DOI QR코드

DOI QR Code

Triple Pelvic Osteotomy and Autograft to the Gap of Ischium for the Treatment of Pelvic Canal Narrowing in a Cat

  • Park, Ji-Hun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Kim, Keun-Yung (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Chae-Yeong (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Si-Eun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Park, Hyojin (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Hwang, Tae-Sung (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hee-Chun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Dongbin (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Jae-Hoon (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2020.09.07
  • Accepted : 2021.09.03
  • Published : 2021.10.31

Abstract

Pelvic canal narrowing secondary to pelvic fractures can lead to episodes of recurrent constipation in cats. Triple pelvic osteotomy is considered as a surgical treatment method; however, there is potential for future recurrence of pelvic canal narrowing. This report describes a surgical method using a pelvic symphyseal autograft to keep the distraction of the ischial osteotomy gap to prevent the recurrence of pelvic canal narrowing. A triple pelvic osteotomy was planned to expand the narrow pelvic canal. The cranial ramus of the pubis was cut, and ischiatic and iliac osteotomies were performed. After expanding the ilium, the malunion pelvic symphysis was cut approximately 1 cm and then autografted to the gap of the ischiatic osteotomy line to keep the distraction. The patient showed clinical improvement postoperatively without recurrent pelvic canal narrowing related to triple pelvic osteotomy. However, constipation recurred on post-operative month-5. It was managed conservatively, and subtotal colectomy was performed eventually nine months post-operatively. There were no complications for five months of follow-up.

Keywords

References

  1. Beittenmiller MR, Mann FA, Constantinescu GM, Luther JK. Clinical anatomy and surgical repair of prepubic hernia in dogs and cats. J Am Anim Hosp Assoc 2009; 45: 284-290. https://doi.org/10.5326/0450284
  2. Bertoy RW. Megacolon in the cat. Vet Clin North Am Small Anim Pract 2002; 32: 901-915. https://doi.org/10.1016/S0195-5616(02)00020-7
  3. Bookbinder PF, Flanders JA. Characteristics of pelvic fracture in the cat. Vet Comp Orthop Traumatol 1992; 05: 122-127. https://doi.org/10.1055/s-0038-1633081
  4. Colopy-Poulsen SA, Danova NA, Hardie RJ, Muir P. Managing feline obstipation secondary to pelvic fracture. Compend Contin Educ Pract Vet 2005; 27: 662-670.
  5. DeGroot W, Gibson TW, Reynolds D, Murphy KA. Internal hemipelvectomy for treatment of obstipation secondary to pelvic malunion in 3 cats. Can Vet J 2016; 57: 955-960.
  6. Denny HR, Butterworth SJ. The pelvis. In: Denny HR, Butterworth SJ, editors. A guide to canine and feline orthopaedic surgery. 4th ed. Iowa: Blackwell Science Ltd. 2000: 441-454.
  7. Ferguson JF. Triple pelvic osteotomy for the treatment of pelvic canal stenosis in a cat. J Small Anim Pract 1996; 37: 495-498. https://doi.org/10.1111/j.1748-5827.1996.tb01751.x
  8. Griffon DJ, Hamaide A. Complications of double and triple pelvic osteotomies. In: Griffon DJ, Hamaide A, editors. Complications in small animal surgery. Hoboken: John Wiley & Sons. 2016: 759-777.
  9. Hamilton MH, Evans DA, Langley-Hobbs SJ. Feline ilial fractures: assessment of screw loosening and pelvic canal narrowing after lateral plating. Vet Surg 2009; 38: 326-333. https://doi.org/10.1111/j.1532-950X.2009.00500.x
  10. Lanz OI. Lumbosacral and pelvic injuries. Vet Clin North Am Small Anim Pract 2002; 32: 949-962, vii-viii. https://doi.org/10.1016/S0195-5616(02)00029-3
  11. Leighton RL. Symphysectomy in the cat and use of a steel insert to increase pelvic diameter. J Small Anim Pract 1969; 10: 355-356. https://doi.org/10.1111/j.1748-5827.1969.tb04671.x
  12. Matthiesen DT, Scavelli TD, Whitney WO. Subtotal colectomy for the treatment of obstipation secondary to pelvic fracture malunion in cats. Vet Surg 1991; 20: 113-117. https://doi.org/10.1111/j.1532-950X.1991.tb00317.x
  13. McKee WM, Wong WT. Symphyseal distraction-osteotomy using an ulnar autograft for the treatment of pelvic canal stenosis in three cats. Vet Rec 1994; 134: 132-135. https://doi.org/10.1136/vr.134.6.132
  14. Rosin E, Walshaw R, Mehlhaff C, Matthiesen D, Orsher R, Kusba J. Subtotal colectomy for treatment of chronic constipation associated with idiopathic megacolon in cats: 38 cases (1979-1985). J Am Vet Med Assoc 1988; 193: 850-853.
  15. Schrader SC. Pelvic osteotomy as a treatment for obstipation in cats with acquired stenosis of the pelvic canal: six cases (1978-1989). J Am Vet Med Assoc 1992; 200: 208-213.
  16. Trevail T, Gunn-Moore D, Carrera I, Courcier E, Sullivan M. Radiographic diameter of the colon in normal and constipated cats and in cats with megacolon. Vet Radiol Ultrasound 2011; 52: 516-520. https://doi.org/10.1111/j.1740-8261.2011.01830.x
  17. White RN. Surgical management of constipation. J Feline Med Surg 2002; 4: 129-138. https://doi.org/10.1053/jfms.2002.0171