MODIFIED PANCARPAL ARTHRODESIS “Dobro hrumvane” – new extreme challenge, new success

logoThis year the created 5 years ago by our team new orthopedic technique for cases with radial nerve palsy in cats (see article http://balkanvets.com/index.php/2019/03/09/main-topic-a-new-approach-to-radial-nerve-palsy-in-cats-clinical-case-series-report/) met its biggest possibe challenge and led the case to unexpected 100 % success:

Cat, M, approx 3 years old, Otelo.  The cat has survived after severe trauma which forced colleagues to amputate one front limb and to try saving the other one using standard surgical procedure.  Weeks later the cat came to us for euthanasia: lethargic, anorhexic, with decubital wounds and with very deep and extremely inflammated and painful exhoriation at the chest area due to body dragging on the floors. The not amputated leg wasn’t functional. It was swallowed, with severe purulent inflammation and permanent fistula, with evaluating maluinon (high degree rotation and mild varus) and with radial nerve paralysis, the antebrachial bones showed all radiographic signes of osteomyelitis.  The patient showed all clinical and paraclinical signs of evaluating sepsis. Additionally Otelo had also severe lungs problem. We took the risk to prepare the cat for the DH arthrodesis surgery and to test our technique in these extremest possible conditions.

Otelo’s condition 1st day in clinic:pic 1

 

It took almost 3 weeks to prepare Otelo fur surgery, lungs multimodal treatment including Opti-Airwei, treatment against the systemic and local infections and lesions, chronic pain and exhaustion.

We used the technique on its standard way, we just decreased the rerotation angle from 90-95 degrees to 80-82 degrees, because cats with only one front limb move the existing one to the median body line which leads to natural 10-12 degrees carpal rerotation.

 

Otelo 5 min post-op X-ray: pic 2

Pre- and intra-operatively we took material for bacterial identification and antibiogram. Of course we counted as usual on VetDiaLab with their unique system for automathic identification even to subtype and for authomatic machine antibiograms. The VetDiaLab fantastic work was the key for complete solving of the chronic multi-infection.

Thanks to the precise lab results, the reliable technique and the amazing post-op care of our team (even including adoption of the patient by “fallen in love” with him team member) Otelo overcame the victim pose, the decubital wounds, the chest deep exhoriation and uses its leg with full geometrical functionality. The deep antebrachial bone infection was 100 % overcome only after removing one of the screws which kept infection – after this manipulation the operative suture finally healed 100 % and we removed the collar on Christmas!

 

Otelo Christmas video:

Luba Gancheva