Feline Orthopaedics

Harry Scott, Juan M. Marti, Philip Witte

• Publisher: CRC Press
• Year: 2022
• Print ISBN: 9781498764971
• eBook ISBN: 9780429531965
• Edition: 2
• Topic: Medicine
• Subtopic: Veterinary Medicine

Cats are not referred to specialists as frequently as dogs, meaning the general practitioner must routinely treat cats that have been involved in road traffic accidents and other musculoskeletal trauma. This book is the first of its kind to provide a practical and user-friendly guide to feline orthopaedics. With a new author team, led by RCVS Specialist in Small Animal Surgery (Orthopaedics) and Veterinary Neurology Harry Scott, the second edition has been thoroughly revised and updated. New chapters cover Physiotherapy and Oncology of the Feline Skeletal System.

The book includes highly structured fully referenced text that provides a concise, straightforward guide to the recognition and management of specific diseases and conditions. In this new edition, the neurological causes of lameness have been given more in-depth discussion, with an emphasis on early recognition of clinical signs and diagnosis. The disorder sections are now divided into those likely to be associated with trauma (fractures and luxation) and those which are congenital or developmental.

The text is supported by high quality radiographs, colour photographs and colour line drawings to illustrate principles, techniques and procedures. Combining their experience in practice and education, the authors have produced a book that appeals to general practice veterinarians, specialist feline practitioners and to students.

1 Introduction to Feline Orthopaedic Surgery

DOI: 10.1201/9780429091537-1

(Chandler & Beale 2002, McCartney & MacDonald 2006, Nolte et al. 2005, Richardson & Thacher 1993, Scott 2005, Shively 1977, Toombs et al. 1985, Toombs & Wallace 1985).

The popularity of cats as pets has increased in recent years and population numbers of owned cats now exceed those of dogs in many developed countries with recent estimates suggesting there are more than 200 million cats in the United States, Canada and Europe. Despite an increasing trend towards keeping cats indoors vehicular trauma remains common particularly in young cats under 2 years of age. In older patients, a combination of increased longevity and greater client expectation has led to the recognition and description of a number of degenerative orthopaedic disorders that were previously overlooked or considered to be of little clinical significance.

It is often stated that cats make good orthopaedic patients because of their small size, undemanding lifestyle and their ability to redistribute weight and protect an injured limb. There is a common misconception that feline fracture repair is simple to perform and healing is not prone to complications. The facetious remark that two cat bone fragments will unite if placed together in the same room is familiar to all orthopaedic surgeons. This casual attitude is not borne out by clinical and experimental studies, which show that the cat is subject to the same range of complications of fracture repair as the dog. The notion that feline orthopaedics is straightforward is all too often testimony to the ability of cats to compensate for or conceal impaired function.

The obvious drawback of small size is the difficulty that this creates for the surgeon in terms of visualization and manipulation of small bones and bone fragments. The small bones of the distal extremities, in particular, are challenging to manipulate and repair surgically. According to the familiar proverb a bad workman blames his tools, but even the most dexterous of surgeons will be frustrated without the correct instruments and implants. Fortunately, the armamentarium of the modern feline orthopaedic surgeon comprises a range of equipment designed for small bone fracture repair that is ideally suited for cats. Historically, there has been a trend towards conservative treatment of many feline orthopaedic injuries, the canine equivalent of which would be treated surgically. While conservative treatment may be appropriate, treatment should always be tailored to the individual case. The goal of the feline orthopaedic surgeon should be to return the patient to optimum function as soon as possible using the treatment with the most predictable outcome and the least morbidity for the patient.

Evaluation of the Orthopaedic Patient:

(Garosi 2012, Kerwin 2012, Moody et al. 2018, Perry 2014).

For the veterinarian who is more familiar with the canine orthopaedic patient successful feline orthopaedic examination requires a change of mindset that incorporates an understanding of the unique qualities of feline behaviour. Feline orthopaedic examination is facilitated by appropriate handling and examination techniques, and modifications to the environment. The goal should be to minimize stress for the patient whilst achieving accurate localization to allow formulation of an appropriate diagnostic plan. Cats are solitary predators with a well-developed flight or fight reaction in response to a perceived threat. The veterinarian has a degree of control over many environmental factors that determine whether a cat will want to run from, or confront, its handler. Desirable environmental modifications for cats include reduction of noise levels, gentle handling, absence of dogs and absence of odours that are perceived as unpleasant. Allocation of a secure consulting room that is used exclusively for cats is strongly recommended. Synthetic facial pheromone analogue should be provided in all areas frequented by cats, whereas the smell of dogs should be eliminated as far as possible. Ideally there should be a separate entrance and waiting area for cats as this will help to reduce stress and anxiety prior to examination. In the examination room provision of equipment such as a non-slip rubber mat and a blanket or thick towel, catnip, treats and a laser pointer may help to make the cat more relaxed.

In comparison with dogs where gait analysis is an important component of the orthopaedic examination most cats cannot be made to walk on a lead and reliance has to made on indirect methods of assessment. The aim should be to gain as much information as possible using indirect techniques and minimal restraint. Gait analysis in cats is challenging because when a cat is fearful or anxious it will stay as close to the ground as possible and will either refuse to move or will attempt to hide. If possible, a cat presented for lameness examination should be allowed to leave its carrier voluntarily and should initially be observed moving around the consulting room as it explores its surroundings. A number of techniques can be used to encourage ambulation including the use of laser pointers, carrying the cat’s basket around the room or placing it on the opposite side of the room. Movement can often be assessed by placing the cat on a low stool or chair as most cats will jump down and walk away. A useful way to supplement this examination if a cat is uncooperative is to suggest that the client makes a video of the cat in the home environment.

Hands on examination should always be performed last, and any potentially painful areas or uncomfortable manoeuvres should always be left until the end of the examination. Handling and restraint should be performed using a ‘less is more’ approach with the cat held in a position of its choosing, still able to move its head, body and limbs, if it chooses to do so. When a cat is placed in a stressful situation its coping mechanism is avoidance of, or retreat from, the source of stress. The handler should use light restraint to allow the cat to feel that it still has the option of retreat otherwise stress levels will escalate and an aggressive response will be elicited as a last resort. For fractious cats, acceptable restraint techniques include a thick towel or blanket and an Elizabethan collar. Gauntlets should be worn to remove a cat from its cage if necessary to avoid injury to the handler. Heavy restraint methods such as scruffing, increase fear, stress and anxiety and are therefore counterproductive as they lead to an increase in the likelihood of defensive aggression. In contrast to dogs where an apparently uncomfortable manoeuvre can usually be repeated to show consistency this approach is poorly tolerated by cats. Once the cooperation of the patient has been lost and an aggressive response has been elicited, such as attempting to bite or scratch the examiner, then the examination should either be abandoned or the cat should be allowed a respite.

Comparative Features:

(Conzemius et al. 2003, Corbee et al. 2014, Hill 1977, Hudson & Hamilton 2010, Jaeger et al. 2007, Johnson 2013, Langley-Hobbs 2012, Lund et al. 1999, Mahoney 2012, Maritato et al. 2020, Ness et al. 1996, Newton 1985, Rochlitz 2003a, Rochlitz 2003b, Rochlitz 2004, Schnabl & Bockstahler 2015, Schnabl et al. 2017, Stadig & Bergh 2015, Thrall & Robertson 2016, Wilson et al. 2017).

The feline musculoskeletal system has some unique anatomical and biomechanical features that will be discussed in this section. There are also fundamental behavioural differences between dogs and cats that demand a feline-specific approach to many aspects of diagnosis, treatment and post-operative management of orthopaedic disease. Furthermore, feline physiology places some limitations on post-operative analgesic regimens that are discussed in chapter 3. Optimal outcomes for feline patients can only be achieved by adopting a species-specific approach that is expressed by the familiar adage ‘cats are not small dogs.’

In comparison with the dog, cats are less likely to be presented to veterinarians for lameness or intervertebr...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Authors
• Preface
• 1 Introduction to Feline Orthopaedic Surgery
• 2 Examination and Diagnostic Tools
• 3 Management of the Orthopaedic Trauma Patient
• 4 Fracture Classification, Decision-Making and Bone Healing
• 5 Instruments and Implants
• 6 Fracture Fixation Methods: Principles and Techniques
• 7 Arthrology
• 8 Forelimb Fractures
• 9 Other Disorders of the Forelimb
• 10 Hindlimb Fractures
• 11 Other Disorders of the Hindlimb
• 12 The Skull and Mandible – Fractures and Dislocations
• 13 The Skull and Mandible – Other Disorders
• 14 The Spine – Fractures and Dislocations
• 15 The Spine – Other Disorders
• 16 Physiotherapy and Rehabilitation
• 17 Neuromuscular Disorders
• 18 Miscellaneous Orthopaedic Disorders
• 19 Oncology of the Skeletal System
• Index