what happened next…

The cat nursing set-up.

           

If you find descriptions of surgery and treatments upsetting, please read no further. I am not graphic in the story that follows, but there is some general detail some readers might find disturbing. The bottom line is that the little Jasper cat is recovering with us and doing well.

We wrote in to our regular vet’s email over the weekend, telling her that we were sufficiently concerned about Jasper that we had called the emergency clinics. However the emergency staff were so overwhelmed that they told me unless the case was life-threatening we shouldn’t bring in the cat. Given this, we emailed our own vet that we would be bringing in Jasper on Monday morning with the plan of leaving him there until our vet could see him. This is an arrangement our vet offers and we are very grateful for it!

What had us so worried? Jasper was seriously limping since his kicking the screen sliding door off its tracks into the yard, and the limb while not odd-looking in any way, clearly would not bear weight without causing him considerable pain. I palpated his paws– all had the same cool temperature and this action did not seem to cause him any pain when he was lying down, so it might not be time to panic—still, we felt the limb was impaired. More important, the young beast wasn’t eating or drinking. On Sunday I gave Jasper some water by mouth using a plastic syringe given to me years ago by the doctor for this purpose when we had an ailing cat. This was popular with none of us!

We had managed by tempting him with treats to get him to eat a few mouthfuls now and again, but while normally a cat obtains enough water from consuming any ‘wet’ food, be it raw or from a can, when cats aren’t eating, dehydration can follow. They are not meant to fast for long. If any of you have tried to keep a cat hydrated by mouth, it’s daunting because an adult needs over 100 ml (or cc) of water in a twenty-four hour period. You can only administer about five ml or less at a time, because you don’t want to risk them inhaling the water. So this is a taxing job. I think I managed to give him about seventy ml during Sunday. This probably was enough to make do, since he did eat a scant amount of wet food that day.

How did I persuade a cat to eat? By finding an exotic and tempting canned kitten food, and dipping my finger in it for him to lick off. I think my finger warmed the food and made it smell more interesting, and I would lightly bump his muzzle with it so he had to lick his chops to clean his face and thus he would get a taste of the delights in store. There is also an appetite enhancer called Fortiflora, and I mixed some of this into the canned kitten food to up the ante.

I’m giving you this much detail because I hope it may be of use to any of you cat people who may face a similar circumstance. But remember I am no professional, I only report what worked on our own particular cat, and hope it may give you your own ideas that may work for yours.

On Monday some hours after we’d dropped Jasper off at the vet’s, our vet called us and said she’d x-rayed the limb and Jasper had broken the growth plate off the head of his femur. If left untreated his pain would become a chronic state that would not only make him suffer but lead to arthritis and the kind of pain that destroys a cat’s ability to socialize with people or other cats.

 To my wonderment she explained that this was actually not an uncommon accident for a young neutered male cat. The solution most commonly applied, is surgery to remove the broken cap and ball of the femur and the short neck behind the head of the femur as well. Then you close up the incision and let the cat heal. This removes the grinding bone pain.

You look at me in horror, wondering how can the cat get on, missing part of a major bone and its nesting joint. Well, it’s fascinating. Apparently the body sets to work infilling the missing bone with what I imagine is a cartilaginous tissue that makes a false joint to carry the remaining shortened femur. The mighty gluteal muscles hold everything in place. After the first two weeks of no running or jumping and holding the cat confined in a crate, the vet surgeon gives you exercises to do with your cat to build up the necessary area. Why not continue leaving it alone? Because Nature mends what is needed, and bed rest tells Nature that there’s no need for swift healing. Works for people in recovery too—physical therapy can be uncomfortable, exhausting, but it informs the body that these parts must work, that they are necessary to life. Also, left unchallenged, unworked, the cat body’s infilling material can set too tight, resulting in a restricted range of motion. Recovery will not be as successful and there may be future arthritic issues that will cause chronic pain. So in about three weeks you may imagine us dancing with our Jasper by holding up his forepaws and encouraging him to step about slowly. He’s a very people-oriented animal so I have hopes we will do well enough.

We do hip replacements in humans, so you may wonder why we bother. Why not just remove the head of the femur when Grandfather breaks his hip? Unfortunately for us, the process I just roughly described for the cat doesn’t work in us humans. Apparently before hip replacement was devised for humans, surgeons did indeed remove the ball and neck of the femur, hoping to rid the patient of the bone-on-bone grinding pain, and left nature to infill. But we are bipedal, not quadrupedal, and the stresses of our structure made healing always go awry. (There were many World War I veterans who remained crippled and with chronic pain for life because of this. Apparently it is simply not possible to create a good false joint in a bipedal creature.)

The next question is of course, why didn’t we do a hip replacement for Jasper? First of all it is notably expensive. Second, the nearest surgical center we would have had to reach is a good distance away, and would have meant a considerable delay in treatment. Third, a hip replacement does mean a more challenging and risky surgery, with increased chances of complications. All in all, we didn’t believe it was the right choice—our Jasper had already had to wait long enough. But here’s where we had superb luck. The surgeon our vet recommended had an opening Tuesday for the consult, and a surgery spot for Jasper on Thursday.

 The surgery was out of town, (about an hour away from our home when traffic is good,) and we took Jasper down for the consult. Liked the surgeon and his team when we met them, had a clear and reassuring discussion, and we took Jasper down on Thursday in the dark of dawn and brought him back home Friday. All reports say that despite his feral origins he was an excellent gentleman cat about the proceedings.

I am hoping, as I said, to share some small bits of useful information with other cat owners who may be reading this. For Jasper’s first two weeks of recovery we set up two dog crates zip-tied together with the door between tied open and the fourth side of the smaller crate left flat to its floor. This we covered with a thick bath mat, not too fluffy but soft and comforting. The picture at the beginning of this post shows what I mean. For the catbox, we put one in the far end of the larger crate. To make this catbox we took the bottom of an old deep catbox and cut a smooth curve that would allow him to enter the box without effort or catching his Elizabethan collar (it’s huge, but must be in order to keep him from licking his incision.) So the catbox on its in-facing side is no more than an inch high as you can see in the photo below. I recommend Feline Pine or pelleted horse bedding for the litter. We made the mistake of starting out with a clumping litter and of course the poor Jasper stepped with each foot in his water bowl, dragged his tail through the bowl, and then got clumping litter setting up like concrete in his toes and fur. That has led to a long slow grooming of our little cat that I suspect has been good for his healing, because it gently encouraged circulation and makes him feel tended, since he can’t do any licking of his fur with his head in that Elizabethan cone.

Last bit of practical information for fellow cat carers. If you have an NSAID to be given to your cat, it usually necessitates that the cat eat, so the stomach isn’t damaged by this anti-inflammatory. If your cat has no appetite, try giving his anti-anxiety pills or Gabapentin prescribed by the vet surgeon, then wait about forty minutes. (I’m sorry if you have to force the pills down his throat—I certainly had to do so in the beginning with Jasper.) With Jasper his appetite woke once the Gabapentin and Tramadol took some effect, and after waiting those forty minutes I was able to feed him several tablespoons of kitten food before giving him the NSAID anti-inflammatory.

My last piece of information—the patient is doing well, I believe. His ears are generally cool, his nose wet and cool, he purrs in greeting and also while you gently wipe him down with a lightly moistened paper towel followed by a dry one (trying to mimic mother cat tongue.) He is finally showing a decent appetite.

Onwards we go! But I’ll tell you what I told the vet surgeon.

No more karate lessons for our cats.