Hi

I am hoping someone out there has some experience/advice to share with me about hip dislocation corrective surgeries.

Thomas (11mnths) was in a cat fight almost 3 wks ago and only today has the vet discovered that he has a dislocated hip and will need surgery!

He is suggesting starting with an open hip relocation surgery where they cut into the leg and place the femur ball near the socket then stitch and bind the leg. They can't reposition the femur without cutting because the muslces are too stiff/contracted.

However, this op might not work and I feel it most probably won't because the tendons/ligments/muslces have been stretched out of place for soo long and the shape of the hip sockets in cats. Also, I can't see Thomas accepting his leg being bind for the required.

The next step is to perform a Femoral Head Ostectomy where they cut the ball of the femur off and leave it for form fibrous tissue which will anchor the femur to the socket. Sounds painful but simple and effective BUT Thomas has lost soo much muscle mass that there are now 'complications'! My understanding is that the muscle is suppose to aid support the leg and allow the fibrous tissue to develop. Thomas doesn't have strong or, possibly, even enough muscle to make this a successful long term solution and as a result may experience the femur and hip socket to grind together.

So what would be next? Hip replacement? Unfortunately, I was to upset to fully question the vet and it wasn't the same vet that I have been dealing with before. Original vet was too busy to see me face to face but had phone me to give me the x-ray result and the options. However, he didn't mention the 'complications' of lost muscle mass. I only found out when I picked up Thomas and saw another vet. I was told with a dog, they would use swimming therapy to rebuild the muscle but you can't do it with cats.

Any experiences of a Femoral Head Ostectomy will be great. Especially, if there was muslce loss before hand. All the information I have found online is regarding Femoral Head Ostectomy immediately after a dislocation or break has occurred. Nothing about complications and muscle loss prior to op.

I'm not sure what to do. I really don't want to put him through these ops only to have another major operation later on in life or for Thomas to be in ongoing discomfit with the bones grinding. And they want me to walk in on Monday with the ok to proceed with the open hip relocation and to proceed to the Femoral Head Ostectomy if they find it is necessary once they tried the first option.

Really hope some out there has something to share.
ThomasAndRocco

I'm sorry your poor kitty is going through this, I have no experience of it though but didn't want to read and run, I would discuss it further with the vets and maybe even look to getting a second opinion or taking him to an orthopaedic specialist.

Is he insured? If so and if he were mine I wouldn't want anyone but an orthopaedic specialist to do it, and I mean someone who does orthopaedics dayi n day out not just someone with an interest in orthopaedics. As you say there is complications and a femoral head and neck excision does rely on the muscles so I've no idea how it would turn out if they're already atrophied, I've seen FHNE's done numerous times and they are usually very successful, but I can't recall seeing them in cats where the injury was weeks previous (but then I don't work in referral).
What area are you in out of interest?

HI

Thanks for the replies.

Stupidly, we don't have pet insurance. So, specialist fees are out of the question and as it has been so long already I don't want to delay any further by waiting for a second opinion.

Doolally - I'm in Whyteleafe, Surrey. Near Caterham.

The thing that is upsetting me the most is, that I mentioned that Thomas's hip looked swollen on the side at his follow up appt, 4 days after the attack. Unfortunately, hubby and the vet (who didn't take I closer look at the time) put it down to Thoma over compensating and putting his weight on his good leg. The vet was surprised that Thomas was in some much discomfit from cat bites but didn't think an x-ray was necessary. Even though he has been limping all this time, he was been getting about, jumping up on the couch and even running after Rocco (our 4mnth old). But as he has lost muscle mass and continue to limp, the bump became more obivious.

I'm kicking myself for not being more pushy, for NOT following my instinct and, worse of all, accepting the vet's verdict that my cat had a "low pain threshold", "it could be emotional" when he was in more discomfit than expected at his follow up appt.

ThomasAndRocco

Hmmm tough one.

What i'd probably do actually, is try and get your vet to speak to an orthopaedic specialist and see what their opinion of what would be best for Thomas is...The specialists will often give out free advice to vets of cases (especially if they *think* they might get a referral out of it), and most vets know someone they can talk to about different cases.


Meant to say above actually some cats do take quite well to hydrotherapy, so it might be something to think about.

I am sorry that i don't have any advice to give you.
Try not to kick yourself. It's not your fault and you are doing your best for him!
That's why you are on here.

Many years ago our first cat was hit by a car and had a dislocated hip. The vet said that he tried to put it back but kept popping out. He had a hard lump which i think must have been the bone on the top of his hip.
He had one leg slightly longer than the other but he never had any problems through out his life. He never had Arthritis and he lived till he was nearly 19 years.
Operations and medical stuff is different now so that's why i cannot advise you.
I wish Thomas all the best and hope he makes a full recovery.

Do you think it was the cat fight that caused the injury? Usually they just get a few scratches and maybe an abscess?

__________________

Doolally - Thanks for the advice. I will speak to the vet and see if he will phone a specialist.

jill3 - Yes, I think it was due to the cat fight. He had a couple of small bite marks on his outer thigh, 1 bite mark on the inner thigh and what appears like shallow stratch marks on his belly. Also, that night we had a strange cat stuck in our kitchen. Hubby picked up Thomas from the bottom step and put him by his new cat litter location, closed the kitten in the kitchen and went to bed. At 2am hubby was sleep walking so forgot to completely lock the cat flap and didn't notice there was something wrong with Thomas. It was only the next morning that we realised there was something wrong when Thomas didn't come down for his breakfast and his hind legs collasped when I put him in front of his food. The cat that came in sprayed on the kitten's litter tray and I think had we not changed Thomas and Rocco's sleeping areas, Thomas might have been dead because he couldn't get up the stairs and there would be no where for him to hid. Rocco hid behind the fridge which I think saved him for the 5hrs he was trapped with the intruder. I think it would have to be a major concidence for us to an intrude on the same night that Thomas was injured. To get indoors Thomas has to jump at least one 6ft fence and most probably fell badly whilst injured/being chased. It doesn't appear as he was hit by a car.

Thanks for your messages of support, everyone. I'm on a rollercoaster, one moment I'm feeling positive and the next I'm in tears. Don't know whether it is Thomas or I that is suffering (him - physically, me -emotionally)

I can only reiterate what's already been said about getting a specialist on board though I can understand why a referral centre might be difficult at present. You need to get everything just right now to prevent any problems in the future. I'm sure a specialist could put your mind at rest regarding the best choice of procedure etc I would still get an idea of costs involved anyway.

However, since essentially you're in this position because the vets didn't pick up on this in the early stages, I feel it only fair they should in effect compensate you for this. I would certainly discuss this with the head of the practice and hopefully you can work something out.

Best of luck with it all!

The first option would include suturing the joint capsule which is what helps hold the head of the femur in place, not just the muscles so don't be totally pessimistic about this option.
I have seen a femoral head and neck osteotomy done on a kitten with a several month old fractured femoral head that was degenerating and the kitted had very atrophic muscles. It worked fine and with some good post surgical care and (whatever the word is where you get the muscles active again) they rebuilt up strength.
It's used for dogs with Legg-Calve-Perth disease which is where the head of the femur lyses over time and the dogs use that leg less and less so have significant muscle atrophy and it works well on them too.
It's a suprisingly successful operation depsite it seeming a little mad how it might work.