Guest guest Posted October 20, 2011 Report Share Posted October 20, 2011 Hello!I need advice on a case I saw yesterday. I recently got my certification and need as much help as I can get. I was presented with a 4 1/2 month old male DSH kitten with a history of bilateral elbow dysplasia and bilateral grade 4 medial patellar luxations that have caused the tibia to become markedly deformed. The cat is a stray rescue and finances are a serious concern. Since the hind limbs were the ones causing more difficulty ambulating, this was addressed first by the surgeon, who performed a medial release with lateral imbrication and wedge trochleoplasty of both stifles. Osteotomies were considered, but finances made this impossible. The surgeon mentioned it was very difficult to get the patella in place and there was a lot of tension of the surrounding muscles (quads/hamstrings etc.). This was done aprox. 6 weeks ago. The cat can walk slightly better now, but has severe shortening of the angle of extension of the stile. The LH stifle extension angle is approx. 135 degrees and on the RH limb it's 115 degrees. I read in the " hand book of small animal orthopedics and fracture repair " that the limiting factor in grade 4 luxation repair is the flexure contraction at the stifle, and they mention other possible surgical options including arthrodesis for these severe cases where nothing else works. Does this apply to cats as well? Will rehab help this patient (since further surgery is not an option for the owner at this point) and if so what therapies/modalities/excercises would you suggest? The owner cannot even do passive ROM exercises with the cat at home and brings him to the clinic so we can do that at least, but it's not helping much at this point. Thanks for your help!Alma Alicea-Garces, DVM, CCRT Quote Link to comment Share on other sites More sharing options...
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