Cat with possible Osteogenesis Imperfecta

[Debbie-Spain]

We went to collect Milu, a male European shorthair tabby, last Thursday from the other side of Spain.

He is approx. 10 months old and came with a tentative diagnosis of Osteogenesis Imperfecta (brittle bone syndrome). He was a stray taken in at the age of 2 months approx.

We did X-rays and he has multiple (several dozen) fractures, some healed, some still healing, mainly in all four limbs and most ribs. His humerus when he arrived was broken in two (my vet has bandaged it because it is impossible to insert any metal in there). Spine seems to be OK.

We are awaiting test results, especially to see whether it could be hyperparathyroidism of some type.

I know this subject has been discussed on here before (already did a search) and I have read, I think, every article available on the Internet that talks about it. There seem to be only a very small number of cases documented.

Milu is unable to walk but can move his legs, is very alert, quite talkative, eats and drinks with gusto. His main problem is obstipation, his whole pelvis is kind of squashed, the femoral heads almost touch each other, so there is only a very small channel for the poop. Since he arrived Thursday he hadn't pooped (and the X-rays show large accumulation of poop in intestines) but last night he "performed". He is on laxatives etc.

The vet who originally treated him said before we went to get him that she felt he was not in pain. That is my impression from the last few days with him. He cries but for attention; as soon as you stroke his head, or even talk to him, he stops. Last night he started purring for the first time since he got here when I was stroking him. The original vet said she had studied the condition in people and it seems that the more brittle the bones, the less painful the fractures (I haven't been able to confirm that...)

There is a word file I produced that can be downloaded with photos and x-rays. It is a large file (23 MB). Unfortunately I can't get the X-ray images out of it to post them here but they are quite striking. If anyone wants to download it it is here (there is some text in Spanish that just describes his situation).
http://www.sendspace.com/file/48okso
(no need to register)

I have a feeling we are not going to find any specialists here in Spain interested in his case. Because OI is quite rare I am just posting in case anyone has dealt with a similar case and got a final diagnosis or in case anyone knows of or has contact with a specialist in the US that might be interested in advising us in terms of what further tests to run, to check for malabsorption syndromes and other differential diagnoses.

As I say, we are waiting for some results later today. Milu doesn't seem to be as worried about it all as I am... he is here lying on his back asleep beside me. He is really really sweet... the picture was taken in the clinic the day after he arrived and he was a little stressed... he looks much more relaxed now but my camera needs recharging...

Debbie

[critters]

Interesting! I've known people with OI, but it was several decades ago.

PS--He's a real cutie! He looks like my Spirit.

[Debbie-Spain]

Do you know if it's true that they feel less pain when their bones fracture than people with "normal" bones do?

At the moment he's playing with a furry mouse... (using his mouth). He complains bitterly if he wants something and doesn't get it. If he wants you to stroke him he just complains. If he wants water/food etc. he complains and licks his lips every time you look at him, he's really expressive!

Another question, I want to supplement his diet with seafish, any idea what fish would be best? Preferably something I can buy in a can and not have to cook...

Thanks!

Debbie

[Debbie-Spain]

Lab tests are just back and on paper he looks healthier than me

I asked for parathormone level and it wasn't included in the results, not sure if it will come later or they forgot it, it was to try and rule out secondary nutritional hyperparathyroidism... am waiting for their response on that.

If we could repair his fractures we could probably do a bone biopsy but we can't repair his fractures until they stop fracturing, so it's a kind of vicious circle.

Debbie

[critters]

I don't know if it's less painful; if I ever had that discussion with the people I knew, I don't remember the answer. With the internet, you could probably find somebody with OI and ask.

I don't know anything about fish, but it seems to me you might consider fish with bones, if such a thing exists for cats, because the bones should give him extra calcium.

[Bendy Kitty]

canned sardines have soft easy to absorb bones.

when mom was helping raising servals (wild cats that require a lot of calcium when growing) they would grind up chicken and turkey necks in a meat grinder. The soft bones and the cartilage in them was easy to absorb.

OI is condition i don't know anything about, but he sounds like he is a happy guy.
Keep us informed, Debbie! smoochies to you.

Mom says she will see if she can find out anything about OI.

headbonks

bendy

[Debbie-Spain]

Thanks Bendy!

First intact parathormone test came back as "unprocessable" after a 2-week wait, so last week we sent blood for another. The lab is paying for it this time, so let's hope they get a result.

If the parathormone result looks like it isn't nutritional secondary hyperparathyroidism then we will start looking at tests to try and show OI, which I don't think is easy...

I just put a video of him up, it's in Spanish but you can see his (lack of) mobility (may need to wait some time for it to appear)...
http://www.dailymotion.com/video/xa2sbb ... al_animals

and you can see some of his X-rays in this thread on our board in Spain:
http://elclubdekat.org/phpBB3/viewtopic.php?f=25&t=4680

He seems quite happy despite all the fractures...

Will keep you updated if we get anywhere with the tests.

Debbie

[mumpkees]

Debbie: He is absolutely adorable - so precious. The look of happiness and love on his face is priceless. Thank you for sharing your baby with us. /mari

[Debbie-Spain]

Thanks Mari; what you wrote means a lot to me because I know you have tons of experience and can understand kitty expressions. So many people here think he should just be put to sleep because, they feel, he must be in too much pain. When I look at his x-rays I flinch, but watching him day in day out, he never acts as though he is in pain, only once when he first arrived and couldn't poop, but since then he has been fine. He gets really happy-excited every time I get a brush (he has a selection now) out and he is always asking me for food or water or belly rubs or whatever. Sometimes he even plays a little on his own, I just don't think he would be like that if he were in pain...

Hope to get a result for his parathormone test this week...

Thanks again

Debbie

[critters]

Awww! He sounds a lot like my severely disabled baby. Wish my monsters liked a brush! At least the baby doesn't mind baths.

[Debbie-Spain]

His parathyroid hormone (intact parathormone) test is back. The normal range is 0-40 and his value is <3.

Every traumatologist we consulted here has insisted it is nutritional secondary hyperthyroidism. I think that test shows it isn't. If it had been 33 I might have thought it was NSH and he was recovering, but with such a low value I don't think it can be...

Not sure where we will go from here, I am trying to find out whether there is definitely a skin fibroblasts culture that can diagnose OI, otherwise vets have suggested a bone biopsy but I don't really want to do that unless we have to...

I took some cute video of him playing yesterday, but his next video is going to be a "Milu Audiovisual Phrase Book" I think...

Will keep you updated on any developments...

Debbie

[Bendy Kitty]

sending all the gud thoughts we can his way. how is he doing? is he healing his breaks? has he had any new injuries?

bendy snugglies to ya, Debbie.
we know you're givne him the bestest he can get.

bendy

[Lilybug]

Hi Debbie,

I have dealt with this personally with my Lily (RIP 4-29-09) and will gladly share our experience with you. However, reading thru this thread brought an avalanche of emotions and I'm going to have to come back to continue because I can't see thru my tears to type. I will be back tho. Love your kitty with all of your might. He knows you are trying to help him.

This is Lily...she loved pink!


here are some more pics of her. Some (read: a lot) are pretty lousy. I wasnt selective when I took them off the camera, so there are some out of focus disasters. they were all taken of her on my bed-that is where she lived. She knew her limits and was happy on the bed, and considered it her domain.

http://public.fotki.com/tutti/cats/lily/


RuEtta

[critters]

lilybug!

[Debbie-Spain]

Thank you for your message Lilybug. What a beautiful cat... something in her expression reminds me of Milu.

Unfortunately Milu died last Sunday. We had to operate twice in a couple of weeks to try and sort out his hips, he was unable to defecate because his pelvis was so collapsed that his femoral heads were touching each other.

The first operation seemed to go well but after a few days he started having problemas again, it seems that when he "pushed" in order to poop, it was pushing everything together again.

The second operation was to see if it was possible to insert a spacer in order to hold the hips apart but it was impossible to fasten it to his bones, they just disintegrated. So option B was to remove his femoral head, a bit like they do sometimes when small dogs have dysplasia.

It should have worked. He was operated on the Saturday, Sunday morning he was lively and ate well, urinated, etc. but didn't poop. In the afternoon he was quiet but I was with him all the time and didn't feel he was really bad. Suddenly he let out four "meows" and started having problems breathing. I called my vet immediately as I put Milu in his carrier; he was at the clinic and in 10 minutes we were there but Milu had already died.

I can't start to tell you how very special he was. He reminded me so much of Kat because of the communication we had, I have other cats too but he was really unique. I can't believe what a huge void such a tiny thing can leave behind. Since he came here in June he was my constant companion, always happy, always "talking", always rolling over for belly rubs... I work at the computer and he brightened my days.

I miss him terribly... my only comfort is that I think that we did everything possible...

The attached photo is from the time between the two operations: our association had a stand at an adoption fair and I couldn't leave him at home all day alone, so he came with me. He made so many friends and I think a lot of people could see how happy he was despite his great disability.

I'm waiting the results of the autopsy to see if they can confirm Osteogenesis Imperfecta. During the first operation we did a bone biopsy but they could only confirm the symptoms, not the cause.

Thanks again for your kind message, I'm sorry to have sad news...

Debbie