I never do case studies because I don’t want to violate client-patient-doctor relationship confidentiality, but this is now my own pet so I can tell y’all allllll about it.
Beren came to my clinic right after a dangerous tango with a (new) lawnmower blade. He was alive and slightly shocky, and the gentleman who brought him in didn’t know if it was a boy or a girl, or have a name for the little one, but also wanted me to “do whatever I could to save him”. In my industry, we know that’s code for “I have no money to pay you for any of this”. After a brief exam I determined that the tiny 7 week old kitten’s front left leg was completely broken through the middle of the humerus (upper arm bone) and the tissue around it was barely hanging on, so it would need to be amputated. His back left leg had a lot of laxity in his metatarsals (ankle bones), suggesting a fracture in one or more (there are 4), but since the skin and surrounding muscles were all still intact it could possibly just be splinted and allowed to heal. I gave the owner a quote for the surgery and splinting, and he agreed to the charges.
The next morning, after 12 hours of pain meds and observation to ensure his little body was healthy enough for surgery, we sedated him for the amputation and splinting. I decided to simply remove the dangling tissue and smooth the edge of the broken humerus and close up around the end of it, since I didn’t want him under anesthesia too long. It went really smoothly and the skin closed up beautifully around the remaining part of his leg. We splinted his back leg while he was recovering from anesthesia, and by lunch time he was eating kitten food and meowing for attention. We gave him pain meds and antibiotics and a cone of shame, plus dewormed him since we observed several creepy-crawlies exiting his rear end during surgery (major yuck). I took him home over the weekend to continue his pain meds and help him use the litter box, and he did well. He turned out to be a snuggle bug, and got lots of loving from Husbeast and Punkadoodle all weekend.
Monday morning (36 hours post-op) his amputation site starting to ooze some purulent discharge (read: infection), plus some of the stitches were popping open. I started him on another antibiotic and we cleaned the site. Tuesday it was even more dehisced (open), so we put some staples in it after cleaning it up again. The tissue looked healthy, so I didn’t quite understand why the sutures weren’t holding. He couldn’t lick it with the elizabethan collar on, and his back left leg was in a splint so he couldn’t scratch it, either. I got him out Tuesday evening to go to the litter box and figured it out. When he was laying down the piece of bone left in his arm was in one position and the skin closed over it beautifully. When he stood up and tried to move his nub the bone protruded straight through the sutures, poking a hole in the appositioned tissue. Dang it.
I placed a bandage over the amputation site to keep the area clean and covered until I could get in touch with the owner. To go in and repair the damage would require a full amputation- dis-articulating the remaining humerus from the scapula at the joint. More anesthesia, a longer and more intense procedure that makes me nauseous even just in theory, more pain meds, and, as medical services and supplies are not free, more money. We tried unsuccessfully to get in touch with the owner for days, and by Friday knew we had to do something or he could die from sepsis. One of my co-workers volunteered to track him down at his work in town, but he wasn’t there. She told his co-workers that we really needed to get in touch with him, and he finally called us mid-morning. When I told him about the kitten’s complications and how he needed another surgery, the owner said he didn’t have the money. He was going to elect humane euthanasia. I texted Husbeast and asked him to talk me out of saving a 3-legged kitten that needed another surgery and would be in a splint for a few more weeks, at best. Can y’all believe that he not only failed to talk me out of it, but told me that we needed another kitten anyway, since our latest foster finally got a forever home and now our Fawkes kitty would be lonely?!?! Let’s all take a moment to appreciate who the real bleeding heart is in this family. And if we end up with a cuss-ton of cats one day, it is NOT my fault.
So I told the owner he could instead surrender the cat for a good Samaritan to take over the medical care and find him a home. He agreed, and we immediately started prepping for surgery. This surgery was a lot more difficult, and as someone who abhors orthopedics, it took every bit of willpower to not vomit or faint during the surgery. I made it through, closed up the skin, and we changed the bandaging on his splint while he recovered. He came out of anesthesia just fine and again, was up and eating within a few hours. I took him home again for the weekend, to administer his antibiotics and pain meds, but by 24 hours post-op it was clear that he was feeling better than he did after the first surgery. He was walking around a lot easier, even running, and wanting to play. That second surgery made such a difference, and I’m so glad he got his second second chance!!
We also took repeat radiographs* of his back left leg, and I almost fainted when I saw the first rad come out. It looked perfect. I compared it back to the rads we took on day 1, and there was clearly a break, so did it heal that fast?!?! I had my techs take another radiograph from a different angle, and lo and behold, there was the fracture. Tricksy bones in 2D… Always always always take orthogonal views (at least two different angles)! So, back in the splint he went. Hopefully his age is on his side, as young bones heal faster than old bones. He was healthy enough for his first boosters, and should everything go well he will hopefully be out of the splint and a “normal” kitten in another 3-5 weeks. (*Side note, it is incorrect to call them x-rays, because that is merely the type of radiation used to create the image, which is called a radiograph. You can use that fact at parties, free of charge. )
It’s so hard to take a picture of radiographs… same foot, two views. See the misalignment/fractured metatarsals on the right?
Anyway, now I have a 3-legged kitten running around my house. Fawkes is just smitten with him and gently bear-hugs him and alternates between soft play bites and grooming him. Punkadoodle is enamored. She carries him everywhere. She loves nurturing little animals and dolls and babies, so something that can’t escape her very quickly is her ideal target. The other day she had out her doctor kit and had him on her bed being her patient while she examined him. Be still my heart. So that’s our newest addition, although Husbeast swore we weren’t going to add any more pets to the family for a long time. He probably loves him more than I do, but that’s only because he doesn’t have the memory of a nauseating surgery attached to that sweet little face. 😉
And his name is of course a fantasy fiction reference. But what did you expect, with our other two being named Fawkes and Tonks? ( We did not name Jager or Griffin– those were their names when they were service dogs in the Guide Dog Foundation. But we pretend Griffin is short for Gryffindor.)
Grace and Peace,