Hemipelvectomy in Cats

Hemipelvectomy is a surgical procedure used in cats to treat certain conditions of the pelvis and surrounding soft tissues. This will involve removing all or part of the hemipelvis and the attached limb. Because it is considered an invasive and aggressive surgery, hemipelvectomy may not be the first line of treatment for conditions affecting the pelvis.

There are several approaches to hemipelvectomy. The procedure used will depend on the location of the tumor or condition. The general procedure steps for total hemipelvectomy are outlined below.

1. Before surgery, the surgeon will conduct blood work to ensure it is safe for the cat to undergo anesthesia.
2. Because the risk of hemorrhage is high, the surgeon may or may not choose to acquire blood from a veterinary blood bank or similar facility in case a blood transfusion is required.
3. The cat will be anesthetized. Analgesics will be administered intravenously.
4. The operative area will be shaved, cleaned, and draped.
5. A urinary catheter will be placed. A purse string suture will be used to suture the rectum so that bowel contents are not emptied during surgery.
6. The surgeon will then make the initial skin incision.
7. The muscles surrounding the pelvis will be separated along their natural seams. A saline solution will be administered to ensure the muscles retain moisture. 
8. Major arteries and veins may be ligated to prevent hemorrhage.
9. The abdominal muscles are cut and separated from the pubis, exposing the external iliac artery and vein. These are isolated and double ligated.
10. The iliopsoas muscles are then isolated and separated from the pelvis.
11. The sacrum is then exposed and the ilium elevated so it can be cut with an oscillating saw.
12. The pubic symphysis is cut and elevated. Remaining muscle attachments will be incised.
13. The nerves will then be separated from the pelvis and limb.
14. The surgeon will inject the nerve sheath with a local anesthetic.
15. The surgical site is then flushed with a saline solution.
16. Metal hemoclips may be placed for patients requiring radiation treatment.
17. The muscles are replaced prior to site closure.
18. The cat will then be hospitalized from three to ten days.

It is difficult to speculate on the efficacy of this procedure since it is rarely performed in cats. The cat’s overall health and limb function will influence the outcome of the procedure. The efficacy will also depend on the surgeon’s expertise. However, it is generally considered safe, provided that the condition warrants the treatment and the surgeon is highly skilled.

The cat will remain in the hospital for up to ten days to recover. However, nine out of ten patients are discharged within seven days. During this time, analgesics and anti-inflammatory medications will be administered to manage pain and inflammation. The veterinarian may assist the cat with walking within forty-eight hours following surgery.

Cats are usually able to walk relatively quickly following surgery, although healing times will depend on the overall health of the cat and the underlying condition. Owners should follow all their surgeon’s postoperative care instructions exactly. An Elizabethan cone may be required to prevent the cat from disturbing the surgery site. Owners should check the surgery site each day to ensure no swelling, draining, bleeding, or rupture has occurred. A follow-up appointment will be scheduled for ten to fourteen days after surgery to remove sutures. Additional follow-up appointments will be scheduled as needed to administer additional treatments, particularly in patients with tumors.

The cost of hemipelvectomy will vary based on standards of living and additional costs incurred. On average, the cost of hemipelvectomy ranges from $2,000 to $4,000.

Complications associated with hemipelvectomy include, but may not be limited to:

• Moderate to severe hemorrhage
• Wound rupture and discharge
• Incisional hernia
• Infection
• Urethral and/or rectal trauma
• Pressure point sores
• Tumor recurrence

There is approximately a 20% chance that tumors will recur in cats that have been diagnosed with cancer and treated with hemipelvectomy. Hemorrhage is a major concern of this surgery because it involves the transaction of large muscles. However, 80% of patients experience no postoperative complications. No life-threatening complications were observed in the remaining 20%.

Cancerous conditions are impossible to prevent. For cats that have suffered pelvic fracture, owners should follow all their veterinarian’s recovery instructions carefully. Improper fracture healing may require hemipelvectomy.