- Not a substitute for professional veterinary help.
Our flexible cats are famous for their air-righting reflex. However, the physical trauma a cat might sustain from jumping off a high balcony or rooftop could cause a rare but serious joint injury. Carpal hyperextension causes tendon and ligament damage, chronic inflammation, and instability in your cat’s carpal (“wrist”) joint, says Dr. Danny Sack, DVM, Surgical Resident at MedVet Columbus and Big Barker Veterinarian Expert with a background in Veterinary Orthopedic & Sports Medicine.
“Like most orthopedic injuries, this is not a life-threatening injury in itself, but it can affect your cat’s ability to do normal activities and limit their quality of life,” Dr. Sack explains.
With expert insights from Dr. Sack and other veterinarians, we’ll explain hyperextension and take a closer look at how cats live with carpal hyperextension, how it’s treated, and what recovery looks like.
What Causes Carpal Hyperextension?
While most cases of carpal hyperextension are caused by high falls, it’s not the only one. Dr. Candy Akers, DVM, a holistic veterinarian, and Dr. Sack outline the following common causes of carpal hyperextension in cats.
- Falling from a high place
- Physical trauma
- Car or motor vehicle accident
- Arthritis
- Diabetes
What Are the Symptoms of Carpal Hyperextension?
Since carpal hyperextension is a joint injury in your cat’s wrists, it has some very distinctive symptoms.
Dr. Akers and Dr. Kevin Baker, DVM, the associate Medical Director at the Veterinary Emergency Group, say that you’re likely to see a visible change in your cat’s walk. In milder cases, cats might walk with a limp or favor one front leg over the other. In severe cases, your cat’s wrists bend or press into the ground. Other carpal hyperextension symptoms include:
- Visible swelling at the wrist joint
- Abnormally angled, bent, or “dropped” wrist
- Decrease in activity or energy level
- Reluctance or hesitation before jumping or climbing
- Avoiding jumping or climbing
- Frequently or excessively licking or biting at the injured wrist
- Not using one or both front legs
- Unwillingness to walk
- Refusal to drink water or eat
- Increased vocalizations
- Overgrooming
- Skin lesions, pressure sores, and ulcers where the wrist touches the ground
The best way to determine if your cat has carpal hyperextension is to take them to the vet for a professional examination and evaluation. Dr. Sack says this is essential because they can also simultaneously catch (or rule out) other injuries.
How Do Vets Diagnose Carpal Hyperextension?
Dr. Sack says a physical exam is always the first step to diagnose carpal hyperextension. Once your vet confirms the injury, they’ll take X-rays to determine the level of damage to your cat’s injured wrists. Since most cases of carpal hyperextension require surgical intervention, the X-rays help decide the best course of treatment.
Sometimes, a vet specialist will use additional imaging to evaluate the bones and ligaments of your cat’s injured carpal joint more thoroughly.
X-rays and other diagnostic imaging costs vary; however, a pet insurance plan may fully or partially cover them. Check with your provider before these tests to avoid unexpectedly high vet bills.
How to Treat Carpal Hyperextension in Cats
Carpal hyperextension will never heal on its own without veterinary intervention.
While pain medication, rest, and physical therapy are treatments for mild cases, Dr. Baker says most cases require surgery. Dr. Sack adds that surgery has the best functional outcome for stabilizing your cat’s joints and getting them back on their feet.
1. Physical therapy
Dr. Sack says physical therapy is a beneficial and effective way to get your kitty on the road to recovery. Physical therapy is a surgery-free way to improve your cat’s range of motion in their carpals and forelimbs, help them maintain and build muscle mass, and improve their overall comfort.
2. Cold laser therapy
As a holistic veterinarian, Dr. Akers prioritizes non-invasive treatments that address the root cause of injuries. Cold laser therapy is a painless, brief, non-surgical way to help treat the traumatic damage to your cat’s ligaments and tendons. These therapeutic lasers use infrared light waves to target your cat’s damaged cells and tissues, reduce inflammation, enhance blood flow, and promote healing.
Cold laser therapy is most beneficial when started soon after the injury; however, it can treat carpal hyperextension injuries up to two years old. Using a high-quality cold laser device at home allows treatment in a familiar, stress-free environment.
3. Nutritional supplements
Joint supplements are designed to strengthen and tighten your cat’s ligaments. These include whole-food-based supplements that contain vitamins and minerals such as manganese. Supplements can reduce inflammation at the carpal site when coupled with other treatments and a higher-quality diet.
Dr. Akers says excessive inflammation hinders your cat’s body’s ability to heal and can prolong their pain.
4. Splinting
“Using support wraps or orthotics in cats is notoriously difficult as they are rarely willing to wear devices on their limbs,” Dr. Sack cautions.
However, if you have a kitty who is willing to try them, Support wraps or short splints can help support the injured carpal joint, minimize painful motion at the affected joint in instances of higher activity, aid in immobilization, and prevent further damage and tears.
Importantly, splinting is most effective when it’s combined with physical therapy.
5. Environmental changes
For very mild carpal hyperextension, Dr. Akers says cats are resilient. She’s seen them adapt well to their joint disorder, finding new ways to jump, play, and interact with the world around them.
You can adjust the household environment of indoor kitties by adding cat steps or ramps, lowering cat shelves, moving cat trees, or adjusting or restricting access to high places.
6. Surgery
“Typically, the ligaments cannot be repaired, so the most effective injury treatment is a carpal arthrodesis, a surgical fusion of the joint,” Dr. Baker explains. This surgery stabilizes their joints, improves their mobility, and reduces pain. Additionally, Dr. Baker says the surgery ranges from $1,500-$7,000. Pet insurance should cover this surgery as long as the carpal hyperextension isn’t a pre-existing condition.
While your cat might not climb or jump high after surgery, they can place weight on the affected leg.
How Do Cats Recover From Carpal Hyperextension Surgery?
After surgery, Dr. Baker says a vert will give your cat a splint to wear for 6-8 weeks with weekly changes. Keep the splint clean and dry after surgery. Dr. Baker says jumping restriction is also essential until the site has fully healed.
While surgery is typically successful, Dr. Baker says potential complications after surgery include:
- Swelling of the limb
- Discharge from the incision site
- Poor appetite
- Vomiting
- Lethargy
- Increased vocalization
- Infection
- Fusion delay or failure
- Implant loosening
Dr. Baker says the overall prognosis is good, and your cat’s mobility will continue to be re-evaluated every 1 to 3 months after surgery. Schedule regular follow-up visits to check that the splint is working and the surgery site is healing appropriately. They’ll order new X-rays to monitor the progression of the joint fusion.
Once the splint is removed, rehabilitation through physical therapy will further your cat’s recovery by minimizing muscle atrophy, strengthening their muscles, and improving their range of motion.
It typically takes cats 12 to 16 weeks to fully heal from their arthrodesis surgery. Once they’re completely healed, they can go back to being the curious kitty you know and love!