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A 2‐year‐6‐month‐old, female, neutered Greyhound was diagnosed with idiopathic chylothorax. Surgery was performed, which included thoracic duct ligation, subtotal pericardectomy, total right caudal lung lobectomy, chyli cisterna ablation and pleural port device placement. Fluorescein sodium was injected into a mesenteric lymph node through a right paracostal laparotomy for colourisation of the different branches of the thoracic duct to assist in identification. A sterile ultraviolet torch (LED 395 nm) was used to activate the fluorescent yellow‐green signal, enabling visual assessment of the thoracic duct and its branches. Finally, the different branches were ligated using haemovascular clips. Success of the thoracic duct ligation was assessed by contrast fluoroscopy. The dog recovered well from the surgery, but was euthanased without investigation 4 weeks after the procedure due to anorexia, diarrhoea and abdominal pain. This is the first report of thoracic duct ligation for idiopathic chylothorax in a dog using fluorescein sodium as a fluorophore to help with the identification of all the thoracic duct branches. [ABSTRACT FROM AUTHOR]

Medial glenohumeral ligament injury is commonly reported during medial shoulder joint instability in dogs. Arthroscopy is considered the gold standard procedure, but it is invasive and requires distension of the joint. Ultrasonographic examination of the medial glenohumeral ligament has been studied as a possible, less invasive alternative to arthroscopy however it has not been considered a useful method of assessment due to the interference of the probe with the pectoral muscles. The aims of this prospective analytical randomized pilot study were to develop a standardized ultrasound protocol for visualizing the canine medial glenohumeral ligament and to compare goniometry and ultrasound findings in cadaver dogs with versus without transection of the medial glenohumeral ligament. Nine adult Beagle cadavers (18 shoulders) were used. The first six shoulders were used in a preliminary study to describe an ultrasound technique to identify the medial glenohumeral ligament. Arthroscopy was performed on the remaining 12 shoulders, with six randomly selected medial glenohumeral ligaments from these shoulders, transected during the procedure. Ultrasound examination was performed after each arthroscopic procedure by an ultrasonographer blinded to the patient group. Four medial glenohumeral ligaments (67%) were correctly identified during the preliminary study. Ultrasonographic examination failed to diagnose the transection of all six medial glenohumeral ligaments in the second part of the study. No difference was observed in the ligament thickness between the dogs with and without a transected medial glenohumeral ligament. Dogs with a transected medial glenohumeral ligament had a wider articular space compared to dogs without a transected ligament (P < 0.001), and an articular space wider than 8.2 mm was discriminatory of a transected medial glenohumeral ligament in all the shoulders. In conclusion, the medial glenohumeral ligament could be identified with a medial ultrasonographic approach of the shoulder and a wider articular space can be a sign of a medial shoulder joint instability. Further studies are needed to confirm these preliminary findings in living dogs, with and without shoulder instability. [ABSTRACT FROM AUTHOR]

Proximal tibial deformities or patellar luxation may occur concurrently with cranial cruciate ligament rupture. The objective of this study was to describe the management of those conditions with a modified triple tibial osteotomy (TTO) in nine dogs. Medical records of dogs who underwent a modified TTO were reviewed. The mean pre- and postoperative patellar tendon angles were 104.2° and 92.9°, respectively. The mean pre- and postoperative mechanical medial proximal tibial angles were 99.5° and 91.5°, respectively. Medial patellar luxation was present in five dogs (55.6%) and treated in all five dogs with a tibial crest transposition. Tibial torsion was grossly resolved in two dogs (22.2%). Perioperative distal tibial crest fracture was treated by pins and a figure-of-eight tension-band wire in five dogs (55.6%). One major (surgical site infection) and three minor postoperative complications were observed. At the last follow-up, seven dogs (77.8%) had no lameness, one dog (11.1%) had mild lameness, and one dog (11.1%) had moderate lameness. Radiographic evaluation showed good (2/9; 22.2%) to excellent (7/9; 77.8%) bone healing. The visual analog scale evaluation revealed good-to-excellent owner satisfaction. Cranial cruciate ligament rupture, tibial deformities, and medial patellar luxation are difficult to treat together. A modified TTO may be used to treat these conditions. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to describe the perioperative and postoperative complications as well as short-term and long-term outcomes in cats with ureteral obstructions treated by placement of a subcutaneous ureteral bypass (SUB) device without imaging control. The second objective of this study was to compare cats treated by SUB device with cats treated by traditional surgical intervention. Methods Data were obtained retrospectively from the medical records (2014–2016) of cats that underwent SUB placement (SUB cats) and cats that underwent traditional ureteral surgery (C cats). Results Nineteen SUB devices were placed without fluoroscopic, radiographic or ultrasonographic guidance in 13 cats. Fifteen traditional interventions (ureterotomy and neoureterocystostomy) were performed in 11 cats. Successful placement of the SUB device was achieved in all cats with only one major intraoperative complication (kinking of the kidney catheter) and one minor intraoperative complication (misplacement of the kidney catheter). Eleven SUB cats recovered from the surgical procedure; two SUB cats and three C cats died during the anaesthesia recovery period. Postoperative SUB complications included anaemia (n = 2), urinary tract infection (UTI) (n = 4), non-infectious cystitis (n = 5) and SUB device obstruction (n = 1). Postoperative traditional surgery complications included anaemia (n = 7), UTIs (n = 6), non-infectious cystitis (n = 1), re-obstruction (n = 4) and ureteral stricture (n = 1). Median postoperative duration of hospitalisation (3 days) was significantly shorter for SUB cats than for C cats (P = 0.013). Ten SUB cats (76.9%) and four C cats (40%) were still alive at a median follow-up of 225 days and 260 days, respectively. Owners were completely (90%) or mostly (10%) satisfied with the SUB device placement. Conclusions and relevance SUB device placement appears to be an effective and safe option for treating ureteral obstruction in cats, and this study has shown that fluoroscopic guidance is not essential in all cases. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the effect of arthroscopic partial meniscectomy in dogs with bucket handle meniscal tears and tibial plateau leveling osteotomy (TPLO), compared with dogs with cranial cruciate ligament rupture and no meniscal tear treated by TPLO alone. ANIMALS: 30 client-owned dogs with cranial cruciate rupture treated by either TPLO and arthroscopy alone if the meniscus was normal (normal meniscus [NM] group, n = 14) or by TPLO and an arthroscopic partial meniscectomy if a bucket handle tear was diagnosed (meniscal tear [MT] group, n = 16). METHODS: Medical records, lameness score, and symmetry gait analysis parameters were retrospectively collected from patient records preoperatively (PreO), then at 1, 3, and 6 months postoperatively (M1, M3, and M6, respectively). Osteoarthritic (OA) radiographic score was performed and compared at PreO and M6. RESULTS: PreO gait analysis parameters were lower in the MT group (P < 0.005). In the MT group, the lameness score significantly improved between PreO and M1, and there were no significant differences between groups at M6. OA score was significantly higher in the MT group at PreO and M6. However, postoperative progression of OA did not differ between the 2 groups (P = 0.16). CLINICAL RELEVANCE: Treatment for meniscal tear results in a significant improvement in lameness, with postoperative outcomes at 6 months comparable with dogs with intact menisci. Despite having significant osteoarthritic lesions at all time points, the progression of osteoarthritis is similar between dogs with meniscal tears and those with intact menisci. [ABSTRACT FROM AUTHOR]

Objective:  The objective of this prospective study was to evaluate the use of ultrasonography in the diagnosis of medial coronoid process disease in unclear cases., Study Design:  Fifteen elbows (on thirteen dogs) for which radiography and computed tomography did not lead to a clear diagnosis of medial coronoid process disease were included. On each elbow, ultrasonography was performed with a high frequency linear transducer (12-18Hz). Then, arthroscopic examination of the joint was performed by a surgeon who was unaware of ultrasonographic findings to confirm medial coronoid process disease., Results:  At least one ultrasonographic lesion was detected in 13 out of 15 elbows. The main reported ultrasonographic lesions were joint effusion (10/15 elbows) and an abnormal shape of the medial coronoid process (irregular, ill-defined or fragmented) (9/15)., Conclusion:  Ultrasonography can be a helpful additional diagnostic tool to confirm medial coronoid process disease of the elbow joint before performing arthroscopy in unclear cases. Further studies will be needed to evaluate the use of higher frequency transducers and determine if it could improve the diagnostic value of ultrasonography., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective:  The aim of this study was to assess the feasibility and efficiency of an arthroscopically guided ligamentoplasty of the medial glenohumeral ligament to treat medial shoulder joint instability., Study Design:  Six Beagle cadavers were used (12 limbs). Both arms of the medial glenohumeral ligament were severed using arthroscopic guidance. Arthroscopically guided reconstruction of the ligament was performed. Threaded sutures were fixed with a bone anchor on the medial aspect of the glenoidal cavity of the scapula, passed through a humeral tunnel and finally tensioned with a suture button on lateral aspect of the humerus. Shoulder abduction angles were measured before and after the section of the medial glenohumeral ligament, and following the surgery. Two orthogonal radiographic projections and dissections were performed after each procedure to grade the placement of the implants., Results:  Surgical repairs were achieved in 10 out of 12 limbs. The abduction angles after repair with ligamentoplasty were not significantly different from the abduction angles measured before the section of the medial glenohumeral ligament., Conclusion:  Arthroscopically guided ligamentoplasty with a scapular bone anchor and a humeral drilling tunnel is feasible in cadavers, and efficient to restore acutely shoulder abduction angle in a minimally invasive manner. Further clinical studies are required to assess in vivo results., Competing Interests: T.C. is a paid consultant for Arthrex., (Thieme. All rights reserved.)

Objectives:  This study aimed to describe a stress radiography to detect medial glenohumeral ligament rupture and to investigate the repeatability and reproducibility of this test., Materials and Methods:  Six adult Beagle cadavers were used. Both shoulders of each dog were randomly assigned into two groups: a normal shoulder group (NS group) and an affected shoulder group (AS group) where the medial glenohumeral ligament was arthroscopically transected. Goniometry, image analysis and radiography (normal and stress views) were performed before and after arthroscopic procedures. An abduction angle was determined for each stress view and an evaluation of the repeatability and the reproducibility was performed., Results:  Abduction angles were significantly larger in the AS group as measured by goniometer ( p  < 0.001), image analysis ( p  < 0.001) and radiographic stress view ( p  < 0.001) than in the NS group. The abduction angle difference varied from 12° to 29.3° (median difference of 19.4°) between NS and AS groups. There were good intra-observer and very good inter-observer agreements. A very good ( r  = 0.74; r  = 0.72, respectively) significant ( p  < 0.001) positive correlation between goniometric and radiographic techniques and between image analysis and radiographic techniques was observed., Clinical Significance:  Shoulder abduction angles measured with a stress radiograph-specific view provide objective data that may contribute to diagnosis of medial shoulder instability in dogs., Competing Interests: The authors have no conflict of interests with regard to this manuscript., (Georg Thieme Verlag KG Stuttgart · New York.)

Objectives:  This study aimed to compare outcomes between the tibial plateau levelling osteotomy (TPLO) procedure and a modified tibial tuberosity advancement (TTA Rapid) in dogs with cranial cruciate ligament rupture., Materials and Methods:  Twenty-six dogs were prospectively randomized into two groups: a TPLO group ( n  = 13) and a TTA Rapid group ( n  = 13). A lameness score evaluation, gait analysis and radiographical examination were performed before surgery, the 3 days after surgery, and then at 1, 3 and 6 months postoperatively. Finally, owners were asked to subjectively rate their level of satisfaction., Results:  The duration of surgery was significantly shorter for the TTA Rapid procedure ( p  < 0.0001). There was no significant difference in the occurrence of complications between groups. Lameness scores were significantly higher during the first 3 days after surgery for the TPLO group ( p  = 0.01 at day 1, p  = 0.01 at day 2 and p  = 0.003 at day 3). One month after surgery, the symmetry index between healthy and affected limbs for the relative stance time during the gait cycle (symmetry index/%) was significantly higher for the TTA Rapid group ( p  < 0.01). No gait parameters were significantly different between the two groups 6 months after surgery. All of the owners of dogs in the TPLO group were completely satisfied, whereas only 11/13 owners of dogs in the TTA rapid group were completely satisfied., Clinical Significance:  Tibial plateau levelling osteotomy and TTA Rapid were associated with high long-term success rates in dogs. The immediate postoperative recovery seemed faster with TTA Rapid, but thereafter there was no difference., Competing Interests: The authors have no conflict of interests with regard to this manuscript., (Georg Thieme Verlag KG Stuttgart · New York.)

Objective: To explore the long-term safety and efficacy of canine allogeneic mesenchymal stromal cells (MSC) administered intra-articularly as single or repeated injections in appendicular joints of dogs affected by moderate to severe refractory osteoarthritis. Study Design: 22 pet dogs were recruited into a non-randomized, open and monocentric study initially administering one cellular injection. A second injection was offered after 6 months to owners if the first injection did not produce expected results. Materials and Methods: Anti-inflammatory treatment (if prescribed) was discontinued at last one week before the onset of treatment. Each injection consisted of at least 10 million viable neonatal allogeneic mesenchymal stromal cells obtained from fetal adnexa. Medical data was collected from veterinary clinical evaluations of joints up to 6 months post-injection and owner's assessment of their dog's mobility and well-being followed for a further 2 years when possible. Results: Mild, immediate self-limiting inflammatory joint reactions were observed in 5/22 joints after the first injection, and in almost all dogs having a subsequent injection. No other MSC-related adverse medical events were reported, neither during the 6 months follow up visits, nor during the long-term (2-years) safety follow up. Veterinary clinical evaluation showed a significant and durable clinical improvement (up to 6 months) following MSC administration. Eight dogs (11 joints) were re-injected 6 months apart, sustaining clinical benefits up to 1 year. Owner's global satisfaction reached 75% at 2 years post-treatment Conclusion: Our data suggest that a single or repeated intra-articular administration of neonatal MSC in dogs with moderate to severe OA is a safe procedure and confer clinical benefits over a 24-month period. When humoral response against MSC is investigated by flow cytometry, a positive mild and transient signal was detected in only one dog from the studied cohort, this dog having had a positive clinical outcome.

Objectives:  The main purpose of this article is to evaluate the correlation between the distraction index (DI) and Norberg angle values in distracted hips (distraction Norberg angle, DNA) at 4 months of age and the official hip score based on the Fédération Cynologique Internationale (FCI) grid at 12 months of age., Methods:  For dogs ( n  = 215) from two guide dog training organizations, the DI and DNA were measured by a single expert on distraction radiographs performed at 4 months of age. The FCI score was determined by the same expert at 12 months of age on a standard hip-extended view.Statistical analysis included receiver operating characteristic curve analysis and concordance correlation coefficient calculation., Results:  The mean DI was 0.48, the mean DNA was 86.5° and 59.5% of hips had an A FCI score. The concordance correlation coefficient of DI and DNA was 0.78. The DI threshold for D- and E-scored hips that was associated with the least misclassification was 0.58 (sensitivity [Se] = 0.6, specificity [Sp] = 0.82). The DNA threshold that was associated with the least misclassification was 85° (Se = 0.83, Sp = 0.68)., Clinical Significance:  DNA has a fair correlation with DI at 4 months and reflects hip passive laxity. D and E FCI scores at 12 months cannot be reliably predicted from the 4 months value of DI or DNA but 96% of hips with DI < 0.58 at 4 months had an A, B or C FCI score at 12 months of age. Similarly, 98% of hips with DNA > 85° at 4 months had an A, B or C FCI score at 12 months of age., Competing Interests: None., (Georg Thieme Verlag KG Stuttgart · New York.)

Objectives:  This article evaluates the variation in the distraction index (DI) and Norberg angle measurement with the femur in a neutral position and the hips distracted (distraction Norberg angle [DNA]) between 4, 6 and 12 months of age., Methods:  Radiographic data from dogs ( n  = 306) line-bred for favourable characteristics, including hip conformation, were reviewed. Dogs underwent stress radiographs, using a Vezzoni distractor, at 4, 6 and 12 months of age. The DI and DNA were calculated, and their evolution was studied for the total population and the sub-category of hips with a DI > 0.7., Results:  For the total population, the DI showed a significant increase from 4 to 6 months and a significant decrease at 12 months. For the hips with a DI > 0.7 at 4 months, DI at 6 and 12 months showed a significant decrease (0.14 and 0.26, respectively, on average). For the total population, the DNA followed the same pattern as the DI, and the values are significantly associated ( p  < 0.001)., Clinical Significance:  The DI varies significantly from 4 to 12 months in dogs, and the time of radiographic evaluation of hip laxity may strongly influence the value of the DI. The DNA is strongly related to the DI, and its use as a more convenient indicator of hip laxity in dogs should be further investigated., Competing Interests: None., (Georg Thieme Verlag KG Stuttgart · New York.)