case_images: PMC10734167_01
case_images: Preoperative view of the left pelvic limb (A) and intraoperative view of the left thigh (B,C). (A) Lateral to the proximal femoral epiphysis, a chronic, perforating wound could be seen and distal to this, an exudative skin lesion was present; this extended proximo-distally from the wound to the level of the stifle joint, was circa 3-4 cm wide and was located over the latero-caudal aspect of the thigh. The paw was circularly edematous. (B,C) Intraoperatively, there were severe necrotic changes affecting the muscles of the lateral thigh, including the m. vastus lateralis (*) and the m. biceps femoris, and the surrounding fat and connective tissues, with palpable subcutaneous emphysema.
case_images: fvets-10-1328331-g001.jpg
case_images: PMC10734167_01_fvets-10-1328331-g001.jpg
case_images: fig1
case_images: On the lateral aspect of the proximal left thigh, there was a chronic wound with a diameter of 1 cm and an additional exudative skin lesion along the whole length of the caudo-lateral aspect of the thigh (Figure 1A). IV; Arterenol, Cheplapharm, Greifswald, Germany) for vasopressor support due to hypotension, fluid therapy using a crystalloid solution (5 mL/kg/h, IV; Sterofundin ISO, B.Braun Vet Care, Melsungen, Germany) and amoxicillin-clavulanic acid (20 mg/kg, IV q8h; Amoxiclav Hexal i.v. 500/100 mg, Holzkirchen, Germany). Intraoperatively, the musculature of the thigh was necrotic and multiple vessels were thrombotic (Figures 1B,C).
case_images: Ten-month-old, female neutered domestic shorthair cat 2 days (A) and 4 days (B) after amputation of the left pelvic limb due to a necrotizing fasciitis and myositis. The cat shows severe generalized extensor rigidity, with opisthotonos and increased extensor tone of the tail (A); the facial musculature is also mildly contracted. Subsequently, it developed stiffness of both ears and bilateral protrusion of the third eyelids (B), as a consequence of the tetanus toxin effect on the extraocular muscles which leads to enophthalmos.
case_images: fvets-10-1328331-g002.jpg
case_images: PMC10734167_01_fvets-10-1328331-g002.jpg
case_images: fig2
case_images: Two days after surgery, the neurological abnormalities became more evident; the cat was increasingly obtunded, it started being very sensitive to light and loud noises, and it developed a generalized increase in extensor muscle tone, with intermittent opisthotonos (Figure 2A). Repeated neurological examinations revealed on-going obtundation, erect and stiff ears, contraction of the facial muscles, permanent protrusion of the third eyelids (Figure 2B), and unchanged moderate to severe extensor rigidity of all three limbs and the tail.