Carpal Laxity: Hyperextension

[Mollycat]

Morning all, Molly just to be clear is in the process of being taken to the vets this month, but just fishing for any thoughts and experience of this to add to my reading.

Molly, age 15, adopted at 6. Was overweight and noticeably walked with front feet slightly flat - easier to post a well described link than try to do it myself https://vcahospitals.com/know-your-pet/ ... on-in-cats. There has not been any sudden injury. She lost weight in 2016/17 and her stance improved to just about normal. Last March she was put of renal food at the vet's suggestion (though I have some doubts on her blood tests) since when she has again ballooned and guess what the flat footed stance is back, along with some joint swelling and strange positions.

What makes more sense is the related article on carpal laxity in kittens, from poor nutrition and care - now that sounds much more like Molly than an injury https://vcahospitals.com/know-your-pet/ ... in-kittens - but whatever the root cause, Molly has flat feet and they look rather painful. Her kitten home was rather noisy and chaotic and she was overhandled, so if she developed this I find it likely she would not have been treated.

Does anyone know any more about this that they can share, in particular related to weight gain and diet and the difference these can make to the condition? Obviously weight gain is far from ideal and Molly's comfort comes higher priority than her mild renal failure.

The third picture shows her flat foot stance, the first suggests to me great discomfort and a "stretch" to alleviate it; the other two are the odd ways she holds her wrists at rest which seems to bend too sharply and too high up.

[Ruth B]

Thank you for putting this up, and it seems once more you and me are on similar pages at the same time when it comes to cats.

I've noticed my old girl Tiggy has been walking a bit differently lately, not limping, not appearing to be in any pain, but I had noticed her front paws seemed to be a slightly odd angle. My first thought was her claws weren't retracting as they used to and were tipping her paws back a bit rocking her onto her heels, but having a look at that, I think the problems may be the muscles and ligaments loosing their strength. While she hasn't' had any high falls, she does have a habit of forgetting where she is and occasionally tumbling from windowsills or desks when she decides to try and walk from one place to another and then try and have a scratch and wash all at the same time, she had one tumble from the windowsill, onto the radiator top, onto her hammock, onto my tool box and onto the floor that probably sounded far worse than it was and had me checking her all over for injury.

For her I think it is all part of her old age, so can't really give any advice and with her age I'm certainly not going to be looking at any type of treatment, she is already on the Gabapentin for her kidneys and bladder, and as that is meant to be a bit of a relaxant, it could be it is effecting other muscles as well. She is several years older than your Molly and doesn't seem to be in pain so I'll just add it to the things i'm watching with her. I hope you can get Molly sorted, or at least find out if there is anything you can do to improve things with out having to go down any type of invasive options.

While I'm here, I will add that Freyja has had a reprieve when it came to her vaccines, the vets haven't got any of the Leukemia one at the moment, they are hoping to get it in in the next couple of weeks, so as taking her now (assuming I can) and then again in a couple of weeks, just makes me laugh at the thought we are waiting until then. By then she should be starting over with her vaccinations, but again, getting her their a month apart seems rather unlikely. Fortunately she doesn't go in a cattery, so it is only for her own protection, so i'm happy to settle at one dose, and the vet seemed to accept that that would be the best option for her as well. He also mentioned that if I have to cancel again, then when I can get her in a carrier afterwards, ring up and they will see her, if only to put a needle in her neck.

[susand]

Hi Mollycat, Your post is the first Ive heard of this condition in cats but reading the links you’ve provided, I wonder if it’s analogous to hypermobility syndrome in humans, which is caused by a congenital generalised laxity of ligaments and tendons. I have this condition so can tell you a bit about it.

Although I’ve always had rather wonky legs and flat feet due to the loose ligaments around my knees and ankles, in my childhood and early teens I was a fantastic gymnast, easily able to do the splits both ways etc etc. Sounds great if your ambition is to be a ballerina, hey? Wrong! Unfortunately, the excessively lax ligaments mean the boney surfaces of joints are put under strain and I started getting joint injuries at a very early age (I slipped my first disc at 18) and had developed arthritis in my back, neck and knees by the time I was 30.

I’m mentioning this because, given Molly’s age, it may be that she has developed arthritis on the background of the carpel laxity, in which case, surgery might not help and could possibly make things worse for her.

If she is on the rotund side then losing weight would take the stress off her joints and provide some relief. Metacam might also relieve her joint pain but of course wouldn’t be great for her kidneys.

As I say, I don’t know anything about carpel laxity in cats, other than what I’ve read in your post, so I could be completely wrong but if, as I suspect, it is similar in some ways to hypermobility syndrome in humans then the above may be helpful to you.

[Mollycat]

Oo that's already a ton more than I was expecting, quite frankly, thank you both! I should have said, I would not dream of putting Molly through surgery or even splinting, I saw this improve once before though I'm unsure what made it improve but diet and weight have to be first.

Ruth - Just how old is Freyja? 20 ish rings a bell. Does she venture out enough to warrant the torture of vaccines, if she is so old? Does she come into much contact with other cats?

The accident part doesn't fit Molly either and she had this years ago, hence the stereo approach, accidents and poor nutrition/exercise in kittenhood. They do cite arthritis as a possible underlying cause but it sounds like not a lot of research has really gone into the subject. What interests me the most in Molly is the possible nutrition or weight link, and weight is indeed a major factor in any pressure on joints. I dug up Molly's last test results 11 months ago and will reserve judgement until new tests but it is just possible she doesn't really have renal failure at all, in which case we may have been depriving her of phosphorous, so I am away down the internet rabbit-hole of what symptoms and effects can be caused by phosphate deficiency. More news later.

Susand - I knew a young lady with Ehlers-Danlos Syndrome, is that the kind of hypermobility you mean? So debilitating and misunderstood among the general public, as are many uncommon conditions. It seems to be a different scenario described in cats, in the sense that for kittens it seems slightly congenital and mostly nutrition and exercise, with a nod to slippery floors. I have never been a big fan of hard floors but now they are my nemesis since the last 18 months with a dog who had a cruciate ligament go pop. We watched Dogs Behaving Badly and one dog had an "irrational" fear of hard flooring - I was screaming at the television that the dog was right and these people should listen to her. If it can cause these sort of problems in kittens that's just added to my list of venom against hard flooring.

[Ruth B]

You are getting Tiggy and Freyja mixed up. Tiggy is my golden oldie at 19, and hence why she has a lot of the problems she does, it is just a matter of getting old. Freyja on the other hand is about 7 years old (it seems only a couple of years ago when we got her at 6 months old), she likes to go out, but I'm fairly certain she doesn't go far, just a garden or two over when its quiet. Tiggy actually had her jabs a few months back, it was when she was having the problems with her kidneys and bladder and the vet was rather surprised that my question was what were the danger of her having the vaccines, I think she was more used to having to explain to people the danger of not having them. As they weren't going to cause Tiggy any harm even in her weakened state, she got jabbed.

Interesting that you mention Ehlers-Danlos Syndrome, one of the cats where Saturn and Freyja came from has EDS so is remaining in rescue. Sally who runs the rescue posts quite a lot of photos of him, he can have horrible skin sores and frequent problems with his paws, but its certainly not the same as Carpel Laxity. As an interesting side note, EDS also causes the skin to stretch and not return to its normal position, if you have ever heard of 'winged cats' this is normally the cause, the skin stretches at the shoulder and back area enough to form large flaps that can look like wings.

[susand]

Hi Mollycat,

Re: “I once knew a young lady with Ehlos Danlos syndrome. Is that the sort of hypermobility you mean?”

Yes and no. It is similar in some ways but hypermobility syndrome is not synonymous with EDS. It was called “being double jointed” by lay people when I was growing up and is not that uncommon. Hypermobility syndrome is generally a diagnosis given to people with much milder symptoms than is seen in classic EDS and we don’t have stretchy skin! There are overlapping features and there are probably people with very mild EDS who’ve been labelled as ‘hypermobility syndrome’ but the latter diagnosis is descriptive of the main feature rather than a distinct group of people with a specific genetic mutation.

It’s interesting that cats can have EDS too, I didn’t know that Ruth.

[Mollycat]

** UPDATE ** well sort of update

Vet was unconcerned by Molly's carpal laxity or perhaps just dealing with things one at a time. She didn't feel there was much to suggest arthritis but did find Molly "a bit tender" on the back end - which seems much better 5 weeks later but how much is down to Loxicom and how much to simply having her loose mats combed out, who knows.

I am sticking my neck out on treatment here as nobody is able to give me definitive answers, so Molly is about to become a bit of a lab rat. Both Loxicom and the Devils Claw she is on can cause acidy tummy and she has just had another round of 24 hour pattypoops, so I am dropping the DC for now and keeping to a half dose of Loxicom.

But I bought some collagen powder for the dog, not really realising what I was buying, and he doesn't need it, and it's rather expensive, so I'm going to see if it can help Molly's wrists at all. I have emailed the suppliers who confirm there's nothing in it that is hamful to cats but that I need to speak to the vet about her other meds and conditions. Vet doesn't know but is happy to ask the osteo surgeon who operated on our dog if oral collagen does anything, so I'm going ahead.

If anyone is interested I did find one serious article about joint supplements for pets on the www and here is the link to it - it's fresh out of the labs https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541357/

I'll update on Molly's wrists here.