Last time I was on call for the weekend coincided with a work dinner in honour of staff changes. It was a Friday night so I booked a nearby restaurant in case I had any emergencies to attend. 

My phone remained quiet for the duration of the whole meal and approaching 9 p.m. some were going to the movies.  I decided to risk going as well but of course 10 minutes into the main feature my mobile phone rang.  A distressed owner had found her cat at the back door in considerable pain with severe wounds. I arranged to meet her at the clinic as soon as possible.

"Chico" a ginger long haired cat arrived in a terrible state. He was in pain with an obvious broken leg and a large laceration in his belly clearly as a result of a dog attack. Despite his wounds he managed to crawl back to his home and was being friendly and purring each time I examined him.  Strips of muddied tissue were hanging from the wound which made me immediately doubtful about his future. The initial aim was to make him comfortable and stabilise his circulation -  wounds and broken legs must wait until the patient is fit enough for repair under anaesthesia.  I gave him a potent opiate to control the pain, antibiotics and treated him for shock (which is circulatory failure). 

The next day he seemed stable enough so after our Saturday morning surgery Emma stayed on to help me investigate his wound.  After anaesthetising him I started cleaning up his wound which was extensive. The tissue was badly damaged and had been contaminated with dirt. I was pleased that the wound was entirely subcutaneous - the teeth had not entered the abdomen which may have been ultimately fatal.  Preparing the area for surgical closure is a time consuming process that involves picking off the pieces of foreign matter and hair etc. Then removing devitalised tissue (debridement) and a procedure called epluchage whereby the top layer of tissue is removed leaving a healthy surface behind.  Then the area is irrigated with copious sterile fluids and finally dusted with soluble penicillin.  I was pleased with the final result in Chico's case but just to be sure I inserted a Penrose surgical drain for 3 days.  An x-ray revealed the fractured femur was in 3 segments which would take extra time to fix than a simple break.  At this stage I decided Chico had been asleep long enough and postponed his fracture repair until Monday when the antibiotics would hopefully make the procedure more sterile.

On Monday, Chico was (as ever) very friendly and appeared to be more comfortable. We anaesthetised him and I made a surgical approach to his femur.  The muscles had been badly lacerated either by the dog or possibly by the sharp bone fragments.  I reattached the loose segment to convert the damage to a simple 2 piece fracture then inserted a pin through the middle of both parts.  Two more wires around the fracture to stop rotation and the bone had been reduced (i.e. all the bits were in place). This is only part of the repair process though the cat has to be capable of healing which can be impaired by infection, tissue damage and compromised blood supply amongst other problems.  The cat also has to be confined for 6-8 weeks until the pin is removed after healing is verified by radiographs. Chico proved to be a Houdini from our confinement cage at home and when out he found the pin end painful when he moved.  This caused him to lash out at his owner who was trying to console him and she had to visit the doctors!  It's a good thing he is such a lovely cat and he has such a caring owner! Chico is now confined in one of our clinic cages and is doing very well. In a few weeks his pin will be removed and he will return home good as new. 

More about Chico next time …

© Dr Brett Kirkland

Beach Road Vet Clinic

New Zealand

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