Seek your exp/research on cat with broken pelvis (surgery or not; challenges of bed/cage rest)

Rosebud is 6 year-old spayed indoor/outdoor (American long-hair former city street) cat who was AWOL for 13 days and made it home on her own yesterday morning. Vet who has reputation of being excellent says surgery is option as well as letting things heal naturally, but in either case the recommendation is that ideally she'd be restricted (by cage or medium sized dog pen) in movement to allow for full healing. Minimum bed-rest time would be 4 - 5 weeks - that will be a huge challenge.

She lost 2.5# and is down to 5# 4.5 ozs and was quite dehydrated. Early signs are very promising, and her pelvic fracture and sacral area mis-alignment are present but not terribly severe. Biggest concern is that the shift of pelvic girdle might be impinging on the colon and thus make BM more difficult, however no BM in 1st 24-hours makes sense as food is just starting down the digestive track journey. She is urinating and with each several hours this is increasing in qty; eating and drinking from water dish are getting better. I have confined her to my small office and moved a mattress in so I could sleep nearby. Already today she is unhappy that office door is closed and it is the only time she calls out to complain.

Most often she holds her right rear leg in the air but today occasionally tries to put a little weight on it. She is grooming herself. She is not on pain meds as these can cause constipation, and if she has some pain which is likely given the fractures on one side then this will encourage her to stay more quiet and not overdo thing - it is natural feedback mechanism and I expect that after the injury probably 10 days ago she chose to lay low and nurse herself and begin to heal rather than attempt to get home and deal with the pain of moving. Seems to me that her body has a natural wisdom that has served her well even with the weight loss and some dehydration.

Per vet, it is unlikely that there is kidney/bladder injury, or liver/spleen injury as she probably would be dead rather than getting home. Personally and for cats in this home a natural approach is preferred and I am using homeopathy, and nutritional supplements e.g. Probiotics to support the healing. She will have acupuncture tomorrow from a home visiting vet who will also look at the xrays but that isn't her area of expertise.

Surgery or not?

Will try to post image of the xrays.

If BM is not coming or is not plentiful in a few days then surgery seems like a better option.

I had read a few articles with some anecdotal reports that cats with surgery and pins were more likely to have arthritis issues later in life at that location, but this is hard to evaluate Any opinion on this?

Of course the large expense of surgery is a factor but not insurmountable and not the driving decision making factor.

Both my vet and several articles by vets indicate that the fibrous tissue and scar tissue at the fracture site which are part of the healing process make it more challenging to do surgery as little as a weak after the injury. For Rosebud it will have been nearly 2 weeks. My vet said that he has to move or cut some of this to do his pinning and moving of pelvis into better alignment and that once out of surgery this tissue and its nerve endings will be complaining. It is almost like surgery would be over riding what had naturally taken place to move things into better text-book alignment and while the latter is good to accomplish it you are interfering with what was naturally evolving. Tough choice for me and it seems that several months of increased discomfort for Rosebud might make for better movement for the rest of her life. It also seems that the natural process will not lead to a limp or terribly odd movement, but just something that is a bit unique to her own movement style.

So my inclination is that if BM is OK then no surgery.

Cage and bed-rest - the big challenge

My joke is that I hope I can get her addicted to cat TV and she gets hooked on some soap opera with a multi-year series so she has some entertainment for at least the next 6 weeks. I can work at home and telecommute to office computer; nonetheless, forcing her into an area of about 10 square feet is going to be very tough. I have read on prior forum thread that one orthopedic specialist had wanted only 7 days of cage rest in that situation and length of time varies by case but even for the same case it seems that internet experts have fairly wide differences in what they recommend. Perhaps they all have the same idea of what is best, but some simply know that it is impractical for most to enforce 2-3 months of very limited activity so they don't even try to suggest as it might be too discouraging or counter productive. I guess I could have her xrayed again after 5 weeks to see how things are filling in and healing and decide based on that how much more time makes sense. I do plan to enforce very limited movement to start and then each week allow a bit more activity so that both she and I feel that there is a progression.

Any experience and tips on enforcing bed-rest? Tomorrow 8 panel dog enclosure will arrive so I can start with a 4 panel area and then add to it over time.

I am so happy that she is home, and her two adult cat kids are glad as well but I have severely limited any contact as Rosebud can't take too much stimulation at this point as it makes her want to get up and explore and interact. I do have quiet soothing music that plays continuously which helps make the office a real refuge for her.

Thanks for any of your thoughts and advice. The prognosis is very positive.

I'm so glad she was able to make her way home, and that the prognosis is very positive.

As far as trying to keep her "contained" for even a few weeks, I think that is always the biggest challenge.  It's almost too bad we can't just put them in a medical induced coma while they are healing, just so that don't go stir crazy   At least she is 6 years old.  The last one this happened to was a kitten.  Just imagine having to try to contain an active kitten for 6 weeks .

Anyway, I think using the expandable dog carrier is a good idea, that way (I think) you can move her from room to room as you need to.  For example, when you leave your home office and go to the kitchen, she may want to go with you.  This way she can.  Same when going to the family room, bedroom, etc.  The soft music is also a good idea, and there ARE cat video's out there, although not sure they will hold her attention for too long at a time...probably depends on the cat.  I think the real idea here is to keep her from trying to jump up on things, so I'm guessing she can have a bigger area as long as there is nothing for her to jump up on or jump down from.  If there is a window in your home office, then I would make sure she has a way to "gently" get up to it and get down from it without making big jumps.  Something like stair steps.  I have a futon in front of the window in my home office, and if this was happening in my home, I would go so far as to put a bunch of boxes on the futon, then put pillow on top of them to make the "seat" closer to the back of the futon so she could literally just step up.  I would do the same thing from the floor to the seat, so I would eventually end up with 4 big steps from the floor to the back of the futon, if that makes any sense at all

As far as surgery or not, I tend to agree with you...if she is able to have a good BM as is, then I would probably forgo it.  What do you feed her?  You may need to give her canned in order to keep her well hydrated and keep the stool a little softer.  And, of course, less grains and carbs should equal less stool. 

Good luck with your little Rosebud.  Keep us posted on her progress

I had one (see Grey Boy's Journey at the bottom of my signature here, and see the space he stayed in) who had two badly injured front legs, one just soft tissue but the other broken in 3 places and bone protuding.  He had only a 50-50 chance of survival if he were to infect in the bone.  The vet felt natural healing, even though he would be somewhat cripped, was the best bet, since he would be cared for and not forced to fend for himself.  He was a complete feral and could not be touched.  I confined him to a very narrow hall/laundry room and provided several laundry baskets at different levels with a set of kitty stairs leading to the middle one.  He did actually drag himself to a new bed when he peed in the first bed.  I started using human incontinence pads in layers so I could pull one out if it got wet, leaving a clean one underneath.  It wasn't long before he started using the stairs to go down to the litterbox amd then I left his food & water there too.  He moved very little and did heal.  I think if you gave her a very limited space, she would do likewise.  As long as she can manage to poop and not get impacted, you should be OK.  Maybe some miralax would help keep it soft? 

Thanks for responses and suggestions, I am exhausted and Rosebud is doing better with each 6 hours that go by and late this afternoon had her first poop which was extremely small but then again about 3 hours later and this was perhaps 1/3rd size of her typical BM so good progress there. She is on a home prepared raw diet to which I am now adding extra moisture to help her hydrate. Have another vet consultation tomorrow, after today's acupuncture.

I like the idea of a safely induced cat coma ... My joke is I am planning on getting her hooked on some soap opera especially that has a multi-season run so that she doesn't go bonkers with the lack of activity, or perhaps she would like to listen to audio books starting with Moby Dick, or War & Peace, ...

So glad she was able to have a BM .   And being on raw is good, since those raw stools are so much smaller than on other foods .  I always found if my guys seemed a little constipated while on raw, I just added a little extra muscle meat to their meals once in awhile, and that solved the problem.

I know just what you mean about trying to get her hooked on either a TV series or an audio book .  If only they were that easy to entertain.

Rosebud is going to be just fine. Thank you all for input and support. Just got back from seeing older 2nd vet with lots of surgery exp. He looked at xrays from other ver; watched her move; did external exam; saw the stool samples I brought in; put her under anesthesia to make sure colon had sufficient passage even though pelvis is slightly mis-aligned - she has plenty of clearance. He definitely recommended against surgery especially because injury has started to naturally repair as it is probably 17 days ago now. He even said that if were only day 2 he'd probably recommend the same thing as he has had much exp. with allowing natural healing to take place and the outcome is excellent.

FY all: I did numerous Google searches last night to try to find out the likely range for a small cat of the diameter of a normal poop. Unable to find anything. Lots on examining color; consistency-texture; etc. but nothing on diameter. Yes they should be log shaped, but how wide is the log?? Anyway Rosebud who is a light cat (just under 8# before injury) had poop 3/8" to nearly 1/2" in diameter. Vet viewed things and her size and felt that seemed in normal range and not indicative of colon constriction as it passed thorugh pelvis.

Got to go and prepare another refuge/recovery area for my gal who I can pick up in a few hours.

First, I am very glad to hear that Rosebud is healing and doing better in other ways. Very glad to read that surgery is not likely; that's always so stressful.

Second, I wanted to respond regarding this:

Originally Posted by Lite1  

FY all: I did numerous Google searches last night to try to find out the likely range for a small cat of the diameter of a normal poop. Unable to find anything. Lots on examining color; consistency-texture; etc. but nothing on diameter. Yes they should be log shaped, but how wide is the log?? Anyway Rosebud who is a light cat (just under 8# before injury) had poop 3/8" to nearly 1/2" in diameter. Vet viewed things and her size and felt that seemed in normal range and not indicative of colon constriction as it passed thorugh pelvis.

Click to expand...

I think the diameter of Rosebud's poops sounds just fine, especially if she is eating mostly raw food. As you know, raw fed cats produce smaller poops. I also searched for this same information and could not find it. So I decided to collect my own data.

I collected poop data because we were weaning our male cat off cisapride, a motility drug prescribed for megacolon and severe constipation. When we first started to taper his dose and he was not as "regular", I was concerned that not everything was coming out (we had recently changed foods, which resulted in much smaller poops in both cats). Then, when we added small amounts of psyllium to help with digestion and hairballs, I wanted to make sure his poops weren't getting too big. As a result, I measured and recorded cat poops for several months. When my cats were eating canned food, mostly Nature's Variety Instinct, the 15-pound male almost always had pieces that were around 3/4" in diameter, but some were as small as 1/2". My 10-pound female's rarely exceeded 1/2" and were frequently as small as 1/4". Now that my big male is eating over 50% raw, his have gotten smaller and sometimes are as small as 1/4" and usually do not exceed 1/2". I don't see the 3/4" ones anymore, unless someone accidentally overeats kibble.

Kind of a weird topic, I know, but hope it helps.

@AbbyNTimThanks for detailed info on your exp. with cat poop diameter for your cats, very helpful to me. Sure confirms that Rosebud who now only weighs 5.5# is probably well within normal range for her size and body buils (also confirmed by second vet I had consulted with today). Glad your cats are doing better. Stumbled on megacolon yesterday when trying to find information on cat poop diameter range. Have you considered adding small amounts of Probiotics to the food you feed your cat? This is the strains of healthy bacteria in a normally functioning intestine. While there are some sold specifically for cats at least from the research I have done they are seriously over priced and probably no better than those in the refrigerated section of any health food store. Just find one that does not have any flavor (e.g. fruit) added as such additions might not be compatible for a cat. You probably know that for humans and others that if one needs to be on a round of anti-biotics that while these kill a lot of the bad guys they also kill off a great deal of the good guys and disrupt the natural intestinal flora and bacteria. Many people eat some yogurt after antibiotic treatment, but a probiotic powder is much more abundant in the good bacteria and is not giving a cat a milk product.

Anyway there is lots about probiotics on humans and on pets from a simple google search, so you might want to check it out and particularly see if there are any reasons NOT to try it with a megacolon cat, or reasons to do so. It promotes health digestion in humans and many pets. If it is advisable, I'd suggest starting with half a dose and over the course of a week gradually increase the amount to a full dose. With brand I am using I simply pull a capsule apart and sprinkle a little on with each meal I give my cats.

My dad has a cat that my brother rolled a banana chair over and broke his pelvis.  He healed naturally just by being confined to a small room, now you can't tell anything was/is wrong with him.  It happened several years ago.

Lite1 said:

 
@AbbyNTimThanks for detailed info on your exp. with cat poop diameter for your cats, very helpful to me. Sure confirms that Rosebud who now only weighs 5.5# is probably well within normal range for her size and body buils (also confirmed by second vet I had consulted with today). Glad your cats are doing better. Stumbled on megacolon yesterday when trying to find information on cat poop diameter range. Have you considered adding small amounts of Probiotics to the food you feed your cat? This is the strains of healthy bacteria in a normally functioning intestine. While there are some sold specifically for cats at least from the research I have done they are seriously over priced and probably no better than those in the refrigerated section of any health food store. Just find one that does not have any flavor (e.g. fruit) added as such additions might not be compatible for a cat. You probably know that for humans and others that if one needs to be on a round of anti-biotics that while these kill a lot of the bad guys they also kill off a great deal of the good guys and disrupt the natural intestinal flora and bacteria. Many people eat some yogurt after antibiotic treatment, but a probiotic powder is much more abundant in the good bacteria and is not giving a cat a milk product.

Anyway there is lots about probiotics on humans and on pets from a simple google search, so you might want to check it out and particularly see if there are any reasons NOT to try it with a megacolon cat, or reasons to do so. It promotes health digestion in humans and many pets. If it is advisable, I'd suggest starting with half a dose and over the course of a week gradually increase the amount to a full dose. With brand I am using I simply pull a capsule apart and sprinkle a little on with each meal I give my cats.

Click to expand...

Great news about the second vet consult!

Sorry if I gave the impression my cat has megacolon! In fact, I very seriously doubt he is even prone to constipation. I think he shouldn't have been prescribed cisapride and the concern was whether he had become dependent on it and would be able to poop on his own after being on it for a year. Happily, he is doing just fine, even though the vet that put him on cisapride scared me good by implying he was a step away from megacolon.

Regarding probiotics, that is one of the first things we did when we began tapering the cisapride doses and I think it is really helping him. He still takes it daily. Like you, I break open a capsule and sprinkle it on his food and he doesn't even know he's eaten it. We're using Proviable DC right now, which is a bit overpriced, so will likely look into an alternate probiotic when it's time to get more.

Glad you found the detailed descriptions helpful.

Great news on Rosebud!

Thanks @ mrsgreenjeens I had not seen before that your avatar rotates your photos. Rosebud looks quite a bit like your cat with the white bib. Since I had not noticed the rotation before my thoughts in rapid succession went: I am hallucinating again just like when she was missing and thinking that I see her but it isn't really true; I must be a lot more sleep deprived than I thought; wow that avatar is moving, oh the photos are changing from one to another - wow didn't know that they could do that; oh cool two of those cats actually look alot like my two (the other one is what seems like an all black cat, ,like Rosebud's adult son Laguan).

Anyway thanks for your prior advice and recent post - thought you might chuckle at how spacey I still am.