Air gun pellet in shoulder

Re: Air gun pellet in shoulder

Neil Wheadon — Thu, 26 Jun 2014 15:29:46 GMT

[quote user="Malcolm Ness"]

The vast majority of humeral fractures in cats that don't involve joint surfaces will heal remarkably well with time. Provided this cat can be adequately pain-controlled, my first choice would be to do nothing. Probably repeat rads after 2 weeks to confirm that nothing has moved and nothing is going wrong then review clinically and radiographically at 6-8 weeks by which time the cat should be using the leg very confidently.

Long term, there may be some lameness related to soft tissue impingement or neuro injury but both of those are unlikely. If soft tissue impingement is suspected, then the pellet could be removed at a later date.

[/quote]

Thanks to the resident orthopod expert, I'll try to remember to update in a few weeks.

Neil

Re: Air gun pellet in shoulder

Neil Wheadon — Thu, 26 Jun 2014 15:28:00 GMT

[quote user="Anne Seawright"]Does the cat also have 2 microchips or is that a different artefact?

[/quote]

Yes it does. If anyone recalls I have a slight obsession with microchips failing and it's far below the 1 in 100.000 quoted

The vet owner of this cat has a similar obsession and has found at least 3 non functioning so far this year, not bad for 300.000 consults, she's a busy lady.

So she put another in

Neil

Re: Air gun pellet in shoulder

Malcolm Ness — Thu, 26 Jun 2014 11:07:36 GMT

As implied in an earlier post, the important question to ask yourself with these cases is not so much where the pellet is now, but where has it been - that is especially important with abdo and thoracic injuries.

Re: Air gun pellet in shoulder

Anne Seawright — Thu, 26 Jun 2014 08:23:28 GMT

Does the cat also have 2 microchips or is that a different artefact?

Re: Air gun pellet in shoulder

Julian Earl — Wed, 25 Jun 2014 15:53:26 GMT

[quote user="Martin Atkinson"]

The best (or worst depending on your point of view) air gun injury I saw was a cat that had been shot through the flank. The pellet had passed through a kidney, two loops of intestine, the uterus and came to rest inside the bladder. A nephrectomy, enterectomy, hysterectomy and cystotomy later it made a full recovery!

[/quote]

I'm pretty sure there are or were a host of WW2 veterans walking around with shrapnel inside them for fifty-plus years without apparent problems!

But the quote of Martin here reminds me of a rta-cat that I saw some twenty years ago. There was a penetrating inguinal wound which necessitated a laparotomy to remove a mass of necrotic fat, and Ithen just happened to notice the kidney floating free in the abdomen, a spleen torn in two, but surprisingly little haemorrhage. plus a fractured femoral neck for good measure Eeeek!!! Those injuries must have stung a bit, but the cat lived happily ever after, especially after the femoral head excision some few weeks later.

Re: Air gun pellet in shoulder

Martin Atkinson — Wed, 25 Jun 2014 14:34:00 GMT

[quote user="Gillian Mostyn"]

[quote user="Neil Wheadon"]What the pellet did was 'compress' the humerus head, it can be seen on the RHS of the orriginal X-Ray. [/quote]

I'm glad you said that.... I was looking at the original post thinking 'ooooo - its broke' but when the later posts said nothing about it I thought I was going mad! lol

[/quote] A classical case of 'not seeing the gorilla' * - I didn't expect to see a fracture so I didn't but it is PDO on the smaller of the original X-rays. Should have suspected that Neil wouldn't have posted something so simple otherwise.

It would depend on how lame the lame cat is or more specifically how quickly the lameness is resolving as to whether I got the orthopods involved. We could do with one on here now for that matter. However in the light of that injury I would be at least be giving antibiotics for a lot longer.

*if anyone needs an explanation about the gorilla just ask!

Re: Air gun pellet in shoulder

Bob Russell — Wed, 25 Jun 2014 14:13:49 GMT

[quote user="Anthony Dennison"]

[quote user="Bob Russell"]

Would removal be 'the best of two weevils?' (another Master and Commander reference!).

[/quote]

Hate to be pedantic, but think the quote is 'the lesser of two weevils'.

Nerd Alert over.

[/quote]

Quite right. Been pretty stressful here and I was not concentrating! Post corrected!

Re: Air gun pellet in shoulder

Anthony Dennison — Tue, 24 Jun 2014 18:12:03 GMT

[quote user="Bob Russell"]

Would removal be 'the best of two weevils?' (another Master and Commander reference!).

[/quote]

Hate to be pedantic, but think the quote is 'the lesser of two weevils'.

Nerd Alert over.

Re: Air gun pellet in shoulder

Neil Wheadon — Tue, 24 Jun 2014 17:06:20 GMT

Yes it's one of the vet directors cats where I'm working at the moment. 2 opinions here were leave it alone but looking for a wider assessement and it's a pretty interesting case

Neil

Re: Air gun pellet in shoulder

Gillian Mostyn — Tue, 24 Jun 2014 16:45:01 GMT

[quote user="Neil Wheadon"]What the pellet did was 'compress' the humerus head, it can be seen on the RHS of the orriginal X-Ray. [/quote]

I'm glad you said that.... I was looking at the original post thinking 'ooooo - its broke' but when the later posts said nothing about it I thought I was going mad! lol

I would probably leave it alone to heal.... and if it wasn't doing well, then refer!!!

Re: Air gun pellet in shoulder

Neil Wheadon — Tue, 24 Jun 2014 15:21:41 GMT

[quote user="Bob Russell"]Would removal be 'the best of two weevils?' (another Master and Commander reference!).[/quote]

Very clever

Re: Air gun pellet in shoulder

Bob Russell — Tue, 24 Jun 2014 15:15:47 GMT

Would removal be 'the lesser of two weevils?' (another Master and Commander reference!).

(Edited for the pedantic & correct!)

Re: Air gun pellet in shoulder

Neil Wheadon — Tue, 24 Jun 2014 14:45:03 GMT

The upload wasn't great, try the one below

What the pellet did was 'compress' the humerus head, it can be seen on the RHS of the orriginal X-Ray. The joint looks largely intact, so my question is with minimal displacement is this best left alone as 2 of us here have suggested.

The incidental finding of fur pulled in with the wound and debris removed illustrates to me just how good cats must be at walling of foreign material as most airgut pellets are left in situ.

For film buffs out there, the doctor was accidentally shot instead of the Albatros and he had to have the pellet and associated piece of clothing removed which the pellet carried in otherwise he'd end up in Davey Jones Locker - confused?..... you will be....... and that's before watching Pirates of the Caribbean.

Neil

Re: Air gun pellet in shoulder

Rob Reid — Tue, 24 Jun 2014 14:39:25 GMT

If they are asymptomatic then I tend to leave them alone although I think with certain types of pellet there is a theoretical risk of lead toxicity.

Removed one from a cats sinus last week (had chronic sneezing) - same cat also had two others that weren't causing any issues so left them alone, she's doing well so far. Have removed pellets from a middle ear and spine before in the past as well, both did well afterwards.

Re: Air gun pellet in shoulder

Martin Atkinson — Tue, 24 Jun 2014 14:29:03 GMT

Re: Air gun pellet in shoulder

Bob Russell — Tue, 24 Jun 2014 13:45:42 GMT

Pellets are seen so often as an incidental finding that I would generally leave them alone. We had a cat in this week with a pellet near the jaw. No idea when it was shot but painless on palpation. Chose to leave alone as it is 18 and has a bl**dy great tumour on the other side!

Re: Air gun pellet in shoulder

Martin Atkinson — Tue, 24 Jun 2014 13:34:03 GMT

The pellets don't normally cause much problem if left, it is as you've discovered the debris that goes in with it. the fur balls are common. I don't recall this from Master and Commander but most people died from secondary infection rather than wounds themselves in those days. I do recall that is what did for SS officer Reinhard Heidrich in some movie with Martin Shaw as a Czech partisan - bits of horsehair from the seats of his car when it was blown up got disseminated in his body. Post op antibiotics should do the job.

Re: Air gun pellet in shoulder

Anthony Dennison — Tue, 24 Jun 2014 13:27:01 GMT

[quote user="Neil Wheadon"](Anyone seen Master and Commander?)[/quote]

Did you check the fur around the pellet fully matched the skin wound hole?