Oh Rocky! Really?

About a month ago, I had a client bring in a barn cat because he’d become non-weightbearing lame on his right hind leg. Rocky sauntered around the exam room but was quite uncomfortable when I palpated his hip. We took a radiograph of his pelvis and there was a pathological fracture of the femoral neck.

Legg-Calve-Perthes disease is usually found in small breed dogs between the ages of 5 to 8 months. It is considered an inherited disease where the femoral head doesn’t develop normally. The bone becomes fragile and breaks easily. Now, this is where I know Rocky did not read the correct textbook. He is a two year old cat.

The picture shows the fracture outlined in red on the right hip. The blue line shows where the surgical excision needs to be performed. The green lines show what a femoral neck should look like. I will get to the yellow arrow in short order.

The only treatment is a femoral head and neck ostectomy which is surgery to remove the head and neck of the femur. The patient does well after surgery because the major supporting muscles are not involved and a pain free false joint is created with the scar tissue. I was up front with the owner as to the number of these surgeries I’d done – three. I prefer my surgeries to involve soft tissue not bone. We went forward with surgery. I have included a link to a really great video on this procedure. I would have loved the electro-cautery unit (it instantly zaps bleeders) and the drill. Since the neck was already broken, I had to use bone rongeurs (type of bone cutter) to remove and smooth the bone.
http://www.youtube.com/watch?v=_J9VzqVCWwE&feature=related (Sorry but I couldn't get the link to work so feel free to cut and paste to see the surgery)

The surgery was routine and recovery was going well until he got startled one day in the house (yup, he batted his cute eyes and landed himself in the house). He jumped up, twisted then fell on his left hip. The yellow arrow is pointing at what I'd warned the owner about. He had this disease in both hips and it was a matter of time until the second hip became a problem. I never dreamed my fourth AND fifth femoral head and neck excision would be on the same animal in the same month!!!