MUSCLE AND BONE
Complete fracture (break) of any of the major limb bones usually results in the inability to bear weight on the affected limb, as well as some deformity of the limb. The deformity may consist simply of swelling or may include angulation (formation of an abnormal angle) usually at the fracture site, rotation or shortening of the affected limb, or other deviations from the normal position. The sound and/or feel of bone grating against bone (crepitus), if present, is almost always indicative of a fracture. Unless sensory nerves have been damaged or the cat is in deep shock, evidence of pain can be elicited by manipulating the fracture. Signs of pain, however, are unreliable, since pain can be present in other conditions as well; also many sensitive cats overreact to relatively mild pain, and “stoic” cats may be less likely to react strongly to painful stimuli.
COMPOUND FRACTURES ARE EMERGENCIES
A fracture is classified as simple if there is no communicating wound between the outside of the skin and the broken bone. A compound fracture communicates to the outside. If your cat has a compound fracture with bone protruding from a wound, you should have no difficulty diagnosing the condition. Compound fractures become infected easily and should be given immediate attention by a veterinarian, if at all possible.
If your cat is in fairly normal general condition, a simple fracture is not necessarily a veterinary emergency. The best thing to do is to localize the fracture site, then call your veterinarian for further advice. Fractures of the foot bones are rarely emergencies and can usually be left unsplinted until X-ray pictures can be taken. Whether or not you splint other limb fractures depends on the site of the fracture and the mobility of the bone ends. In many cases, splinting causes more trouble for you and pain for the cat than it’s worth. In obviously mobile fractures, where you see the leg below the break dangling freely and twisting, heavy cardboard cut to the appropriate shape, roll cotton, and elastic bandage can be used to prevent bone movement, interruption of blood supply, and nerve damage. Wrap padding (even a diaper can be used) gently and thickly around the injured part.
Then apply the splint and top it with the bandage. Compound fractures should have a clean bandage applied over the exposed bone ends if splinting is unnecessary or not possible.
SPINAL FRACTURES ARE EMERGENCIES
A special case of fracture (or dislocation) is fracture of the spine. This requires professional veterinary care at the earliest possible time as well as careful first aid. Spinal fractures usually result in partial or complete paralysis of the rear legs and sometimes the front legs as well, often with remarkably little evidence of pain. If your cat shows such signs following trauma, immediate and absolute (if possible) restriction of movement is necessary. If you can get the cat to lie quietly, transport in a shallow open box is best. Do not, however, attempt to hold a frightened and struggling cat down—you may make the damage worse. Cooperative cats may be carried in your arms if you are careful to prevent back movement.
The method a veterinarian chooses to repair a fractured bone depends on the type of fracture present, the fracture site, and the age of your cat. External devices alone, such as casts and splints, can be used in some cases. In many others surgery to place a metal pin, plate, or other internal fixation device into the fractured bone is necessary. A good veterinarian will x-ray the fracture, evaluate all the possibilities for repair, and tell you what he or she thinks is necessary to achieve the best healing.
If you cannot afford the best repair, a veterinarian should offer alternative methods that may not be as ideal for healing but more within your means. (Keep in mind that the alternatives may mean slower healing or complete failure to heal.)
Dislocations (luxations) are seen much less frequently than fractures in most veterinary practices. Dislocations occur whenever a bone is displaced from its normal position in relation to another bone at a joint. The signs of dislocation are similar to those of fracture, but are usually milder.
Dislocations are not emergencies in the sense that they endanger a cat’s life or limb. However, they should be examined by a veterinarian within twenty-four hours of occurrence because they are most easily corrected without surgery during this period. All suspected dislocations should have X-ray pictures taken to determine the true extent of bony damage. General anesthesia is given to relax the muscles and provide relief from pain while the bones are manipulated back into their proper positions. Some dislocations require surgery for permanent correction especially those causing complete disruption of the supporting and surrounding soft tissues.