very swollen limb in a cat

Re: very swollen limb in a cat

Mark Rowland — Sat, 29 Sep 2012 17:16:50 GMT

Has anyone any experience with vivitonin in cases like this?

Re: very swollen limb in a cat

patrick murphy — Sat, 29 Sep 2012 15:32:26 GMT

I had one that we noted initially to be not as warm as per, but went ahead and did external fixation, then the leg practically dropped off before we removed it, so I think probably as yours a vascular injury

Re: very swollen limb in a cat

HMC — Fri, 28 Sep 2012 19:25:38 GMT

Thank you Malcolm. That post has really helped my understanding of what could be going on. I have already cleaned the limb under GA and given convenia and metacam injections and started regular vetergesic injections.

I have spoken to the owner since the original post and she says that he has not been moving much since the cast has been on- he has been on cage rest but not even moving around much in the cage and not weight bearing much.

He was normothermic initially (then hypothermic after ga).

Re: very swollen limb in a cat

Malcolm Ness — Fri, 28 Sep 2012 18:04:24 GMT

if the cast has been on for a month it is unlikely that we are looking at vascular compromise etc - the leg would have fallen off long before now if that were the cause.

It is not unusual to see a maceration/infection of skin under casts and dressings - while the patient can't get at the skin (because of the cast) all looks well but as soon as it is removed the patient licks/chews/traumatises the skin massively to produce the kind of result described here.

I would anaesthetise the patient, wash the limb thoroughly with chlorhexidene or similar then rinse/dry and massage gently before waking the cat up, buster collar in place and treat with broad spectrum antibiotics and pain control. Prognosis is difficult to call - most do very well but I have seen cases go very badly wrong with deep necrosis etc.

As a general point, the use of casts following plating is inappropriate - the "justification" for the expense and morbidity of fracture surgery is the improved prognosis and more rapid return to function - that is negated if a cast is applied after surgery. Additionally, cast and plates are rather antagonistic from a biomechanical perspective.

Re: very swollen limb in a cat

Rajat — Fri, 28 Sep 2012 17:09:48 GMT

Hi Nicola

Yes could certainly be cellulitis. If the cat is traumatising it likely there is pain which oedema should not give us. Does not sound like vascular compromise if directly under the cast tho not definitive. I would be tempted to check a fnab of the skin/finlamed areas or tape strip depending on how deep you thought the problem lay (epidermis vs dermis/deep to dermis) and check for circulating neutrophilia and pyrexia- if the latter 2 present then a course of antibiotics and meloxicam is what I'd probably use. Topical treatment with anti inflammatory steroid cream fuciderm etc may help too.

Best of luck

Re: very swollen limb in a cat

Nicola Lawlor — Fri, 28 Sep 2012 16:52:40 GMT

Could it just be a cellulitis?

Re: very swollen limb in a cat

HMC — Fri, 28 Sep 2012 16:43:09 GMT

[quote user="David Mills"]

Why cast a plated tibia repair? Not a criticism, just interested. I'd only think of casting a leg to allow healing without int/ent fixation (or for e.g. hock repairs), wouldn't do it in a plated tib. Do people routinely do this?

[/quote]

Can't answer that one- I'm not the orthopod!

Re: very swollen limb in a cat

HMC — Fri, 28 Sep 2012 16:42:30 GMT

[quote user="Rajat"]is th elimb swollen above the cast below it or directly under it?[/quote]

Swollen directed under where the cast was

[quote user="Rajat"] Is the skin discoloured?[/quote]

Yes- red and inflammed (but cat has been traumatising extensively)

[quote user="Rajat"]is it pitting oedema or harder (inflammatory type) swelling?[/quote]

Not pitting- the skin is taut.

[quote user="Rajat"]Does the skin bleed when pricked, is there evidence of pulses below the cats (using a doppler ) [/quote]

Will check.

[quote user="Rajat"]any evidence of vascular thrombosis on ultrasound [/quote]

I don't know how to do this.

Re: very swollen limb in a cat

David Mills — Fri, 28 Sep 2012 16:33:13 GMT

Re: very swollen limb in a cat

Rajat — Fri, 28 Sep 2012 16:19:45 GMT

Hi Hannah

Things I would look for to give me hints as to what the prob may be are : is th elimb swollen above the cast below it or directly under it? Is the skin discoloured? Does the skin bleed when pricked, is there evidence of pulses below the cats (using a doppler ) and any evidence of vascular thrombosis on ultrasound if everything else negative..

The swelling - is it pitting oedema or harder (inflammatory type) swelling?

Might give a few pointers..

Re: very swollen limb in a cat

Evelyn Barbour-Hill — Fri, 28 Sep 2012 16:13:52 GMT

Massage?

Re: very swollen limb in a cat

Martin Atkinson — Fri, 28 Sep 2012 16:09:38 GMT

Was the cat in discomfort when the cast was on, i.e. evidence it was too tight, any signs of pressure sores or compromised skin? I would have thought that was the most likely answer. Treat as seen with pain relief I guess is all you can do.