Lemon was presented to us at 9am and Stefaan confirmed he had a severe right hindleg lameness with a swelling over his mid to distal femur. Suspecting a fracture Stefaan wanted to commence treatment to repair this as soon as possible. Lemon's owner had taken him to the VetsNow emergency service in Witham in the early hours of the morning and he had already received pain relief which was wearing off.
He was admitted for sedation so we could radiograph his leg and to start a pain relief program. This included analgesic patches and injections. Being pain free is one of our top priorities to our nursing care plan and aids the patient's overall recovery time. The fracture was confirmed - the bones displaced with a few fragments. Given this type of injury Stefaan suspected he had fallen from a height caught his leg during the fall.
Full recovery from this injury would be life saving for Lemon as he had his front leg amputated in 2009 after being involved in a road traffic accident leaving him with a severely damaged leg. The bone and muscle injuries were unfortunately irreparable.
Lemon was fully anaethetised and prepared for surgery, before taking him to the operating theatre. His vital signs were continually monitored which included blood pressure, oxygen saturation, carbon dioxide and temperature measurements. Keeping Lemon warm from the point of sedation to his full recovery in our cat ward was essential. A low temperature can have a serious effect on any patient's anaesthetic.
His fracture proved to be very difficult to stabilise but was reconstructed by using a combination of pins and wires. We were very concerned about his ability to walk and use this leg so the first few days then weeks of recovery were a critical time for Lemon. Head of Surgery, Lindsey Nice who carried out his operation was concerned that he may need a second operation.
Over the days that followed Lemon continued to receive a high level of pain relief and was reluctant to place his leg. This made toileting difficult for him and his bladder function was monitored regularly. He was taken to surgery for a second time and had further implants placed. With the disadvantage of only having 3 legs this second surgery was needed. A cat with 4 legs would have coped with this injury much better and not needed the second surgery, but this could not be the case for Lemon.
Lindsey's last option was to arthrodese the joint but there would need to be some level of bone healing before his implants could be removed then the arthrodesis performed. Arthrodesis would give him use of his leg again but he would not have the full range of movement in his leg, as his joints would be in effect fused.
His hospitalisation continued along with his pain relief and high dependency nursing care. This included physiotherapy massage, supportive walking and range of movement exercises. Two days after the second surgery Lemon started to place his toe on the floor and was more receptive to his physiotherapy. He was urinating and defecating on his own and his foot which had been very swollen had resolved by 90%. Everyone's prayers were being answered as Lemon started to make this slow recovery.
Lemon continued to improve and was sent home 10 days after he was initially admitted. His owner was shown how to give him his required physiotherapy but would need strict cage rest over the next 2 weeks. He returned to us for a number of check ups, which included being admitted for sedation and further post-operative radiographs. At this point one of his pins was removed. He was now allowed out of his cage but restricted to room rest. Lemon was signed off three and a half months after his injury. His owner felt he was getting on really well. He was unable to use his leg as well as before his accident but felt given the circumstances he was using it really well.
Lemon's owner commented .... "I cannot say enough about how very happy I've been with all the treatment and care he has been given by all the dedicated staff. Lindsay Nice and all of the nurses who helped and encouraged Lemon to walk, Thank you all so very, very much. I know that if Lemon could talk he would say the same. Lemon is great now and runs around like mad thing. He does get tired quite quickly now though. He seems to understand why he can't go out anymore. He has such a wonderful nature and never gets cross and is so loving....he is my best friend and I love that little fella so, so much! Thank you once again."
We were all so pleased with Lemon's progress and recovery, be it several months. But his surgery, treatment and nursing care saved the life of this little cat.