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Please help: my cat has bilateral femoral neck fractures

post #1 of 63
Thread Starter 
Hello all!

It's been a long time since I've posted because my kitties have been doing so well, and I didn't have any issues to ask about!

However, this morning woke up to my Milo making strange meows...he could not walk, and it obviously pained him very much to use his hind legs. Went to the vet...as it turns out, he has bilateral femoral neck fractures. I have no idea what happened...it must have happened while I was sleeping because he was fine when we went to bed, but neither my husband nor I heard anything at all. We're thinking perhaps his femoral necks were weakened by avascular necrosis, and then a simple jump off the counter did it? He's only 1.5 years old and has been perfectly healthy until now.

Anyway, we're considering the options...we have an appointment with an orthopedic surgeon who actually specializes in hips on Monday. Till then, we're keeping him still and controlling his pain. He seems to be OK as long as he's not moving.

Has anyone had experience with this? What do you guys know about total hip replacements versus ostectomy? I mean, doing both total hips would be $9,000 and I don't think we could afford that, but we could afford the ostectomy ($3500 for both sides). However, would he be that much better off after the ostectomies than he would be if we just left him alone and controlled his pain while he heals? How well will he walk after he heals from an ostectomy?

I'm sorry, my thoughts are totally scattered right now and I just want to make sure that the decision I make is the best one for my baby. It hurts so badly that we can't afford to just do what is obviously the best option (the total hip replacements), and I just want to do whatever I can to keep him as functional and pain-free as possible, because I believe he has a lot of good healthy years left!! Any advice or experience is welcome. Thanks in advance.
post #2 of 63
I don't have any experience or advice, but I will be thinking positive thoughts for Milo.
post #3 of 63
Has he ever had any fractures before? You may want them to do a bone biopsy to make sure that there is nothing else wrong.

My cat Neville has a condition known as osteogenesis imperfecta. His body does not produce enough collagen or it produces it improperly. This causes his bones to be VERY weak. He has fractured... his tail, his heel, his right leg twice, his left leg, and his right elbow. He didn't start having any major fractures until he was about 1.5 years old. Thats when he broke his right leg... that healed.... then he broke his left leg....I took him to a specialist, where they dropped him and he broke his right leg again. Then he broke his elbow. I have only ever seen him break one bone... Otherwise I would just see that he was limping and knew that something was wrong. The one that I saw happen, which was his first one, occured when he jumped off the kitchen counter. The next thing I know he is limping and SCREAMING. I FREAKED OUT! He's now almost 3 years old. He has to stay in a very large crate when I cant supervise him. (Fortunatly he has a momma who cares and has built him a crate that takes up half of my living room.) If he jumps... he will break another bone... if he breaks one of his back legs again... there will be no hope. They are too damaged from the other breaks to be able to heal again. His last break took almost a YEAR to heal.

RESEARCH things that could have caused your kitties fractures. Its not normal for a cat to fracture both legs like that. I was the one who brought my research to the vets office to find a diagnosis for him. Even the specialists where dumbfounded... Just make sure you keep pushing for answers.
post #4 of 63
Thread Starter 
Thanks for your replies, Shorty and Beandip.

As far as other bones having problems, the vet said today that he didn't think any of Milo's other bones (or other areas of his femurs) looked osteopenic or abnormal in any way. And he has never had any fractures before, even with him and his sister running around playing rough sometimes!...he's been 100% healthy since he was born. Here's an article I just found:

1: Vet Rec. 1998 Feb 14;142(7):159-62. Links
Femoral neck metaphyseal osteopathy in the cat.Queen J, Bennett D, Carmichael S, Gibson N, Li A, Payne-Johnson CE, Kelly DF.
Department of Veterinary Clinical Science, University of Liverpool Veterinary School.

This paper describes 17 cats that developed an idiopathic necrosis of the femoral neck. In four cats the lesions were bilateral when they were first examined and five cats developed lesions in the other limb within five months. They were all male cats, two years old or younger, and 15 had been neutered. The initial sign was a vague lameness which typically progressed, often acutely, to a more severe lameness. Radiography demonstrated radiolucency and loss of definition within the proximal femoral metaphysis, the femoral neck. In 12 cases there was a complete radiolucent line across the femoral neck. An excision arthroplasty was carried out on all the affected hips and the lameness resolved in all cases. The clinical and radiological signs suggest a primary bone resorption with secondary fracture of the femoral neck. The lesions have some similarities with Legg-Calve-Perthes' disease, traumatic fracture of the femoral neck, canine metaphyseal osteopathy, bacterial osteomyelitis and experimental feline herpes virus osteomyelitis.

This sounds very possible to me....fits him perfectly (male, less than 2, neutered, bilateral). I will take a printout of this to the vet with me on Monday. It makes me feel better that in all of the 12 cases in this paper, the excision arthroplasty (which is the same as the osteotomy that would be $3500) resolved the lameness.

Keep your fingers crossed and prayers coming for us...regardless of what happens, it's going to be a long next several weeks as he rehabilitates.
post #5 of 63
and lots of healing vibes. I'm wishing all the best for you and kitty!
post #6 of 63
Thread Starter 
Thanks so much, catsarebetter!!

He is resting right now...I haven't let him out of his carrier yet because I don't have a good place set up to keep him from trying to walk around...but he's here in the room with me, so I think he's happy. He's laying in his carrier sleeping, and he seems OK as long as I don't try to move him too much.
post #7 of 63
I have no experience with this but I wanted to let you know I'll be sending lots of good vibes your way.
post #8 of 63
More positive thoughts and healing vibes for Milo. Hugs to both of you.
post #9 of 63
Thread Starter 
Thanks so much for the support, guys.

I'm feeling better and better about the prospect of bilateral femoral head ostectomies (FHO's). I just found a journal online that a lady wrote about her kitty who was about the same age as mine when he was diagnosed with Legge-Calve-Perthes disease. This disease causes idiopathic necrosis of the femoral head, and all the signs and symptoms she mentions in her story, now that I think about it, were present in Milo for a few weeks before the actual fractures occurred last night (sitting kinda on his side with his legs splayed out to the side, coming and putting his front paws on the couch asking to be picked up instead of just jumping up on the couch). Anyway, this lady and her kitty decided to do the bilateral FHO's and she has had a really great result, with a happy, pain-free, almost normally mobile kitty. So that makes me feel lots better.

Also, I have learned that the total hip replacement is really only for medium to big dogs...most small dogs and cats do really well with the FHO instead of a total hip replacement. It's just that with increasing size/weight, the FHO is less helpful, and for a big dog who likes to run and play in the park, hips that hurt and don't work very well are a big bummer.

Here is her page:

post #10 of 63
That's a remarkable story about the other cat. It does sound encouraging. It's obvious that you care very much for Milo. I'll be thinking of him.
post #11 of 63
All I can offer is
post #12 of 63
Thread Starter 
Thanks for all the hugs and happy thoughts, everyone!!! I really, really appreciate it. It has been a hard day.

Feeling better now...

The kind soul that wrote the story about her kitty that I posted a link to in my last post replied to an email that I had sent to thank her. She said that her kitty was on top of the refrigerator, about to pounce on his fur-brother...and so obviously, it was worth every penny for them.

So Milo will have the bilateral femoral head ostectomy procedure, I've decided. As it turns out, for cats and small dogs, the FHO procedure is just about as good as the total hip replacement, and a whole lot cheaper. I'm going to shop around a tiny bit to see if I can get it done for less than the $3000 to $3500 that the orthopedic vet is asking...but if we have to pay $3500, we will. He's just so young and perfectly healthy otherwise...I think he has great potential to heal quickly and well, and to live out many many more happy kitty years.
post #13 of 63
Are you taking Milo to Gulf Coast veterinary Orthopedist on 610? They are really good-- ( i work in downtown houston at a vet pharmacy and deal with them alot) Have met a lot of their pet owners and their patients and havent heard anything bad about any of the Gulf Coast Vet groups. Good luck with Milo.
post #14 of 63
Let us know when the surgery is & we'll be here to wait with you!!

How is brave lil Milo doing right now?
post #15 of 63
Thread Starter 
Yes Amitya, that's where we're going!! And the orthopedist we're seeing tomorrow is Dr. Liska, who was one of the founders of the Gulfcoast Clinic, and he specializes in hips and has been in practice for around 30 years. Thanks so much for telling me that you've heard good things...that's really encouraging!

Especially since I decided today that it's not worth keeping Milo in pain with 2 broken hips any extra days just so I can shop around. $3500 is a lot of money, but I would be able to access it right now, and so I'm about 99% sure that I will just tell Dr. Liska to go ahead and do the bilateral FHO's tomorrow when we see him. He's getting a little antsy with not being able to walk, and I just want to get it done and have him on the road to recovery instead of sitting around waiting any longer, yanno?

I'm feeling very good about doing FHO's instead of hip replacements. Everything I've read online reports good to excellent results (some even saying that a year post-op, they really can't tell that the cat doesn't have normal hips) with cats who have had FHO's, even simultaneous bilateral ones like Milo will have. And he's only 1.5 years old and completely spunky and healthy otherwise, so I'm hoping he will heal quickly and easily.

He has been a real trooper. He's currently laying on my bed purring and napping, so it seems that his Fentanyl patch and Metacam liquid are doing nicely for pain control. He took a few steps earlier, but was very unstable and meowing the whole time because of the pain.

The one thing I'm kinda worried about right now is the fact that he hasn't pooped or peed since at least Friday night (since we discovered the fractures). Granted, he's not eating or drinking a whole lot right now, but I'm still a bit concerned. It's just that it hurts him so to squat right now. I guess when he gets desperate enough, he'll go...I've got a really shallow pan for a litter box right now so that he doesn't have to step up and over to get in it.

Hopefully after the surgery, when he no longer has bone-on-bone contact going on, he'll feel better and won't have potty issues.

Any suggestions to encourage him to potty?
post #16 of 63
Thread Starter 
WhiteCatLover, thanks so much, I will definitely let you guys know!! I'm guessing probably Tuesday, since we're not seeing the ortho till 11am tomorrow. Perhaps he does his surgeries in the morning and sees patients in the afternoon??

I just want it done ASAP so we can get on the road to recovery.

Has anyone ever rehab-ed their kitty after surgery or injury? I know that I will have to do rehab with Milo after surgery, so that his muscles strengthen and to prevent adhesions that would reduce his range of motion. Anyone know good exercises to do ?
post #17 of 63
Talk to the surgeon about rehab.
I have a friend in Colorado who used Alameda East for her dog's rehab after cervical disc surgery. They were able to do amazing things - and we could watch on the webcams. One option is to board them at the rehab place - they know what to look for as far as signs of pain and can deal with it.

I know there are some vet rehab specialists in Dallas, so Houston should have them too.

Good luck! Positive thoughts heading your way.
post #18 of 63
Thread Starter 
Yes, I think actually that they do rehab at the Gulf Coast hospital where he will have the surgery. I will definitely explore that option...but may not opt for professional rehab if it would add a significant cost. I know that one thing to do is starting about 5 days post-op, to flex and unflex their legs about 10 times, and do it 4 times a day. Also, I think Lucy will serve as Milo's physical therapist once he's on his feet...she walked by him today and even though he can't walk, he still swatted at her and tried to get her to play! heheh.
post #19 of 63
Thread Starter 
He FINALLY peed last night! He went in the shallow dish I had in his kennel and managed not to get any on himself. You could tell he had been holding it in because he went A LOT. However, I feel better now, because I know his kidneys are working and i know that if it gets bad enough he'll go.

Off to the orthopedist this morning at 11...we'll let you know how it goes!
post #20 of 63
Originally Posted by HOUMedGal View Post
He FINALLY peed last night! He went in the shallow dish I had in his kennel and managed not to get any on himself. You could tell he had been holding it in because he went A LOT. However, I feel better now, because I know his kidneys are working and i know that if it gets bad enough he'll go.

Off to the orthopedist this morning at 11...we'll let you know how it goes!
That's a relief to know he peed ...holding it too long can be bad news for male kitties especially. Let us know how that appointment goes.
post #21 of 63
Thread Starter 
Thanks Beandip, I will. I'm just so ready to get the surgery done with so that he can start healing instead of hanging out in limbo.
post #22 of 63
Thread Starter 
Well, I'll be dropping Milo off at the vet at 7:30 in the morning for tomorrow's surgery. He'll be having bilateral FHO's (femoral head and neck ostectomies). He will stay overnight and if everything goes as planned, I'll be able to pick him up Wednesday afternoon.

Keep sending prayers for him tomorrow, as he undergoes surgery. I know he's young and healthy and so shouldn't have any problems with the anesthesia, but of course I'm still nervous. I will keep you guys updated on how his recovery goes.
post #23 of 63
Good Luck to Milo today. My cat Stewie is waiting to have his second hip done. He too broke both of his hips and we still don't know how. He had his first hip done in November and we will do his second shortly, both FHO. His vet decided that one at a time was the way to go with plenty of time in between to heal. Stewie is doing great. We had to limit his activity for about three weeks but now he gets around pretty good. He still has issues jumping up on things but I am sure that this will get better once he gets his other hip done.

Dozen2Luv (Regina)
post #24 of 63
Sending prayers and healing vibes for your sweet boy.
post #25 of 63
prayers and love to milo.
post #26 of 63
Thread Starter 
Hello everyone!!

Thanks so much for the love and support! The surgeon called me at about 2:30 to say that the surgery went very well, no complications. He said Milo might be able to go home tomorrow, or Thursday at the latest. He just doesn't want to send him home too quickly since he did both hips at the same time.

So once he gets home, the vet wants him up and moving around by about a week post-op. At that point, he's free to do as much as he feels like doing, and my job is to encourage walking around and playing to stimulate his hips to heal.

Dozen, it's encouraging to hear that Stewie did well with his first FHO! I'm sure the second will go just as well. I am more and more encouraged as I hear more stories of kitties doing so well after FHO's. The surgeon kinda wanted to do hip replacements in Milo, and even offered me a deep discount on doing total hip replacements, but the thing is, he has never done bilaterals (and neither has anyone else, to my knowledge). In fact, the first kitty hip replacement ever (unilateral) was done less than a year ago. While the hip replacement would have offered the chance for him to have a slightly better outcome than FHO's, there is also more risk of later complications (infection, further fracture, loosening of the implant) that would require more surgery...and since the first kitty hip ever was done only a year ago, we don't yet know how kitties with hip replacements end up doing years later. So I was more comfortable with the really good chances of near complete recovery that the FHO's would give him...I just wasn't comfortable doing something that's so new and still relatively experimental in cats.

I'll let you guys know when he's able to come home!!! I think his sister Lucy misses him...when I got home today, she followed me around meowing a lot, and she is a very nonvocal cat normally.
post #27 of 63
I am praying for your darling cat!
post #28 of 63
That is wonderful news the surgery went well! Hopefully, he can come home soon!
post #29 of 63
Thread Starter 
Thank you, batgirl and whitecatlover!!!

I'm just overwhelmed with all the love, support, and prayers everyone has offered us over the last few days...I do sincerely thank you all, as it has helped my spirits immensely. And I know your prayers helped get Milo safely through his surgery today.

Sending head bonks and purrs to you all!!
post #30 of 63
I'm glad to hear that Milo is doing well! I'm sure he'll amaze everyone and make a speedy recovery! They are remarkable little critters, even if my Marbled Menace is driving me batty this morning.
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