“The Cone of Shame”: Welfare Implications of Elizabethan Collar Use on Dogs and Cats as Reported by their Owners
2. Materials and Methods
2.1. Survey Tool
2.3. Statistical Analysis
2.4. Thematic Analysis
3.1. Physical and Behavioural Impact of Elizabethan Collars on Dogs and Cats
“The collar made him less mobile, which was sad for him but made it much easier for me to find him, get hold of him and apply the various eye treatments.”—cat owner.
“Our cat just stood in a crouched still position while wearing the Elizabethan collar.”—cat owner.
“The collar made navigating around furniture difficult for the dog as the edge would catch on objects or on my legs.”—dog owner.
“I have a dog door and when he first came home he was obviously confused as to why he could not get through the opening. It took him probably one day to work out that if he turned his head sideways and squished the collar he could get in and out.”—dog owner.
“She refused to eat or drink for 2 days. We had to hand feed her and wet her mouth. We couldn’t take the collar off without hurting her so it had to stay on the whole 4 weeks until the stitches came out.”—dog owner.
“We have raised food dishes for our dogs, so if we fed in a bowl she could access her food while wearing the e collar but she could not eat out of her Kong or other food dispensing toys.”—dog owner.
“…unfortunately his mood was very low with it on”—dog owner.
“The collar made her life miserable. Since she is terminal, I didn’t want her last days to be awful and uncomfortable.”—dog owner.
“I noticed that my cat walked lower and dragged the collar along the wall. She seemed really depressed. Each day I’d go to work and I’d come home and she’d managed to remove it and she was happy about that. Once it stayed off she was back to her old self.”—cat owner.
“His distress with this collar was worse than his constant licking.”—unspecified.
“I took it off because he was so stressed and had to attend vet because he would not urinate due to stress”—unspecified.
“my female cat became immediately distressed as we brought her home with the collar on and frantically ran around the house smashing into things.”—cat owner.
“My cat kept walking backwards and falling over so became dangerous when on the bench etc. Was very stressed. I caught her a few times about to fall.”—cat owner.
“Running in to people, furniture and doorways was the biggest obstacle.”—unspecified.
“…in our case it was 22’ of snow that made it impossible for him to move outside without have the snow fill the collar”—dog owner.
“The collar combined with his eye injury seemed to make him more sensitive to sound and movement near him which he couldn’t see properly because of his eye injury and because of the collar.”—cat owner.
“My dog despised the Elizabethan collar as it makes it difficult for her to hear properly, especially with identifying where the sound is coming from. It greatly disorients her”—dog owner.
“On this occasion, the Elizabethan collar was on a young foster dog who had been rescued from a regional pound and was absolutely terrified when we started fostering her. She was desexed about 2 weeks after she arrived and I noticed that her behaviour became more confident while she was wearing the Elizabethan collar. I’m not sure if this was because sounds were blocked or muted or it gave her a feeling of more space around her which made her feel more secure.”—dog owner.
“The only issue we had is his sister acting aggressively [sic] toward him due to being scared of the collar this finally settled after a few days.”—cat owner.
“Dog is deaf, small breed and soft cat Elizabethan collar was used. Made no difference to her normal interactions.”—dog owner.
“My standard poodle wore the Elizabethan collar for 3 weeks after her spey. Once she got used to it there was no stopping her. She did annoy my other standard though. She would want to play and would ram the Elizabethan collar into the other one. Occasionally my older standard [poodle] would tell her off.”—dog owner.
“The other dog in the house was scared of Grace while she was wearing her collar and as a result was very unfriendly towards her.”—dog owner.
“The increased unfriendly interactions from the other animal in the home was not serious or concerning. The other animal was more interested in what that thing was!”—unspecified.
“One of my dogs is mildly aggressive, and when the other dog wears an Elizabethan collar and bumps her she will growl or snap at him which is not typical.”—dog owner.
“I have a highly anxious dog who needed to wear the collar due to obsessive licking that was causing him injury. Unfortunately, although the collar allowed the time for some wounds to heal, his anxiety was exacerbated during this time and it took a number of days after wearing for him to return to his usual (still anxious) state”—dog owner.
“The cleaning of the collars is a real pain. My cat has some anxiety anyway, so after the trip to the vet, operation, stay in the vet hospital, coming home but with the cone of shame made settling him and his recovery even more difficult.”—cat owner.
3.2. The Size and Fit of Elizabethan Collars
“The collar we received after her surgery was too large for her size and as such (size at-large for 55 lbs dog), she couldn’t drink water or eat food as her snout was not long enough to reach and kept tipping the bowl or stopping her from getting water. I could easily slip the collar over her head at the tightest setting (I then secured it to her regular collar).”—dog owner.
“An Elizabethan collar is a real nuisance for small dogs with short legs. When they drop their head to see where they’re going or to pick something up it also drops and can stick into the ground, pulling them up sharply.”—dog owner.
“Collar was to protect a surgical site. Great Dane means huge collar, he couldn’t cope with it.”—dog owner.
“…these collars just don’t fit greyhounds. Following our dog’s second injury, an interstate vet who obviously didn’t have much experience with greys sold us a collar that was far too small for her...her nose poked out the end, and when she bowed her head it slid off!”—dog owner.
“I have a mini dachshund, so the Elizabethan collar had to be quite long to accommodate his longer snout. Because his legs are so little he had a lot of difficulty with the large Elizabethan collar doing lots of things such as eating and getting outside down a small step.”—dog owner.
“My dog is a bull-dog and his neck got very wet and inflamed from slobbering constantly with it on. He got very down with it on and seemed depressed. Maybe the shape of it was not good for him.”—dog owner.
“We have sighthounds (greyhound and Saluki). The size of the collar to cover their long noses was absolutely ridiculous. Like wearing an umbrella around the neck. The dog was in misery.”—dog owner.
3.3. Outcomes of Wearing Elizabethan Collars
“I have had a number of cats and dogs wearing Elizabethan collars over the years. They have never caused a problem with either cats or dogs. Definitely the best way to stop animals interfering with sutures or vulnerable areas”—dog and cat owner.
“I think that an Elizabethan collar can be a great tool when used properly. If an animal if sensitive to the collar, other methods can be considered”—unspecified.
“The collar was very effective in ensuring that the wound healed completely with no licking or scratching at it.”—cat owner.
“The E collar does its job on protecting my dog from licking her surgery wounds.”—dog owner.
“Made the cat thoroughly miserable but he had licked himself a huge ulcer and the collar was the only way to get it healed. The collar interfered with virtually all aspects of his life, he hated it but fortunately was too stupid to figure-out how to get it off.”—cat owner.
“The collar although inconvenient was necessary to avoid removal of dressings and I believe that the positive elements over-powered the negatives”—unspecified.
“Elizabethan collars are necessary. Doesn’t matter if you or your dog like them it keeps them safe from their selves”—dog owner.
“Elizabethan collar was essential to stop my dog rubbing even briefly at his eye (entropion and enophthalmos). Far, far better that he didn’t disturb the delicate sutures. I’ve seen several dogs disembowel themselves worrying at their surgical site. All but one was DOA [dead on arrival]. the one that survived lost quite a bit of intestine as she chewed on it.”—dog owner.
“Dog was still able to tear out stitches in collar. Learned to lean against wall/furniture and flatten it to enable access to wound”—dog owner.
“Unfortunately my Pekingese had eye surgery and due to her working out how to rub her eye ( that had stiches ) while wearing the Elizabethan collar, she would aim to push her face to the floor where the plastic edges of the collar touched the floor / cushion she’d push harder so the collar would slide a bit further down her tiny neck and she could rub that eye on the floor/ cushion !!! So another operation was needed, I also bought a larger collar cause I needed the plastic edges longer all the way around, now she couldn’t eat or drink while that collar was on, so I would take it on and off while watching the little rascal like a hawk.”—dog owner.
“It was a trying 10 days as my too clever cat discovered that she could pull off the collar by running under the bed in the room that she was confined in and knocking it off when it hit the underside of the bed frame. We ended up dismantling the bed and having the mattress on the floor for 10 days.”—cat owner.
3.4. Physical and Psychological Impact of Elizabethan Collars on Companion Animal Owners.
“Her quality of life was ok. Ours was a bit stressful at times.”—unspecified.
“I dislike the collar a lot. We live in a small house & our dog would constantly be knocking into furniture & us. Nightmare. That is why I would constantly take it off when I was at home supervising her.”—dog owner.
“Was constantly bashing into things and seemed bewildered. Restless at night - had to take collar off and sleep next to him to let us both rest!”—unspecified.
“Bruises on my legs are common when the dogs have them on, from them running into my legs”—dog and cat owner.
“Interacting with him was also very difficult, as he would beat your legs with the collar, which could get pretty painful...”—unspecified.
“It hurts when they slam into your legs…”—dog owner.
"The collar made navigating around furniture difficult for the dog as the edge would catch on objects or on my legs”—dog owner.
“The Elizabethan collar was also aversive to me. My shins were so bruised from him banging into me causing less interactions with us.”—unspecified.
“The collar can cause damage to the house (e.g., scratching walls, damaging furniture as they try walk past)”—unspecified.
“I have sustained a lot of damage to doors and plasterwork over the years as a result of the collars.”—dog owner.
“This dog is mentally fit and resilient and was shaped to wear collar BEFORE surgery. She was also crated and had been crated trained from puppy-hood.”—dog owner.
“I also believe people should be taught how to get their dogs accustomed to wearing (taking on and off etc.) an e collar in a fun and positive way during training or at home so when it is needed for real the dog will not be as stressed by it.”—dog owner.
“I once had a dog who would shred an Elizabethan collar and he was adamant to get it off. I trained a very good ’leave it’ and he was much more compliant and able to rest without using an Elizabethan collar. I think alternatives to an Elizabethan collar and better training could lessen the stress for pets who would traditionally be prescribed an Elizabethan collar.”—dog owner.
“He had a lot of trouble managing with the collar for the first ten days or so but got the hang of it after that.”—dog owner.
3.6. Alternatives to Elizabethan Collars
“I found that a squidgy travel pillow securely fixed around my dog’s neck was more effective and much more comfortable than the plastic Elizabethan collar. We live in a hot, humid climate & the plastic Elizabethan collar seemed to trap hot air and flies (not to mention food scraps...) around my dog’s face”—dog owner.
“My dog didn’t wear the Elizabethan collar for more than 30 minutes because he refused to move and was terrified every time he bumped into something. He went without for a few days while I waited for a BiteNot collar to be delivered”—dog owner.
“I replaced the plastic Elizabethan collar with an inflatable one, so my dogs could eat and drink. This was impossible with the plastic one.”—dog owner.
“Love surgical garments and will always try them first! E collars are last resort.”—unspecified.
“My dog is very anxious and although I had spent a lot of time beforehand trying to get him used to an Elizabethan collar, I was not able to get him comfortable wearing one. After the first time when he freaked out even after the preparation I had done, he wouldn’t let me put it on and would have bitten me so I used a t-shirt tied to a harness instead, which he was fine with.”—dog owner.
“The collar used was one of the soft blue papery ones, not the hard plastic. Because it’s a softer construction, for my cat I was able to flip it down so that he wore it over his shoulders. Much more comfortable and tolerable as it wasn’t in his vision.”—cat owner.
“Alternatives for the plastic Elizabethan collar were both more and less effective—the inflatable let the dog reach a leg wound, the comfy cone was definitely more comfortable for a dog to wear.”—dog owner.
“Elizabethan collar is preferable for certain situations whereas another type of preventative equipment might be preferable for other situations.”—dog owner.
“Wish there were a better design/option. Inflatables are nicer, but rarely stay on.”—dog owner.
“We initially used alternative methods to prevent the dog from accessing the surgical site, e.g., inflatable collar, t-shirt, pool noodle collar, bitterant, due to the discomfort and difficulty in moving generally associated with an Elizabethan collar. Given the location of the wound (desexing) and the length of the dog, however, we eventually resorted to utilising the Elizabethan collar due to the ineffectiveness of the aforementioned methods. While effective, the Elizabethan collar greatly diminished the dog’s quality of life and ability to manoeuvre without assistance and perform normal activities.”—dog owner.
“ended up having to use combination of basket muzzle, Elizabethan collar, PJs and sedation to keep from taking off cast”—dog owner.
“Got an inflatable collar and a sheep shirt for her second surgery and it was much better tolerated.”—unspecified.
“We had to use an Elizabethan collar plus two inflatable donuts to ensure that our very flexible dog couldn’t reach her hot spot”—dog owner.
“I did use an inflatable collar and my other dog popped it. Whilst the injured dog was wearing it!”—dog owner.
“Used a soft Elizabeth collar and a plastic, the soft one allowed her to get a paw between the collar and her neck and she almost choked”—unspecified.
“Was unaware of other alternatives (vet only suggested Elizabethan collar).”—dog owner.
“It was interesting that our vet insisted our dog needed the collar for his own good whereas many friends did not use the collar on their pets at all when their animals were desexed. I found this confusing and annoying as I would have preferred no collar on our dog as well even though he got used to it. The collar was a hindrance and we humans felt very bad about making him wear it, especially if it turned out that it wasn’t really necessary after all.”
4.1. Mitigating Welfare Costs Associated with Elizabethan Collars
- Where appropriate, explore the impacts of alternatives further, so as to confidently recommend their use.
- Given that the key indication for wearing Elizabethan collars was to protect surgical sites on the body, head and neck from self-trauma (accounting for 69.4% of cases), veterinary team members have an important role in counselling owners and carers of companion animals about the potential negative impacts of Elizabethan collars.
- At a minimum, we suggest that any person recommending the use of an Elizabethan collar in a companion animal, or considering using such a collar on their own animal, should be made aware of the potential for the Elizabethan collar to interfere with activities such as drinking and playing (including playing with other animals), the potential for discomfort or injury to animals, and the potential for injury to people in the vicinity of Elizabethan collar wearing animals, as well as harm minimisation strategies.
Conflicts of Interest
Appendix A.1. Questionnaire
|1. Has your cat or dog worn an Elizabethan Collar in the past twelve months?|
|2. Your age (years) _____||*insert age in years*|
|3. Your gender|
|4. Postcode||*insert postcode*|
|5. Are you a veterinarian, veterinary nurse, veterinary technician, animal trainer or a person who works with animals for a living?|
|6. In your household, responsibility for the care of your companion animal is:|
|7. How long was your companion animal required to wear an Elizabethan collar?|
|8. What was the reason?|
|9. Which activities, if any, did the collar interfere with (rate all that apply) |
[1 = cannot perform this activity when wearing collar; 2 = has some difficulty performing this activity when wearing collar; 3 = needs assistance when performing this activity; 4 = Elizabethan collar makes minimal difference when performing this activity; 5 = Elizabethan collar makes no difference to performance of this activity]
|10. Are you aware of how to check whether your companion animal Elizabethan collar is too tight/loose or not?|
|11. Did your companion animal exhibit any difficulty breathing while wearing the Elizabethan collar?|
|10a. If yes, did these difficulties breathing exist before the use of the Elizabethan collar due to prior health problems?|
|12. Were you required to re-size or replace your pet’s Elizabethan collar in the duration that they were required to use it?|
|11a. If yes, why?|
|13. Did your companion animal acquire any injuries as a result of the Elizabethan collar? (tick all that apply)|
|14. While wearing the collar, you would say that your pet’s response to sound is:|
|15. Did you remove the Elizabethan collar during the time its use was prescribed:|
|16. How often did your companion animal remove the collar without your assistance|
|17. If you had any other companion animals at the time your companion animal was required to use an Elizabethan collar, did interactions between these animals change?|
|18.Have you ever used alternatives to achieve the same purpose as an Elizabethan collar? (tick all that apply)|
|17a. If so, was it:|
|19. Rate your companion animal’s quality of life WITH the Elizabethan collar from 1–5 [1 (Couldn’t be better)–5 (very poor)]|
|20. Rate your companion animal’s quality of life WITHOUT the Elizabethan collar from 1–5 [1 (Couldn’t be better)–5 (very poor)]|
|21. Do you wish to provide any additional comments?||*insert any addition comments*|
|How long was your companion animal required to wear an Elizabethan collar?||< 24 h||10||2.3|
|72 h–7 days||158||36.4|
|> 21 days||30||6.9|
|What was the reason?||To protect a surgical site on the body||249||57.4|
|To protect a surgical site on the head or neck||52||12.0|
|To protect a bandage/drain/implant||22||5.1|
|To prevent self-trauma because of a skin condition||83||19.1|
|Other [Please describe]||28||6.5|
|Which activities, if any, did the collar interfere with (rate all that apply)|
|A. Eating||1 a||91||21.0|
|B. Drinking||1 a||74||17.1|
|C. Walking||1 a||21||4.8|
|D. Other exercise||1 a||44||10.1|
|E. Interacting with people||1a||22||5.1|
|H. Outdoor access||1a||59||13.6|
|I. Other [please add]||Other||179||41.2|
|Are you aware of how to check whether your companion animal’s Elizabethan collar is too tight/loose?||Yes||382||88.0|
|Did your companion animal exhibit any difficulty breathing while wearing the Elizabethan collar?||Yes||3||0.7|
|Were you required to re-size or replace your pet’s Elizabethan collar in the duration that they were required to use it?||Yes||122||28.1|
|Did your companion animal acquire any injuries as a result of the Elizabethan collar (tick all that apply)||Skin of the neck was abraded/ulcerated||14||3.2|
|Injury due to limbs getting caught in collar||2||0.5|
|Injury due to interaction with other pets||1||0.2|
|While wearing the collar, you would say that your companion animal’s response to sound is:||As usual||299||68.9|
|Less sensitive to sound||50||11.5|
|More sensitive to sound||84||19.4|
|Not responsive to sound at all||1||0.2|
|Did you remove the Elizabethan collar during the time its use was prescribed?||Most of the time||44||10.1|
|Only for certain activities (for example eating, drinking)||108||24.9|
|Only under supervision||235||54.1|
|How often did your companion animal remove the collar without your assistance?||Never||299||68.9|
|Couldn’t keep it on him/her||11||2.5|
|If you had any other companion animals at the time your companion animal was required to use an Elizabethan collar, did interactions between these animal’s change?||Reduced interaction||146||33.6|
|Increased friendly interactions||10||2.3|
|Increased unfriendly interactions||38||8.8|
|Decreased friendly interactions||27||6.2|
|Decreased unfriendly interactions||2||0.5|
|No change in interactions||90||20.7|
|Have you ever used alternatives to achieve the same purpose? (tick all that apply)||Local Dressing||76||17.5|
|T-shirt or wrap||105||24.2|
|Elizabethan collar alternative, e.g., inflatable collar||120||27.6|
|Rate your companion animal’s quality of life WITH the Elizabethan collar from 1-5||1 b||32||7.4|
|Rate your companion animal’s quality of life WITHOUT the Elizabethan collar from 1-5||1 b||305||70.3|
|Variable/Question||Category||No.||Chi Squared||p Value|
|How long was your companion animal required to wear an Elizabethan collar?||< 72 h||6||2||63||17.2||0.069|
|72 h–7 days||23||13||122|
|> 21 days||5||0||25|
|What was the reason?||To protect a surgical site on the body||27||24||198||7.9||0.446|
|To protect a surgical site on the head or neck||7||6||39|
|To protect a bandage/drain/implant||2||1||19|
|To prevent self-trauma because of a skin condition||16||6||61|
|Other [Please describe]||4||5||19|
|Which activities, if any, did the collar interfere with (rate all that apply)|
|D. Other exercise||1||2||1||41||28.5||<0.001|
|E. Interacting with people||1||2||1||19||19.3||0.014|
|H. Outdoor access||1||5||0||54||23.1||0.003|
|Are you aware of how to check whether your companion animal’s Elizabethan collar is too tight/loose?||Yes||48||42||292||4.8||0.090|
|Did your companion animal exhibit any difficulty breathing while wearing the Elizabethan collar?||Yes||0||0||3||0.9||0.639|
|Were you required to re-size or replace your pet’s Elizabethan collar in the duration that they were required to use it?||Yes||19||7||96||3.6||0.168|
|Did your companion animal acquire any injuries as a result of the Elizabethan collar (tick all that apply)|
|A. Skin of the neck was abraded/ulcerated||Yes||2||2||10||0.406||0.816|
|B. Injury due to limbs getting caught in collar||Yes||0||0||2||0.586||0.746|
|C. Injury due to interaction with other pets||Yes||0||0||1||0.292||0.864|
|While wearing the collar, you would say that your companion animal’s response to sound is:||As usual||40||36||223||7.807||0.099|
|Less sensitive to sound||6||4||41|
|More sensitive to sound||10||2||72|
|Did you remove the Elizabethan collar during the time its use was prescribed?||Most of the time||1||2||41||13.612||0.034|
|Only for certain activities (for example eating, drinking)||14||7||87|
|Only under supervision||35||24||176|
|How often did your companion animal remove the collar without your assistance?||Never||41||28||230||3.139||0.535|
|If you had any other companion animals at the time your companion animal was required to use an Elizabethan collar, did interactions between these animal’s change?||Decreased||24||12||139||15.5328||0.004|
|No change in interactions||12||18||60|
|Have you ever used alternatives to achieve the same purpose? (tick all that apply)|
|A. Local Dressing||Yes||9||9||58||0.541||0.763|
|B. T-shirt or wrap||Yes||13||8||84||0.755||0.686|
|D. Elizabethan collar alternative||Yes||18||9||93||1.378||0.502|
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|Location||New South Wales||183||42.2|
|Worked with animals *||No||276||63.6|
|Responsibility||Mostly my responsibility||310||71.4|
|Mostly someone else’s responsibility||3||0.7|
|Shared between household members||121||27.9|
|Injury (Itching/ Irritation) c||Yes||2.466||1.087||11.8||1.4–99.0|
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Shenoda, Y.; Ward, M.P.; McKeegan, D.; Fawcett, A. “The Cone of Shame”: Welfare Implications of Elizabethan Collar Use on Dogs and Cats as Reported by their Owners. Animals 2020, 10, 333. https://doi.org/10.3390/ani10020333
Shenoda Y, Ward MP, McKeegan D, Fawcett A. “The Cone of Shame”: Welfare Implications of Elizabethan Collar Use on Dogs and Cats as Reported by their Owners. Animals. 2020; 10(2):333. https://doi.org/10.3390/ani10020333Chicago/Turabian Style
Shenoda, Yustina, Michael P. Ward, Dorothy McKeegan, and Anne Fawcett. 2020. "“The Cone of Shame”: Welfare Implications of Elizabethan Collar Use on Dogs and Cats as Reported by their Owners" Animals 10, no. 2: 333. https://doi.org/10.3390/ani10020333