 Pebbles
is a 22 year old, beautiful domestic long haired kitty who presented to
us with sudden lameness of the left hind limb. Pebbles lives in the
house and
has been healthy up to this point according to the owner. The owners do
not know what could have happened to cause the lameness as Pebbles was
fine the day prior to the onset of the lameness.
On physical examination, Pebbles was bright and alert. For her age,
she looked really good! Her left leg was swollen and painful in the area
of the thigh (femur). Due to Pebble's age, we recommended blood tests
and radiographs to evaluate her problems. Despite her age, Pebbles blood
tests were quite normal. We gave her a mild sedative an took radiographs
of her leg and chest.
The radiographs are presented below:
Even for non veterinarians, it must be apparent that Pebbles
fractured her left femur. However, when you look closely at the
bone (double click on the photos for detailed view), the quality of the
bone in the middle of the leg does not look normal. If you compare
it to the other bones, you will notice that the center portion of the
bone has lost detail and the area near the fracture looks like the bone
is dissolving. These types of changes are often caused by
cancer growing in the bone. As the cancer grows, it weakens the
bone and then it becomes subject to easy fracture. This type of
fracture is known as a "pathologic" fracture because there is pathology
(in this case probably cancer) in the bone which led to its weakening
and ultimate fracture.
While we have the capability of repairing fractured bones, given
Pebbles age and our suspicion of cancer, we were forced us to
recommend amputation for Pebbles. The owners love Pebbles and in
spite of her age, they decided to proceed with the surgery. We
checked the chest radiographs and took abdominal radiographs to see if
there was any spread of the cancer into other parts of the body before
proceeding to surgery. The survey radiographs were clean and so we
performed a special type of amputation in which the bone is
removed from the hip and the entire leg is removed. During normal
amputation, 1/3 to 1/2 of the femur is left on the body to help protect
the abdominal organs. In this case, the possibility of there being
cancer in the bone posed too great a risk for us to leave any bone in
the body.
Pebbles surgery went very smoothly and she recovered without
incident. We were able to send her home a few days after surgery and she
is doing well there. We sent the limb off to the pathologist to
check for cancer. These specimens need to be decalcified (remove
all the calcium) before they can be analyzed. This process may take a
few weeks and so we don't have a definitive diagnosis at the time of
this writing (we will update as it becomes available).
Pebbles Post op
Amputation Site
This case is a perfect example of how we shouldn't let the age of a
pet determine what we can accomplish to improve their quality of life.
Regardless of the ultimate diagnosis, we have eliminated Pebble's
pain and given her owners more quality time to spend with her.
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