Pet Cone and Alternatives: Safe and Effective?

If your pet recently had surgery or trauma and has a splint or bandage or even a superficial skin infection, a cat or dog cone may have been prescribed by your veterinarian. Cones protect your pet and their injury, incision, skin, and overall well-being by preventing licking and self-trauma. In most cases, a hard cone (collar) is ideal. However, some cone alternatives for dogs and cats may be helpful, primarily for pets that do not readily tolerate typical cones. Regardless of what is used, protecting the pet helps prevent damage and further medical care necessities and maintains the human-animal bond.

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The cone of shame (E-collars)

If you have ever owned a pet, chances are you’ve dealt with a cone. An Elizabethan collar, E-collar, pet ruff, lampshade, or radar dish are just a few ways veterinary professionals and others refer to this tool. This recovery cone protects pets from self-harm. E-collars save owners money by preventing pets from licking at wounds, incisions, infections, and more, and they help in the healing process.

E-collars serve a great purpose. They come in many shapes, materials, flexibility, and sizes. A few cone alternatives may be less uncomfortable for the pet or human companions. However, not all collars and alternatives are suitable for your pet. The pet, size, reason for the cone, and other factors play a role in what is used and recommended.

Why do pets wear cones?

There are many reasons why your pet may need to wear a cone. Vets will use cones for pets for the following reasons:

1. Post-operatively. If your pet has a surgical incision, an E-collar will prevent licking, scratching, rubbing, or other movements that can delay healing.
2. Abrasions, wounds, road rash, and other trauma healing without surgery. If your pet has wounds of any kind, even if not surgically repaired, they are at risk for infection and worsening if your pet licks at the area.
3. Bandages, splints, casts. Regardless of the underlying cause, whether your pet wears a cast, splint, or bandage, the area should be kept dry to promote healing.
4. Skin infections. Animals prone to allergies often manifest with skin infections. These can be itchy and uncomfortable, and licking and scratching prevent healing. The cone protects the skin until the medications or shampoos take effect.
5. Behavior modification training. Cones may be used to help modify behavior in animals that overgroom, have obsessive-compulsive behaviors, are aggressive, or constantly eat things in the environment and put things in their mouths that they shouldn't, though this method has fallen out of favor in most circles.
6. Eye injuries. In animals with eye injuries, infections, ulcers, and related issues, E-collars prevent pets from rubbing at the eyes and causing further trauma.

Regardless of the reason for the cone, your pet should always follow the veterinarian’s directions. They can be annoying, cumbersome, frustrating, and even cause trauma to pet parents and family members as pets adjust to them. However, they serve a purpose. They prevent licking, scratching, rubbing, and other movements that can result in complications.

Why do pets lick?

Pets lick because they are itchy, bored, painful, or curious. Proper post-operative pain or wound management lessens the risks and likelihood of licking. Properly controlling an itch in skin infections improves outcomes. However, pain medications, anti-itch medications, and treating underlying infections may not entirely prevent licking behavior; thus, E-collars help keep your pet safe.

Hard E-collars

Hard E-collars are the gold standard because they are rigid and prevent your pet from turning and reaching areas that need healing. This is the first type of collar vets commonly reach for when protecting incisions or wounds in areas within easy reach of your pet’s mouth. Further, they prevent rubbing and scratching at wounds on the face or eyes. They come in several forms, from clear plastic (ideal for a pet’s ability to see) to a less translucent white color. Some require more skill to assemble them, while others use Velcro to form the cone. All types typically use the pet’s collar or tie gauze (string) to help affix it around your pet’s neck.

Dog cone alternatives

If your pet doesn’t tolerate the hard collar, and you want to try something else, ask your veterinarian whether the injury, incision, or infection permits it. If so, you have a few options, each with peculiarities.

You may feel that clothing or an alternative option is best for your pet; some pets do not tolerate clothing, are more bothered by it, may not eat with them, or may soil them. Suppose your pet has a full-body suit on to protect an incision and has an accident. In that case, this can increase the risk of infection if not immediately changed. If you aren’t home, that isn’t feasible. Thus, they aren’t without risks.

All of these come with pluses and minuses; no matter your choice, your pet should never be left unsupervised without protecting the incision, wound, or other cause requiring adequate protection. One lick could be enough to remove sutures or staples, trigger infection, or open the area. While a cat or dog cone alternative can be used for your pet, the best protection is a hard E-collar. Unless these are too short for your pet’s snout, they protect the pet and prevent them from reaching the areas we are trying to shield. However, they may not be suitable for every pet. Work with your vet to find the best fit for you.

Remember, regardless of what you feel will work with your pet, check with your veterinarian first! Using an alternative may not be appropriate for the injury or underlying disease. Further, suppose you are having trouble keeping your pet calm. If your pet is agitated or not acting normally because of the cone (or other method used), talk with your veterinarian about a sedative or anti-anxiety medication that may help them get through this recovery time.

What does the evidence say?

Research on the best way to protect your pet is limited. The best advice is to go with what is tried and true in clinical practice: the hard E-collar for belly incisions and limbs. Wounds and post-operative areas that are harder to reach usually respond well to the cone alternatives.

A 2020 survey by the University of Sydney asked pet owners about E-collars and their pets’ quality of life. Many felt that the collar negatively affected their pet’s quality of life in the short term. However, this is not a rigorous scientific study, nor does it have a bearing on patient complication rates. It doesn’t deal with alternatives, so we cannot make a recommendation. Only you and your veterinarian can decide what's best for your pet.

Veterinarians in practice, especially emergency vets, see the adverse effects of improper collars or methods to 'prevent' licking. From ingesting the clothing or booties, removing them, flattening the soft collars, and getting around them, the hard E-collars still ensure the best way to protect the incision. They aren’t without issues, but until studies compare the alternatives to this standard, it remains the best viable option when combined with proper pain management, exercise restrictions, and other meds as needed to keep the pet comfortable and calm.

Making your dog's cone more comfortable

Most often, your vet will fit the cone to your pet. However, if you purchase elsewhere or take the cone on and off, knowing how to put it on properly is critical to ensuring it does its job successfully.

Ensure that whatever you use to put the collar around your pet’s neck, you can easily put two finger between the collar and neck. More than that, it is too loose; less than that, it is too tight. You do not want the collar to fall off. Further, ensure the collar extends past your pet’s nose in all positions. If your pet looks straight up or down or turns to the hindlegs, you want to ensure there is still part of the cone past the nose; if not, they can lick.

Train your pet ahead of time

If you schedule an elective surgery, like a spay or neuter, you should know that your pet will likely need a cone. You can prepare your pet (and yourself) for this. Using positive reinforcement methods such as cooperative care training (see Deborah Jones, PhD book Seven Steps to Stress-Free Husbandry) can help acclimate your pet to the E-collar and teach many more things like cooperating for nail trims, physical exams, and even anal gland expression. It provides a great way to bond. If your pet knows what to expect and is rewarded for tolerating the cone when necessary, they won’t be stressed or upset, making recovery much smoother.

What if I left off the cone for just a few minutes?

Problems can arise in the blink of an eye. When the vet tells you to keep the cone or alternative on when not 100% supervised at all times, this is for a good reason. It takes one quick second for your pet to get their tongue on the area of concern, resulting in complications. However, if your pet refuses to eat or becomes highly agitated, you may remove the cone for a few minutes, but ensure you monitor them the entire time.

Please do not leave the room for a second when the cone is off; that is all it takes. Further, make sure you replace it properly and snuggly, ensuring you are comfortable with removing and replacing it will prevent issues down the line.

Cone complications

While E-collars protect pets from self-trauma, they aren’t without challenges, especially the hard ones. Pets can be exuberant and active, though they are usually restricted in exercise while wearing them. However, it can take a pet a few days to get used to their decreased peripheral vision and not having their whiskers to help them know where they are in space. Further, they can ram into you and your furniture, causing unintentional harm. Some animals may experience:

• Difficulty eating or drinking until they get used to it
• Difficulty navigating small or narrow areas
• Have a decreased appetite
• Be more anxious or distressed by the collar
• Struggle to play as they normally would (though they likely shouldn’t be while healing)
• Easily escaping or breaking the collar

Does pet insurance cover cone after surgery?

Thankfully, the cost of most E-collars and related devices is low compared to the overall cost of surgeries and medical care for wounds and infections. Depending on the type of tool you choose, hard or soft cones, inflatable, t-shirts, or surgery suits, prices may range from $10–60 for most species. If your pet has surgery, most veterinarians include an E-collar as one of the itemized items included with that procedure. If your insurance covers the procedure, they will cover the cost of the E-collar or related item. In fact, it is in their best interest to do so.

Failing to use a cone could lead to surgery complications requiring additional care. Pet insurance companies definitely don't want to cover complications. They may not cover problems that arise because an owner left a cone off (failing to follow post-operative directions), allowing the pet to lick and cause trauma.

Cones help your pet heal

Whether you use the standard hard dog cone, an inflatable doughnut, a soft collar, or clothing, all come with inherent problems (getting them on/off, patient comfort, owner comfort). However, regardless of what you choose, remember it is temporary. Depending on the reason for the cone, most pets need to wear them for 10 -14 days. While the duration may vary, it is important to have your pet wear the cone until your veterinarian instructs you to discontinue use. It prevents your pet from causing trauma, removes sutures/staples or bandage material, prevents rubbing and irritating the face and eyes, and minimizes the risk of post-operative infections and complications.

Talk with your veterinarian about what is right for you and your pet. It may be that the type of collar/protective barrier you use in conjunction with pain management and sedatives makes all the difference in a rapid return to normalcy.

Remember, regardless of what you feel will work with your pet, check with your veterinarian first! Using an alternative may not be appropriate for the injury or underlying disease. Further, suppose you are having trouble keeping your pet calm. If your pet is agitated or not acting normally because of the cone (or other method used), talk with your veterinarian about a sedative or anti-anxiety medication that may help them get through this recovery time.