Femur fracture repair of a tiger cub (Panthera tigris tigris) suffering from nutritional secondary hyperparathyroidism and osteopenia

Abstract

A five-month old tiger (Panthera tigris tigris) presented for an acute-onset pelvic limb lameness workup. The cub had been fed a meat-only diet. Radiology revealed severe generalised osteopenia, pathological fractures of the pelvis and proximal right femur. The history, clinical presentation and pathognomonic radiographic findings were consistent with nutritional secondary hyperparathyroidism. The cub was initially treated conservatively by dietary management (whole chicken supplemented with calcium-multivitamin powder). Fourteen day follow-up radiographs revealed increased bone density, healing pelvic fractures and callus formation around the displaced femoral fracture fragments. Despite the osteopenia, the femoral cortices were considered dense enough to allow internal fixation using a locking plate–rod combination. Fracture reduction was complicated by extensive callus formation and muscle atrophy. Follow-up radiography on day 63 revealed excellent secondary bone healing and improved bone density. The cub was discharged into the owner’s care and has reportedly made a full recovery.