Intensive, extensive, expensive. Management of distal limb shearing injuries in cats

Practical relevanceCats often present with distal limb shearing injuries as a result of road traffic accidents (RTAs). Many apparently unsalvageable limbs can be saved through intensive and appropriate early treatment if the basic principles of good wound management are followed.Clinical challengesWhen a limb is crushed under the wheel of a car, the skin, soft tissues and bone can be injured in a variety of ways, and the wounds are invariably heavily contaminated. Management of such cases is intensive, extensive and expensive. As well as the client's financial constraints, the ethics of prolonged treatment versus the alternative of amputation should be carefully considered. This article reviews the priorities for managing these cases, and presents a logical approach for achieving optimal outcomes.Patient groupAny cat allowed access to the outdoors is potentially at risk of sustaining RTA injuries, young cats particularly so.Evidence baseMany textbooks and original articles have been published on aspects of managing soft tissue injuries and skin grafting. To the author's knowledge, only two peer-reviewed papers have dealt specifically with shearing injuries, both presenting a retrospective analysis of cases in dogs.