Zeus, a three year old mixed breed cat, was a real character with a zest for exploring. His owner, Mr. Summers, was wary of Zeus’ inquisitive nature, so he trained Zeus to stay indoors overnight after his evening meal. The routine suited them both, and, at night, Zeus liked nothing more than curling up with Mr. Summers in front of the TV.

One evening, Zeus was late for supper, and Mr. Summers heard a terrible commotion at the front of the house. He ran outside to find Zeus frantically flailing in the jaws of the neighbour’s dog, who was on his evening walk. Their paths had crossed at the wrong moment. Zeus was vigorously shaken for a minute before they could prize open the dog’s jaws and release him. A panicked Mr. Summers scooped Zeus up, and they sped to the vet clinic. 

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Triage at the vets

At the vets’, the receptionist saw the frantic look on Mr. Summers’ face as he burst through the doors, and she rushed Zeus through to the hospital; time was of the essence.

Zeus had collapsed, his heart was racing, and his breathing was rapid and shallow. The vet placed him in an oxygen chamber and gave him pain relief and intravenous fluids to manage the shock. The vet explained to Mr. Summers that the extent of his injuries was unclear but was likely very serious. They would need to stabilise him first and then investigate for internal injuries. If Zeus continued to deteriorate despite treatment, then they may have to discuss the option of euthanasia. 

Mr. Summers could not imagine his life without Zeus and wanted to give his young cat every chance of survival. He knew it would be a tough few days, but he was prepared to be guided by the vet in deciding what was best for Zeus. The vet estimated considerable costs, but Mr. Summers explained Zeus had been insured since he was a kitten. Although he would have to find the funds initially, Mr. Summers felt relieved that finances would not influence any decision he made.

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Critical condition

The vets continued to stabilise Zeus. Blood tests showed signs of poor circulation (high lactate and urea) due to shock. A triage ultrasound scan (FAST scan) of his chest and abdomen showed fluid in the lung tissue due to bleeding within the airways (pulmonary contusions) as a result of being shaken and crushed. There was also a swelling on his right flank that could be gently pushed back into the abdomen; an abdominal wall rupture was suspected.

The vet explained that Zeus would require ongoing intensive care overnight, and they planned to do further imaging the next day to check the extent of his internal injuries. The vet was worried that Zeus might not survive the night. Mr. Summers reluctantly went home; it was a very long night.

Investigating for internal injuries

The 7am phone call stating that Zeus had remained stable overnight was a huge relief. The vet recommended mild sedation and a CT scan. Surgery is generally delayed for as long as possible in unstable trauma patients due to the risk of anaesthesia. However, life-saving surgeries sometimes have to be performed within this critical window despite the increased risk to the patient. 

The CT scan was performed quickly and efficiently. The CT showed, as suspected, a 4cm tear in Zeus’ abdominal muscles. Luckily, however, there were no signs that the dog’s teeth had pierced the abdomen. Surprisingly, there was another unexpected complication. The force with which Zeus had been shaken had burst his diaphragm, the thin muscular film that controls breathing and separates the chest from the abdomen. With three tears in the diaphragm, the vacuum-like chest had a leaking seal, and the lungs couldn’t stay fully inflated; it was no wonder Zeus was struggling to breathe.

A call to the specialists

Zeus’ vet was an accomplished surgeon, but she called a specialist veterinary surgeon to ensure that they followed the best advice possible. They agreed that delaying surgery for a few days was safest to allow the lung bruising to improve and for any crushed abdominal tissues to become more obvious. A few days after trauma, symptoms can deteriorate before they start to improve. 

By day three, Zeus’ breathing was worse, and the whole team were worried. Repeated ultrasounds showed that the bleeding in the lungs was improving, but there was air in the chest due to the ruptured diaphragm. The specialist advised that surgery should be performed that day, despite the risks.

Challenging surgery

The surgery was a big undertaking and lasted several hours. Zeus was placed on a ventilator which supported his breathing once he was fully anaesthetised. The external pressure of air entering the chest through the torn diaphragm collapses the lungs, so breathing for the patient is essential. When the vet opened his abdomen, thankfully, there were no other unexpected injuries. The diaphragm tears were painstakingly sutured closed, and a chest drain was placed to remove any residual air in the chest. The abdominal wall hernia was repaired after removing any devitalised tissue. A feeding tube was placed through his neck directly into Zeus’ oesophagus, as he had not eaten since he was admitted to the hospital, and this in itself can make cats exceptionally ill.

A tough recovery

Mr. Summers was over the moon that Zeus had survived the surgery, but he had a long way to go before he would be discharged from the hospital. His chest drains were checked regularly for any air leaking into the chest cavity, he started to gradually receive tube feeds, and he remained on oxygen and multiple pain relief medications whilst the bruising started to heal. After a couple more days, Zeus was showing more personality, he could walk around his kennel, and he was licking tentatively at his food. The veterinary team were delighted. He was no longer oxygen dependent, and the chest drains were finally removed the following day.

Five days after his surgery, Zeus was finally ready to return home. Mr. Summers could not believe that he had survived such terrible injuries. Just a few weeks later, Zeus was back to his normal self, eating well, off his medication and asking to go outside. His transformation was outstanding, and the vets very happily signed him off. Mr. Summers knew that Zeus would never settle as a house cat, so he decided to let Zeus out whenever he was at home with him. Zeus became his favourite gardening companion, although Zeus was more interested in bird watching than gardening.

Details changed to protect client privacy.

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