog hates the toenail trim so much, you really should be looking at yourself and wondering what it is YOU can do to help your pet.