Feline pelvic disease, which most commonly occurs from trauma, requires complete orthopedic and neurologic examination, noting presence or absence of neurologic tone and/or sensation in the distal limbs, perineum, tail, anus, and bladder. Careful physical and radiographic investigation of crepitus, abnormal anatomical landmarks or limb movements, and the presence of pelvic canal stenosis are also important in determining therapy. Surgery for pelvic trauma is best within 7 days, before granulation tissue and muscle contracture complicate exposure, fragment manipulation, and fracture reduction.
Traumatic sacroiliac luxations are common in cats. The spinal cord terminates at the level of L7 or the LS junction (vs L5 in dogs); therefore, disease can cause urinary, fecal, and/or hindlimb neurologic dysfunction. Sacrocaudal luxation, or tail-pull injury, causes traction on caudal nerve roots and compromised tail motor and sensory function, resulting in a paretic or paralyzed tail with no sensation. Prognosis depends on presence or absence of perineal sensation or sensation to pressure applied to the tail base with tissue forceps. Urinary or fecal incontinence should be managed for 4 weeks to allow recovery; prognosis is poor if improvement is not made within this time. Other conditions and surgical approaches, including surgical management of acetabular fractures, are discussed. Most cases of feline pelvic injury have a favorable prognosis with appropriate management.
The cost of orthopedic surgery or availability of surgical expertise often deters clients from aggressive care. Fortunately, cats often do well with conservative therapy if weight-bearing surfaces and neurologic function are not compromised. Alternative therapies (eg, acupuncture, physical rehabilitation) are not mentioned but can help cats return to function as quickly and painlessly as possible. Off-label pain management is often employed to address signs, and certified pain practitioners are well-versed at managing many of these cases after surgery or throughout conservative care.—Heather Troyer, DVM, DABVP, CVA
Conditions of the feline pelvic region. Witte P, Scott H. IN PRACT 34:498-511, 2012.