When the Price Tag is the Show Stopper

There are not too many Pawbly questions that I carry over into my blog. But every once in a while I get hit by a question that reminds me that my primary duty is to help pet parents. Whether they be near, far, wide, rich, or unfortunately, in many cases, those people trying to take care of their pets and live within  budget.

Here is the question that Damion asked us today on Pawbly:

We adopted a kitten about 3 months ago. She is now about 5 1/2 months old. Normally she is VERY playful cat, jumping and running all over the place. Yesterday when I got home she was laying down and instead of her usual come up and greet me, she continued to lay there so I knew something was wrong. When she attempted to get up she was not putting any pressure on her back leg. She did this about a month ago as well but was fine after a couple of days so I figured it was a simple injury. As bad as it seemed this time, I knew it was more serious. We took her to the animal hospital last night to find out she has severe hip displasia and bad knees. Her one hip is now disclocated and would not stay back in after sedating her and attempting to relocate it. At his point we are told the socket joints are too shallow to hold the femur bone in. The surgeon said the one side is dislocated and the other MAY dislocate in the future as well. He suggested we do a femorial head resection surgery (or FHO) on the disclocated hip and we can do the patella luxation surgery on the knees, but the total cost is around $4,000. This doesn't even include surgery on the other hip. We don't have the money for the surgery and we don't want to take her to a shelter where they will put her down. The shelter where we took her from said they can do an evaluation to see if she could be surrendered but that would only place us on a waiting list and more than likely she would need too much attention and care to be able to take her back. We want to keep her and nurse her back to health but we don't know what to do. She is on pain meds now and doesn't seem to be in pain but is walking very little. She is eating and drinking but is not really using the litter as she really can't climb in. Please let us know if there is anything we can do, some financial assistance possibly? Thank you.

Here is my answer;

Hello Damion,

I am so sorry to hear of your kittens mis-fortune. What a terrible set of diagnoses.

It sounds as if your kitten may have some congenital rear leg deformities which left her susceptible to luxation of the hip(s). If the surgeon said that both hip sockets were shallow then she certainly may be at risk for dislocation of the contralateral (other) hip.

Without having the x-rays, and performing a physical examination (and because this is the internet, and I couldn't diagnose without seeing your kitten and discussing all of the concerns with you), I would strongly suggest that you ask for and seek out a second opinion. Maybe from a general practitioner who is comfortable and proficient in orthopedic surgeries in kittens? (A good hint here is to call ALL of your local rescues and ask them who they go to, or recommend, AND ask ALL of your local veterinarians too).

Many general practitioners are able to do this surgery and often they are significantly less expensive than a surgeon.

I have also seen some success in people starting a Facebook page, or local petition to ask for funds to help subsidize their own veterinary expenses.

For example I know of a client who had 2 kittens with fractured rear legs. After some networking and searching he was able to get both of them fixed for $500, (after receiving estimates for over $4,000) so it is possible.

As a last mention. There are many kittens and cats with limited mobility who live happy lives by their parents making adjustments to their home environment. Think about significantly reducing the size of your kittens living area so that she does not have to walk a great distance for any of her routine needs, i.e., litter box, bed, food, water, scratching mat, etc. If her rear legs get too weak there are carts available to help support their weight and assist in mobility. (See (http://www.handicappedpets.com/).

If you are anywhere around my neck of the woods I would be happy to help your kitten with an examination and discussion, or maybe even surgery?

I wish you the very best of luck and hope that you can find some help for your kitten. I also hope that she can stay with you, and that you can help her regardless of her current, or future handicaps.

Sincerely,
Krista

For those of you who don't know which kittens I am referring to see; Elliotts story. Or Kits story.

Is It Possible To Save A Life AND A Limb For Pennies?

There are a few patients, clients, and cases that become indelibly etched in your heart and soul. Some of them are disastrous, heart breaking, and cause you to question why the heck you ever decided to care so much, invest so much, and even try to help people in the first place?

BUT,

there, thankfully, are more of the good cases to keep your spirit fulfilled and to carry you through the train wrecks.

This is Elliott. He is a two month old, never been seen before by a veterinarian, grey and white kitten. He is a sweet gentle boy,

BUT,

he, unlike so many of the other kittens that I see, is healthy, bright, purring, and calm.

His dad is an older man with a story about Elliott. It went as follows; He and his wife had recently bought a home here in rural Harford County Maryland. Unbeknownst to them when they bought the home they also acquired a few cats. Those few cats did what all cats do, they populated.

When they realized they had more mouths to feed, they started a proactive approach to getting the felines under control.

As I listened to his story I relaxed. He was trying and I was beginning to think that maybe for the first time in a long time I wasn't going to have to try to figure out how to convince a person to take care of their pet.
First challenge appears to be diverted.

Elliott was here today because as his dad reported "he has a bum back leg. That bad leg is a mystery as to how it happened. But Elliott won't use it and so he has come to visit us."

The right side is normal, the left has three fractures.
Can you see them all?

An x-ray later we had our answer. Elliott had a broken femur, a broken tibia, and a broken fibula. No wonder he won't use that leg. There aren't any intact bones of his back leg to hold him up.

Second challenge, paying for surgery.

The challenge is all too often the same: 1. Trying to coerce a person to step up to the plate and do both steps; and 2. take responsibility and follow through with a treatment plan.

Today, the gods were smiling on Elliott. His dad loved him, he cared about his injury, he wanted to treat it, BUT, he had a herd to manage and a budget.

In the area of Elliotts injury he has a laceration over his hip.

Here is where I put my BIG disclaimer!!
I did what I hate to admit in public, on record, and in reality do all too often. I sat down and negotiated.

Why do I hate it? Because it sets a terrible precedence. It de-values what I do, it makes it harder to hold future expectations on par, and it further drives my profession into scrambling to make ends meet. It perpetuates the same problems that we vets have been plagued with forever. Why should I work for free? Who else but vets get asked daily for free services AND then are made to feel guilty when they decline? Think about it, how would you feel if everyday at your place of work your boss came to you and asked you to work an hour (or more) later for nothing? And then gave you some guilt trip about why you should after you reluctantly tried to discuss why you didn't want to work late.

In typical never-confess-this-exchange to my husband mode I offered to "try" fix the leg for $300.

To put this in perspective, at a boarded surgeons I would expect they would start the opening bid at $1,000 US dollars.

Me, heck no, I will not only significantly undercut my own services I will also add a mountain of stress onto myslef. Why? because damn it I still can't learn my lesson. I still can't turn a blind eye, and say "not my problem." And, mostly, I liked this kitten and this guy. If he's willing and committed to taking care of his feral cat population I'm willing to throw my best pitch.

We 'hang' the broken leg in the hopes of straightening the broken bones.

Holding both parts of the femur together with thumb forceps (you know them as tweezers) to pin the leg.

There are two stainless steel pins in the hollow part of the bone.
They will stay in for about 4-8 weeks.
Elliott is a kitten and they heal fast!
I am so proud of this that I beam every time I see this x-ray!

Elliott was walking on his leg by the end of his surgery day. He was given pain medications for the first few days and very very strict cage rest. NO running, jumping, or playing!

Elliott will have his pins removed in about two months. When I remove them we will also neuter him.

I saw Elliott tonight for his first re-check post op. He is happy and he is walking on his leg!!

go Elliott!

Best of luck Elliott and family!

Update:

Elliott had his pins pulled on Monday the 9th of September. They came out easily and his bones are all healing splendidly!

In a matter of minutes Elliotts pins were removed.

Elliott has a few more weeks of rest ahead of him, but I expect a fully functional leg in spite of his three fractures.

If you have a question about Elliott, or fracture repair in a kitten please find me at Pawbly.com