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NQR, or How Do You Do a Lameness Exam On a Cat?

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  • NQR, or How Do You Do a Lameness Exam On a Cat?

    I have an old lady cat with plenty of milage on her body and also diabetes.

    Cat generally looks like crap, movement-wise. But watching her walk today, I get the vibe that she's lame on the RF and its high up, like elbow.

    How do you all assess your cats' soundness?
    The armchair saddler
    Politically Pro-Cat

  • #2
    You take kitty to the vet for a lameness eval!

    They will (likely) be able to narrow it down to where the cat is painful and either do further diagnostics or supportive treatments from there.

    Cats generally tolerate NSAIDs fairly well, but something like Cartrophen (pentosan) or Cosequin may be enough to help old kitty.

    Comment

    • Original Poster

      #3
      You know, small animal vets seem to be worse at lameness exams that I am.

      And the cat doesn't help. She won't walk on a straight line or circle as a horse would. Heck, the cat won't walk at all, but scrunch down and ask us when the vet visit will be over. I can't figure out how to do a flexion test on a cat. I could drink a few beers and get ideas, though.

      In any case, Catness had some Dasequin a few years ago and it did diddly.

      IMO, the cat has plenty of arthritis, mainly high up. If you x-rayed these joints, I think you'd find very little cartilage left to prop up with neutriceuticals.

      Can we just go ahead and mask pain for as long as that works and all it good? It's not like kitteh needs to pass a drug test.
      The armchair saddler
      Politically Pro-Cat

      Comment


      • #4
        Originally posted by mvp View Post
        You know, small animal vets seem to be worse at lameness exams that I am.
        AGREED!

        Originally posted by mvp View Post
        And the cat doesn't help. She won't walk on a straight line or circle as a horse would. Heck, the cat won't walk at all, but scrunch down and ask us when the vet visit will be over. I can't figure out how to do a flexion test on a cat.
        This, too! It's way harder to see lameness on a cat than a dog. They hide it pretty danged well! From what I've seen, the main thing with diagnosing arthritis is the stiffness and diminishing jumping ability.

        Comment

        • Original Poster

          #5
          Originally posted by JumpQH View Post
          This, too! It's way harder to see lameness on a cat than a dog. They hide it pretty danged well! From what I've seen, the main thing with diagnosing arthritis is the stiffness and diminishing jumping ability.

          But only we HOs would try.

          I also think that cats are way, way stoic (plus light and flexible), so by the time you see a problem, that thing is really, really crippled. JMO, but I should say that I haven't used joint supplements to the degree that I would with a horse.
          The armchair saddler
          Politically Pro-Cat

          Comment


          • #6
            We have one boarded surgeon at work who is particularly good with lameness in cats. However...yes, generally supportive treatment is the ideal route for cats.

            Metacam is now labelled for cats.

            Comment


            • #7
              Metacam is indeed an arthritis wonder drug for many cats...my own senior included. BUT, have labs pulled because it can be horrific on kidneys. Other options are Cerenia (originally anti-nausea) which is given several days in a row and then off for several days or gabapentin which works on nerves. I had remarkable luck with Trixsyn--feline HA--which is ironically enough the same stuff/company/formulation as Hyaluronex for horses. A month's worth of Trixsyn--$30. 480 days worth of Hyaluronex--$48.95 from Smartpak. But if there's no cartilage, I'd try either Metacam or Cerenia first.

              For the record, I'm just a humble, nerdy cat owner, BUT I put my senior kitty through several arthritis clinical trials at our local vet school and spent LOTS of time shamelessly pumping the gurus about therapies. Senior kitty's joints were trashed on xray and exam (which she was sedated for because the xrays were so bad).
              Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

              You call it boxed wine. I call it carboardeaux.

              Comment

              • Original Poster

                #8
                ^^^

                Thank you for all the info.

                Frankly, I was just too lazy to open this research can of worms. Old Lady would probably like it if I did.
                The armchair saddler
                Politically Pro-Cat

                Comment


                • #9
                  Video kitty walking badly, jumping badly. Then show the vet the video

                  Comment


                  • #10
                    mvp--If you want to avoid the research, I'm happy to share all my info. PM me a good contact for you.

                    And Dasuquin didn't do squat for my senior kitty.
                    Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

                    You call it boxed wine. I call it carboardeaux.

                    Comment


                    • #11
                      Second the video idea. When my cat was limping, I took the video at home by putting her at one end of the hallway with the food on the other side. Once I had the video, I took it and her to an orthopedic specialist for an exam as finding a distinct source of pain in cats is often very difficult since they don't appreciate being touched anywhere.

                      For anyone that likes lameness... this is about the best video of a cat limping you'll ever get and it's still not easy to tell which leg she's lame on. She was hiding and acting NQR and when I watched she had an obvious lameness. My assessment agreed with the orthopedic specialist (all my equine lameness came in handy!) but not all the vets watching agreed on which leg until it was in slow motion. For the armchair vets - anyone care to try and tell which leg?

                      https://www.facebook.com/video/video...01438411159333
                      Last edited by In The Gate; Nov. 18, 2012, 01:31 PM.

                      Comment


                      • #12
                        I'm no armchair vet, but will venture to guess. FWIW, I didn't slow it down, just watched at normal speed a couple times. Rear right?

                        Comment

                        • Original Poster

                          #13
                          Originally posted by JumpQH View Post
                          I'm no armchair vet, but will venture to guess. FWIW, I didn't slow it down, just watched at normal speed a couple times. Rear right?
                          That was my first guess, too, but it felt like a vibe more than a reasoned interpretation.

                          Did I guess right?

                          Oh, and I like the "flapping down dead" at the end. That's a very cat response to unsolicited medical care.
                          The armchair saddler
                          Politically Pro-Cat

                          Comment


                          • #14
                            Nope, not the right hind. She's lame on the left front. If you watch closely, she has a head bob similar to what a horse would have. It's much easier to see her head going down than coming up, and if you watch when she's going straight you can see her head goes down when her right front leg hits the ground. As the saying from equine lameness goes, down on sound so this is a left front lameness.

                            I'm a small animal vet (now in an Oncology residency) though I did a lot of work with horses through my education. My initial guess was left front, but when I showed it to my coworkers we were split about 50/50 right and left front. Slowing the video down made it more obviously left and our orthopedic surgeon confirmed. She was painful in her left elbow and x-rays showed arthritis (sadly she's only 4 in the video!). I put her on an opiate type pain medication for a few days, a weight loss plan (ahem...), and joint supplements. She still limps every once in a while but it's not bad enough to take the risk of giving NSAIDS since it's mild and she's young.

                            If I didn't have the video I don't think we ever would have figured out which leg she was lame on. It was hard to tell with her moving freely even though she was obviously limping. If I had taken her to the orthopedic surgeon without a video she wouldn't have walked enough you could see anything!

                            Comment


                            • #15
                              Oh, and if your kitty has arthritis it's fine to manage with pain medications. I try to start with buprenorphine (and joint supplements and Adequan even if I'm not optimistic they're going to help much) first as opposed to NSAIDS. Using a long term NSAID in a cat should be reserved for when nothing else is providing adequate pain management due to the risk of renal failure. While most cats do tolerate NSAIDS fine, if your kitty is the one that goes into renal failure it doesn't matter that the majority of cats did not.

                              Even if the buprenorphine and joint supplements aren't doing a lot, it may be just enough that you can do an NSAID every other day instead of daily which will be safer for your girl in the long run.

                              Another good option for pain management is another opioid derivative called tramadol. It's a very good pain medication, however the main downside is that it tastes terrible and cats hate taking it, both as a pill and as a liquid. This can be solved by having a compounding pharmacy make it into a capsule, though the capsules tend to be a little bit bigger in size.

                              Comment


                              • #16
                                I love love love Cerenia for pain in cats. We have used it in several cats now for quality of life management and got a better response than to bupernorphine. And relitevily cheap too, ESP if you buy the next size up and split the pills. You can split them and have them not lose effectiveness if you keep the broken pill in a ziplock in the refrigerator.

                                Also, the dosing schedule we foun worked best was every other day, which was a lot more convenient than 2-3 times a day with bupernorphine.
                                You can't fix stupid.... but you can breed it!

                                Comment

                                • Original Poster

                                  #17
                                  Thanks again for giving me the ideas and names for pain management as well as the joint support. I'll know better what to ask this vet.

                                  Kitteh has an amazing amount of First World Geriatric crap wrong with her. You could fix one thing and use of the rest of that hand counting other problems. So, frankly, it wouldn't be the end of the world if she chose the rock star route: became a junky, trashed her kidneys and but felt like a million dollars for the time she had left.
                                  The armchair saddler
                                  Politically Pro-Cat

                                  Comment


                                  • #18
                                    Originally posted by mvp View Post
                                    Thanks again for giving me the ideas and names for pain management as well as the joint support. I'll know better what to ask this vet.

                                    Kitteh has an amazing amount of First World Geriatric crap wrong with her. You could fix one thing and use of the rest of that hand counting other problems. So, frankly, it wouldn't be the end of the world if she chose the rock star route: became a junky, trashed her kidneys and but felt like a million dollars for the time she had left.
                                    I feel the same way about my senior. And she IS a rock star. (Note to self: never name a cat "Diva." It's way too suggestive of certain behaviors.) I feel lucky that I have a vet who's been willing to experiment with pain control, but is totally on board with the rock star route for when the time comes. Better living through chemistry...until the chemistry stops working.
                                    Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

                                    You call it boxed wine. I call it carboardeaux.

                                    Comment

                                    • Original Poster

                                      #19
                                      Called the vet for a phone consult. There's too many joints to X-ray, IMO. And this vet rides, so I think we can have a profitable conversation given that we both understand OA management in horses.

                                      I'll let you know what happens.
                                      The armchair saddler
                                      Politically Pro-Cat

                                      Comment


                                      • #20
                                        Originally posted by mvp View Post
                                        You know, small animal vets seem to be worse at lameness exams that I am.
                                        I totally agree with this! My cat has been struggling with a left hind lameness for a few years now. I described it to my vet a while back, and he examined the cat. He claimed nothing was wrong. The cat would go from apparent soundness to profound lameness on that left hind periodically and then eventually walk out of it.

                                        A few months ago, my husband said he felt something pop when the cat shifted on his lap. I had a lightbulb moment and checked out the cat's stifle. I self-diagnosed the cat with upward fixation of the patella. Just took the cat into the vet last week, and, yep, that's what it is.

                                        Now the vet is suggesting surgery...but...yeah...not so confident in having him do this when I ended up having to diagnose my cat myself. Additionally, the vet's manipulation of the patella seems to have lamed the cat further, and now his patella seems to be "out" much more often than it is in. I can pop it back into place, which the cat seems to appreciate, but I'm not always around. It's a sad state of affairs. He's only 9.

                                        Comment

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