27. Miscellaneous procedures: legal and ethical considerations

Introduction

27.1  From time to time, veterinary surgeons and veterinary nurses may be asked to carry out procedures on animals which may not have a legal basis in the UK (e.g. purely cosmetic procedures or procedures sought for the sole convenience of the owner). Veterinary surgeons and veterinary nurses should be aware that UK animal welfare legislation legally restricts mutilations to animals (i.e. procedures which interfere with sensitive tissue or bone structure) unless they are carried out for the purposes of medical treatment:  

1. In England and Wales, the Animal Welfare Act 2006 prohibits mutilations “otherwise than for the purpose of its medical treatment” or permitted by specific regulations (Section 5). 
2. In Scotland, the Animal Health and Welfare (Scotland) Act 2006 prohibits mutilations except “where they are carried out for the purpose of the medical treatment of an animal” or permitted by specific regulations (Section 20).
3. The Welfare of Animals (Northern Ireland) Act 2011 provides that a prohibited procedure is one which involves interference with the sensitive tissues or bone structure of the animal, except in relation to  (i) any procedure carried out by a veterinary surgeon;  (ii) any procedure carried out for the diagnosis of disease;  (iii) any procedure carried out for the purposes of medical treatment of an animal;  (iv) any other procedure which is specified in regulations made by the Department (Section 5).

27.2  There are some procedures which are technically mutilations, but these are exempt from the ban due to reasons such as long-term welfare or animal management benefits, control of reproduction or identification purposes. These procedures are listed in the regulations for the relevant UK jurisdiction:

1. the Mutilations (Permitted Procedures) (England) Regulations 2007
2. the Mutilations (Permitted Procedures) (Wales) Regulations 2007
3. the Prohibited Procedures on Protected Animals (Exemptions) (Scotland) Regulations 2007
4. the Welfare of Animals (Permitted Procedures By Lay Persons) Regulations (Northern Ireland) 2012

27.3  These regulations also include additional requirements on how the various procedures should be performed (for example, requiring the administration of an anaesthetic, specifying the required age for an animal or setting down husbandry or conservation requirements).

27.4  Veterinary surgeons and veterinary nurses asked to perform procedures, which they consider may not have a legal basis, should consult the regulations and seek advice from the RCVS where necessary.

27.5  Below are some examples of the types of procedures / mutilations, which veterinary surgeons or veterinary nurses may be asked to consider in practice. Please note that this is not an exhaustive list, but includes some of the common topics.

Tail docking (dogs)

Veterinary Surgeons Act 1966

27.6  The removal of the whole or part of a dog’s tail amounts to the practice of veterinary surgery and therefore can, as a general rule, only be carried out by a veterinary surgeon.

27.7  The Veterinary Surgeons Act applies to the United Kingdom (England, Wales, Scotland and Northern Ireland).

Animal Welfare Act 2006

27.8  In England and Wales, Section 6 of the Animal Welfare Act 2006 makes it an offence to remove the whole or part of a dog's tail other than for the purpose of medical treatment, subject to the exemption for docking the tails of certain working dogs. In particular, the legislation provides: 

1. that any veterinary surgeon who docks a tail must certify that they have seen specified evidence that the dog is likely to work in specified areas and that the dog is of a specified type;
2. the dog must be no older than five days when docked and will also need to be microchipped before it is three months old;

27.9  In England, the Docking of Working Dogs' Tails (England) Regulations 2007 (SI 2007/1120) specify the certification requirements for veterinary surgeons docking working dogs’ tails (the form of words for the docking certificate can be found in Schedule 2 of the Regulations). In particular, the Regulations specify:

1. the types of dog that may be docked namely hunt point retrieve breeds of any type or combination of types, spaniels of any type or combination of types or terriers of any type or combination of types;
2. the types of evidence which the veterinary surgeon will need to see;
3. identification and microchipping requirements.

27.10  In Wales, the Docking of Working Dogs' Tails (Wales) Regulations 2007 (SI 2007/1028 (W.95)) are similar to those which apply in England but not identical (information about the certification required is available on the Welsh Assembly website). In particular, the regulations specify:

1. the types of dog which may be docked are more narrowly defined in Schedule 2 Part 1 of the Regulations;
2. the certificate which must be completed by both veterinary surgeon and client requires  the client to specify the breed of the dog and its dam, and the veterinary surgeon must be satisfied that the dog and its dam are of the stated breed;
3. the certificate must specify the purpose for which the dog is likely to be used and confirm that evidence relevant to the particular case has been produced.

Animal Health and Welfare (Scotland) Act 2006

27.11  In Scotland, Section 20 of the Animal Health and Welfare (Scotland) Act 2006 prohibits the mutilation of animals, however the Prohibited Procedures on Protected Animals (Exemptions) (Scotland) Amendment Regulations 2017 provides an exception for the non therapeutic docking of dogs' tails where certain requirements are met. In particular, the regulations specify: 

1. the procedure must be carried out by a veterinary surgeon;
2. the procedure may only be carried out on a spaniel (of any breed or combination of breeds of spaniel), or a hunt point retrieve (of any breed or combination of breeds of hunt point retrieve);
3. the dog must be no older than five days;
4. not more than the end third of the length of the dog’s tail may be removed; and
5. the veterinary surgeon who carries out the procedure must certify that they have seen specified evidence showing that the dog is likely to be used for work in connection with lawful shooting of animals.

27.12  The regulations state that in addition to certifying that the dog is likely to be used for work, the veterinary surgeon who docks a tail must also sign a certificate which:-

1. certifies that the dog is aged 5 days or less, according to the date of birth given by the owner, or the person reasonably believed to be representing the owner; and
2. states the breed and type of dog, the sex of the dog, the colour and description of the dog, the microchip number of the dam of the dog or the microchip number of the dog.

Welfare of Animals Act (Northern Ireland) 2011

27.13  In Northern Ireland, Section 6 of the Welfare of Animals Act (Northern Ireland) 2011 provides that a person does not commit an offence if the whole or any part of a dog’s tail is removed by a veterinary surgeon for the purpose of medical treatment; or in order to prevent or remove an immediate danger to the life of the dog in circumstances where it is not reasonably practicable to have the tail, or as the case may be, any part of the tail, removed by a veterinary surgeon.

27.14  There are also exemptions for docking the tails of certain working dogs. In particular, the legislation provides: 

1. that any veterinary surgeon who docks a tail must certify that s/he has seen specified evidence that the dog is likely to be used for a specified type of work and that the dog is of a specified type;
2. the dog must be no older than 5 days when docked and will also need to be microchipped before it is 8 weeks old at the same veterinary practice that carried out the docking procedure.  

27.15  The Welfare of Animals (Docking of Working Dogs’ Tails and Miscellaneous Amendments) Regulations (Northern Ireland) 2012 (NISR 2012/387) set out the certification process for the exemption for future working dogs, which must be completed by the breeder and the veterinary surgeon at the time the dog’s tail is docked and subsequently microchipped. The docking certificate can be found on the NI Direct Website.

27.16  There will also be evidence which must be presented to the veterinary surgeon to allow them to decide if the pup meets the conditions to qualify as a potential future working dog. The pup and its dam must be presented to the veterinary surgeon within five days of the birth of the pup. If the dam has died since whelping, the veterinary surgeon must see veterinary certification to this effect. In particular, the Regulations specify:

1. the types of dog that may be docked namely hunt point retrieve breeds of any type or combination of types, spaniels of any type or combination of spaniel, or terriers of any type or combination of terrier; 
2. the types of evidence that the veterinary surgeon will need to see;
3. identification and microchipping requirements.

(Please note that the NI Direct link above also provides detailed information on the types of work and the evidential requirements) 

Further information

27.17  Further guidance on the practical and legal approach to the docked puppy has been provided on the British Veterinary Association Animal Welfare Foundation website for both members and non-members.

Removal of dew claws

Veterinary Surgeons Act 1966

27.18  The removal of dew claws amounts to the practice of veterinary surgery and therefore can, as a general rule, only be carried out by a veterinary surgeon. Schedule 3 to the Veterinary Surgeons Act 1966, however, allows anyone of or over the age of 18 to amputate the dew claws of a dog, before its eyes are open.

27.19  The Veterinary Surgeons Act applies to the United Kingdom (England, Wales, Scotland and Northern Ireland).

Animal Welfare Act 2006

27.20  In England, Schedules 1 and 9 to the Mutilations (Permitted Procedures) (England) Regulations 2007 (SI 2007/1100) state that the removal of dew claws is a permitted procedure with the condition that ‘an anaesthetic must be administered except where the dog is a puppy whose eyes have not yet opened’.

27.21  In Wales, Schedules 1 and 9 to the Mutilations (Permitted Procedures) (Wales) Regulations 2007 (WSI 2007/1029) state that the removal of dew claws is a permitted procedure with the condition that ‘an anaesthetic must be administered except where the dog is a puppy whose eyes have not yet opened’.

Animal Health and Welfare (Scotland) Act 2006

27.22  In Scotland, Schedule 9 of the Prohibited Procedures on Protected Animals (Exemptions) (Scotland) Regulations 2007 (SSI 2007/256) states that the amputation of dew claws is an exempted procedure and may be carried out for the purpose of general animal management. The Protection of Animals (Anaesthetic) Act 1954 continues to apply in Scotland and provides that anaesthetic must be administered except for ‘the amputation of the dew claws of a dog before its eyes are open’.

Welfare of Animals Act (Northern Ireland) 2011

27.23  In Northern Ireland, Schedule 8 of the Welfare of Animals (Permitted Procedures by Lay Persons) Regulations (Northern Ireland) 2012 (NISR 2012/153) states that the removal of the dew claws of dogs is a permitted procedure which may be carried out as a management procedure by lay persons but may only be carried out before the pups eyes are open. Otherwise, the removal of the dew claws of dogs is a prohibited procedure and may only be carried out by a veterinary surgeon.

What are a dog’s dew claws?

27.24  Colloquially, dew claw refers to the first digit on the hind limb and the first digit on the fore limb.

27.25  Anatomically, the dew claw is defined as the first digit of the hind limb. Dew claws (hind limb) are very variable in their occurrence, ranging from complete absence to a fully formed digit with skeletal components; most consist of a nail, skin and connective tissue with no skeletal articulation. Such a vestigial structure is certainly very vulnerable to damage through catching on vegetation; therefore, there is a good argument for removal of dew claws before five days of age.

27.26  Anatomically, the first digit of the fore limb is not a dew claw. Generally, the first digit of the fore limb is fully formed and has an important function. Not surprisingly dogs are often seen to use these ' thumbs ' exactly as you would expect - to help grasp food and other objects because they can be adducted, flexed or extended like any other digit, due to the bony articulation and the muscle attachments.

27.27  Legislation has not defined dew claws and ultimately, it is for the courts to decide the meaning of dew claws applying to any specific legislation.

Conclusion 

27.28  The removal of the first digit of the hind limb (true dew claws) is justified in most circumstances.

27.29  The removal of the first digit of the fore limb is justified only if, in the veterinary surgeon’s professional opinion, the particular anatomy/appearance of the digits invites possible damage.

Canine surgical artificial insemination

27.30  Surgical Artificial Insemination (AI) is prohibited by UK animal welfare legislation which legally restricts mutilations to animals (i.e. procedures which interfere with sensitive tissue or bone structure), as it is not a procedure exempt within the relevant regulations for the UK jurisdictions set out in paragraph 27.2 (a-d).

Prosthetic testicles

27.31  The RCVS has decided the insertion of prosthetic testicles is not a procedure that benefits the animal and is not in the animal’s interests. There is also concern that the procedure allows an owner to claim an animal with a prosthetic testicle had the natural conformation.

27.32  The RCVS advice is that the procedure is unethical.

Feline renal transplantation procedures and ethical sourcing

Please note that the following guidance on feline renal transplantation was introduced in November 2016 following a legal and ethical review by the RCVS of previous guidance on this subject. That previous guidance was suspended in 2013 and has now been formally withdrawn and replaced with the following paragraphs:

27.33  The RCVS does not support the use of living source donors for feline renal transplantation. This is contrary to a basic tenet of veterinary practice that inflicting pain and discomfort on an animal can only be justified as an act of veterinary surgery if it is for the benefit of the animal receiving that pain and discomfort. 

27.34  The RCVS does not support feline renal transplantation from pre-euthanasia donors. This is because pre-euthanasia donors are still living source donors. Additionally, from a legal perspective, to remove a kidney from a pre-euthanasia donor could be a considered a prohibited mutilation in certain UK jurisdictions; a criminal offence. 

27.35  The RCVS does not, in principle, oppose the use of the dead animals as donors for transplantation procedures (i.e. where the tissue is taken from animal patients post-euthanasia only). In some cases, cadavers or tissue may also be donated for the purpose of scientific research or the advancement of veterinary education.

27.36  Cadavers and tissues should be ethically sourced. In the opinion of the RCVS this means that cadavers and tissues will have been obtained from animals that have been euthanased for justifiable animal welfare reasons. Animals that have been bought or bred solely to provide cadavers and tissue are not generally considered to be ethically sourced.

27.37  Veterinary surgeons involved in such procedures should ensure that decisions on euthanasia are made on clinical grounds and they should ensure that cadavers and/or tissues are ethically sourced. Decisions relating to donation should not be directly linked to the decision to euthanise.

27.38  Veterinary surgeons should seek informed consent from the client for the use of their animal’s body or tissue. It is advisable for consent to be obtained in writing. Given the sensitive and emotional nature of the subject it may not be appropriate for veterinary surgeons to offer or discuss donation as an option with every client. Clients should not be unduly pressurised into proceeding and should be given sufficient information to make an informed choice. Veterinary surgeons should make sure that clients have sufficient time to ask questions and to make decisions.

27.39  It may be helpful to discuss general options for disposal at an early stage (i.e. when the client is not dealing with the stress at the time of the euthanasia). Appropriately and sensitively worded written information / leaflets can also assist in explaining disposal options to clients. Even if disposal options are discussed at an early stage, informed consent for any final decision should still be obtained.

27.40  The same principles of animal welfare and ethical sourcing should apply in the event that other forms of transplantation procedures are considered. Veterinary surgeons considering other forms of transplantation procedures may wish to seek advice from the RCVS.

27.41  Centres intending to carry out transplantation procedures must meet the following requirements:

1. To safeguard recipient animals, there must be a suitably qualified team of veterinary surgeons to remove and implant the organ and to provide the necessary post-operative support to recipient animals. The team should include veterinary surgeons with Diplomate or Board Certified Level qualifications in Medicine, Soft Tissue Surgery and Anaesthesia and qualifications or experience in microvascular surgery and critical care. Ideally, at least one member of the team should have firsthand experience of transplant surgery at another centre over a period of time.
2. To safeguard the ongoing care of the recipient, the centre must ensure satisfactory arrangements for active lifelong care, as determined by the group specified in paragraph a.
3. In particular, before carrying out transplantation procedures the centre must:
   1. provide the recipient's primary practice with aftercare guidelines; and    
   2. ensure that the veterinary surgeon(s) from the primary practice are willing and able to undertake this aftercare.
4. Approved centres will be expected to keep appropriate records of the transplantations carried out, undertake regular audit of clinical outcomes and be up to date with current developments that significantly improve outcomes.
5. The centre must consult with an Ethics Committee to ensure that all procedures are subject to rigorous and critical review. This review mechanism should include lay representation and must represent the health and welfare interests of the recipient animals and the views of staff involved.