Hi, I’m Skippy’s Mom, and was recently faced with the difficult decision of whether or not to do remaining leg surgery on our beloved tripawd cat. I searched the internet for stories of other cats who might have undergone something similar, and didn’t find much. I felt really overwhelmed by the decisions our vet was asking me to make, and so I decided to take advantage of the Tripawds Foundation’s awesome free blog space to share Skippy’s story. So if you find yourself in a similar position, please know that you are not alone! What follows is an overview of Skippy’s original amputation, his subsequent injury, and the course of treatment that we took. I hope you find it helpful.
Last Fall, about six months into the 2020 pandemic, I found myself telecommuting for work, and really feeling the emptiness of being at home. We had lost our family dog earlier that Spring, and so I reached out to several local animal rescue agencies and signed up to be a cat foster. During the course of my volunteer work, I met the amazing Skippy!
Skippy came to a local rescue agency with a broken pelvis and severe nerve damage, and it was decided that an amputation was his only option. He was only 9 months old at the time, and his kind and loving demeanor won over everyone that he met. The amazing veterinarian who performed his surgery relayed to me the overwhelming emotion she felt at taking his leg, and how when he awoke from surgery, he put his paws around her neck and hugged her and purred his gratitude. On some deep level, I truly believe this amazing cat knew that she was saving his life. After surgery, he stayed with a phenomenal medical cat caregiver, who would become a dear friend to our family and especially to Skippy.
I pretty much knew I wanted to adopt Skippy from the first moment I met him, when he wobbled over to the crate door at the rescue vet’s office and lovingly “booped” me through the woven metal door. My heart melted, and there was pretty much no going back from there. Approximately 60 days post amputation, he was cleared for adoption, and he officially became a member of our family. I was so nervous at first, and worried about his limitations and his safety, but he quickly proved to me that he was a normal rambunctious kitten, who just happened to have three legs. He never let it slow him down, not for one single moment.
It was six months after we’d adopted Skippy, when one day out of the blue, he wasn’t able to propel himself up onto the sofa, and I noticed that he didn’t seem to want to bear any weight on his remaining hind leg. I called the vet’s office for an appointment, and was initially told that he probably had spinal arthritis. Because his symptoms had a very sudden onset, I was a bit skeptical of this diagnosis, but I went along with the proposed plan of laser therapy 3x per week and hoped for the best. He also weighed in at 12 pounds, and it was suggested that we get him down to 11 pounds. I found this helpful chart from Chewy, and set a daily goal of 240 calories for Skippy.
After one week passed, and Skippy wasn’t showing any improvement, I went and saw a different vet to request x-rays. The new vet did a thorough range of motion examination, and Skippy showed clear signs of discomfort when she palpated his hip. She agreed that an x-ray was the next logical step, and after what seemed like the longest wait, she walked back into the exam room with her laptop and a grim look on her face. I cried so hard when she told me that Skippy had a fracture of the femoral head on his remaining hind leg.
Skippy was strictly an indoor cat, and to this day we aren’t really sure how the injury happened – he is a super active cat who climbs everything in the house and loves jumping from high places. When the veterinary team reviewed the old radiographs from his original injury, they thought that perhaps this bone had originally been fractured back in 2020, and had healed due to his young age. Perhaps now the bone had had been re-fractured by a jump or fall. Unfortunately, because Skippy was now 18 months old, and no longer growing bone, we were told that the fracture might not be able to heal on its own.
Given all the information at hand, our veterinarian suggested a Femoral Head Ostectomy for Skippy (amputation of the femoral head/ball joint), with the disclaimer that they had never performed this surgery before on a tripawd. I felt sick when I learned what the surgery entailed, and was really afraid of Skippy losing all mobility in his remaining hind leg. I also didn’t want to put him through another major surgery less than a year after his amputation surgery. So, given the weight of the situation, and the risk of having Skippy never walk again, we ultimately opted to try a conservative approach at first, to see if the fracture might heal on its own. This approach would also give me time to do some research so that I could make the best decision for our sweet boy.
I did my best to transform a large dog crate into a comfortable space for Skippy, but his response was to climb the door and the sides, which would result in him falling down and landing hard on his broken hip. After half an hour, I gave up on the crate idea and moved him to a small spare bathroom. I was able to find a low sided litter box at Petco (sold as a dog litter box), and added a comfy bed, food and water, and some low-impact toys to keep him from getting too bored. We picked up a piece of plexiglass from the local hardware store, and made a “baby gate” out of it, so that Skippy was contained, but could still see and hear us. This definitely helped reduce his feelings of isolation and depression. I reached out to Skippy’s previous medical caregiver for advice, and she let me know that YouTube has a vast array of bird videos available to keep cats engaged! I set up our iPad in the bathroom with him, and would keep the bird videos playing all day.
In the meantime, while Skippy was on bedrest, I was combing the internet for information about FHO surgery, and remaining leg surgery on tripawds. I wasn’t finding a lot of examples of tripawd FHO surgery, and so I began contacting every orthopedic veterinary clinic on the West Coast, from British Columbia to California. I emailed medical records, sent off copies of x-rays, made pleading phone calls, and tried to find any board certified orthopedic veterinarian to see him and consult on his case. I was frustrated to learn that they were all booked out for months, and some of them didn’t have openings until next year. They were all kind enough to review the records, however, and all agreed that FHO was the only way to go other than euthanasia. Unbeknownst to me, this was a very common surgery among four-legged cats. And euthanasia wasn’t something we were even willing to consider.
And so after nearly a month of bed rest, it was obvious that Skippy wasn’t getting better, and that surgery was going to be our only option. Out of the blue, we received notification from a local ortho specialist that he had an opening, and could work Skippy into his schedule immediately. And although we were still terrified at the idea of surgery, we were anxious to put an end to Skippy’s pain, and wanted to get him on the road to recovery. We gave him an early supper, and then made sure he was fasting overnight for surgery in the morning.
Next up is the overview of Skippy’s surgery and recovery process. In hindsight, I wish I hadn’t spent those 30 days trying to conservatively heal his fracture, but at the time I did the best I could with the information that I had. If I had to do it over again, I would opt for immediate FHO surgery.
Surgery Day! I prayed hard today for Skippy, and for the amazing veterinarian that we’d entrusted him to. I was so impressed with the kindness and thoroughness of his surgical team, despite the fact that it was all done “covid style” from outside in the parking lot. They texted me updates about how he was doing before surgery, and the vet phoned me as soon as he was out of surgery to let me know that all was well.
Skippy’s surgery entailed the removal of the femoral head (aka the ball joint) of his remaining hip, and then a careful smoothing of the femur and socket, to ensure no painful rubbing would occur in the future. The vet explained to me that this surgery would only be successful if Skippy developed his muscle and ligament strength enough to create an artificial joint of sorts. So, unlike most other surgeries, our goal was to get him up and moving as soon as his pain tolerance would allow. Our surgeon also let us know that Skippy now weighed 12.4 pounds, and that we should set a weight goal of 10 pounds for him. So, we would need to further reduce his calories. Ugh.
He was discharged that same afternoon with a fentanyl patch, and the vet added on a 24 hour nerve block to bridge the gap until the patch fully kicked in. We also paid a little extra for a two week injectable time released antibiotic, to minimize the amount of pills he would have to take. Lastly, the vet prescribed four doses of Metacam, which would be administered orally every other day to help keep inflammation down. So, we had pain, inflammation, and infection well covered. The vet also gave us a five day supply of a special urgent care recovery food – Hill’s a/d. We continued mixing his food with the Dasuquin Sprinkles and another awesome joint supplement called Super Snouts made from Green Lipped Mussels.
After surgery, a recovery room was created for him in a large spare bathroom. It gave him a bit of room to move around, but nothing that presented any risk of falling or hurting himself. He was agitated that first night, but having someone stay close by seemed to help him feel safer and stay a bit calmer. That night and for the next two weeks, one of us would sleep on the floor next to him. This allowed us to not put an e-collar on him, and instead we would just gently redirect him when he tried to lick his incision. Admittedly, it was exhausting, but we all loved Skippy so much that we were willing to sacrifice some sleep in exchange for bringing him comfort. And during those first few days, I was so overwhelmed with emotion that I couldn’t bear the thought of being away from him.
Because it wasn’t clear whether Skippy would be able to bear any weight while using his litter box, our caregiver friend recommended setting out some incontinence pads for Skippy to use. We both knew he was really fastidious about using his litter box though, (such a good boy), and so it soon became obvious that he wasn’t willing to pee anywhere else. A flat cookie sheet with some litter sprinkled on it was added to the room, and he immediately slid over and peed. He would lean on his nub while urinating, and so he had some litter stuck to his back end that would need some gentle cleaning. We use a compostable cat litter (I think it’s made from corn), so I wasn’t too worried about him possibly ingesting a bit of litter while grooming.