Tendon Contractures

Genetic or Not? - a Korat breeder sees a genetic link
"Twister" - Progress of my Oriental Longhair kitten from birth
Case Study by Dr. Susan Little

"Born With a Twisted Leg" by ShowCatsOnline.com

A tendon contracture is when the tendon in a leg joint is too tight and pulls the joint tight. This is a self correcting condition and is not associated with any deformity. It is not "club foot," although as you can see in this picture of a Korat kitten at birth, the position into which the feet are pulled can resemble the club foot position.

Tendon contractures in newborn kittens are a somewhat common condition, and it is not yet known exactly why they happen. I have had two kittens with tendon contractures, both born to large litters. It seems to be from the position of the kitten in the womb, where perhaps the joint did not have room to extend.

This condition has been studied more fully in cattle and horses, where it is seen much more frequently. There is little information available to breeders and vets regarding treatment for it in smaller domestic animals. This FAQ page will hopefully be able to provide a reference for people who come across this for the first time. If you have had an experience with tendon contractures and would like to contribute, please e-mail me.

 

Genetic or Not?

Some breeders have experiences that lead them to believe the condition has a genetic influence, although most who see this only see it once or twice in their lives. The photo above and the ones below are of the same Korat kitten, one of four kittens born with this condition out of the same Korat stud and four different females. This suggests an inherited condition, although all four kittens corrected completely. (continued...)

I began this page when Twister was born, when he was 10 weeks old I had another kitten born with identicle contractures. The mother of the litter is the full sibling of Twister's father. The new litter, born 6/13/02, was an accidental product of a father-daughter breeding. If there is a genetic component to these kittens' condition, then this situation certainly demonstrates it. Here are pictures of Twister and the newborn kitten side by side for comparison, the resemblance is obvious.


Baby at one day old

Twister at a few hours old

 


Twister's Story
Oriental Longhair kitten born with tendon contractures in three joints.

NEWBORN
This little guy was born with tendon contractures in both front legs and the rear right leg. Notice how the rear right leg appears twisted towards the center. Both front "wrist" joints can not extend further than a 90 degree angle. I named this little guy Twister, an appropriate wind name for him I think. :) I will follow his progress with his condition on this page as he grows.

 

2 WEEKS
Some kittens need gentle physical therapy or splinting as they grow, and some correct on their own. Twister's rear leg is already almost straight it 2 weeks of age. The front feet are more flexible, but still not able to extend fully.

In the picture on the right you can see that he has his right rear leg in the proper position underneath him. He is still walking mostly on his wrists in the front, but can get his paws under him when he tries. When they start walking he will be exercising this joint more and the progress should pick up. He will start having splints on for a few hours a day at three weeks. It has been suggested that I use a heat compress first to loosen the tendon, and my vet has agreed. I will take pictures of what I come up with and document the relative success.

 

3 WEEKS
Here is little Twister at three weeks with his first set of splints. They are made of a 1"x1/3" piece of tongue depresser covered in gauze and help in place with stretchy vet wrap. Twister has gotten used to walking on his wrists, so despite the splints help in straightening his legs, he is still struggling to walk in them. They are encouraging him to put his paws underneath him, but he gets very tired and rests a lot. Because of this, I am only leaving the splints on for an hour, and no more than twice a day for now. I also left his front claws unclipped to give him as much traction as possible. (As you can see, his rear leg has straightened completely.)

Update...
I am having trouble finding the right splint for Twister. When I add a stiff brace (platic, wood or cardboard), his paws swell. When I leave it out and do a soft wrap, it slips above or below the bend and doesn't help much. Everything seems to slip off.

 

4-6 WEEKS
Twister had a severe upper respiratory infection at five weeks of age, which progressed to pneumonia by six weeks. I almost lost him, but his little spirit didn't give up and he pulled through. During this time, however, I did not splint him at all. I didn't want to deter him from the few feedings that he took on his own or stress him further than necessary. I continued the physical therapy and massaging, but he learned to walk on his wrists and the inward bend in his right wrist became quite pronounced because of this.

These pictures are at 7 weeks and he is recovered completely from the URI, this is right before I started splinting him again. As you can see, he was walking on his outer toes only and the wrists are bent inwards in addition to not fully extending. He did not walk on his paw pads at all. Because of this he can not really run, he kind of hops, and he can't climb or catch a toy with his paws. :(

 

7 WEEKS
I finally found the right splint! It doesn't slip off, his paws don't swell, and it is light enough that it doesn't hinder his walking. This meant I could finally leave them on for more than a few hours. He sulked and refused to walk for the first night, but I resisted the cute kitten face and left them on anyway. In the morning he as walking like a champ, up on his paw pads for the first time! He figured out that it was much easier and quicker, since his feet didn't get caught underneath him. I let the kittens out to play in the living room, and I saw Twister run for the first time ever. He looked so happy, I nearly cried. Even after just one night, the flexibility in his wrists improved a great deal. He started to play like a normal kitten, it was wonderful to see.

SPLINTS:

  • Johnson & Johnson Hurt-Free Tape, 2" inch - stiff padded gauze wrap that sticks to itself but not skin (or fur).
  • Small 1/75" carboard piece, rounded on edges. Cut from center of vet wrap, has a slight curve to mold to the leg.
  • Flexible cloth medical tape
  • Nexcare Self-Adherent Wrap, basically vet wrap.

 

For each paw: cut one length of the gauze wrap long enough to wrap around twice, from top of toes to elbow. Wrap firmly but not tightly, only a slight stretching of the material is needed. The 2" size is ideal, no cutting required. Place the cardboard in the best position to brace the contracture, and hold in place with a piece of medical tape on the top and bottom. It is not necessary to go all the way around the limb, but if you do make sure it is not tight. Cover with a layer of vet wrap, just enough to cover and protect the gauze. Again, be careful not to wrap it tightly. This adds support, but should not add too much weight.

 

8 WEEKS
Here's Twister on a break from his splints showing off how he can walk on his paws now! He runs around and chases his sisters, and loves to attack the little fuzzy ball toys.

As you can see, he still buckles his right ankle over without the brace, but does place his paw down correctly. The left ankle can almost extend fully, the right is showing a lot of improvement. The most important step is that Twister has learned how to walk correctly and will now be building the correct muscles and stretching those tendons on his own. At this point the braces are on at least half of the day with several long breaks. I want to stretch those tendons but still force Twister to build the muscles and use the joints. They make his little legs itchy, so he really enjoys the massage he gets when they come off. :) The physical therapy of course is still very important.

10 WEEKS
Twister still has to wear a brace on his right leg to keep his wrist from collapsing inwards when weight is placed on it. It is only a soft wrap of vet-wrap, like an ace bandage. Both legs can be flexed into a near normal position, but only the right collapses.

As you can see from the pictures above, I can hold the right wrist in a normal position. He can sit with it fairly straight, but as soon as weight is applied the joint can not hold it's position. I started wrapping his right leg only for 12 hours at a time in hopes that it will help him build muscles to hold it correctly.

 

13 WEEKS
The wrapping of his right leg worked very well and within two days his leg was able to withstand weight with only a little collapsing. Over the next week or so it continued to bear more and more weight without collapsing.

Twister is visually corrected to about 98% at this point, although I can still feel a little stiffness when manipulating his joints. They do not flex quite as flat as they should, but I am confident that they will get there. He walks, runs, jumps, and plays normally.

 

15 WEEKS
Twister is 100% corrected with no more stiffness on his joint. His right wrist can not be forced into an abnormal position. He doesn't know anything ever was wrong with him. :) He is now ready to find a wonderful loving pet home who will cherish him as much as I do.

5 MONTHS

Twister went to his new home with Paula and his new cat buddy Deisel. He's adjusted very well and loving every minute of his little life!

 

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