Digital flexor tendon contracture treated by tenectomy: different clinical presentations in three cats

Flexor tenectomy: salvage surgery following feline onychectomy

OBJECTIVES

Onychectomized cats (Felis catus) with inappropriate elimination behaviors or aggression may be responding to painful paw pathology, even several years after the initial onychectomy. The objectives of this study were to evaluate the onychectomized toes of this population of cats for pain (thorough physical examination and/or buprenorphine trial), pathological changes (using high-resolution radiographs) and response to tenectomy in those with hyperflexion of the proximal interphalangeal joint.

METHODS

Cats in this study were previously onychectomized and exhibited inappropriate behaviors (inappropriate elimination, biting), exhibited pain associated with the onychectomy site or had behavioral improvements when put on a 2-week buprenorphine trial. A detailed history was obtained, including verification of proper litter box placement and management. Physical examinations included a close analysis of the onychectomized digits for resistance to extension and pain on palpation. Only cats with a normal urinalysis were included in the study. High-resolution radiographic imaging was performed on all study cats. A total flexor tenectomy was performed on cats with hyperflexion of the proximal interphalangeal joints.

RESULTS

All 42 cats included in the study benefited from total flexor tenectomy surgery. Two cats remained biters, even after a long course of analgesic medication. All cats walked more comfortably post-tenectomy surgery.

CONCLUSIONS AND RELEVANCE

Onychectomy can lead to pain, inappropriate elimination and aggressive behavior. The presented salvage tenectomy procedure can alleviate or eliminate inappropriate behaviors by reducing the pain from the original onychectomy.

2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques

PRACTICAL RELEVANCE

The '2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques' (hereafter the 'Cat Friendly Veterinary Interaction Guidelines') support veterinary professionals with feline interactions and handling to reduce the impact of fear and other protective (negative) emotions, in so doing enhancing feline welfare and In implementing these Guidelines, team satisfaction and cat caregiver confidence in the veterinary team will increase as the result of efficient examinations, better experience, more reliable diagnostic testing and improved feline wellbeing. Veterinary professionals will learn the importance of understanding and appropriately responding to the current emotional state of the cat and tailoring each visit to the individual.

CLINICAL CHALLENGES

Cats have evolved with emotions and behaviors that are necessary for their survival as both a predator and prey species. A clinical setting and the required examinations and procedures to meet their physical health needs can result in behavioral responses to protective emotions. Cat friendly interactions require understanding, interpreting and appropriately responding to cats' emotional states and giving them a perceived sense of control while performing the required assessment.

EVIDENCE BASE

These Guidelines have been created by a Task Force of experts convened by the American Association of Feline Practitioners and the International Society of Feline Medicine, based on an extensive literature review and, where evidence is lacking, the authors' experience.

ENDORSEMENTS

These Guidelines have been endorsed by a number of groups and organizations, as detailed on page 1127 and at catvets.com/interactions and icatcare.org/cat-friendly-guidelines.

Late-onset osteosarcoma after onychectomy in a cat

Case summary

A 12-year-old neutered male onychectomized Ragdoll cat presented for a 3 day history of swelling and hemorrhagic purulent discharge on the first digit of the left manus. Radiographs revealed fragments of the third phalangeal bone (P3) present in the partially amputated digits with swelling adjacent to the P3 fragment on the first digit of the left manus. Thoracic radiographs revealed no evidence of primary or metastatic neoplasia. Surgery was performed to remove all P3 fragments and the associated swelling on the diseased digit. On gross examination of the excised swelling, a mass was present at the cut edge of P3. The bone fragment and associated mass were submitted for histopathological evaluation. Osteosarcoma was diagnosed. Because neoplastic cells extended to the surgical margins, amputation of the left thoracic limb was performed. The cat recovered from surgery, and survival time at the time of writing was 8 months.

Relevance and novel information

To our knowledge, this is the first reported case of onychectomy-associated osteosarcoma. Trauma from partial P3 amputation during onychectomy is suspected to have played a role in osteosarcoma development in this case. Malignant transformation may be considered a potential complication of onychectomy achieved by partial P3 amputation.

Multiple idiopathic fibrotic myopathies, including the tensor facia lata muscle, in a cat

To describe the clinical features and treatment of a cat that was initially presented with fibrotic myopathy affecting the left tensor fascia lata. Approximately 5 months later, the cat was presented again with multiple idiopathic fibrotic myopathies, affecting the ipsilateral rectus femoris and the contralateral semitendinosus muscles. These were each separate lesions and occurred without known history of trauma. Surgical resection of the fibrotic portion of the affected muscles resulted in immediate, but not long-term, resolution of clinical signs.

Use of adjunctive prednisolone in the management of a cat with bilateral quadriceps contracture following trauma

Case summary

A 6-month-old cat was successfully treated for bilateral quadriceps contracture. Conventional treatments including surgery, dynamic flexion apparatus and physical therapy along with analgesics and non-steroidal anti-inflammatory drugs resulted in temporary clinical improvement that was relapsing. The initiation of supplementary corticosteroid treatment with prednisolone coincided with an immediate and sustained clinical improvement and long-term resolution.

Relevance and novel information

Successful treatment of bilateral quadriceps contracture has not previously been reported in a cat. Quadriceps contracture remains a challenging condition to treat with some cases unresponsive to therapy. Systemic prednisolone treatment appeared to be of benefit in the management of this case and may have a role in some cats where muscle contracture appears relapsing in nature. Further prospective investigations in cats with muscle contracture, including muscle biopsies of affected cats, are warranted.