Carpal Hyperextension in cats

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Until our boy cat Jasper badly injured his paw, I had no idea what carpal hyperextension was, let alone that it was something that cats might deal with. When he came home limping so badly he could barely put his paw to the ground without yelping in pain, I had no clue that we would have a long, challenging and expensive few months on the road to his recovery from what can be a life changing injury for cats.

So, I thought I would share what it is, and our story.

In mid May 2023, our boy cat, Jasper, came home, limping very badly. He was clearly in a lot of pain, and because he has dislocated his shoulder before, we immediately suspected he had done that again, and we whisked him off to our vet to be checked out and hopefully “fixed”.

Unfortunately, the news we got back from the vet was that it wasn’t that. An overnight stay, an anesthetic, x-rays and thorough examination they told us that it was a rather worse injury called carpal hyperextension. We think he did a big jump down from somewhere and landed badly and damaged his paw.

So what is it and how does it happen?

Carpal hyperextension in cats, also known as carpal laxity or “dropped wrist,” is a condition that affects a cat’s front limbs, specifically the carpus, which is the equivalent of the human wrist. This condition can be both painful and debilitating for cats, and it is important for cat owners and vets to be aware of its causes, symptoms, and treatment options.

Carpal hyperextension can be caused by various factors, including:

• Trauma: Accidents, falls, or injuries can lead to carpal hyperextension. When a cat lands forcefully on its front paws, it may cause damage to the ligaments and tendons that support the carpal joint, resulting in hyperextension.
• Genetic Predisposition: Some cat breeds are more prone to carpal hyperextension due to genetic factors. Maine Coon cats, for example, are known to be at a higher risk.
• Age: Older cats may experience carpal hyperextension as a result of natural wear and tear on their joints.
• Weight: Obesity can put extra stress on a cat’s joints, increasing the likelihood of carpal hyperextension.

Symptoms: Knowing what might be wrong is crucial and the sooner you get your cat medical attention the better the outcome.

1. Limping: Cats with carpal hyperextension often limp or hold their affected limb off the ground.
2. Swelling: The carpal joint may appear swollen and inflamed.
3. Reduced Mobility: Cats may have difficulty flexing or extending their front limbs, leading to reduced mobility.
4. Pain: Cats may exhibit signs of pain, such as vocalization, reluctance to use the affected limb, or aggression when the joint is touched.
5. Abnormal Gait: Cats with carpal hyperextension may walk with an abnormal gait, making their movements appear uncoordinated.

How is it treated? The treatment can depend on your vet’s expertise in the area of cat orthopedics, and you may be referred to a specialist for your cat’s injury.

• Rest and Immobilization: Mild cases may be treated by restricting the cat’s movement and providing a splint or bandage to stabilize the affected joint. This allows the ligaments and tendons to heal.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and reduce inflammation.
• Physical Therapy: Physical therapy exercises can help improve joint flexibility and strengthen surrounding muscles.
• Weight Management: If obesity is a contributing factor, a weight management plan may be recommended to reduce stress on the affected joint.
• Surgical Intervention: In severe cases or when conservative treatments fail, surgery may be necessary to repair damaged ligaments and tendons. This is often considered a last resort.
• Assistive Devices: In some cases, assistive devices like orthopedic braces or boots may be used to provide support to the affected limb.

Our vet and the specialist vet that we were referred to, all agreed, based on their research and experience that whilst the non surgical interventions might ease some of his pain, ultimately, the best option for carpal hyperextension is surgical treatment and repair. We could have opted for a brace but both vets felt that they had never seen much success with that line of treatment and whilst they knew that asking us to undertake a surgery that would require a long stretch of rehabilitation, crate rest and some expense, they and we felt it was the best plan to get him back to as functional as possible and as good a quality of life as possible. We were told that the surgery might not work, that there was a risk of infection, that the joint they would create to repair the damage might not “take” and be rejected. The surgery was also very expensive, but fortunately, our pet insurance covered the bulk of the costs, much to our relief.

The surgery involved inserting a metal plate in his paw, because the damage was so exenstive, and a repair of the tendons was not feasible.

So, at the beginning of June 2023, Jasper had surgery. He was at the vet for 24 hours, post op, and then came home with a semi hard cast, to 6 weeks of crate rest, and minimal movement to try and allow the paw to heal.

It was long and hard, for him and us, but he was incredibly brave and although he has not enjoyed being first on house arrest, then crate rest, then house arrest again, because of the skill of our vet, and us being incredibly strict about his post operative care, he is, today, as healed as he possibly can be, and the vet continues to be very pleased with the results. He is not fully back to normal in that he will never be able to be a fully outside cat without restrictions, but we have got him to a place where he can spend time in his beloved garden and outdoors and his paw is stable and he is pain free. He has always been used to being able to go out, so being indoors for such a long time, did impact his mental health and he was struggling with being not allowed out at all. Some vets will advise that a cat with a healed carpal hyperextension injury must remain indoors but our vet said we needed to make the decision based on what we thought was best for Jasper and to be cautious but allow him freedom if it was beneficial for his mental health.

The paw was made for helping him live his best cat life, and we are relieved that what we now call his golden paw (because it was such an expensive and complicated issue) is holding up and he’s back to his old happy cat self again, bringing mice home to us and being top cat in his garden.

If your cat is given a diagnosis of carpal hyperextension, don’t panic. It does sound scary, but if you work with your vet, there is a strong possibility of a good outcome and it is possible to get them back to reasonable mobility and health, even if it takes some time.