Broken Hip, Orthopedic Surgery Tomorrow

[Patti]

I'm so sorry to hear about Chongo. Cats (of all breeds) tend to do better with propofol than ketamine if you are given an option for an injectable anesthetic, but it is often best to go with whatever the vet feels most comfortable using. I'm sure he will do just fine, and as others have said, it will be the recovery and convalescing that will be difficult - probably harder on you than on Chongo!

 

[Brigitte Cowell]

Hi John...welcome, and I am so sorry it is under such stressful circumstances :-(

I prefer inhalable anesthesia to injectable anesthetics such as ketamine... it's more adjustable and so safer. So saying that, if the surgeon is more accustomed to ketamine, you don't want them experimenting with your kitten! But ketamine is also a hallucinogen which to me given your kitten needs to be kept calm after surgery does not seem a good idea as he could be disoriented coming out of ketamine anesthesia.

Keeping him calm and not using his leg is a challenge...it sounds like you've already thought of this with a recovery cage. At first I am sure he'll be sore and sorry for himself so may rest okay, I just imagine that after a couple weeks he'll be really wanting to move about too much for his own good. I don't envy you watching and worrying over him!

Please update us on his surgery!

 

[Tina Kinsley]

Oh my goodness, John. I am sending good thoughts your way for Chongo. Poor guy!

 

[John Popp]

Totally understand about the Ketamine, that one rolls off my tongue when I talk to the vet. At both the emergency clinic and my regular vet when I mentioned about ketamine, they looked at me as if I were talking about some medieval cocktail made from berries and roots. Of course today is whole other deal with a specialized orthopedics veterinarian and I expect/hope to get the same response about ketamine.

Some of my other concerns are that the fracture occurred really close to the growth plate. That makes the task of keeping him calm even more important. I'm sure he's not going to like the cage much as he really didn't like having his own room while we were introducing him to our home and the other cats. Already rethinking the cage I built yesterday.

Thanks so much for the extra advice on the anesthesia. We'll let the doctor know that Ketamine is a non-mover for us and gas is preferred. Propofol is the preferred injectable and we'll run from there. I'll make sure I post updates about how things went and are going with his surgery and recovery. Lastly I'm wondering if the more abundance of tryptophan in turkey will help keep him a bit calmer and if there is anything I should look out for switching his raw diet from chicken to turkey.

Thanks again, you guys are the best!

 

[jungle boy]

Thanks Paige!

We always defer to the specialist, and only ask that they hear what we have to say. Notes of caution seem to be what's in order and I certainly wouldn't want to push the surgeon out of their comfort zone.

We did select a hospital that has 4 staff orthopedic surgeons/neurologists. Our Surgeon specializes in small animals (not small for a kitten) as the same name came up from our vet, the emergency clinic and two friends also in the field. I feel as comfortable about where Chongo will get his care as I could be, and one of two places in the state of Ohio that specialize in the care he will need.

Sorry for the delay in responding, I've been working on building a recovery cage that it's going to break my heart to put him into.

I just prayed for a complete recovery and healing for your little man!

 

[John Popp]

Well I just returned from the surgeon's office and they were absolutely great. Covered my questions pretty easily and were in line with accepted anesthesia methods as discussed here, so no ketamine. Small dose of injectable to slightly sedate him and then gas to keep him under.

The bigger issue is going to be deciding the appropriate course for the surgery. There are two options, the first option is using pins to help the two sections with pins. Not the easiest surgery, there could be some issues with healing properly and a worst case scenario is a second surgery could be necessary. There are also a great deal of likelihood of arthritis in his later years. The other option is Femoral Osteotomy. This is basically creating a false joint by shaving down the bone and scar tissue develops and the muscles holds things together. Sorry for the lack of specifics and I do have it in my head it's just hard to explain all the information we were loaded with.

Anyway, at this point we will have one more conversation this evening and then render a final decision in the morning. Most importantly we want to do the right thing for Chongo. I'm sure when it's all over with he will be the happy and lovable kitten he has always been. He wasn't purchased for any type of vanity reasons, we just wanted a fun loving and active cat. I don't see that changing along the way, just want to make sure we make the decision that gives him the most quality of life.

Thanks again for the thoughts and prayers, they are well received and greatly appreciated.

 

[Sue]

I am sure you will make the right decision and he will be fine once he recuperates. My thoughts, prayers and good wishes for a speedy recovery.

 

[Brigitte Cowell]

What is the downside of the femoral oseotomy then? The first option was having a likelihood of a second surgery and arthritis...so what is the downside of the second option. Is the second option more likely to result in a permanent limp than the first option perhaps? I don't know... just when choosing the best course I like to know the disadvantages of both options and choose the "least bad" option.

Which was the surgeon most positive about, and why?

 

[KMcgown]

Glad to hear he is on the mend...poor little guy. I assume that is the cutie in your avitar.

 

[John Popp]

The downside of the FHO is that it isn't putting the hip back to the state that nature intend it. The femur would be riding on scar tissue and supported largely by muscle mass. There is more physical therapy to undergo and the length of time limping could be longer. That's about as good as I can explain things at this point and the two surgeons who looked at the X-ray deferred to a third surgeon that will be performing the surgery tomorrow. I won't really know until we speak with the surgeon if placing pins in is even a viable option.

That said and as I understood things, it isn't a zero sum game. There isn't one that's better or worse and a lot of it depends on how much bone is left attached to the femoral head. At some point we just have to trust in the surgeon, and in Ohio there are just two places to go for the best in this type of care. The facility we chose has 7 surgeons, a neurologist and 5 residents at the facility. They aren't just veterinarians that do surgeries, they are full time DACVS veterinary surgeons.

I'm just very hopeful that tomorrow morning we get an answer with a lot of confidence behind the direction we should go. We are ending up with the surgeon everyone has recommended and also where our research has pointed us to. I'll do my best to most updates as things progress but more than anything we just want our little buddy back at home with us so we can begin his recovery.