This case report describes metacarpophalangeal (MCP)- and metatarsophalangeal (MTP)-level amputation and reconstruction of all 4 paws of a young female domestic shorthair cat. All 4 paws, the ears, and the distal portion of the tail underwent severe frostbite injury resulting in tissue death. Following MCP and MTP amputation, weight-bearing surface reconstruction was achieved using metacarpal and metatarsal paw-pad advancement flaps. Remaining open wounds on non-weight-bearing surfaces were reconstructed using full-thickness skin grafts. All limbs healed uneventfully, allowing return to weight-bearing function. Key clinical message: Good postoperative function can be achieved with the use of metacarpal and metatarsal paw-pad advancement flaps for reconstruction of multiple-limb MCP- and MTP-level amputations.
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