Progress since operation ... advice please

October

I posted a couple of times before about my cat's operations, the most recent here..

http://www.boards.ie/vbulletin/showthread.php?t=2056028889

My cat is about 8 years old and when he was about 1 (before I had him), he broke his leg in a few places and had several operations.

In July, it was discovered that a pin had become detached and travelled into his knee joint and he had an operation to have that removed. All was good for about 4 weeks when he suddenly started limping badly and appeared to be in a lot of pain. A growth appeared and he had another operation to have that removed. The vet said it looked like a tumour but didn't really make sense that it was one because it wasn't there at the first operation

Anyway, there was no improvement in the pain and he had a further xray and it was discovered that he had two more pins in his knee and the pins/screws had become infected, the infection had got into the bones and the bones were crumbling so two weeks ago today, his leg was amputed. He stayed in the vet for seven days and I picked him up the following Sunday. When I got him home I noticed a little hole in the wound and it was weeping. On that Sunday he also managed to pull two more stitches out despite the fact that he had a cone on him.

I brought him back to the vet and the vet had to put a staple in the wound to close it and he was kept at the vets for two days. I got him back last Wednesday and everything was going well. He was very quiet which I put down to the extra big cone to keep him away from the stitches but he had a great appetite and seemed fine otherwise.

I thought I would be bringing him to the vets tomorrow to get the stitches out. I examined the wound last night and it looked really well. Even the part where he pulled the stitches out looked completely healed.

I came home from work today to find the wound had opened up a lot and there was a lot of fluid and puss coming out. I brought him to the emergency vet who told me there was an infection in it and the cat had not pulled stitches (he couldn't reach them anyway) but rather the wound had opened up to let the puss/fluid out. He is staying at the emergency vet over night on antibiotics and a drip and I have to pick him up tomorrow and bring him to my regular vet.

My nerves are shot to pieces with all the set backs over the past couple of months and my poor cat, who doesn't like being handled at the best of times, has had a really rotten time.

Should my cat have been put on antiobiotics when he opened up his wound a week after the operation? I am annoyed that he was given back to me with a little hole in the wound and it was weeping also.

I really don't know what to think - has my cat just been unfortunate or is it time to change vets? I know it's difficult to give advice just based on the above..... but any advice? Should I be really annoyed at the vet? What questions should I ask him when I see him tomorrow?

I really thought tomorrow was going to be his last visit to get the stitches out and he could get back to normal.

Sorry for the long post but I'm so worried and upset about my cat.

Thanks

MaryK666

Hey October, it sounds like both you and your poor little kitty are going through the mill at the moment.
I'd be interested to know where in the country you're based as I would like to avoid your current vet like the plague. I would have thought that before any operation, he would have completed enough x-rays to be aware of all the pins in your poor kittys leg and whether any of them had moved. And to mis-diagnose a tumour - please take away my soapbox now, before I get started. That could have been anything from a bursa to calcification if a pin had moved and was causing friction/inflamation and pain.

It sounds like the emergency vet you used is more on-the-ball and I'd stick with him/her for now if you can.
Any kind of surgery is traumatic for both you and your cat and can carry the risk of so many complications for him.
The post-op problems you have could be caused by so many different things but your own vet should have attempted to foresee at least some of them or at least be able to diagnose them correctly as they occured.
And I'd have thought that antibiotics would be normal procedure post operative and at the first sign of any infection. The wound would have to have been left open for any pus/fluid to drain out but he should have been on medication.
It's hard to suggest what to ask him on your return as he may well waffle to cover his tracks. If I were you I'd just cut and run.

I have an awesome vet who's great with both cats and dogs and he's the only one I'd trust my three cats with but I'm based in Kildare. If thet's any use to you, pm me and I'll send you his details.

Hopefully there'll be a good resolution and your little man will be back to full health and infection free as soon as possible.

October

Hi MaryK666

Thanks for your reply, much appreciated. I'm in Dublin

I've brought my cat back to my regular vet and he's keeping him until Saturday. The wound is still open to allow drainage.

I asked him if he should have been put on antibiotics after wound opened the first time and he said they gave him antibiotics during the three days they kept him after that. They didn't send me home with any though so I'm not sure if a three day antibiotic course would have been of benefit.

I examined the wound on Sunday night (I even got a little torch so I would get a good look!) and the wound looked perfect. Not a hint that anything was going on. And 24 hours later the wound was open and fluid and pus coming out.

I'm really none the wiser after speaking to the vet. To be honest, money is becoming a bit of an issue. It has cost me €1,200 (three operations and about 20 days "in-patient" in total) over the past two months and vet is letting me pay last €300 off over the next few months. I will pay whatever is necessary to get him better and I'm assuming the vet will charge me a minimum amount, if any, for the treatment and boarding over the next few days. Can't really move vets at this stage as I can't really afford new vets fees!

Hopefully this is the last episode of it all and another couple of weeks for infection to clear up and then the wound to heal and then back to normal!

MaryK666

Hi October, some vets can be awesome and then there are some, for some strange reason, that just don't seem to be 'as' on the ball as others. It seems to me to be very convoluted and involved for an amputation and there's far too many complications and too much infection. These things are supposed to be done with sterile instruments in sterile conditions by a confident, knowledgable surgeon and I'd have expected it to have healed by now. And the amount of money you're being charged is outrageous, considering it's probably the vets fault in the first instance.
The wound may have looked ok to you from the outside but when you're dealing with removing bone from a joint, sorting out tendons, ligaments and tying off blood vessels it's easy to miss an infection deep in the wound that will need time to make it's way to the surface to drain so it wasn't anything you missed or indeed there wasn't anything you could have done to prevent it. The only thing that would have prevented it from happening was good operation hygene and adequate medication and that seems to be where your vet fell down. And as for all the mess with the pins moving and not being spotted - it doesn't say a lot about him as a vet. Is he an older vet or a younger person? There's a lot of good training out there for qualified vets if they're willing to go and get it but some just don't seem to bother.

If you're willing and able to travel, I'd really recomend my vet who's based in Celbridge. He's not all about the money and he's an excelent practicioner. He knows that all our cats are rescues and that we occasionally find other ferals who need help and we get a special rate which includes diagnosis, medication and occasional surgery. It's awesome as our ex-feral boy is FIV+ so he's always down there for something as I watch him like a hawk for any bumps, lumps or scrapes. It would have bankrupt us by now if we'd used any other vet so we fell on our feet when we found him.

Let me know how your little boy gets on and what progress he's making and with a bit of luck he'll be home where he belongs in no time.

October

Hi MaryK666

I got my cat home yesterday morning. He's in great form and eating great. He has had two episodes of diarrhea. I'll keep a check on that but I presume his tummy is upset because of the antibiotics. The wound is still open a little bit. I'm not sure I understand how that will heal when the two sides aren't meeting but I'm bringing him back to the vet for a check up on Tuesday and I'll ask him then. The wound is clean and dry. Most of the stitches will probably come out on Tuesday but he will still have to wear the big cone until the wound fully heals.

Celbridge is too far for me to travel to. Hopefully this is the last leg (very bad pun!!) of it all and he'll be fully recovered in the next 2-3 weeks.

Thanks for your advice