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What is Femoral Head and Neck Ostectomy?

The term 'ostectomy' refers to the surgical removal of bone from a body. The femoral head and neck form the top of the femur, the part of the thigh bone that fits into the hip joint. Some conditions can cause a weakening of this joint, as well as severe pain. To alleviate this, vets may opt to surgically remove the femoral head and neck from an affected cat, thereby stopping its pain and providing an opportunity for the joint to continue working (albeit in a manner that is not bone-to-bone). It should be noted that femoral head and neck ostectomy is by no means a primary method of care, and is commonly regarded as a last resort when other techniques have failed.

Femoral Head and Neck Ostectomy Procedure in Cats

Before starting the operation, the cat will be immobilized via the use of a general anesthetic before being prepared for the procedure by having a patch on its hip shaved and disinfected. The surgeon will then make an incision in the skin and pull it back to reveal the joint beneath. The next step is to cut the femoral head and neck away from the femur itself. This can be done either with one cut or by using a saw to divide the bone into smaller pieces for ease of removal, depending on the vet's personal preferences and individual training. After this has been done, the incision is sutured shut and disinfected and the cat is allowed to wake up.

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Efficacy of Femoral Head and Neck Ostectomy in Cats

It will take some time before the full results of the operation become apparent. This is mainly due to the fact that there is a long period of healing and rehabilitation that follows the procedure and the results of this recovery will determine how useful the hip joint is in future. In most cases though, the cat can be expected to regain the use of the joint and enjoy a surprising amount of mobility for the rest of its life. Some people may wish to pursue a total hip replacement as an alternative to the ostectomy, claiming that it allows both a faster recovery and a more natural range of motion to be retained. Whilst these points are somewhat true, it should be remembered that prosthetic hips can cause cats to develop more problems with the connective tissues in a joint, causing more pain than is warranted.

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Femoral Head and Neck Ostectomy Recovery in Cats

Following surgery, it will be necessary for owners to limit the amount of exercise their cat tries to engage in. Extensive physical therapy will be necessary for the cat to properly develop the tissues that will give it full control over the joint; a process that could take several months. The animal will also require painkillers and antibiotics until the wound is fully healed, which could take as long as four weeks (or longer if the cat is particularly old). To prevent the cat from tearing out its stitches, the owner will have to take measures such as removing potentially dangerous clutter from its living area and fitting the animal with an 'e-collar' so that it does not bite the wound open.

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Cost of Femoral Head and Neck Ostectomy in Cats

The cost of a femoral head ostectomy can be quite high, with costs varying widely depending on things such as the age of the cat being operated on (with older animals being more expensive) and the availability of the required skills in your area. Most operations of this type will cost between $1,500 and $3,000. A total hip replacement, by contrast, can be expected to cost at least $4,000 due to the need for prosthetic components to be obtained and fitted.

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Cat Femoral Head and Neck Ostectomy Considerations

Although the operation can have very positive results for the cat (both in terms of pain reduction and in terms of increased mobility), there are some risks that are part and parcel of the procedure. Foremost amongst them is the risk that the joint will become useless due to healing badly after the ostectomy. Although there is always a chance that the cat may lose the ability to effectively make use of the joint, if the proper aftercare procedures are observed and the appropriate physiotherapy regimen is followed, the animal will heal properly. The second risk factor is the ability for the surgical wound to become infected due to the cat's propensity to lie on its side. However, this can easily be prevented by making sure the animal's living environment is kept clean for the duration of the recovery process (though the wound itself will usually close within four weeks).

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Femoral Head and Neck Ostectomy Prevention in Cats

Hip dysplasia happens due to an inherited defect, meaning that it is purely a matter of genetics whether or not the cat develops the condition in later life. Damage to the femoral head is also hard to predict, as it will typically happen as a result of blunt force trauma (such as that from being hit by a vehicle). Although some owners try to minimize this possibility by confining the cat to the house, this too can cause joint problems, as a good amount of exercise is imperative for helping a cat to maintain a healthy body.

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Femoral Head and Neck Ostectomy Questions and Advice from Veterinary Professionals

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Belbel

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moggie

dog-age-icon

4 Years

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Moderate severity

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2 found helpful

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Moderate severity

Has Symptoms

Limping

Dear dr, I have a 4 years old cat, whose hip bone was broken 2 years ago. she got screws but recently started to limp heavily and be in pain. as a solution, the vet is suggesting femoral head removal. I am a bit concerned: as she has had her hip injured for two years now, she has been trying to avoid it - bunny hopping, pulling herself with front legs and also we stopped letting her out to prevent bigger issues. But that also means her muscle is degrading. If they remove the femoral head - would a muscle which was not really used for two years strong enough to hold everything together? after the op, do we need to keep her in cage rest for 6 weeks, de we need to be with her non-stop? thank you so much in advance!

Aug. 18, 2018

Belbel's Owner

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2 Recommendations

In cats with hip disorders, femoral head and neck ostectomy is normally a good solution as the joint is removed and a false joint forms which allows cats and small dogs to regain movement without pain. I cannot see why Belbel would be a suitable candidate for this surgery but it is down to your Veterinarian to determine suitability; after the surgery, strict cage rest is recommended for four to eight weeks but you don’t need to monitor her 24/7 during that time. Regards Dr Callum Turner DVM

Aug. 18, 2018

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Spork

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Maine

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9 Months

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Moderate severity

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0 found helpful

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Moderate severity

Has Symptoms

Limp Leg, Curled Foot

It's been 5-6 weeks since the operation. Her leg is mostly limp and non weight bearing, she doesn't lift it, she doesn't jump, her paw is curled over and she uses the top like a stump more than the bottom like a foot. Sometimes I see a small bit of improvement after we have done some physio with her but its so fleeting. She is only 8mo old. I really thought recovery would be quicker. I called the vet 2 weeks in and he said it just takes time and to make sure we do the physio. Is it just slow or is something wrong?

July 1, 2018

Spork's Owner

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0 Recommendations

Generally femoral head and neck ostectomy is a successful surgery with dogs walking almost normally between weeks six and eight, however each case is different and without examining Spork myself I cannot comment on his progress. For now, continue the physiotherapy and check in with your Veterinarian to monitor improvement. Regards Dr Callum Turner DVM

July 1, 2018

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Savannah

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domestic short hair

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2 Years

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Moderate severity

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1 found helpful

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Moderate severity

Has Symptoms

Lifts Leg When Runs

My 2 year old cat had this operation after he jumped to catch a bird and fell down we are almost 6/7 weeks post op and about 3/4 weeks of being allowed walk around the house but I don’t see any improvement like he can get around no problem but he isn’t using his leg that much he tend to lift it when he runs and still dosent seem to be able to put a whole lot a weight on it he’s not allowed out yet but my parents feel he is well able ? He is well able to get around and can jump but I have noticed he drags himself up onto things using his front paws and tends not to use the leg that much . Does this look like the operation didn’t work ?

June 26, 2018

Savannah's Owner

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Dr. Michele K. DVM

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1 Recommendations

It can take some time to recover from that surgery, and Savannah may still be recovering. He should not go outside until he is fully healed and using that leg. There can be complications with that surgery and it would be a good idea to have a recheck for him, since he should be well on the way to recovery at this point.

June 26, 2018

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Kodi

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short hair

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2 Years

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Serious severity

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0 found helpful

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Serious severity

Has Symptoms

Recovery

My almost 2 year old cat had this procedure done 2 weeks ago due to a the femoral head being broken from the femur, our vet said this was the best option for treatment. We were not provided any instruction for physiotherapy treatment to insure proper healing and ongoing movements and I am concerned as 2 weeks in he drags the leg as, and puts no pressure on it at all, almost like it is limp to him. Can you help with any advice to make sure all is ok? He was able to get the e-collar off this past weekend and chewed slightly at the stitches, which did bleed a bit but otherwise seems ok.

March 26, 2018

Kodi's Owner

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0 Recommendations

This method is a quick simple way of resolving hip pain from fractures or other issues, recovery isn’t instant and a lot of rest is required immediately after surgery; the success of the surgery is dependant on a false joint being formed in the hip. Your Veterinarian should have given you instructions on discharge with a follow up appointment date, no physical therapy should be done until your Veterinarian is happy with the recovery from the surgery. If your Veterinarian hasn’t given you specific instructions you should call them for instructions and you would need to visit for a follow up anyway and to have any stitches removed (if not dissolving stitches). Regards Dr Callum Turner DVM

March 26, 2018

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Izzie

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moggie

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5 Months

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Fair severity

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3 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Fair severity

Has Symptoms

Limping

We have discovered that my 5 month old kitten doesn't have a femoral head. On the xray there is just a small piece of bone. I have had a vet that won'ts to amputate the leg and other that wont's to shave the bone off. She is a normal kitten playing jumping up on our beds couch etc. She does favor the leg and when you hold her up it is shorter than the other and walks with a lip, can the leg be left as is?? The muscle on the bad leg is leaner than the good, can you please advise what the pros and cons are?? Am very confused on what to do Thank you

March 6, 2018

Izzie's Owner

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3 Recommendations

These type of issues are taken on a case by case basis as no two cases are the same; however if we are able to save the limb and Izzie still has mobility it would be best to remove the piece of bone if it runs a risk of causing issues later in life like arthritis. If Izzie doesn’t really have much control of the limb, you should consider amputation as she will be able to adapt to life without the leg and wont be affected by health problems later in life. I cannot answer which way is best, but if there is an opportunity to keep a functional (whether semi-functional or not) limb it should be attempted. Regards Dr Callum Turner DVM

March 6, 2018

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Bonnie

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Siamese or Snowshoe mix

dog-age-icon

10 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Broken Pelvis, Dislocated Hip

Two years ago my kitty showed up in my driveway as a stray. She had apparently been hit by a car, breaking her pelvis and permanently dislocating her hip. After her pelvis healed, she had FHO surgery. She recovered quickly in spite of her age (estimated 7-10 years old) and now, two years later, she jumps and climbs anywhere she pleases. One of her favorite perches is on top of a 4 1/2 foot high desk. You would never guess that she's a senior lady who's missing the top of her femur!

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Ever

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Domestic shorthair

dog-age-icon

5 Months

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Limping,
Non-Weight Bearing

I am an American living in Asia. I have a 5 month old kitten that I rescued back in August off the streets with severe injuries. The vet diagnosed a break in her femoral head and recommended cage rest for 4 weeks and then surgery to remove it. I had to return to the US for a bit and left her with another lady who rescues cats. However, the other foster mom didn't take the kitten in for surgery until 6.5 weeks after the rescue. I don't know how well she did or did not stick to cage rest before and after the surgery. I got her back a little over 3 weeks ago and it's been about 6 weeks since the surgery now. She walks with a limp still, but when standing or squatting, she puts no weight on the affected leg, basically just resting it on the floor, usually a bit to the side and behind her. When squatting, it'll start scooting out to the side from beneath her (I have slick floors, there's no carpet here.) She still sometimes meows like she's in pain. The vet kept her at the hospital for 1 week after the surgery to administer pain medication but then sent the other foster mom home with no follow-up pain medication. She's not had any additional pain medication since. The vet has told me she needs "exercise" now, but when I've asked specifically what kind of exercise, he can't say. I'm not sure that vets here are all that well educated. He just keeps insisting I exercise her. I've been keeping her in my living room, alone, and starting last week started to give about 5-15 minutes a day of play with my other two cats (both 1 year olds). When she plays too hard though, her limp becomes more pronounced and she acts like she's in pain more. I've told my vet what I'm doing and all he did was nod and say "yes, exercise, no cage." (The people here are notoriously non-specific, so I doubt I'd get any more details than that even if I was completely fluent in the language!) Are there any resources for what types of activities I should be doing with her?

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