A very sweet, young adult, neutered male cat was presented by a Good Samaritan for evaluation. He had been found by the road. The Good Samaritan was unwilling to provide care for the cat so he was surrendered to the clinic. The cat was found to be extremely thin, body condition score 1/9, febrile at 103.9, depressed and mildly dehydrated. His right hind leg did not seem to work well and the thigh was severely swollen, warm to the touch and had multiple wounds present. Radiographs were taken of the leg and a severe fracture was confirmed. He was rehydrated and sedated to evaluate the swelling of the leg. See the video. Feline Leukemia and FIV tests were negative.
What is this and what is the best course of action for this kitty?
This cat was dubbed Halo by the clinic staff. Given his very sweet demeanor one of the technicians decided to accept responsibility for him. The video shows the drainage of a very large abscess in the right thigh. It was not clear how the fractures, wounds and abscess originated. Given the large number of bone fragments a crushing injury of some sort seems most likely.
Step one was to treat the abscess. This would help Halo become a better surgical candidate by improving his general condition as well as the area of the surgery. During the procedure in the video the abscess was drained as well as possible and 2 penrose drains were placed. He was placed on antibiotics, pain medications and supportive care.
Given the severity of the fracture combined with the severe infection, the best option was deemed to be amputation of the leg at the hip. This could not be done for several days due to the infection. During this time Halo was very happy with any and all attention and eating like he had never seen food before.
Three days after presentation he was judged to be ready for surgery. He was still mildly febrile at 102.9 F. We decided that this was due to the inflammation in the leg and was unlikely to resolve until the leg was removed. Drainage was minimal.
Halo was anesthetized and prepared for sterile surgery to amputate at the hip. He was very stable under anesthesia. Because of the fracture and abscess the surgical anatomy was not normal and there were infectious plaques throughout the surgical field. An additional abscess pocket was found and about 6 ml of the same thick white pus was expressed. Ultimately, almost all of the muscle and tissues had to be removed (much more than normal during this procedure). There was barely enough left to close a layer of muscle tissue over the acetabulum (hip socket). Before closing, the area was flushed copiously.
Halo recovered very well from surgery. He was up and walking around about 30 minutes after surgery and had eaten voraciously within an hour of surgery.
He is now continuing his convalescence with the technician. Her husband has dubbed him Lou (in reference to Lt. Dan from Forrest Gump). His appetite has finally slowed a little and as you can see in the video he is walking around just fine.
Cats are amazing healers. They seem to be able to wall abscesses off extremely well. Most can heal severe wounds quickly. Cats never cease to amaze. We expect Lou to make a full recovery and make a very fine pet.