This weekend I managed to get Craig to take some photos of the physio positions.
Leila’s wrist movement is fairly normal
This is the wrist movement. I have been working on her wrist range of motion for a few months now. It became very stiff from lack of use and the vets were concerned that she was begining to put weight on the bent joint.
The elbow was fused in the first operation so has very limited movement. I can tell Leila isn’t comfortable with this exercise so I don’t push her.
Very limited movement
‘Normal’ range of motion would be similar to the human elbow, completely folded to completely straight. The first picture shows Leila’s elbow flexed, the second extended.
Her shoulder is a bit stiff from lack of use but full motion is returning very quickly.
Her shoulder moves back correctly, the extension is a little stiff; the leg should ideally go straight past her face. She can actually stretch a little further than this but when she is resisting it’s best not to push too hard.
Overall Leila is doing well. We have now completed the first of 3 weeks of cage rest. She has had total rest for the last week, only coming out for physio and cuddles. This week I will encourage her to walk around a little more, but closely supervised and for short periods. She must not jump in case she lands on the leg – the impact could still cause it to collapse. Unfortunately jumping is one of her specialities. Not long now Leila!
I often feel sorry for other people’s pets, because I know they are not loved as much as mine are. It’s rare to meet people who love their pets like I do. This is the thing I love most about tripawds. People on here ‘get it’. People (you) are on here because you do love your pets like I love mine. Your pets are family; substitute or additional children, siblings, best friends.
When I joined tripawds, I was scared, confused, unsure of what the future held for Leila and me. Probably very similar to most people who joined pre-amputation (or in our case, surgery). Reading about the experiences of other animals has helped me to realise that Leila will cope just fine, whatever our future holds. Amputation isn’t a big scary word anymore, it’s now something which may well be in our future if arthritis begins to cause her too much pain, but something we will face together and overcome to continue living our nice, happy lives together. I would like to thank every one of you who gave your supportive comments, and to all of those tri-kitties whose blogs I have read; Fang, Smore, Jill, Mona and more. You made me both cry and laugh at times.
So now we are onto physio.
There is a YouTube clip which the vets showed me. You can find it by searching Passive range of motion – front leg of a dog, www.youtube.com/watch?V=GOMnrgifzsc. As usual there is very little cat-based material, although I imagine getting a cat to lie still like the golden retriever in the clip would not be an easy task. In dogs, they recommend warming the area with a heat pad for 10-15 minutes, and icing it afterwards for 15 minutes. Good luck with a cat. Leila is very good at sitting, but I’m pretty sure she wouldn’t be up for all that! I warm up her leg with a bit of a gentle massage while she is sitting on my lap. For anyone who didn’t watch the clip, the physio involves gently manipulating each joint, whilst supporting it and keeping it inline with the body – like an exaggerated walking action, one joint at a time.
Her wrist is pretty good because I have been doing very similar exercises on it since her initial operation because she had been curling it under her (probably for protection) and she had lost a lot of flexibility. Her shoulder is stiff from lack of movement so the back motion is ok but the forward motion will only get to slightly over 90° from her body. It is important not to force any movement as that can harm her. Initially I feel resistance because she is deliberately resisting the motion but she quickly relaxes and lets me move the joint. Her shoulder should recover full motion in time.
Her elbow joint was fused during the first surgery, however when she fell and pushed that pin through her bone so that it had to be removed, the joint regained some movement. This is where arthritis may have already set in and will possibly/probably cause her problems. This joint is very stiff. She has almost no movement and I am very aware of not forcing it. I can tell she isn’t too happy with me manipulating this joint so I leave it until last. Then we have a cuddle so she’s happy again.
Milo didn’t want to come out again.
Considering how different my two cats are, I am so lucky and grateful that they love each other so much. Today I opened Leila’s cage to take out the litter tray I leave in there over night until after breakfast (I’ve got quite familiar with her bathroom habits in the last few months), and Milo decided he was going in there too. He snuggled up with her on the pillow she has in there and did not want to come out again. He misses his friend. I let him stay for a while because they were happy, but I took him out when I had to go out. He can play a bit roughly for a slightly broken Leila.
My sister had two cats – a brother and sister from the same litter, who could not even be inside her house at the same time. They would fight whenever they saw each other. I definitely appreciate what I have.
I will have to wait until Craig is at home to get some pictures of our physio sessions – it’s a two-handed job. I will update on Leila’s progress soon.
So far so good. My biggest problem has been keeping Leila resting. She is back in the cage, which she handles really well. She spent 4 months on cage rest with her pins in her leg, then for the last couple of weeks – since the vet told me that she would almost certainly lose the leg – I have let her out as if she weren’t injured. I could tell she was very happy about that. Now the pins are out, but there are still four holes left where the pins were, so the leg is quite fragile. Also we have no doors and a Milo, the combination of which would give her very little chance of rest. She jumps up onto our barstool chairs when she has had enough of his playing.
In the cage
Leila is clearly very happy to have the pins out and the big external fix gone.
She came out for a cuddle this morning. Her favourite thing is still to sleep on my lap. Milo joined us this morning. This is how I know she is ok. Milo keeps his distance when she is in pain or sick. He is my monitoring device! They were happily washing each other this morning before falling asleep. That’s normal for them.
There are hardly any marks on her, just the holes from the pins. There are no stitches because the holes should heal by themselves. You can see the bone has not healed smoothly and that will not improve, however, when the fur grows back and her muscle begins to build again, she won’t look so bad. The vet said she should wear the collar of shame again (We like to call it her ‘Martini glass’ costume) but she had other ideas. After four months of wearing it she has become an expert at taking it off. She rolls on her back and uses her back feet to pull it over her head. I’ve tried making it as tight as I dare, but she just takes it off anyway. She is not bothering with the wounds, so after trying a few times, I’ve decided to leave the collar off. I’m at home most of the day to keep an eye on her anyway.
The only negative experience is that the vet told me, as I was leaving with Leila, that she probably already has arthritis in the elbow from where the joint was partly fused in the first surgery, and that she will likely be in chronic pain. That is not the outcome I was aiming for. I will have to monitor that and see how she is. If it is causing her problems in the future then maybe amputation will be on the cards again. I would hate for her to be suffering unnecessarily. This is where having a Milo will be useful. He can tell how she is feeling, I have to watch his reaction to her.
“Having a Milo’ is a phrase we use a lot in my home. It probably sounds strange to those who have not met him. We use the phrase often when we look at nice things: “That’s really nice, but we can’t have it, we have a Milo.” We mean that we have a 5 year-old kitten who doesn’t show any sign of acting like an adult, and will probably (usually) destroy any nice thing we have. I think he is one of the nicest things we could have though so I don’t mind not having other things.
Helping me with the filing.
I will post some updates about physio with Leila as we progress. Jerry suggested it might help others to have some details so I will do that.
I dropped Leila off with almost no tears (almost). I got on with my jobs, I’m still getting on with my jobs – for some reason going away for the weekend seems to lead to huge amounts of cleaning and laundry to be done on Monday. The vets planned for a simple pin removal and said that, if it came to amputation, they would call me before they did it. Otherwise they would call after the surgery. I wasn’t sure exactly what time the surgery would be done as she was third in line today so I tried not to clock-watch too much.
They called after the surgery!
Her leg has healed. It has not healed straight and the x-rays aren’t pretty (as I posted in a previous blog). She will be back on the dreaded cage rest for at least 3 weeks and absolutely no jumping. They are worried that the bone is still weaker. I will have to do some physio with her to help increase her movement, but she will always have slightly limited movement of that leg. Fingers crossed. We’re still on the road to recovery, and there is still no certainty that the leg will not break, but for now it’s hopeful. I can bring her home this evening.
Four more days until ‘That’ day. The operation day. The day when Leila may or may not keep her leg.
We are going away this weekend so today is the last day I get to spend with her before the operation. The trip is the reason I put off the surgery until next week, I didn’t want to go away and leave her so soon after surgery. I am trying not to think about it too much because I know there is nothing I can do now to change the outcome. It helps that four vets now have agreed on the next course of action, I know I’m doing the right thing. I know that whatever the outcome, Leila will be fine within a few days or weeks, any scarring will heal and she can go back to enjoying her life. I’m not worried about the outcome as much as the operation itself.
My first real pet was a guinea pig. I was 11. We found a lump under her skin. It was removed once but it came back. During the second surgery she died under anesthetic. It has left me terrified of surgeries. Each of Leila’s other three surgeries (including when she was spayed) have gone fine for her. I have been a wreck all day. The vets say that if it is just the pin removal then it should be a straightforward procedure and she can go home the same evening. If it becomes an amputation then obviously it will be more complicated. I won’t know until afterwards what the outcome will be.
I don’t know what I will do on that day. Milo hates being alone so I will probably spend most of the day here. Although he will sleep in one of his usual favourite spots if I’m here, if I leave him for too long then he gets distructive. He’s still like a kitten, despite being 5 years old. Apparently that’s a Siamese cat thing. I think I need a jobs list to just get through on the day. Cleaning and laundry, other easy things.
Does anyone else have any tips? I take her in at 8.30am (I wish I didn’t have to drive myself but there isn’t another option). The vets should call me around midday, I hope.
Her shoulder moves back correctly, the extension is a little stiff; the leg should ideally go straight past her face. She can actually stretch a little further than this but when she is resisting it’s best not to push too hard.
