Seeking vet for cat with joint, skeletal, or related problem
September 9, 2014 2:14 PM   Subscribe

Artemis is an awesome cat in Durham/Chapel Hill, NC, who walks, runs, and jumps, but not as well as she should. One vet, in March, found nothing wrong; another, in June, saw she was walking oddly and said to wait a while to see if it got better on its own. Now I'm looking for a vet with expertise or interest in feline musculo-skeletal issues for the next steps.

This cat still does not exactly belong to us, but we are proceeding with the blessing and help of her owner (whose rescue dog chased poor Artemis out of her former home).

Artemis suddenly seemed to develop joint or other problems in February, when she was living outside; she may have fallen or been chased into some non-incapacitating injury. Shortly after, she moved in with us (followed us home, went in the front door, walked upstairs, found an unoccupied cat bed, and rolled over and over in it; granted, it was super cold outside). She learned agility tricks in no time flat (see linked video), and *loves* doing most of them, but jumping much seems to hurt her. She also goes up stairs with a kind of hopping motion sometimes, and it seems to be worsening.

I know about the NCSU vet school and the vet referral practice on Morreene Rd., but would like to find a non-referral vet to start with. Still, if you know a specific vet in either of these referral practices who would be a good fit, that's welcome information also.

I don't think it's arthritis (yet), since it seems to have been precipitated by some kind of event while she was living outside. Yes, I feel terrible having waited so long, but it's been hard to know the right thing to do, especially since Artemis' real owner did get her checked by a vet early on who found no problems.

This is a very sweet, friendly, smart cat who deserves the best care. Even if she doesn't stay with us, she could keep some often-seated person's lap warm for hours on end, always comes when called, very good with strangers and new places -- she could easily be a therapy cat and bring a lot of love to a lot of people. She's only 4-5 years old!

Thank you! Any advice is welcome!
posted by amtho to Pets & Animals (10 answers total) 2 users marked this as a favorite
well, i don't have a specific doctor rec. but if you don't get one, what about going back to the vet who said come back if it doesn't get better? do you have video of her walking oddly? when i was trying to get an asthma diagnosis for my cat, i sent my vet a couple videos of him coughing, since he likely wasn't going to cough while at the vet. artemis may or may not walk painfully while in the presence of the vet, and having something to look at may help with diagnosis. the vet should also of course do a physical exam (hopefully this was done?).

i am very impressed by her running and jumping the obstacle course! my franklin comes when i shake the temptations, but that's about it! (he's a champion snuggler too)
posted by misanthropicsarah at 3:20 PM on September 9, 2014

Response by poster: The vet did at the time did, immediately, notice problems with her gait, but didn't recommend x-rays at the time. It had already been several months, though -- I'm not sure I should have followed that recommendation. The vet checked her leg joints, but wasn't able to diagnose any real problem; she said "it could be tendonitis, like runners get". Today, a visitor here said Artemis moves like her cat who has lower back arthritis... I'm not sure that was even considered. I'm a fan of the vet we visited today, but because of this and other factors I'm not sure I want to return there with Artemis.

Just to be clear - The video is a bit dated, and I do worry she's in pain; we don't do those kinds of jumps now. Her problems are more obvious to even casual observers now. My goal is not to make her some kind of super agility cat, just to make sure she's having a fun and pain-free life.

Sarah, I would never underestimate the importance of snuggling in a cat's repertoire :)
posted by amtho at 3:30 PM on September 9, 2014

Response by poster: I meant "I'm a fan of the vet we visited back then".
posted by amtho at 3:41 PM on September 9, 2014

I would just take her somewhere with an orthopedic vet and really good imaging equipment, so probably the vet school or a large surgical clinic. Even if you just do xrays, not all xray machines are created equal. Without imaging the vet is just guessing, cats can't tell you where it hurts.

Decide now how much you want to spend before you go. Xrays are probably the cheapest at a couple hundred dollars (they're going to have to sedate her). MRI is considerably more. Ultrasound is cheap but I imagine not much used on cats. Thermal imaging.... it just goes on from there.

Oh and be wary of a diagnosis of "arthritis" from a non specialist vet. Shoot enough xrays of any vertebrate and you'll find arthritic bony changes somewhere. 90% of them probably are symptom free.
posted by fshgrl at 4:43 PM on September 9, 2014 [3 favorites]

Best answer: I work at the NC State vet school teaching hospital, so I'm a bit biased on this one, but my wife works at the Cary branch of VSH Carolinas, and they have a location in Durham, so she says she will kick me in the face if I don't mention them. Even so, our Orthopedic service is referral only (as are most specialty clinics I know of in the area), so you will need to have a general practice vet see her first. I definitely agree with misanthropicsarah about getting some good video, but you may want to hold off on getting x-rays at the regular vet, as any specialist you see is going to want to re-do them to their own standards. Send me a MeMail tomorrow if you want more detail. I can talk to you about some general estimates once I'm at work. And yeah, it's not going to be cheap, fshgrl is right. Even the diagnostics are going to be several hundred bucks, and if she needs surgery it might get into the thousands. Good luck, and I'll buy you a coffee if you end up at State.
posted by Rock Steady at 4:54 PM on September 9, 2014 [1 favorite]

Have you considered any of the nearby universities with veterinary clinics? NC State has one, and that's in Raleigh, so it's not too terribly far. I'm not suggesting you go to a student vet; rather that you go to a place that does research and is more likely to have someone who specializes in feline musculoskeletal issues.

I looked and didn't see anything for Duke or UNC-Chapel Hill, but State has more of a veterinary tradition anyway.
posted by nightrecordings at 4:55 PM on September 9, 2014

I absolutely adore my vet, the Cat Hospital of Durham and Chapel Hill. They are a cat-only practice and they genuinely love and are passionate about cats. They have a great relationship with the NC State vet school and don't hesitate to refer/get consultations from specialists. I have a cat with a very interesting and delicate health history (she is a breast cancer survivor, among other things) and the Cat Hospital has been an amazing part of our family.
posted by missjenny at 4:57 PM on September 9, 2014 [1 favorite]

If she seems in pain then regular vet is the first stop. They can prescribe painkillers, rule out other disease process by blood work, refer as needed.

Diagnostics will run into the thousands. "Just" a full blood panel, urinalysis, and a few X ray views are over $500. If ultrasound is needed to rule out other disease (eg tumour), $400 per major segment (chest and abdomen are two segments). MRI and CT are priced higher for pets than for humans, $1500-$2000 each.

An initial xray from first vet might help just in case you should be seeing a neurologist, not orthopedic surgeon.

If it were me, I might rule out non orthopedic/neurological problems and treat for pain. The proper diagnosis might not be necessary if you cannot afford the interventions a specialist might provide. Give kitty a budget and discuss this with your vet.

Give some thought as well as to what you want done in the worst case that kitty is paralyzed due to degenerative neurological or orthopedic disease process. Your kitty might not live a full life. Work backwards from the outcome you desire to determine how much to put into diagnostics and treatment.
posted by crazycanuck at 5:30 PM on September 9, 2014

Have you tried glucosamine to see if it helps. My friend has a older dog who was having trouble jumping up on the couch and just moving in general and it's made a world of difference. Even if the problem is an injury, it could help with healing. It might be worth a try while you're trying to track down a good vet.

Feline glucosamine and condroitin usagesl
posted by stray thoughts at 8:44 PM on September 9, 2014

Response by poster: In case others are dealing with similar issues - I found this feline musculoskeletal pain index questionnaire on the NC State Vet School site. You can easily get the questionnaire after filling out the form asking for your e-mail address, reason for needing, etc. - there's no confirmation e-mail, it just records the information (for some kind of research?) and gives you a download link.

The questionnaire doesn't give you a score or anything, but I'm guessing it will be helpful to frame conversations with any vet about the indications that a pet is in pain (which is so difficult to determine at all, let alone discuss).

FWIW, I don't think Artemis is in a lot of pain, usually, just when she jumps a lot. I hope.
posted by amtho at 6:44 AM on September 10, 2014

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