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Amputation in Cats

26th July 2018

Amputation in Cats

Adapting to life on three legs: The story of Buba

Teresa Martins looks at how owners can help their cats adapt to disability and the loss of a limb.

phantom limb cat

Pet cats can sometimes find themselves having to adapt to life on three legs. The loss of a limb can affect normal feline behaviour and activity. Although cats usually find a way to adapt and live a happy life, the adaptation process can be aggravated by the distress of the incident or illness which resulted in amputation.

Buba was a neutered male six-year-old, extrovert and friendly domestic shorthair who lost his left hind limb in a motorbike accident. His story illustrates the process of adaptation pet cats must go through. After surgery, a three-legged cat will find out that for some mysterious reason it is no longer able to perform some tasks it could easily do before. Frustration and anxiety can make the cat feel unsettled and can, in some cases, lead to distress and altered behaviour.

Facing up to life with three legs

Buba’s adaptation to life on three legs was not easy. He became depressed and inactive. He stopped playing, gave up grooming, stopped cleaning himself after using the litter tray and also stopped purring. Perhaps because he felt frustrated, Buba compulsively engaged in a behaviour that still gave him pleasure and caused him no pain: eating.

During the first days after hospitalisation Buba was unsettled, not least because he needed to wear a collar to prevent him from damaging the wound. Initially, Buba also became more introverted and aloof, wary of strangers as he had never been before the accident. However, his extrovert character won the day and over time he gradually lost his fear of strangers.

Physical adaptation may be complicated by hallucinosis (phantom limb). The cat will feel that it can still rely on the missing leg and it may take longer for the cat to find alternative ways of performing tasks that involve the amputated leg. Four years after the accident, Buba still tries to scratch his left ear with his missing leg. Observation of Buba suggested that phantom pain may be a problem in cats, as in humans. Several months after the surgery, when healing was completed, Buba was uncomfortable with his stump being touched. During vaccination, he was extremely reactive when he was injected in his left hindquarters, near the stump. However, this sensation eventually seemed to subside and he could tolerate being touched on the stump.

The role of the owner

Even though a cat’s adaptation to a life on three legs will depend in part on their personality, it is clear this can be a difficult period for the cat. The pain and fear associated with many of the situations leading to limb loss can traumatise and distress the cat as well as adapting to their new limitations. It is important for owners to help their cats to cope with this new situation.

Buba faced a number of practical problems following the amputation. Jumping onto favourite furniture was difficult and he was inclined to give up. To aid him, furniture was rearranged enabling Buba to move from one piece to another, and gain easy access to favoured places. As his confidence and ability increased, so the furniture was moved apart until eventually it was returned to its normal location and Buba was able to go wherever he wanted.

Similarly, to enable him to get up on the bed, a step was provided at the side. As his confidence and muscle tone improved he was able to pull himself up and gained more freedom.

The litter tray was another problem. Despite the removal of its cover and the provision of a step, Buba was reluctant to use it. Buba was helped into the tray each time and initially helped to cover and dig which enabled him to gradually re-learn the habit and adjust to his new situation. Cleaning himself after using the tray was also initially difficult and he needed to be cleaned when he would not clean himself. However, as his balance and skills improved, and when he no longer fell over while trying to turn around to wash, normal grooming and cleaning habits were re-established.

Buba’s compulsion to over-eat was overcome by distracting him with play when he started to search for food. Soon his natural desire to play, along with steady adaptation to life on three legs, overwhelmed his compulsion to eat. A three-legged cat’s body weight should be controlled, as becoming overweight can exacerbate difficulties in them adapting to life. It may be useful to use low-calorie foods, especially as the cat will be less active (at least initially), and especially if they start to over-eat.

In summary, the owner has a critical role during the adaptation of cats to a life on three legs. Some cats adapt quicker than others, but especially when the process falters, a caring owner can help the cat adapt, help motivate them, and help them re-learn or develop new skills. Thoughtful adjustments will help accelerate the process of adaptation to enable the cat to have a full and enjoyable life.

Owning a cat with an amputated limb

International Cat Care  helped fund a vet (Lyn Forster) to undertake some important research on improving the welfare of cats which have had limbs amputated for one reason or another. Her research formed part of the work of the Centre for Animal Welfare, where she worked with Dr Sandra Corr, at Nottingham Vet School in the UK. For part of her work, Lyn surveyed owners of cats which had lost a limb or tail to help us understand better how a cat copes after this sort of loss.

Limb and tail amputations are undertaken to treat different conditions — most commonly in cats this is a result of trauma, very often after being injured in a car accident.

phantom limb cat

Results of the survey

More than 230 cats with amputations were included in the survey. Some of the results were as expected:

  • 80% of the cats were domestic shorthair (DSH) cats – this corresponds to the breed populations in the UK
  • Two-thirds of the amputee cats were male – this is probably because males roam further than females, and so are more likely to get into accidents
  • Two-thirds of the cats were under four years old – probably because younger cats are less experienced and therefore more likely to come into contact with dangers
  • Trauma, such as broken bones
  • Nerve damage, and
  • Damage to the skin and muscles.
  • The main causes were the same for both leg and tail amputees, although tail amputees had nerve damage as a reason for amputation more commonly
  • Few people see the event that caused their cat’s injury, but it was thought in most cases these were caused by road traffic accidents
  • Cats were equally likely to lose a left leg as a right leg
  • The front legs carry more weight than the back legs – it is generally believed that amputation of a back leg will be more successful, so amputation of a front leg may not be offered so frequently
  • Cats that have damage to the front leg are more likely to also have damage to the chest, and this may reduce their chances of survival
  • It is possible that the back legs are actually injured more commonly as well

Differences between cats and dogs

So a ‘typical’ cat amputee would be a young male DSH, with a leg amputated following a suspected road traffic accident. This is different to what might be expected in dogs, where a typical amputee may well be an older male, probably purebred, who had a leg amputated following a tumour. It quickly becomes apparent that as with other issues, we must look at and consider cats as a unique situation, and not just as small dogs.

How do cats and owners cope with amputations?

Owners were asked questions about their cat’s behaviour, activity, movement, speed, playfulness, mood, body and coat condition, appetite, grooming, and friendliness with humans and other animals.

Interestingly, the only differences noted by owners with a cat amputee were that they tended to be less active and moved slower – in  all other aspects  the cats were generally no different following amputation. When providing extra information, some owners reported that their cat got tired more easily. These observations probably reflect the increased effort involved in getting about on only three legs, but show that quality of life for most of the cats appears excellent. In fact, over 90% of owners believed that their cats had a normal quality of life after the amputation. This is very encouraging – although there are still 10% of cats do not achieve this, most owners are very satisfied that amputation has not impacted on their cat’s quality of life significantly. When asked whether they would make the same decision if they knew then what they knew now, 95% of owners said they would.

Importance of pain relief

Almost 90% of owners were aware that their cat had received pain relief medication to go home with after the amputation surgery. This is reassuring as the surgery is inevitably painful. However, 36% still thought their cat had been in pain at some point after it had returned home, suggesting improvements could be made. As well as being emotionally unpleasant, pain is known to delay healing, and if we can improve the way pain relief is monitored in these postoperative amputee cats we can potentially improve their speed of recovery as well.

Interestingly, the results of the survey showed that if the owner thought the cat was in pain, the cat took over a month to recover from the surgery, whereas cats that were not in pain took on average only two weeks to recover.

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Neuropathic pain in a cat post-amputation

Affiliation.

  • 1 Carepoint Veterinary Surgery, South Townsville Queensland 4810. [email protected]
  • PMID: 16555554
  • DOI: 10.1111/j.1751-0813.2006.tb12233.x

Phantom limb pain is a form of neuropathic pain experienced by human patients who have had amputations. To date there are no reported cases of phantom limb pain in the veterinary literature. A cat presented with signs consistent with neuropathic or phantom limb pain 42 days after iatrogenic sciatic nerve injury and 38 days after subsequent hind limb amputation. Multimodal analgesic therapy resulted in resolution of signs of pain.

Publication types

  • Case Reports
  • Amputation, Surgical / adverse effects
  • Amputation, Surgical / veterinary*
  • Analgesics / therapeutic use
  • Cats / injuries
  • Cats / surgery*
  • Hindlimb / surgery*
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / veterinary*
  • Phantom Limb / diagnosis*
  • Phantom Limb / drug therapy
  • Sciatic Nerve / injuries*

Pain from the Nervous System in Cats

Pain from the Nervous System in Cats

Neuropathic Pain in Cats

An injury or disease relating to the body’s nerves and how they function, or within the spinal cord itself is commonly the origin of neuropathic pain. This particular kind of pain is difficult to pinpoint, especially in patients that are unable to respond to specific inducements. A common condition seen in cats is diabetes, and a tingling and pain in the hind legs is one form of neuropathic pain.

Symptoms and Types

Damage to the tissues of the body, and the nerves running through them, creates a constant (chronic) pain that is brought on by a light touch to the affected area and/or a heightened perception of pain. Pain originating within the spinal cord causes problems with mobility and various functions of the body.

Some of the symptoms of neuropathic pain may include:

  • Limping or dragging a limb
  • Shaking or twitching of the skin
  • Chewing on the affected area
  • Muscle wasting (atrophy)
  • Crying out (vocalizing)
  • Decreased appetite
  • Urinating and defecating inappropriately (incontinence)

Neuropathic pain may result from an injury to body tissues or a growth (tumor) in the spinal cord. Diseases that affect the spinal cord, such as intervertebral disc disease ( IVDD ), may cause pain in different areas of the body, depending on which part of the cord is affected. Another potential cause of neuropathic pain is amputation of a limb. Phantom limb pain results in the impression of pain coming from a leg that has been surgically removed.

In cats, a common cause of neuropathic pain is diabetes mellitus. The result is a weakness in the hind legs which comes from damage to the nerves caused by constant high levels of sugar in the blood. Pain may accompany the weakness, with tingling and numbness in the limbs.

In general, neuropathic pain is diagnosed by ruling out other causes of pain and performing reflex tests to evaluate the nervous system. Basic blood tests can help rule out infectious and disease-related causes. Blood glucose tests will help to determine if your cat is diabetic, if the cat has not already been previously diagnosed. X-rays and special imaging may be necessary to search for tumors in the bone or spinal cord. Finally, a good discussion of your cat's medical and behavioral history, and the symptoms that led up this condition will help lead to the proper diagnosis.

Analgesic medications (those that relieve pain) are used as the initial treatment for neuropathic pain. The amount given may need to be changed until the best effect is achieved. Other types of pain relievers may be tried until the one that works best for your cat is found. Some veterinarians may choose to use several pain medications at one time and then taper off until only one is being given.

One medication that is has been used with success for long-term pain is gabapentin. This anti-seizure drug has analgesic properties that are particularly effective for reducing neuropathic pain in cats. Gabapentin is given once daily for pain control and can be given with or without food. The particular side effects of this drug include sedation, weight gain, and stumbling (ataxia). Diarrhea may also be seen in some animals.

Dosages of gabapentin may be too small for cats. If this is the case, your veterinarian may need to have the drug specially made at a compounding pharmacy.  

Living and Management

If your cat is in chronic pain it may gain considerable relief from analgesic medications. The quality of life for these animals can be much improved, as long as the underlying condition causing the pain is under control.

In cats with kidney problems, the dosage of gabapentin may be reduced, as the drug is processed through the kidneys and they must be functioning properly for the drug to be removed from the body. Animals that are pregnant should not be treated with gabapentin. When discontinuing the medication, gabapentin should be slowly tapered off to prevent seizures from occurring after long-term use.

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Limb Amputation And Recovery In Cats

Julia Wilson, 'Cat World' Founder

Affectionately referred to as tripod cats , leg amputation is the surgical removal of the limb. Cats are such agile creatures, it is hard to imagine how a cat could cope on three legs, but they manage easier than we often give them credit for.

Indications

The most common cause of amputations in cats is due to severe trauma, usually as a result of a traffic accident.

Some cancers can affect the leg including bone cancer and VAS (vaccine-associated cancer) . This is a rare cancer with an incidence of 1 in 1,000 to 1 in 10,000 vaccinated cats . Osteosarcomas and fibrosarcomas are two cancers that can develop in the leg.

Other indications common causes may include birth defects, severe burns , frostbite, loss of function of the limb due to nerve damage and severe infection which is not responsive to therapy.

Amputations can be performed on both the forelegs or hind legs. Hind limb amputation is twice as common as forelimb amputation. It is rare for more than one leg to be amputated and a specialised cart will be required for your cat to move around if more than one leg is removed, cats can easily move around on three legs.

Ideally, the cat will not be overweight as amputation places more weight on the remaining legs. Diabetic cats and cats with arthritis can also have issues, and pros and cons need to be weighed up before surgery in these cats.

Pre-surgery

Before surgery, your veterinarian will want to perform some diagnostic tests.

  • Baseline tests will include biochemical profile , complete blood count , and urinalysis to evaluate the overall health of your cat before surgery.
  • Biopsies of tumours.
  • If he has cancer, an x-ray will be taken of the leg as well as the chest to check for signs of the tumour spreading.

Unlike dogs (and humans), almost all amputations involve the entire limb. In many cases dogs and humans have the availability of prosthetics to use after surgery; however, this isn’t widely available to cats yet, (although some cats have been given prosthetics). I suspect once prosthetics in cats become more mainstream, we will see more partial leg amputations. But at the moment, they’re mostly full. The most common type of amputation in the foreleg is ‘scapulothoracic disarticulation’ , in which the entire leg is removed up to the shoulder (scapula). There are two types of amputation in the hind leg. Either amputation at the hip joint, or amputation at the upper third of the femur (thighbone), known as ‘high femur’ , this surgery will leave a short stump behind.

Surgical procedure

Your cat will need to fast from the night before surgery; usually, he will be scheduled to arrive first thing.

  • The veterinarian will administer a general anesthetic to induce deep sleep and insert a tracheal tube to maintain anesthesia with gasses.
  • The hair on the leg and surrounding area will be shaved off and cleaned with an antiseptic solution.
  • Drapes are placed over the cat, with a small open area around the surgery site.
  • The forelimb will be removed up to the shoulder ( scapulothoracic disarticulation ), or the hindlimb up to the hip joint ( coxofemoral disarticulation ).
  • If a forelimb was amputated, a bandage will be placed over the surgery site.
  • Painkillers will be administered post-surgery to relieve discomfort.
  • An Elizabethan collar will need to be worn to prevent the cat from damaging the surgical site while it heals.

Can a cat live a happy life missing a leg?

Cats are excellent at adapting after they have recovered from the surgery, they will be able to come home; during the first few weeks keep indoors while they recuperate. It doesn’t take most cats long to adjust to living with three legs. In most cases, they will be able to do nearly as much as they did before.

While many amputees continue to jump, they may be more hesitant to do so than they were in the past.

The rear legs propel the cat in an upward direction, natural; if the cat has lost a leg, he will not have the same amount of power. The forelegs are used when the cat jumps down and act as shock absorbers and help to balance the cat.

Recovery period

Younger cats tend to recover quicker than older cats, but most cats should be up and about within 1-2 days of surgery and 2-4 weeks for a cat to make a full recovery.

The length of hospitalisation depends on overall health, any other medical issues they may have and how fast recovery is. A cat who has been in a car accident may have other injuries he needs to recover from.

Exercise should be limited until the sutures are removed at 14 days.

How to care for a cat after a limb amputation

  • The cat will be discharged with painkillers and antibiotics, administer as prescribed.
  • Confine the cat to one room or a dog crate during recovery. The Elizabethan collar will need to stay on until the site has properly healed. Your veterinarian may allow its removal while the cat eats. Stitches are removed 14 days post-surgery. By this time the wound should be nicely healed, and the Elizabethan collar can be removed.
  • Keep the cat inside for several weeks while in recovery.
  • Keep a close eye on the surgical site for signs of infection; this may include redness, swelling, discharge and a bad odour. If you are at all concerned, contact your veterinarian immediately.
  • Avoid over-exerting the cat. Discourage jumping.
  • Make sure the litter tray is in an easily accessible spot.
  • Provide a litter tray that is suitable for the cat’s needs, this may include one which has lower sides and an uncovered one. You may also consider cutting one side out of his litter tray.
  • Make sure the cat maintains a healthy weight; obesity puts too much pressure on the remaining limbs.
  • If your cat has had a leg amputated due to cancer, chemotherapy or radiotherapy may be required post-surgery.

Do cats experience phantom pains like humans?

Amputee cats can experience phantom pains after limb amputation, due to the nerve endings at the site of the amputation sending signals to the brain.

With a little time and tender loving care, your cat should make a full recovery from his amputation surgery and bounce back quickly. His quality of life shouldn’t suffer because he has lost a leg. It is advisable that you keep your cat confined indoors or a cat run for his safety. While tripod cats generally have no problem running and jumping, they may not be quite as agile as they were previously, making them at greater risk to vehicles and predators.

Frequently asked questions

How long does it take a cat to recover from a limb amputation?  The cat should be able to walk a small distance within a day and will be fully recovered within 2-3 weeks.

How long does the surgery last? A limb amputation takes between one and two hours to perform.

How long will the cat be hospitalised?   Most cats are hospitalised for 5-7 days post-surgery.

How much does a leg amputation cost? The cost to amputate a leg can vary depending on the underlying cause and if the surgery is an emergency or scheduled but typically costs between $1,500 to $2,000.

Julia Wilson, 'Cat World' Founder

Julia Wilson is the founder of Cat-World, and has researched and written over 1,000 articles about cats. She is a cat expert with over 20 years of experience writing about a wide range of cat topics, with a special interest in cat health, welfare and preventative care. Julia lives in Sydney with her family, four cats and two dogs. Full author bio

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Table of contents.

  • Award Proceedings
  • Dermatology
  • Elbow Dysplasia in Dogs
  • Emergency & Critical Care
  • Feline Medicine
  • Global Nutrition
  • Global Pain Council
  • Hereditary Diseases
  • How I Treat
  • Infectious Disease
  • Integrated Medicine
  • Internal Medicine
  • Nurse Technician
  • One Care Management
  • Ophthalmology
  • Oral Abstracts

Cranial Cruciate Ligament Disease

  • Differentiating Orthopedic & Neurologic Disease
  • Elbow Dysplasia in the Dog
  • Emergency Management of Status Epilepticus
  • Hindlimb Lameness in the Cat
  • Introduction to Ligament Repair
  • Is It the Hip Or the Stifle?
  • Management of Shearing Injuries
  • Nutraceuticals: What Do We Know?
  • Skull Fractures in the Cat
  • Pain Management for Spinal Disease
  • Pelvic Fractures in Cats
  • Surgical Technique Tips for TPLO
  • Art of Canine Lameness Evaluation
  • Art of the Orthopedic Exam
  • Pathology/Oncology
  • Poster Abstracts
  • Small Animal Surgery
  • Soft Tissue Surgery
  • Vaccination Guidelines Group
  • WAVMA-Ornamental Fish
  • Wellness/Welfare

'For every diagnosis missed for not knowing, ten are missed for not looking.' 1

Most lameness in cats can be attributed to traumatic fractures or abscesses. Other causes can present more of a diagnostic challenge to the clinician and some of the conditions that cause lameness are unique to the cat. 2,3 A thorough examination of the cat is important to localise the problem, and distinguish neurological from non-neurological causes of lameness and identify multiple problems. Cats with obvious gait abnormalities due to an open hock luxation for example may have other more proximal injuries such as femoral head and neck fractures or a dislocated hip that may be missed if a thorough examination is not performed. A full description of orthopaedic examination of the cat is given in Chapter 1 of Feline Orthopaedic Surgery and Musculoskeletal Disease 2 and in an article by Kerwin 2012: 1 a summary of pertinent points is given here. It is necessary to have a calm and patient approach to examining the cat. Ideally the examination is done in a room that is kept free from dogs and in a room that has no escape routes or hiding places.

Visual Exam of Gait - Reduced Weight Bearing or Abnormal Stance

An area should be identified that is free of encumbrances where cats can hide and be difficult to extricate. It can be useful to place the cat at one side of the room and its basket at the other end as it may choose to seek refuge in the basket. Although have an assistant ready to shut the door and prevent its re-entry if the examination has not been completed. If the cat refuses to walk in the consultation room having the owner video the cat in its home environment can be useful.

Standing Exam of the Cat - Gentle Palpation for Symmetry and Comparison Between Limbs

One hand may need to be placed under the abdomen to keep the cat standing up. Cats are best examined using minimal restraint, flat hands can be used to provide gentle containment. Avoiding scruffing, if possible, as this will cause the cat to tense up and limit further examination. However there may be the occasion where it is necessary to scruff a cat to suspend it to examine a single lame limb. Careful assessment of the limbs and skin for swelling and scabs or puncture wounds that occur in the case of bite wounds is an important part of the orthopaedic examination in cats. Some fractious cats will not allow any physical examination; in this case the examination may need to be performed after anaesthesia or sedation. In animals with painful fractures in which a complete examination is not possible in the conscious animal then further assessment should be performed after anesthesia.

Examination of Joints - Swelling, Pain, Instability, Range of Motion and Manipulation

This is best done with the cat lying down. An assistant uses two flat hands to gently hold the cat on the table with one hand over the cats' pelvis and one on the shoulders and around the neck to prevent the cat turning its head and biting. If the cat will not lie on its side then it is easier if the cat is held slightly suspended under its abdomen or supported under its chest while examining each limb. All four limbs should be systematically examined starting at the toes and working proximally examining for swelling of joints, pain, particularly when taking joints through the range of motion, and whether the range of motion is normal. Cats have greater laxity in their joints than dogs so before deciding that a joint has normal or abnormal laxity it is important to compare it with the contralateral side or with normal values for cats.

Further Investigations

Following the gait evaluation and standing and lateral recumbent physical examination further investigations may be required to aid in obtaining a diagnosis. Investigations may include a more thorough examination under sedation or anaesthesia, clipping of hair to look for puncture wounds or evidence of cellulitis, aspiration of joint fluid or swellings with cytological analysis and/or culture. Diagnostic imaging modalities that are useful include radiology, ultrasound, CT and MRI. The investigation of hindlimb lameness in cats (excluding common fractures and abscesses) will be illustrated by discussing the following conditions:

Pelvic Limb Lameness

Slipped Capital Femoral Epiphysis

Affected cats are usually young male neutered cats that present with unilateral hind limb lameness often of insidious onset. Radiographs show a slipped femoral epiphysis, there may be 'apple coring' of the femoral neck. Treatment is femoral head and neck excision or total hip replacement. The other femoral head may fracture at a later date.

Cats that suffer cruciate ligament rupture are generally heavier than the general population of cats and there is evidence reported that this injury parallels the degenerative cranial cruciate ruptures seen in overweight small breed dogs. They have similar bilateral hind limb stiffness or unilateral pelvic limb lameness, stifle swelling and instability associated with the ruptured ligament.

Patella Luxation

Patellar luxation should be considered as a cause of hind limb lameness in cats. It is generally seen in young cats and clinical signs vary from stiffness, reluctance to jump, unilateral hind limb lameness to marked reluctance to bear weight on either hind limb. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation.

Patella Stress Fracture

An atraumatic transverse stress fracture of the patella has been recognised in young cats that present with marked unilateral hind limb lameness associated with quadriceps insufficiency and an inability to extend the stifle. A careful oral examination will reveal retained deciduous teeth in many affected cats. Cats will commonly fracture the contralateral patella within 2–3 months of the first and then other bones such as the tibia, pelvis and humerus as they grow older. 4

Myositis Ossificans

Generalised and localised forms of myositis ossificans have been reported in cats. The generalised form is known as progressive ossifying fibrodysplasia. The localised form tends to occur in specific muscles such as the biceps femoris or semitendinosus bellies. Its formation may be related to local or repetitive trauma. Recurrence of the lesion in cats is likely after excision.

Lumbosacral Disease

Clinical signs in cats with lumbosacral disease include reluctance to jump, low tail carriage, elimination outside the litter box, reluctance to ambulate, pelvic-limb paresis, single limb lameness, urinary incontinence, and constipation. Cats will usually have lumbosacral hyperpathia on palpation. A normal cat will tolerate full extension of the tail and side to side movement, in a cat with lumbosacral disease movement of the tail may cause pain. A combination of radiographic, myelographic CT and magnetic resonance imaging findings have been used to confirm the suspected diagnosis of disc-associated lumbosacral disease in the various reports in the literature.

Myasthenia Gravis 5

Cats with myasthenia gravis (MG) may present with generalised weakness or exercise intolerance, muscular weakness and apparent stiffness. The gait may be mistaken as being associated with bilateral hind limb problems such as hip dysplasia, or patella luxation. Other clinical signs indicative of neuromuscular disease include neck ventroflexion, lack of palpebral reflexes, dysphonia and less commonly regurgitation. The Abyssinian and Somali cat are predisposed breeds, and cats are usually older than 3 years. MG is a condition whereby muscles are unable to contract or maintain contraction due to a deficiency or disorder of acetylcholine receptors (congenital form) or blockage of the receptors by immune complexes (acquired form). The acquired form is more common in the cat. The disease is confirmed by testing for acetylcholine receptor (AChR) antibodies. Many cats with MG will have a cranial mediastinal mass, most commonly a thymoma.

Arterial Thromboembolism

Ischemic neuromyopathy results from embolization or long standing compression of arteries. It is usually seen in cats with cardiomyopathy. The most common site of obstruction by emboli is the aortic trifurcation. The onset of signs is acute and painful paraparesis or paralysis occurs. Limbs are cool on palpation, there is absence of a femoral pulse and the nail beds appear blue or cyanotic. Gastrocnemius muscles are firm on palpation and can be painful. Pain sensation is often absent in the distal limbs. The ability to extend and flex the hip and stifle joints is usually preserved and the patellar reflex remains intact. Initially the hind limbs may be held in extension due to ischaemic muscle contracture.

Pelvic Limb Peripheral Neuropathy

Usually due to pelvic fracture or repair, femoral fracture repair, sacroiliac fracture luxation or repair and injections into the caudal thigh muscles. 6 The sciatic nerve and its branches the peroneal and tibial are most commonly involved. Peroneal nerve injury results in knuckling and loss of dorsal limb sensation and an inability to flex the stifle and hock. Tibial neuropathy results in a dropped hock with decreased hock extension.

The Dropped Hock

A common gait abnormality seen in the cat is that of a dropped hock. Evaluating these from a distance may suggest that the underlying cause is a tibial neuropathy but other causes exist. These include Achilles tendinopathy, calcaneal fracture, SDFT luxation and avulsion of the origin of the gastrocnemius.

Thoracic and Pelvic Limb Lameness

Plasma Cell Pododermatitis

Affected animals have enlarged food pads, usually metacarpal or metatarsal pads, and the pads have a soft spongy consistency and mauve colouration. Ulceration of the pads may occur. The condition is suspected to be an immune mediated or allergic disease.

Digital Metastases

A cause of lameness in middle to older aged cats is digital metastases usually from a primary bronchial carcinoma; squamous cell carcinoma has also been reported. 7 Affected cats usually present with lameness. Thoracic and distal limb radiographs are indicated to check for a primary lesion. Overall the prognosis is poor for cats with metastatic digital tumors, with median survival times of 1–2 months. 7

Diabetic Neuropathy

Peripheral neuropathy is a recognised complication of diabetes mellitus in cats. Cats usually have a symmetrical distal limb polyneuropathy and a plantigrade stance, paraparesis, distal limb muscle atrophy and pelvic limb hyporeflexia. Cats can have difficulty jumping, abduction of the pelvic limbs and weakness when standing.

Nerve Root Signature

The nerve root signature is lameness associated with nerve root pain from a physical obstruction or inflammatory condition adjacent to the nerve root, most likely a disc protrusion, osteomyelitis, neoplasia or a fracture fragment. The author has seen this condition in a cat with a sacral fracture. The diagnosis of these diseases requires careful attention to the signalment, a complete history, and a thorough physical examination focusing on the neurologic and orthopedic components. Ancillary testing should be selected based on these results. Electrodiagnostic testing, radiography, and advanced imaging may help to localize the lesion more precisely and sometimes to confirm the diagnosis. Surgical exploration and histopathology often provide the definitive diagnosis. These cases of non-weight-bearing lameness are a diagnostic challenge, but when successful resolution can be reached, it is gratifying to the clinician, client, and patient.

Diagnosing the underlying cause of lameness in a cat can be a challenge a patient, cat centred approach is needed to optimise the chances of identifying the problem(s).

1.  Kerwin S. Orthopaedic examination in the cat. J Feline Med Surg . 2012;14:6–12.

2.  Montavon PM, Voss K, Langley-Hobbs SJ. Patient assessment. In. Feline Orthopedic Surgery and Musculoskeletal Disease . Elsevier Saunders; 2009:3–10.

3.  Langley-Hobbs SJ. Musculoskeletal oddities in the cat: an overview of some curious causes of lameness. J Feline Med Surg . 2012;14:31–42.

4.  Langley-Hobbs SJ. Fifty two patella fractures in the cat. Vet Rec . 2009.

5.  Shelton GD, Ho M, Kass PH. Risk factors for acquired myasthenia gravis in cats: 105 cases (1986–1998) J Am Vet Med Assoc . 2000;216:55–57.

6.  Garosi L. Neurological lameness in the cat. J Feline Med Surg . 2012;14:85–93.

7.  Gottfried SD, Popovitch CA, et al . Metastatic digital carcinoma in the cat: a retrospective study of 36 cats (1992–1998). J Am Anim Hosp Assoc . 2000;36:501–509.

  

S. Langley-Hobbs School of Veterinary Sciences University of Bristol Langford, Bristol, UK

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Welcome Nadine! FYI: We've moved your topic to our new forum here just for Three legged Cats. Your future forum posts will not require moderation.

Whether dog or cat, phantom pain is real. How long it lasts can vary greatly but there are many ways to help provide relief.

Here are some tips for managing phantom pain from the Tripawds Downloads blog . Gabapentin has been proven to help, so ask your vet if you're interested in adding/changing medications. Massage can help relieve phantom pain symptoms. And Farabloc is another method many members have found helpful.

While you wait for comments from others, use the Advanced Search above to refine your forum search results with specific phrases, and you're sure to find lots of helpful feedback. You can also search all blogs here . Start here for help navigating the Tripawds community and feel free to call the toll-free Tripawds Helpline anytime!

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Hi and Welcome!

What are seeing in your kitty exactly? Can you describe what your seeing, and how often it is happening and lasts?

As the Admin said & his suggestions listed ,there are a lot of things that can be done for phantom limb pain.

Our Cat Purrkins was on Gabapentin for for 14 days after surgery. Purrkins also went for acupuncture treatments.

There are also homeopathic remedies for nerve pain.

Boiron Homeopathic Medicine Hypericum Perforatum, 30C Pellets .It may be given long term for phantom pain . I used the Hypericum Perforatum on Purrkins after the Gabapentin. These are little tiny pellets, I would crush them into powder and add a tad of water and syringe that to him ,your could put them crushed in his food or a little bit of baby food (we use turkey and gravy) 

Here is a article on the natural remedies for Amputation Recovery in Dogs,Cats.

http://nutritio.....n-recover/

Forum post on phantom pain on cat -

http://tripawds.....st-4-days/

Holly & Purrkins

purrkins said Hi and Welcome! What are seeing in your kitty exactly? Can you describe what your seeing, and how often it is happening and lasts?
Boskers is experiencing some uncontrollable  scooting backwards accompanied by confused crying. It happens a few times a day and it seems to be very upsetting for him. It only lasts about 40 seconds. He also seems very lethargic and depressed, spending most of his time in his bed. Thank you for your comments and suggestions. I will try the Hypericum Perforatum. The vet did put him on another pain reliever (not gabapentin though) so I'm hoping this helps ease his symptoms and therefore his distress. I hope this isn't a long term condition as it's upsetting to both of us 

It sounds like phantom limb pain to me.

The gaba is a very useful drug to help with nerve pain! If the new drug or Hypercium does not help please, don't hesitate to call your vet back.

heart

nadine3519 said Boskers is experiencing some uncontrollable  scooting backwards...  

Other tri-kitty members has reported similar behavior in their cats after amputation...check out these topics for further discussion:

Cat displaying strange behaviour after amputation

Recently Rescued a Tripod Cat (Tips & Advice for a Newbie}

Here are some articles I could find on phantom pain in cats...

Do cats experience phantom pains like humans? Yes, it is possible for your cat to experience phantom pains. This is due to the nerve endings at the site of the amputation sending signals to the brain.

http://www.cat-.....-cats.html

Bottom of this article under -

Over the next few weeks Occasionally pets do suffer phantom pains in removed limbs so if you suspect your cat is in discomfort, chat to your vet as they may need some further treatment.

https://www.pur.....on-in-cats

http://munchlov.....limb-pain/

1.13.17 Day 5 Post Op: Phantom Limb Pain The following post operative complications were the main inspiration for us to share our story. We hope this information will help others navigate through difficulties in the post op period:

At 1:30 a.m. Munch was sleeping between our pillows like she usually does, and out of nowhere she darted out of bed and looked angry. I gave her pain medication 30 minutes early thinking she was restless from pain.  I brought her back to bed and caressed her head her until she fell back to sleep. She repeated the same stunt out of bed around 6:30 a.m., but no medications were due. Then at 10:15 a.m. she went to use her litter box, and while she was in there she went crazy as if she was in a cat fight with herself. I tried to console her as I took her out of the cat box; she was covered in litter at this point with litter in her eyes and mouth. I was completely horrified since this was the first time she had ever acted out like this. I called the hospital and by the time I was told to bring her in, Munch managed to rip off five claws from her back paws. I brought her into the ER and she needed x-rays of her bloody paws to determine whether she had damaged the bone and needed amputations of any digits. I couldn’t help but think, “how much more of her do we have to remove?” Thankfully, removal of the claws and wound care was what she needed. We were sent home with Trazodone (a sedative) to keep her calm, and arrived home around 9:00 p.m. Once the sedation wore off from the ER visit, Munch was back to growling, screaming, and fighting herself. Around 2:00 a.m., we made yet another trip to the ER. Since she was a harm to herself, tranquilizer was needed. The doctors couldn’t figure out whether she was having a bad reaction to the pain medications or experiencing phantom limb pain. They put her on Gabapentin which helps with nerve pain, and applied a Fentanyl patch near her incision site for sustained pain relief. By morning she seemed to have calmed down but was still anxious, so we had to be present in order for her to eat and relax. Four days later, she was discharged; she adjusted to her new medication regimen and has been doing well ever since.

Takeaways from this experience: Munch’s surgeon informed us that phantom limb pain post amputation is apparently uncommon in cats. She expressed that this was the first cat with phantom limb pain she had encountered during her lengthy career. For anyone reading, here is a list of the signs & symptoms Munch exhibited: • Anxiety attacks, acting out while no stimulus was present • Screaming as if she was in a catfight, completely unprovoked • Growling and hissing • Inconsolable • Erratic movements • Ripping off claws during an anxiety attack • Scratching abdomen with back paws (photo below) • Rapid heart beat (felt when picking her up) • Drooling (I was concerned she was having a neurological issue, but actual pain was the cause)

THANK YOU for sharing this and making it easier for folks to find other TriKitty's experiences. You rock!

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Nicholas did have some phantom limb pain after his surgery. His episodes were not as severe as Munch's above. We're three years out now, so I don't remember exactly how long it was an issue for... few months, maybe? He responded very well to gabapentin. I kept him on it long term because of another condition, but discontinued it several months ago and have not seen anything resembling a phantom pain episode since.

I know that in humans, pre-surgical pain is a known risk factor for the development of phantom limb pain. I don't know if that fits for Boskers, but it was the case with Nicholas. His tumor was inside the bone, so there was no obvious mass, and he didn't show any signs of lameness. We found it (and amputated) when it finally weakened the bone enough that it fractured during normal activity.

Best of luck with Boskers! I'm not on as often as some (things are a bit crazy at the moment), but am always happy to answer questions about our experience. (Right forelimb amp, 2/01/14, osteosarcoma.)

Nicholas and family I know that in humans, pre-surgical pain is a known risk factor for the development of phantom limb pain.

I know that in humans, pre-surgical pain is a known risk factor for the development of phantom limb pain.

Very true. I believe it's why vets who practice the latest pain management protocols will start the patient on Gabapentin a few days before surgery. 

'   height=

 At was diagnosed with phantom limb pain and bit her nails off and now has infection between her paw pads with a cone on and gabapentin and clavimox. So depressed will this ever go away as she can’t wear a cone for the rest of her life. Amputation die 3/19Thank you

Hopefully the antibiotic will clear it up soon so that she can get the cone off as soon as possible. Paws crossed!

'   height=

My cat gets energy work. I realize energy work is a woo woo kind of thing, and many people don't believe in it. But I've witnessed it help my cats (and humans) firsthand. I did buy the Farabloc , but my cat never sits on it. We did a lot to help integrate the energy of the leg. I can't guarantee Rita won't get phantom limb pain, but I think the energy work-- like acupuncture--will help.  If you have any interest in trying this for Boskers, I'm happy to send along a recommendation.  Just PM me.   

kmdenver said My cat gets energy work. I realize energy work is a woo woo kind of thing, and many people don't believe in it. But I've witnessed it help my cats (and humans) firsthand. I did buy the Farabloc , but my cat never sits on it. We did a lot to help integrate the energy of the leg. I can't guarantee Rita won't get phantom limb pain, but I think the energy work-- like acupuncture--will help.  If you have any interest in trying this for Boskers, I'm happy to send along a recommendation.  Just PM me.      

That's wonderful that the energy work helps the kitties feel better. I say whatever works! Reiki definitely helped calm our Jerry when he had vet visits. His oncologist would do it before every exam, it was wonderful to watch him ease into it.

So no Farabloc relief for Rita? Did you try putting it in her bed? Be sure to update us on how she's doing!

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

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StatPearls [Internet].

Phantom limb pain.

Aaron A. Hanyu-Deutmeyer ; Marco Cascella ; Matthew Varacallo .

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Last Update: August 4, 2023 .

  • Continuing Education Activity

Phantom limb pain is the perception of pain or discomfort in a limb that is no longer there. PLP most commonly presents as a sequela of amputation. The underlying pathophysiology remains poorly understood. The condition should be differentiated from other related clinical conditions such as residual limb pain, which was formerly called "stump pain" and is pain that originates from the actual site of the amputated limb that tends to resolve with wound healing. This activity describes the evaluation and management of phantom limb pain and highlights the role of the interprofessional team in the management of this pain.

  • Describe the epidemiology of phantom limb pain.
  • Review the presentation of a patient with phantom limb pain.
  • Outline the treatment options for phantom limb pain.
  • Explain the importance of improving coordination amongst interprofessional team members to optimize outcomes for patients suffering from phantom limb pain.
  • Introduction

In the United States (U.S.), 30,000 to 40,000 amputations are performed each year. Amputations can occur for many reasons including severe trauma, tumors, vascular disease, and infection. Pain after amputation of a limb is a common symptom and is separated into two types of pain including residual limb pain (RLP) and phantom limb pain (PLP). PLP is clinically defined as the perception of pain or discomfort in a limb that no longer exists. Although PLP most commonly presents as pathological sequelae in amputee patients, the underlying pathophysiology remains poorly understood. Furthermore, PLP can present along a wide clinical spectrum and varying severity of symptoms. The condition should be differentiated from other related but separate clinical conditions, including RLP. This latter condition, formerly known as "stump pain", is pain that originates from the actual site of the amputated limb. It is most common in the early post-amputation period and tends to resolve with wound healing. Unlike PLP, RLP is often a manifestation of an underlying source, such as nerve entrapment, neuroma formation, surgical trauma, ischemia, skin breakdown, or infection. [1] [2]  Of note, more than half of people with PLP also have RLP. It is important to know the difference between the two because the causes and treatments for each differ, but also be aware that both of these elements can coexist at the same time. [3]  

PLP and RLP represent an important challenge in medicine, in terms of epidemiology and therapeutic difficulties. Ninety-five percent of patients, indeed, report experiencing some amputation-related pain, with 79.9% reporting phantom pain and 67.7% reporting RLP. Again, these clinical manifestations can significantly worsen the health-related quality of life (HR-QOL) and in some cases are very difficult to manage. 

The exact etiology of PLP is unclear. Multiple theories have been debated, and the only agreement is that multiple mechanisms are likely responsible. The predominant theory for years involved the irritation of the severed nerve endings causing phantom pain. This was enforced by evidence that almost all amputation patients will develop neuromas in the residual limb. Over the last few decades, advances in imaging and laboratory techniques have shown evidence of central nervous system (CNS) involvement. Imaging studies such as MRI and PET scans show activity in the areas of the brain associated with the amputated limb when the patient feels phantom pain. The pain is now thought to involve many peripheral and central nervous system factors. [4] [5]

  • Epidemiology

In 2005, there were 1.6 million people (1 in 190) living with limb loss in the U.S. This same study projected a striking increase to 3.6 million cases by 2050.  The literature reports PLP affecting 60% to 85% of amputee patients. [6]   The following underlying causes are given clinical consideration:

  • Vascular etiologies (most common)
  • Cancer/malignancy
  • Congenital conditions
  • Pathophysiology

Despite, the phantom limb sensation was described by French military surgeon Ambroise Pare (1510-1590) in the sixteenth century, even today we do not have a clear explanation of this complex phenomenon and, therefore, the pathophysiology is explained by a wide range of mechanisms. These mechanisms. which are the basis of theories, they are not necessarily mutually exclusive

Peripheral Nerve Changes

During the amputation, there is a significant amount of trauma that occurs in the nerves and surrounding tissues. This damage disrupts the normal afferent and efferent signals involved with the missing limb. The proximal portions of the severed nerves start to sprout neuromas, and the nerves become hyper-excitable due to an increase in sodium-channels and resulting in spontaneous discharges.

Spinal Cord Changes

In the spinal cord, a process called central sensitization occurs. Central sensitization is a process where neural activity increases, the neuronal receptive field expands, and the nerves become hypersensitive. This is due to an increase in the N-methyl-D-aspartate, or NMDA, activity in the dorsal horn of the spinal cord making them more susceptible to activation by substance P, tachykinins, and neurokinins followed by an upregulation of the receptors in that area. This restructuring of the neural components of the spinal cord can cause the descending inhibitory fibers to lose their target sites. The combination of increased activity to nociceptive signals as well as a decrease in the inhibitory activity from the supraspinal centers is thought to be one of the major contributors to phantom limb pain.  [7]

Brain Changes

Over the past few years, there has been significant research into cortical reorganization and is a commonly cited factor in phantom limb pain.  During this process, the areas of the cortex that represent the amputated area are taken over by the neighboring regions in both the primary somatosensory and the motor cortex. Cortical reorganization partially explains why nociceptive stimulation of the nerves in the residual limb and surrounding area can cause pain and sensation in the missing limb. There is also a correlation between the extent of cortical reorganization and the amount of pain that the patient feels.  [8]

Psychogenic Factors

Chronic pain has been shown to be multi-factorial with a strong psychological component. Phantom limb pain can often develop into chronic pain syndrome and for treatment to have a higher chance of success the patient's pain behaviors and pain processing should be addressed. Depression, anxiety, and increased stress are all triggers for phantom limb pain.  [9]

  • History and Physical

PLP is often described as tingling, throbbing, sharp, pins/needles in the limb that is no longer there. It occurs more commonly in upper extremity amputations than lower extremities and tends to be intermittent in frequency. Pain severity varies, and onset can be immediate or years afterward. It is important to try and distinguish PLP from RLP. The goal of the physical exam is to rule out the causes of RLP. First, the skin should be carefully inspected for evidence of wounds or infection. Sensation needs to be tested, along with looking for allodynia and hyperalgesia. The joint above the amputated limb should be examined for any signs of dysfunction. in terms of pain intensity, RLP usually is not severe, and features pressing, throbbing, burning, squeezing, and stabbing sensations.

The diagnosis of PLP pain is primarily a diagnosis of exclusion and heavily dependent on the patient's history.  Because of this lab tests are often not needed.  A complete blood count (CBC) can help rule out infection. An ultrasound can be ordered to look for neuromas as a possible pain generator. A psychology evaluation may be indicated if the patient is having a significant amount of extrinsic triggers that may be contributing to his or her pain.

  • Treatment / Management

Treatment, unfortunately, for PLP has not proven to be very effective. While treatment for RLP tends to focus on an organic cause for the pain, PLP focuses on symptomatic control.

Pharmacotherapy

  • NSAIDs/Tylenol are the most commonly used treatment for PLP. [10]
  • Opioids. Although observational and randomized controlled trials have demonstrated the effectiveness of certain opioids such as tapentadol for neuropathic pain  [11] and PLP, they should be used in conjunction with antidepressants or neural modulating agents (i.e., gabapentin, pregabalin).  [12] . Furthermore, their use in a condition of benign pain should be done with caution in order to avoid potential effects from tolerance and dependence.  [13]
  • Antidepressants are commonly used for addressing PLP. Amitryptiline, in particular, tends to be the tricyclic antidepressant (TCA) of choice as it has shown the best overall results, but other studies looking at nortriptyline and desipramine have shown them to be equally effective. However, most of these studies were not very rigorous and in a 6 week randomized trial between amitriptyline and placebo involving 39 patients, there was no significant difference between the two.  [14] Duloxetine is another medication that has been showing some positive results.  [15]   
  • Anticonvulsants (gabapentin, pregabalin) have shown mixed results.  [16]   The results overall for gabapentin have been conflicting, but a Cochrane review examining multiple studies did feel that the combined results favored Gabapentin over placebo.  [17]
  • N-methyl-d-aspartate (NMDA) receptor antagonist mechanism is not clear. These drugs have been shown to have benefit in pain syndromes, primarily with ketamine and dextromethorphan. Memantine has had mixed results. In the Cochrane review of 6 studies that were included looking at memantine versus placebo, there was no statistical improvement in pain between the groups  [17] .  Ketamine infusions have shown much better results than memantine, although the results between the two are not clear given their similar mechanisms. There is level 2 evidence to support the use of Ketamine infusions for the treatment of PLP  [18] .
  • Beta-blockers (propranolol) and calcium channel blocker (nifedipine) show unclear data.
  • Topical Analgesics like Capsaicin have been shown in some small studies to reduce hypersensitivity and PLP, but the evidence is still weak and requires more investigation.  [19] [20]
  • Botulinum toxin type B injections have been used to treat hyperhidrosis (excessive sweating) in the post-amputation patient. Hyperhidrosis can not only hinder the use of a prosthetic but can adversely affect the course of both the phantom limb and RLP. Treatment of hyperhidrosis with botulinum toxin type B injections has shown in several small studies to reduce RLP, PLP, and sweating.  [21]   Botulinum toxin type A is also being investigated, but so far has not been shown to decrease pain intensity compared to lidocaine/methylprednisolone.  [17]
  • Local anesthetics. A Cochrane review looked at two studies examining the effectiveness of local anesthetics, lidocaine infusion at 4mg/kg and bupivacaine 0.25% as a contralateral myofascial injection, in treating PLP in randomized trials. The one-time contralateral myofascial injection of 1cc bupivacaine 0.25% showed significantly improved pain relief in the 8 patients studied  [22] .  Lidocaine infusion was not found to have any significant improvement compared to placebo  [23]
  • Other pharmacological strategies such as calcitonin have no clear evidence.

Non-Pharmacologic Options

  • Transcutaneous electrical nerve stimulation (TENS) shows moderate evidence supporting its use. Low-frequency and high-intensity are thought to be the most effective for PLP. It may also be used to help relieve RLP.
  • Mirror therapy. A small randomized trial of mirror therapy in patients with lower leg amputation showed a significant benefit of PLP. [24] Another study was minimally helpful.
  • Biofeedback shows limited evidence.
  • Acupuncture research is still ongoing.
  • Spinal cord stimulation (SCS) is obtained through an implantable device that stimulates transdural dorsal columns of the spinal cord. It is often effective therapy for PLP. 
  • Apart from TENS and SCS, other neuromodulation approaches such as peripheral nerve stimulation (PNS) can be helpful for both PLP and RLP.
  • Virtual and Augmented Reality has provided some novel opportunities to utilize technology as an advanced form of "mirror therapy."  Researchers have been able to program myoelectric movement patterns from the RLP into the virtual or augmented reality headsets and then correlate those movements to the movements of the "complete" limb in the virtual world.  This has been shown in several case studies to be effective treatments for PLP, but no large studies have been conducted.  [25]   [26]
  • A sympathetic block may also help.
  • Stump revision
  • Differential Diagnosis
  • Septic arthritis
  • Osteomyelitis
  • Foreign body reaction
  • Enhancing Healthcare Team Outcomes

PLP is very complex and difficult to treat. It is best managed by an interprofessional team The first treatment is usually conservative and should include nonpharmacological and nonsurgical methods. The prosthetic professional should assess the stump and train the patient in the use of the prosthetic device. A mental health nurse and psychotherapist should help ease anxiety and depression. If this fails, The pharmacist should work with the clinician to select an appropriate agent, as well as educate the patient on the different pharmacological agents available, their effectiveness, and their adverse effects. A pain specialist should be involved as well

There is no one treatment that works reliably or consistently in all patients. Most patients are prescribed multiple agents to control pain, but tragically, this polypharmacy also has serious adverse effects that tend to lower compliance. Patients with PLP often doctor shop and try many types of conventional and non-conventional therapies to relieve the pain.

A pain referral should be ordered and the patient's HR-QOL should be improved. 

Patient education is key and members of the team should communicate with each other so that the patient is provided with optimal treatment. The outcomes for most patients are guarded and the quality of life is poor.

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Disclosure: Aaron Hanyu-Deutmeyer declares no relevant financial relationships with ineligible companies.

Disclosure: Marco Cascella declares no relevant financial relationships with ineligible companies.

Disclosure: Matthew Varacallo declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

  • Cite this Page Hanyu-Deutmeyer AA, Cascella M, Varacallo M. Phantom Limb Pain. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

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phantom limb cat

Do Cats Have Phantom Tail Pain?

Introduction

When the vet delivers the news that kitty’s tail must be amputated, you wonder how it will affect him. He’ll have to adjust his balance, but you may be concerned that he’ll feel phantom pains as well, and, if so, what can be done about it.

Yes, They Do

Phantom limb pain is a trick of the brain, a neuropathic condition that makes the body feel burning and tingling where there’s no longer a limb to feel. Kitty parents have witnessed their felines acting as if they were experiencing phantom tail pain, and authoritative sources such as “Withrow and MacEwen’s Small Animal Clinic Oncology” confirm that animals do experience phantom pain.

How Can You Tell?

Unfortunately, your cat can’t tell you that he has the odd sensation of feeling pain where his tail used to be, so it’s hard to be sure whether his actions indicate phantom pain or an actual complication with the remaining part of his tail. Cats who are experiencing phantom tail pain gnaw, compulsively lick or otherwise self-mutilate at the location of the amputation. If your cat is suffering from phantom pain, he may also be more sensitive to pain in general. Your vet should be consulted to help determine what is causing your cat discomfort so that a treatment can be prescribed.

Standard Treatment

If your cat experienced pain in his tail before surgery, he’s more liable to develop phantom pain afterwards. Before a surgical amputation, talk to your kitty’s vet. It’s always best to consult an experienced veterinarian regarding the health and treatment of your cat. She will likely advise treating your cat with painkillers before, during and after surgery as a preventative measure. According to the 2009 book “Recognition and Alleviation of Pain in Laboratory Animals,” this practice can significantly reduce the chances of developing phantom pain. Every case is different, so there’s no surefire prevention or treatment that works every time for phantom tail pain. If your cat does experience phantom pain from his missing tail, painkillers are the conventional treatment your vet will administer.

The prognosis for a kitty with phantom tail pain isn’t clear-cut. “Pain Management in Small Animals,” published in 2006, says that phantom pain can gradually diminish over time, but doesn’t say that it always fades or that it goes away entirely. You can offer some help if your cat experiences phantom pain. The book “Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals” notes that aerobic activity causes the body to produce natural painkillers, so getting your kitty’s mind off his phantom pain with a rousing game of “chase the feather” could keep the pain away for a while afterward. Feeding him a favorite treat may also distract him from the unpleasant sensation. Keep in mind that every cat is different, so not all things work the same for all them. You may have to do some testing on your own to find what alleviates or prevents phantom tail pain for your cat.

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COMMENTS

  1. Amputation in Cats

    Physical adaptation may be complicated by hallucinosis (phantom limb). The cat will feel that it can still rely on the missing leg and it may take longer for the cat to find alternative ways of performing tasks that involve the amputated leg. Four years after the accident, Buba still tries to scratch his left ear with his missing leg.

  2. Amputee Cat Won't Let Anyone Near Remaining Hind Leg: 'Very ...

    Though phantom limb pain is a condition largely associated with humans, a case report published in the Australian Veterinary Journal in 2006 detailed the case of a cat who presented with...

  3. Neuropathic pain in a cat post-amputation

    Phantom limb pain is a form of neuropathic pain experienced by human patients who have had amputations. To date there are no reported cases of phantom limb pain in the veterinary literature. A cat presented with signs consistent with neuropathic or phantom limb pain 42 days after iatrogenic sciatic …

  4. Phantom limb

    [5] Repressed memories in phantom limbs could potentially explain the reason for existing sensations after amputation. Specifically, there have been several reports from patients of painful clenching spasms in the phantom hand with the feeling of their nails digging into their palms.

  5. Dr. Downing Explains Phantom Leg Pain in Pets

    The Truth About Phantom Limb Pain in Pets Tripawds: Do you think animals get phantom pain? Dr. Downing: Absolutely, absolutely. How do we get phantom pain? When there is damage to the nervous system, damage to a nerve and then that nerve tries to regenerate itself. That's the genesis of the phantom limb phenomenon.

  6. Approaching phantom complex after limb amputation in cats

    In humans, as a consequence of amputation, a syndrome called "phantom limb complex" (PLC) can develop including signs of: (1) stump pain (SP), defined as pain localized in the remaining postamputation stump due to development of neuromas; (2) phantom limb sensation (PLS), defined as the perception of any sensation other than pain which originate...

  7. What to Expect: Post Amputation Pain Medication for Cats ...

    July 1, 2020 by jerry If your cat is losing a leg soon, now's the time to get familiar with post amputation pain medication for cats. What you learn here can save you and your cat from a long, painful amputation recovery. The Importance of Post-Amputation Pain Medication for Cats Duffy relies on the humans for a pain-free life! Image: CL Davis

  8. Pain from the Nervous System in Cats

    Phantom limb pain results in the impression of pain coming from a leg that has been surgically removed. In cats, a common cause of neuropathic pain is diabetes mellitus. The result is a weakness in the hind legs which comes from damage to the nerves caused by constant high levels of sugar in the blood.

  9. Approaching phantom complex after limb amputation in cats

    Approaching phantom complex after limb amputation in cats - ScienceDirect Article preview Abstract Introduction Section snippets References (36) Cited by (1) Journal of Veterinary Behavior Volume 50, April 2022, Pages 23-29 Approaching phantom complex after limb amputation in cats Marika Menchetti a , Giorgia Della Rocca b , Ilaria Tartari a c ,

  10. Intra- and postoperative opioid-sparing analgesia in a cat undergoing

    Neuropathic pain and phantom limb pain induced by surgical nerve damage is among the frequent complications of limb amputations in people. 7 Signs attributable to chronic pain are common after limb amputation surgery in cats, 8 and phantom limb pain has been described in this species in a recent case report. 9 While in humans the use of ...

  11. Clinical updates on phantom limb pain

    Results: The scientific evidence for best practice is weak and contrasted by various clinical reports describing the polypragmatic use of drugs and interventional techniques. Approaches to restore the body scheme and integration of sensorimotor input are of importance.

  12. Approaching phantom complex after limb amputation in cats

    The aims of this study was to describe the presence, clinical manifestations, risk factors, quality of life and measurement of mechanical nociceptive threshold (MNT) of phantom limb complex in...

  13. Amputee Cat Tries To Play With Phantom Leg (Storyful, Cats)

    Storyful 199K subscribers Subscribe 3.2K views 8 years ago Joyce's beloved cat Eileen had a tough start to life being a three legged cat. Eileen was adopted by Joyce who didn't care about the...

  14. Limb Amputation And Recovery In Cats

    Amputee cats can experience phantom pains after limb amputation, due to the nerve endings at the site of the amputation sending signals to the brain. Summary. With a little time and tender loving care, your cat should make a full recovery from his amputation surgery and bounce back quickly. His quality of life shouldn't suffer because he has ...

  15. New Insights Into the Phantom Complex for Small Animals

    Dogs undergoing limb amputations can experience post-amputation pain and behavioral changes associated with a phantom complex.

  16. Hindlimb Lameness in the Cat

    Affected cats are usually young male neutered cats that present with unilateral hind limb lameness often of insidious onset. Radiographs show a slipped femoral epiphysis, there may be 'apple coring' of the femoral neck. Treatment is femoral head and neck excision or total hip replacement. The other femoral head may fracture at a later date.

  17. Feline Phantom Limb Pain

    1 26 January 2017 - 1:58 pm My boy (cat) is almost 8 weeks post op. He has started exhibiting signs of phantom limb pain and I'm wondering if this is something that will eventually subside? And if so, approximately how long does it last? Is it necessary to medicate at this point?

  18. Phantom Limb Pain

    Phantom limb pain (PLP) is a common and complex condition that affects many amputees. It is the sensation of pain or discomfort in a limb that has been removed. This book chapter provides an overview of the causes, diagnosis, and treatment of PLP, as well as the differences between PLP and residual limb pain (RLP). It also discusses the current challenges and controversies in the management of ...

  19. The Truth About Phantom Limb Pain in Pets

    Pet pain expert Dr Robin Downing discusses the reality of phantom limb pain in amputee dogs and cats, with a personal story that proves phantom pain is real....

  20. Behavior Problems and Phantom Pain in Declawed Cats

    Jady Jady was adopted on June 11, 2016. It was "Just One Day" and she had been brought in as a stray. She was on "death row" far longer than usual, because Animal Control thought her owners would come looking for such a beautiful cat. Her owners never came for her. To be clear, Jady wasn't a stray cat. She is front-paw declawed.

  21. Phantom Leg Syndrome in a Cat

    My cat, Icarus, lost his leg in 2009 due to an unknown wild animal attack. Don't worry, he's strictly indoors now. Here he is exhibiting phantom limb syndrom...

  22. Phantom Limb Pain: What is It, Causes, Treatment & Outcome

    The phantom part refers to the location of the pain: the missing limb or part of the limb (such as fingers or toes). Phantom limb pain ranges from mild to severe and can last for seconds, hours, days or longer. It may occur after a medical amputation (removing part of a limb with surgery).

  23. Do Cats Have Phantom Tail Pain?

    Cats who are experiencing phantom tail pain gnaw, compulsively lick or otherwise self-mutilate at the location of the amputation. If your cat is suffering from phantom pain, he may also be more sensitive to pain in general. Your vet should be consulted to help determine what is causing your cat discomfort so that a treatment can be prescribed.