Caring for a Three Legged Dog or Cat
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Hi all
My cat Lotus fractured her femur sometime in July. I did not know it happened at the time. After a couple x-rays, my vet thought the fracture was healing (she has spent time in a cage to aid in the healing process). This past Monday, an x-ray showed it was not healing and had gotten worse. My vet thinks that amputation is the only option.
The following description is what I remember my vet saying plus what I've learned online. I think I have everything correct... The fracture is her left femur at the medial condyle. The fracture is not straight across the bone. It starts on the side of the condyle and goes down toward the intercondylar notch. My vet said it's not healing and there is avascular necrosis. He said it's only going to get worse and the segment of bone will break/collapse.
Before I talk to my vet again, I'm trying to research to be informed when I ask him questions. As I've learned, a vet doesn't know everything. I thought some of you may have experience with something similar and may know about possible options to amputation.
I've read about surgeries that repair femoral fractures (including condylar fractures) using pins, wires, plates. etc. I'm not clear on whether a fracture with avascular necrosis can be repaired. Since the part of the femur that is fractured is the condyle, and it will "collapse" because of poor blood supply, can it somehow be salvaged and surgically pinned/wired to the femur?
My vet did say something about a bone graft but said it wouldn't work. I can't recall why. I've read about regenerative injections for avascular necrosis that use stem cells to regrow new bone but it seems new and not widely done. I read about knee replacements but they also seem to not be widely available.
Does anyone have any thoughts or experience with this type of fracture and know of any options to amputation?
Any help would be truly appreciated.
Trevor
Hi Trevor! I'm in the Tripawds Chat right now for a bit if you want to talk. Back in a sec with some feedback.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Lotus is so fortunate to have such a great pet parent! Just curious, how old/young is she?
I love that you are doing all your research and looking into the possibilities. For me, my next step would be to have a boarded orthopedic surgeon look at her case and see what, if anything can be done. A vet surgeon like our friend Dr. Brian Beale out of Houston would probably have lots of ideas. If your vet hasn't referred you already, that would be helpful. Second, even third opinions can make or brek a decision and around here it's not uncommon for someone to do that.
Also, one of our favorite vet surgeons, Dr. Sarah Boston, recently published a study about a new kind limb salvage procedure on a Mastiff dog. What she basically did was shorten the leg to save it. I'm thinking if they can do it on a Mastiff, why not a kitty? Hmm.
What you may run into is that when it comes to cats, vets say they tend to make bad patients when it comes to a long term recovery, such as putting an external fixator on a leg and having to leave it there for a while. Perhaps Lotus isn't like other cats though and could tolerate a device for the healing. That would be great!
One other bit of advice: look for vets who are experienced at feline veterinary medicine, certified as a Cat Friendly practice would be ideal. Cats get such a second-class back seat in the veterinary world, that if you decide to pursue a limb salvage you really want to make sure that vet understands cat through and through.
I hope this helps. Stay tuned for feedback from others and let us know what you decide to do.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Jerry
Thanks for your response. Lotus is 8 1/2. I probably also should have mentioned that I am in Pennsylvania ( 2 1/2 hrs east of Philly, 45 minutes below the capital, Harrisburg).
I've spend countless hours since Monday trying to find answers and there doesn't seem to be many options.
I'm surprised that I can't seem to find an answer as to whether it's possible to surgically repair a condylar fracture with avascular necrosis (or any fracture with avascular necrosis).
Do you know of any other forums where I might be able to get some feedback? A couple forums I used years ago are inactive.
Thanks again
So Lotus is still pretty young with lots of years ahead, that's great.
Nope, don't know of any forums that might guide you in that direction. Right now the best person would be an orthopedic surgeon. Have you considered going to UPENN?
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
I have considered UPenn. My vet (and his wife who is a vet) went there. They graduated over 20 years ago so I don't know if they have any contacts there and if so, whether they'd be comfortable reaching out to them.
To let you know a bit about where I am, emotionally, mentally... I'm coming off of a very bad 2018. My cat Leo was diagnosed with diabetes in the Fall 2017, nearly died twice, and after everything looked OK he was diagnosed with chronic kidney disease (CKD) in February 2018. During all this, I had to check Leo's blood glucose 3-8 times per day, give him subcutaneous fluids once or twice a day, constant medications given at various points of the day, and there were visits and stays at the ER vet. I spent well over $10,000 and I am not well off by any means. I never left Leo alone for more than 3-4 hours at a time after the CKD diagnosis. I woke up during the night to check on him. I spend countless hours online reading, learning, talking to people in a CKD group. My vet said I should have been a vet. He said he never had a client do more for their pet.
CKD can't be cured. You can only hope to prolong life as long as possible. I hoped Leo would have at least 2-3 years but he passed away July 5th. He would have turned 10 that month. I was, and still am, completely devastated. It absolutely broke my heart. It kills me to write this now.
Lotus' situation is even harder to deal with considering everything I went through with Leo. I hoped that I wouldn't have to dive into learning about some other medial condition for a long time. I hoped that I wouldn't have to visit a vet not to mention face more huge bills for a long time. But here I am.
During Leo's illnesses, and even now months later, I look back and see things I wish I could do differently. The same thing is happening with Lotus. I feel like maybe this would have been different if I knew about her fracture earlier. If her leg needs to be amputated, part of me will always feel that it was my fault. That will be very, very hard to live with.
Please don't be so hard on yourself! Kidney disease sucks, to me it is as bad as cancer. I have had a lot more experience with kidney disease and diabetes in cats than with cancer.
Amputating a bad leg is a totally different situation. It's like comparing apples to oranges.
The odds of repairing that leg are slim. I went through this with Huck. Removing that bad limb is the best thing that we could have done.
With that said, recovery can be a roller coaster for a few weeks. But they do so well after!! pain management is a must! Being prepared to baby them and nurse them to health is also a must, but there are many of us here that are living proof that they live happy productive lives after.
Cats don't mourn the lost leg like we do. They celebrate the pain being gone and move on. Period.
Huckleberry celebrated his one year ampuversary a few months ago and he is happy, healthy, and complete.
It's not an abundance of rechecks, regular bloodwork, injections, and medicine. It's just done and over once they are recovered. Some people do chiro if their cats seem uncomfortable, but Huckleberry would not tolerate any of that seeing he was feral, and he does just wonderfully!!
I hope this helps some. Please breathe and try to see this from a different perspective, as this is a totally different situation.
Hugs,
Jackie and Huckleberry❤️
Hugs,
Jackie, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry 
First of all, want to say how sorry we are to hear about the loss of your precious Leo. Please know this, no one would have gone to the lengths that you did to give Leo extended quality time he got because of YOU!! Your lpove, your commitment, your devotion far exceeded what most kitties ever get to experience in a lifetime!❤ It's clear that emotionally you are still raw from the whole ordeal, and understandly so.
But as Jackie said, you are dealing with apples and oranges. This experience with Lotus does not equal that experience with Leo. That was then. This is now.
I don't have any insight into repair options, but I can give you insight into the amputation process. IT IS ONE SURGERY, ONE RECOVERY AND DONE!!! I know it's hard to wrap your head around the word "amputation " at first. We can all relate! I encourage you to read our e-books https://tripawd.....cats-book/ written by one of our most knowledgeable kitty people, along with input from other kitty members, who have all been through rhe amputation process. It's chock full of first hand knowledge of what to expect, how to prepare and how to help your kitty get thr eecovery and onto a pain frre happy life!!
I think once you gain more and more information on the amputation process, it will help lessen your fears and give you more certainty that, as your Vets have suggested, this may be the best path for Lotus.
Stay connected and let us know how we can help. YOU ARE NOT ALONE and you have a very special Guardian Angel watching over you and Lotus❤
Hugs
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!
Hello and Welcome,
I second Jerry on seeing an orthopedic surgeon & UPENN. I would get a second opinion, so you feel comfortable & exhaust all your options going forward. An orthopedic surgeon will give you all the options that are available, and Lotus is a candidate for they can answer all of your questions.
I am sorry to hear of the loss of Leo, you did your absolute best for Leo, and although this is a different scenario, we understand it is terrifying even to consider taking a limb off! No disrespect to your vet we would not have our family doc repair or amputate our leg right nor expect them to have all those answers. We want the specialist and their knowledge to direct us. The university is up to date on all the current protocols your traditional vet may not be aware of and for you to feel like you have done everything to save that leg and have no regrets that is your best path forward regardless of what the Orthopedic surgeon does say. You will rest easier knowing Lotus's options.
I understand you were not aware the fracture occurred at the time this is what leads me to ask if they mentioned a disease process may or may not be happening to cause the fracture and the avascular necrosis. I would also want to know what the odds are for any repair to be successful. Are you & Lotus prepared financially & mentally to go thru a repair and the scenario of it failing then an amputation if need be? We are pro quality of life if that means taking the leg and one surgery or if it means repairing successfully and keeping that leg even better.
I don't have any knowledge on your circumstances Purrkins lost his front left leg/scapula due to a soft tissue sarcoma that was on his wrist 2.5 years ago he is now 8 and does fantastic on three. Know that IF amputation is your only option cats do fantastic on three legs. Purrkins is the same happy go lucky kitty on three legs and can do all kitty things on three legs. We have modified the house as in kitty stairs to all of his favorite lookout spots. If that is the route you have to go we will help you and as Sally has mentioned we have a Feline Amputation and Recovery Care Handbook Cool Tips for Tripawd Cats to hop you thru it will save time digging around for information & we are here to answer any questions & direct you going forward.
Is Lotus on pain management now as your deciding on a path forward? If not, please be sure to get her on some asap. Our animals are so stoic they do not show us pain and I'm guessing Lotus is limping or not using the limb you can bet she is in pain even if she is not showing you she needs to be on something.
Top 10 Questions to Ask Before Amputation Surgery for Dogs and Cats Part 1
Please let us know what you decide from here and if you have any questions going forward.
Hugs,
Holly & Purrkins❤️
Just checking in on you to see how you're doing. You've been given a lot of good advice, i hope all is well.
❤️❤️
Hugs,
Jackie, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry
Wow. I spend a lot of time typing a post, clicked submit and got a message saying something about the link expired and I lost everything. I'm going to try to rewrite most of what I tried to post....
Holly, you said..
"I understand you were not aware the fracture occurred at the time this is what leads me to ask if they mentioned a disease process may or may not be happening to cause the fracture and the avascular necrosis."
My vet mentioned a disease process but had no idea if it was really a possibility or what it could be. If anyone has ideas, please let me know. Osteomyelitis is the only thing I could find.
I've been Googling for an orthopedic surgeon near me. The results I'm getting are any vet close by that mentions orthopedic surgery on their web site. I also can't find any kind of site with a directory or site with a search for veterinary orthopedic surgeons. Any ideas? I'm in Pa, 17257.
UPenn would mean taking Lotus on a 5-6 hour round trip. Also, it would be tough to get their advice and have to decide on the spot if I'm going to go with what they say (if they wanted to do something and keep her) or return home to consider it and then drive back. I would think an orthopedic surgeon closer to me would be able to give some guidance before I make any major decisions.
Thanks to everyone for their replies. I really appreciate it.
I'm sorry you had trouble posting I have no idea what happened if it happens again, please post under technical support the Admin will be able to help you on that.
Did you come across FHO (Femoral Head Ostectomyiny) in your research? I have NO idea if this is an option for Lotus or not. I did the same as you and googled;) It does mention fractures and the avascular necrosis of the femoral head due to Legg-Perthes disease.
Legg-Calve Perthes disease/Slipped capital femoral epiphysiolysis (SCFE)/ Metaphyseal osteopathy
Disregard if it's of no use we are Dr. Googling and that is never a good thing when we don't have a diagnosis I was hesitant to give that info earlier and have you googling on stuff we DONT know, only the surgeon or specialist would know.
Your traditional Vet should be doing the referral for you not all need referrals, but some do. I do not believe you are getting the care and info you need. Please think about finding a new clinic that would have NO problem referring you. We did not have to do any leg work with Purrkins we were referred immediatley to our university.
I understand the long drive, but I can tell you unless it is an emergency you will not be put on the spot to make a decision right then to leave Lotus. That is not how our University works anyway. You ALWAYS have a choice and can say I need time to think and process all of this info wherever you go. What is nice about the university is they have every department right there under one roof. Purrkins saw oncology and the surgeon he had all of the necessary tests done all on our first visit to discuss all options! He was carried to each department. Now I am in no way saying it won't be stressful for you both! Our university is, and it is a half day if not a whole day ordeal to go there, and we are only 25 minutes away. I have no idea if all the universities are this way but for the care and expertise all under one roof, you leave that day with all your answers and options going forward. The choice is always yours!
Here are some links I will attach below to hopefully help you locate a Surgeon and Hospitals and the Cat-Friendly Practices Jerry mentioned above if you want to look at switching Vets. It would be ideal if you had a vet refer you and to know you are under someone's care that will refer you when it is needed. Have you asked? I hate that you even have to it should have just been done.
We HAVE to advocate for our animals, and we learn this going thru such diagnosis and surgeries. So please know you pay these people you have a voice you will need to use, you deserve to know all of your options and feel good knowing you have all options going forward. This uncertainty is what is so stressful in IMO!
American College of Veterinary Surgeons
AAHA-Accredited Hospital Locator
Hopefully, these will help, and Jerry might be able to help direct you to ones she knows or has heard of other then UPENN? I would not rule them out.
Holly & Purrkins❤️
trevor_1 said
Wow. I spend a lot of time typing a post, clicked submit and got a message saying something about the link expired...
How long is "a lot" of time? What you experienced may tend to happen when a long time is taken to draft a post, the ensure forum performance and security. It's a server/user session timeout thing...
If possible, whenever encountering any technical issues please take a screen shot or copy any specific errors verbatim and provide as much detail as possible in the Technical Support forum.
TIP: Whenever taking extended periods to draft a forum post, select and copy the entire post prior to hitting the publish button to avoid losing any content entered.
Sorry for the inonvenience!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Holly
I did read about FHO but Lotus' problem is at the femoral condyle which is the opposite end to the femoral head. The femoral condyle is at the knee.
My vet and I did discuss referrals. We talked about UPenn and another one. After my research online, I think any decent Orthopedic Surgeon who is familiar with knee/femoral surgeries should be able to give an opinion. I don't want just anyone doing surgery if that was possible but surgeons who have seen this before should be able to give me more information that I can use to move forward.
I'm actually hoping a surgeon could look at her x-rays, read her medical history (there isn't much), and give me some
feedback without traveling any where. After all, if I took her somewhere, I'd need to take the x-rays and her medical history and they can't tell anything just from looking at her. The only reason she, or me for that matter, would have to be there is if I wanted more tests. Looking at the x-rays, someone should be able to say if it could be something other than avascular necrosis (I've seen nothing else it could be) and if they think it's possible to be repaired. Of course to be sure they'd need to do more tests, maybe an MRI, etc. But looking at the x-ray should tell them if it's too bad for surgery of any kind or they could not do the surgery she would need. Basically, I wouldn't expect anyone to look at x-rays and be able to say they could fix it, but I would think that they could tell from x-rays if it definitely couldn't be fixed or was beyond their capabilities.
I did read about Cat Friendly Practices. I thought it was vets who specialized in the care of cats. What I read on the web site of one I found near me was this...
"We are proud to say that our hospital is now Feline Friendly Certified. This is an exclusive certification awarded by the American Association of Feline Practitioners. To earn this certification, our staff members have taken additional steps in training and education to ensure our feline patients have a more positive experience here in our hospital. We are trained to handle our feline patients in a low-stress and empathetic way, creating a happier experience for you and your much-loved feline companion."
Honestly, that doesn't seem impressive.
I did read about Cat Friendly Practices. I thought it was vets who specialized in the care of cats. What I read on the web site of one I found near me was this…
“We are proud to say that our hospital is now Feline Friendly Certified. This is an exclusive certification awarded by the American Association of Feline Practitioners. To earn this certification, our staff members have taken additional steps in training and education to ensure our feline patients have a more positive experience here in our hospital. We are trained to handle our feline patients in a low-stress and empathetic way, creating a happier experience for you and your much-loved feline companion.”
Honestly, that doesn’t seem impressive.
I am aware of what that website says did you happen to punch in your zip code and see what comes up under feline only? It depends on what you select. For example feline only or small animal etc. We have 2 feline-only practices that all they see is cats & specialize in cats in our area under our zip code. Those are what we were referring to. You would have to see what comes up in your area. The other ones have made their practice feline friendly and each level indicates what steps that practice has done to accommodate cats but does see other animals. This does make a huge difference for our cats in keeping the visit less stressful. But I was referring to the feline only practices.
Check out the other only websites as well that is the best I can do.
Possibly your vet can call and get these questions answered for you or you can speak to someone yourself.
As I mentioned I have zero experience or knowledge in this situation and was hesitant to post. I had no idea if this was Legg-Perthes disease or if this was even an option. I did a quick google search on fracture and avascular necrosis, and this came up, please disregard.
I agree an Orthopedic Surgeon can & will give you an opinion on if this can be repaired and whom you want to perform the surgery we all want the best for our animals on this site. I hope they can get these questions answered over the phone without them seeing Lotus? It would all depend on the surgeon/practice.
Punch in your zip code under the other sites as well the AAHA & the Veterinary Surgeons. Make some calls or have your Vet make the calls.
Hopefully, someone else can assist you better.
Holly & Purrkins
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