11.6.15 Bluebel Xray preop11.6.15 Bluebel Xray postopBluebell is a beautiful Oriental cat with the most piercing blue eyes that sparkle like sapphires.

But when Bluebell was brought into my surgery last week, those eyes had a distressed look and, coupled with her harsh breathing and her inability to stand, it was pretty clear that she had a problem.  Her owner explained that she had been missing for 2 days and had dragged herself home in that state.

On examination, placing a hand over her hind quarters elicited a nasty feeling crunch that made me suspicious of bone damage. Although I could not be sure, I was very suspicious that she had been knocked down by a car.

After discussing my concerns with her owner, I admitted Bluebell to the Hospital for X rays.

Under anaesthetic, Bluebell was carefully positioned to X-ray her pelvis and hind limbs. We now use digital radiography at all of our surgeries and so I waited apprehensively for the image to appear on the screen.

When the X-ray image appeared on screen, my heart sank as my worst fears were confirmed – Bluebell had sustained a very severe pelvic fracture.

The X-rays showed that the whole right side of her pelvis had caved in with multiple pieces of bone fragments and a severe narrowing of the pelvic canal. The entire bony attachment between the right hind leg and the rest of the body was disrupted and the bone fragments were pressing on the wall of the colon.

On the telephone with the owners, I explained the extent of the injury. Many pelvic fractures can be repaired with a surgical plate and screws however there were so many little fragments of bone that a plate was going to be difficult and I needed another solution.

In limb fractures, we use a lot of “external fixators” which are external frames with pins passing through the skin and into the bone. The pins transfer the forces that are usually supported through the bone, and conduct them through a series of clamps and bars to support the bone.

Although used commonly in leg fractures, they tend not to be common place with pelvic fractures. As a Vet, it is important to be able to problem-solve so I sat with pen and paper and sketched out a framework that used the left side of the pelvis to buttress and support the right side.

Three pins were inserted into each side of the pelvis and those pins were connected with a bar. The bars were connected by a further 2 bars to make a rigid box section above the pelvis holding the bone fragments in alignment.

X rays confirmed the position of the implants and bone fragments and I am pleased to say that Bluebell has been home over the weekend and when I saw her for a post op check, she is already able to walk.

The frame will stay on for several weeks while the fractures heal but I am pleased to say that the sapphire blue eyes are back sparking again.