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Veterinary Practice News Editorial Blog:
February 24, 2011
A Big Cat Dilemma
Phil Zeltzman, DVM, Dipl. ACVS
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Florence Ollivet, a colleague who consultants for exotic and zoo animals in France and abroad, asked for my opinion about an 80 pound, 6-month-old female tiger. Because you know, I’m such a tiger specialist and all.
Our tiger seemed to have a bulge in her right hip area, right thigh muscle atrophy and a subtle lameness. X-rays were suggested as the next step. Amazingly, they were taken awake since the patient was not fasted and her owner—a circus—was leaving town on the next day. They just couldn’t wait.
X-rays revealed a hip fracture with probable femoral head necrosis. My colleague’s question was simple: What on earth do we do about it?
We discussed four treatment options:
A. Do nothing. This would lead to short-term pain and long-term degenerative joint disease, which would lead to more pain and more muscle atrophy. Pretty useless for a circus.
B. Repairing the fracture. But if there truly is femoral head necrosis, then repairing the fracture is not an option.
C. Salvage procedure No. 1: a total hip replacement (THR). Although performing a THR in a tiger would be incredibly “cool,” I didn’t see it as a good option for a number of reasons: She is a young, still growing animal, which means the bone is soft and she will quickly outgrow the implant. In addition, controlling her activity and performing rehabilitation would be tricky at best. Finally, a circus would probably never pay for this costly option.
D. Salvage procedure No. 2: a Femoral Head Ostectomy (FHO). Different surgeons have different cut offs when they consider an FHO in dogs: 30 lbs, 50 lbs, 80 lbs, 100 lbs… Certainly, an 80 pound patient who will likely have an adult weight between 250 and 300 lbs. would not be considered as a great candidate for an FHO…
So what is the solution?
There is clearly no perfect answer to our colleague’s dilemma. So the only “livable” compromise seemed to be a FHO. The results may not be great, but they probably cannot be worse that doing nothing at all.
What would you have advised this colleague for this tiger?
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