Pebbles is a 22 year old, beautiful domestic long haired kitty who presented to us with sudden lameness of the left hind limb. Pebbles lives in the house and has been healthy up to this point according to the owner. The owners do not know what could have happened to cause the lameness as Pebbles was fine the day prior to the onset of the lameness.
On physical examination, Pebbles was bright and alert. For her age, she looked really good! Her left leg was swollen and painful in the area of the thigh (femur). Due to Pebble’s age, we recommended blood tests and radiographs to evaluate her problems. Despite her age, Pebbles blood tests were quite normal. We gave her a mild sedative an took radiographs of her leg and chest.
The radiographs are presented below:
Even for non veterinarians, it must be apparent that Pebbles fractured her left femur. However, when you look closely at the bone, the quality of the bone in the middle of the leg does not look normal. If you compare it to the other bones, you will notice that the center portion of the bone has lost detail and the area near the fracture looks like the bone is dissolving. These types of changes are often caused by cancer growing in the bone. As the cancer grows, it weakens the bone and then it becomes subject to easy fracture. This type of fracture is known as a “pathologic” fracture because there is pathology (in this case probably cancer) in the bone which led to its weakening and ultimate fracture.
While we have the capability of repairing fractured bones, given Pebbles age and our suspicion of cancer, we were forced us to recommend amputation for Pebbles. The owners love Pebbles and in spite of her age, they decided to proceed with the surgery. We checked the chest radiographs and took abdominal radiographs to see if there was any spread of the cancer into other parts of the body before proceeding to surgery. The survey radiographs were clean and so we performed a special type of amputation in which the bone is removed from the hip and the entire leg is removed. During normal amputation, 1/3 to 1/2 of the femur is left on the body to help protect the abdominal organs. In this case, the possibility of there being cancer in the bone posed too great a risk for us to leave any bone in the body.
Pebbles surgery went very smoothly and she recovered without incident. We were able to send her home a few days after surgery and she is doing well there. We sent the limb off to the pathologist to check for cancer. These specimens need to be decalcified (remove all the calcium) before they can be analyzed. This process may take a few weeks and so we don’t have a definitive diagnosis at the time of this writing (we will update as it becomes available).
This case is a perfect example of how we shouldn’t let the age of a pet determine what we can accomplish to improve their quality of life. Regardless of the ultimate diagnosis, we have eliminated Pebble’s pain and given her owners more quality time to spend with her.