If I hadn’t seen it for myself, I wouldn’t have believed it. A pre-vet student who works for me finally wore me down and convinced me to Google it. That’s when I settled in with my morning coffee to watch a 30-minute video on the merits and how-tos of “tummy tucking” for cats. Tummy-tucking? Seriously? Apparently. And it was awful (as you might have expected it would be). In this case, undertaken in a mobile surgical unit on what appeared to be a middle-aged domesticated shorthair female with an average-sized “belly pooch,” the cat was subjected to a 30-minute procedure dedicated to removing as much subcutaneous fat as possible. Horrible. More so when you consider that one of the major complications with liposuction (done in humans with “lipo-wands” designed for the task) is the potential destruction of blood supply to the overlying skin and, therefore, full-thickness skin necrosis. This complication is rare when the procedure is performed correctly, seeing these wands are specifically designed to leave major vessels intact. But in the cat and dog (distinct from humans) the blood supply to the overlying skin is even more tenuous. While humans have multiple musculocutaneous vessels scattered about, offering a rich and redundant blood supply, dogs and cats, by contrast, have few direct cutaneous arteries that travel through the subcutis and branch out on the undersurface of the dermis. Therefore, each segment of skin only has one blood vessel. In particular, the blood supply to the ventral abdominal skin is by two vessels only: the caudal and cranial superficial epigastrics. Kill one, and the skin should live. Cut them both—all bets are off. That kind of necrosis sometimes happens after mastectomies in humans. But even then, the affected skin is usually removed along with the mammae. In this YouTube case, the surgeon almost certainly destroyed the integument’s blood supply (it sure looked like it as he ligated both superficial epigastrics)...but left the skin on the cat. Better to have removed all the skin in this case, seeing as she almost certainly sloughed it all off in the weeks that followed her surgery. Other Experts I had to watch the video carefully, research liposuction in humans (we all could use some, you know), and recruit a couple of surgeons to confirm my suspicions (one a human derm surgeon, one veterinary). This was not just one of those cute, crazy YouTube hoaxes, though I keep hoping someone will tell me it was. This was real live, below-the-standard-of-care veterinary medicine on YouTube for all the world to see how vets in the U.S. do business. All kinds of anatomically and, surgical-based recriminations aside, the animal welfare implications here are plain: There is no need for “liposuction” in pets beyond cosmesis. Sure, the removal of subcutaneous fat and its overlying skin has been shown to be cosmetically beneficial, but otherwise incapable of improving a pet’s health beyond its superficial weight-reducing effect. While losing a fat pad might improve a pet’s ability to ambulate a bit, you’ll have a hard time convincing me (as the video tried to do) that removing one floppy fat pooch is going to help prevent diabetes, heart disease, liver disease or arthritis. No, this is simple cruelty, plain and simple—regardless of our colleague’s honorable intentions. What to Do? It’s been a long time since I’ve been this disgusted by something I’ve seen veterinarians do by way of promoting themselves or their services. Sure, selling ourselves via Groupon coupons rubs me the wrong way, too, but that’s rather more like a romp compared to this slither in the muck of misguided, self-promotional malpractice. So what’s a shocked insider-observer to do? Now, that’s the question. If this kind of thing happened in our human-oriented sister professions there would be hell to pay. Investigations would ensue. Boards would be alerted. Seeing as vet medicine is still so sleepy on this and other issues where there’s no clear animal welfare directive (who would’ve thought someone might actually try a tummy tuck on a cat?), it looks like Dr. YouTube gets to go on strapping a mask on cat after cat until he learns either that A) the procedure can’t actually be deemed a success if the patient’s skin falls off, or B) it’s a really bad idea to make your creepy videos public. Dr. Khuly is a mixed-animal practitioner in Miami and a passionate blogger at Vetstreet.com. She earned her veterinary degree in 1995 and her MBA from Wharton in 1997.
