The declaw, a surgical procedure where the first bones in a cat’s front toes are amputated, is perhaps the most controversial routine procedure in veterinary medicine. Sure, most cosmetic procedures have their foes, but nothing seems to scream "cruelty!" like multiple toe amputations.

I embark upon a treatment of my approach to the declaw only by special request and not without significant trepidation. Like many in my profession, especially within my generation and younger, I have struggled with the morality of the procedure. In my case, it has taken many years to feel comfortable performing them—not only as a result of their deceptive difficulty but because it seemed hard to justify.

If we have a moral responsibility to preserve the well-being of an animal, is it not anathema to this belief that we inflict pain for our own selfish comfort—and that of our furniture (!). I still struggle, but at this stage of my career I now feel I have achieved something of a personal, moral balance on the issue.

To be sure, the procedure is painful. Though there’s a lot more done out there that also falls under "cruel and unusual" in the pet world. For example, I’d argue against ear crops, tail dockings, and some dewclaw removals before declawing—so long as the rationale behind the need for the procedure is sound and so long as the procedure is performed humanely.

These conditions, however, are not so easily achieved. These are my personal standards for how declaws should be dealt with (every vet is different) and see where you find fault with my approach. If so, I warmly welcome your comments.

• Fluffy’s owners are told that I do not recommend the procedure. Her owners must then explain why they’d like the procedure. "Because my cats have always been declawed" is not an acceptable answer. The only acceptable answer is that they would otherwise be unable to keep Fluffy, as she is destructive, or because she hurts the children or their elderly grandmother, or because they’d rather prevent destruction and injury knowing they’d have to find her another home if this occurred.

• I strongly urge clients to reconsider the procedure if Fluffy is over a year old. The older (and heavier) the cat the higher the possibility of serious complications like phantom pain and painful infections. Owners should be told these complications exist and that their rate increases exponentially with age and weight.

• The owners must truly understand the nature of the procedure: Mr. X, when we remove Fluffy’s claws, we amputate her toes at the first knuckle. This will be painful for Fluffy.

• The owners must be advised of alternatives: Have you considered finding her another home, claw coverings such as Soft Paws, or trying a variety of scratching posts?

• The owners must be given no alternatives when it comes to adequate pain relief and follow-up care: If Fluffy is over a year old or overweight she will have to stay in hospital for several days to insure adequate pain relief in a controlled environment. I use nerve blocks, opiate patches, opiate injections, and anti-inflammatory drugs routinely. No declaw procedure escapes a pain protocol (which can add up to $250 to a bill). For this reason an older kitty declaw procedure can cost as much as $600.

• The owners must be committed to adequate follow-up care, including strict cage rest for adults or complete restriction of jumping and climbing for kittens.

• The surgical procedure must be carefully undertaken: I don’t use a laser, as had been recommended in years past (the laser declaw has been largely discarded by the profession). Ultimately, this approach was considered more traumatic than initially billed (especially in the hands of practitioners still learning to use the device). Consistent with leading veterinary surgeon’s recommendations, I use a very sharp scalpel and high-quality, flexible surgical glue on the outside of the incision.

• And finally: Fluffy must remain an indoor cat—no exceptions!

I do indeed understand when people tell me they believe declaws are barbaric. But if declawing Fluffy will allow her to keep her home and give her fifteen years in a loving environment, I’ll do it—as long as I’m convinced I can do it with minimal pain and only if I believe her parent is a responsible, well-informed, and thoroughly compliant client. For the record, the second condition is one far more rarely met.