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Case summary: A 12-year-old neutered female domestic shorthair cat was presented with bilateral progressive forelimb lameness that was unresponsive to anti-inflammatory drugs. Bilateral carpal flexural deformity with hyperflexion of multiple toes of the right forelimb was observed. In the absence of abnormalities detected on radiographs and ultrasound, a bilateral contracture of the carpal and digital flexor muscles was diagnosed. Treatment consisted of single-session bilateral selective tenectomies (5 mm) of the flexor carpi ulnaris, flexor carpi radialis and superficial digital flexor muscle tendons on the left forelimb and tendons of the flexor carpi ulnaris muscle, and branches of the third and fourth digit of the deep digital flexor muscle on the right forelimb. Two months postoperatively, selective tenectomies (10 mm) were performed due to contracture recurrence on the left forelimb. The subjective outcome was rated as good 6 months postoperatively. Relevance and novel information: Digital and/or carpal contractures are rarely described in (feline) veterinary medicine and are limited to a few case reports. The exact aetiology remains unknown. A traumatic/iatrogenic origin seems to be the most likely cause. Surgery is indicated, consisting of selective tenectomy and/or tenotomy, and is associated with minor complications and an excellent outcome. This case report describes the presence, treatment and successful outcome of a cat with bilateral carpal and digital flexor muscle contractures resulting in carpal flexural deformity with valgus deviation treated with selective tenectomies.
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OBJECTIVES: The aim of this study was to document survival, complications and risk factors for the development of complications and mortality prior to discharge after placement of a subcutaneous ureteral bypass (SUB) device in cats. METHODS: The medical records of cats with SUB placement between January 2016 and August 2019 were retrospectively analysed. The development of complications (overall, intraoperative, perioperative, short- and long-term complications) and risk factors for mortality prior to discharge were statistically assessed with univariate binary logistic regression. All variables with a P value ⩽0.10 in the univariate analysis were assessed in a multivariate model. Variables were significant if P <0.05. RESULTS: Twenty-four cats were included; 12 (50.0%) received a unilateral SUB, 11 (45.8%) a bilateral nephrostomy tube with single cystostomy catheter and the remaining cat (4.2%) two unilateral SUBs. Nearly 80% of the cats developed complications, ranging from mild to fatal, including (partial) SUB obstruction (33.3% of complications), lower urinary tract infection (20.8%), pyelonephritis (20.8%) and sterile cystitis (12.5%). Five cats (20.8%) died prior to discharge. Six cats (25.0%) underwent revision surgery. The overall median survival time (MST) was 274 days (range 1-311 days). Complications were most common in the long-term period (14/16 cats), followed by the short-term (9/18 cats), perioperative (10/23 cats) and intraoperative (4/24 cats) periods. Older cats had an increased risk for developing perioperative complications (P = 0.045) and were less likely to survive to discharge (P = 0.033). An increased haematocrit at presentation was a risk factor for the occurrence of short-term complications (P = 0.03). CONCLUSIONS AND RELEVANCE: Although complications similar to those previously described were observed, the complication rate was higher and the MST shorter than previously reported in cats undergoing SUB placement. Despite good short-term survival, the development of complications may necessitate regular and intensive control visits. Owners that consider SUB placement should be informed that follow-up can be strenuous and expensive.
