Search

OBJECTIVE: To evaluate use of the Advanced Locking Plate System (ALPS) in dogs and cats and report outcome. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n 09= 0929) and cats (n 09= 0942). METHODS: The medical records (April 2007-April 2010) of dogs and cats treated with ALPS were reviewed evaluated. Data retrieved included signalment, indication for surgery, complications, and outcome. RESULTS: ALPS was used for 54 fractures, 12 tarsal or carpal ligament injuries and in 6 cases, to prevent or treat fractures during total hip replacement. Complications needing revision surgery occurred in 4 cases (5.5%): fixation failure was identified in 3 (2 fracture-fixations, 1 pancarpal arthrodesis), and a fracture occurred through a screw hole. The most common complication after tarsal arthrodesis was suture dehiscence. All cases had healed by study end. CONCLUSIONS: ALPS offers a reliable alternative for fracture treatment and some other orthopedic conditions in small animals.

Summary Objective: Delayed hair re-growth, pruritus and urinary retention are known complications after epidural anaesthesia in dogs. The aim of this study was to prospectively evaluate the effect of epidurally administered drugs on the occurrence of these complications in dogs. Material and methods: Ninety dogs were included in this study. Eighty client-owned dogs undergoing surgery were randomly assigned to one of three epidural treatment groups: either morphine and bupivacaine (MB), bupivacaine (B), or saline solution 0.9% (S) was administered epidurally to these patients. Ten dogs were only clipped in the lumbosacral area (C). Follow-up started 4 weeks after clipping and was performed every 4–5 weeks in cases of delayed hair regrowth or pruritus. Hair re-growth in the lumbosacral area was observed and compared to hair re-growth in the surgical field and the fentanyl patch area. Cytological analysis and a trichogram were performed if hair re-growth was delayed after 6 months. Time interval to first urination postoperatively was recorded (n = 80). Results: Hair regrowth was delayed in 11 dogs (12.2%; B: n = 7, S: n = 2, MB: n = 1, C: n = 1) with no differences between groups. Pruritus was evident in two dogs (2.2%; MB: n = 1, S: n = 1). After 6 months, hair had started to re-grow in all but one dog (B). After 10 months the coat of this dog had re-grown. Time to first urination did not differ between groups. Conclusion and clinical relevance: No direct correlation between the particular drugs injected epidurally and delayed hair re-growth, pruritus and urinary retention could be shown. Dog owners should be informed that hair re-growth after epidural anaesthesia could be markedly delayed.

Objective To compare radiographic healing and clinical outcome of a frontal-opening wedge osteotomy of canine tibiae when the osteotomy site is packed with either a novel bovine xenograft or standard autogenous cancellous bone graft (ACBG). Study Design Cohort study. Animals Dogs (n = 82) with partial or complete rupture of the cranial cruciate ligament that had tibial tuberosity advancement (TTA). Methods In 48 dogs, the osteotomy was packed with a novel bovine xenograft and in 34 dogs, ACBG was used. Eight week postoperative radiographs from both groups were graded for osteotomy healing using a 0–4-point scale. Data were analyzed using a Mann–Whitney test with significance set at P < .05. Results Thirty-four dogs (39 stifles) with xenoimplants had complete records and radiographic follow-up at 8 weeks. No significant differences between xenografting and autografting were identified in grading of osteotomy fill, osteointegration, or healing of the distal osteotomy. Significant differences were noted in grading of osteotomy healing proximally (autograft > xenoimplant) and of opacity in the osteotomy site (xenoimplant > autograft). Conclusions Radiographic evidence of healing of the xenoimplanted portion of the TTA osteotomy was equivalent to results with ACBG. Healing of the proximal osteotomy site (above the cage) was improved when ACBG was used as the graft.

Effect of tibial tuberosity advancement (TTA) on the patellar ligament has not been described. Our purpose was to evaluate the patellar ligament radiographically and ultrasonographically before and after a TTA. Twenty-one stifles (20 dogs) were evaluated preoperatively (T0), and at six (n=18) (T1) and 16 weeks (n=17) (T2) postTTA. Radiographically, proximal and distal thickness of the patellar ligament was assessed and a ratio to the total length of the ligament was calculated to compensate for the magnification. Ultrasound evaluation included measurements of the transverse thickness and cross-sectional area at three different levels, as well as a subjective score of ligament changes. In comparison with T0, all radiographic and ultrasonographic measurements increased significantly, 6 weeks postoperatively (P≤0.04), and did not change 16 weeks postoperatively compared with T1. The subjective score worsened significantly from T0 to T1 and T0 to T2 (P

Objective: To (1) evaluate radiographic changes associated with osteoarthrosis (OA) before and after tibial tuberosity advancement (TTA) and (2) determine if these changes are indicative of limb function as determined by kinetic gait analysis. Study Design: Prospective clinical study. Animals: Dogs (n=35) with cranial cruciate ligament (CCL) deficient stifles (38). Methods: Variables recorded were: complete or partial CCL rupture, meniscal lesions, arthroscopically graded cartilage lesions, complications, and revision surgeries. Radiographic evaluation and kinetic gait analysis (vertical ground reaction forces [GRFs]) were conducted pre- and 4–16 months postoperatively (mean, 5.9 months). Radiographs were evaluated without knowledge of operative findings and functional outcome. A score (0–3) based on new bone production at 11 specific sites was used to grade OA. Soft tissue changes were classified separately as normal or excessive. Preoperative scores were correlated with clinical variables. Postoperative scores and progression of OA scores were correlated with clinical variables and GRFs. Results: OA remained unchanged in 17 joints and progressed in 21 (55%). Dogs with meniscal lesions had higher OA scores preoperatively, but not at follow-up. Dogs with severe cartilage lesions at surgery had more progression of OA. GRFs improved after surgery and were not correlated with any of the radiographic OA scores. Conclusion: Progression of OA was greater in the presence of severe cartilage lesions at surgery. OA scores were not correlated with GRFs. Clinical Relevance: Progression of OA is generally expected to occur after TTA despite improvement of limb function.

Summary Objective: To assess functional outcome in dogs with cranial cruciate ligament (CrCL) disease after tibial tuberosity advancement (TTA) using force plate gait analysis, and to evaluate parameters potentially influencing outcome. Study design: Prospective clinical study. Animals: Consecutive clinical patients (n=37) with CrCL-deficient stifles (n=40). Methods: The stifle joints were examined arthroscopically prior to TTA. Meniscal release was not performed if the medial meniscus was intact. Open medial arthrotomy and partial meniscectomy were performed in the presence of meniscal tears. Vertical ground reaction forces were measured preoperatively and at follow-up examinations four to 16 months postoperatively (mean: 5.9 months). The ground reaction forces of a group of 65 healthy dogs were used for the comparison. The potential effects of clinical parameters on functional outcome were evaluated statistically. Results: Complete CrCL rupture was identified in 28 joints, and partial CrCL rupture in 12 joints. The medial meniscus was damaged in 21 stifles. Vertical ground reaction forces were significantly higher at follow-up (P

SummaryThis report describes the temporary fixation of a traumatic shoulder luxation in a large-breed dog using a 3.5-mm Locking Round-Hole Reconstruction Plate (LRHRP) to provide stable internal splinting, allowing healing of the injured ligaments, joint capsule, glenohumeral ligaments, tendons, and muscles for restoration of joint stability. The use of a temporary plate with a locking system should be considered as an option in the treatment of canine shoulder joint luxations with severe tissue damage.

Objective Intraperitoneal (IP) bupivacaine provides postoperative analgesia in dogs undergoing ovariohysterectomy (OHE) alone or in combination with incisional (INC) bupivacaine. This study investigated whether the combination of INC and IP bupivacaine is superior to IP bupivacaine alone. Study design Prospective, randomized, blinded clinical study. Animals Thirty-nine privately owned dogs undergoing OHE, aged 25 ± 23 months and weighing 11.8 ± 5.7 kg. Methods Dogs were premedicated with acepromazine (0.05 mg kg−1) and morphine (0.5 mg kg−1) intramuscularly (IM); anaesthesia was induced with propofol and maintained with isoflurane in oxygen. Carprofen (4 mg kg−1) was administered subcutaneously (SC) after intubation. Bupivacaine (3 mg kg−1) IP was administered before complete closure of the linea alba to all dogs. Dogs were randomly assigned into two groups: group B received bupivacaine (n = 20; 1 mg kg−1) and group S received saline (n = 19; 0.2 mL kg−1) INC as a subcutaneous ‘splash’ before skin closure. Postoperative analgesia was assessed with a dynamic interactive visual analogue scale, the short form of the Glasgow Composite Pain Scale, and mechanical nociceptive threshold (MNT) measurement at 0.5, 1, 2, 4, 6, 8, 12 and 20 hours after surgery by one blinded observer. Parametric data were tested using t-test; nonparametric data were analysed using the two-sample Wilcoxon test (p Results There was no significant difference between groups with regard to age, weight, surgical and anaesthetic duration, incision length, sedation and pain scores. MNT values decreased in both groups at all time points as compared with the baseline. No dog required rescue analgesia. No postoperative complications were observed. Conclusion and clinical relevance Bupivacaine IP and carprofen SC after morphine IM did provide satisfactory postoperative analgesia in dogs undergoing OHE with the anaesthetic protocol used. There appears to be no clinical advantage to adding bupivacaine INC. Neither protocol could prevent the development of primary hyperalgesia.

Objective— To describe a technique for carpal panarthrodesis using a medially applied dynamic compression plate (DCP) and to evaluate outcome. Study Design— Retrospective study. Animals— Nine dogs with 10 carpal joint injuries. Methods— Medical records of dogs that had carpal panarthrodesis by medial application of a DCP were reviewed. Signalment, cause and type of injury, preoperative treatment, operative technique, and postoperative clinical and radiographic outcome were retrieved. Results— Screw loosening in the metacarpal bones required surgical revision in 3 dogs. The plate was removed because of lick dermatitis in another dog. No complications were observed in 6 arthrodeses. All dogs were subsequently sound. Conclusions— Medial application of a DCP is a reliable, reproducible method for carpal panarthrodesis. The load on the edge of the plate provides an increased area moment of inertia of the plate, enhancing it resistance to bending forces. Because of the valgus standing position of the canine carpus, dynamic compression is achieved. The DCP is secured to 1–3 metacarpal bones and loosening of the implant and bone fractures are expected to occur less frequently Clinical Relevance— Medial plating for carpal panarthrodesis is a valid alternative method that can be used in dogs with injuries to the carpus for which panarthrodesis of the carpal joint is indicated.

Removal of foreign bodies from the ventriculus in birds may necessitate ventriculotomy. Complications with this intervention include leakage and adhesion formation. To investigate if the use of a coelomic fat patch and a tension-relieving suture in addition to a simple interrupted pattern would improve the healing process after ventriculotomy, 2 groups of 9 Japanese quail (Coturnix coturnix japonica) underwent ventriculotomy. In group 1, only simple-interrupted and tension-relieving sutures were used for closure of the ventriculotomy. In group 2, a coelomic fat patch from the surrounding adipose tissue was applied to the incision site in addition to the sutures. All quail recovered normally and were considered clinically healthy after surgery. Three birds from each group were euthanatized at days 7, 14, and 21 after surgery. On histologic examination, the suture techniques used for closure of the ventriculotomy led to minimal inflammation of the surrounding tissues in both groups. Serosal inflammation was significantly greater in group 2 birds that had the adipose patch at closure compared with group 1 birds. Therefore, the use of a coelomic fat patch to cover the site of ventriculotomy did not result in an improved healing process and its use is not recommended in quail.

Metacarpal and metatarsal fractures are common injuries in small animals and, in most of the cases, can be treated by minimally invasive techniques. Bone plates applied through epi-periosteal tunnels can stabilize meta-bones. Meta-bones III and IV are stabilized by dorsally applied plates. Meta-bones II and V are stabilized using plates applied medially and laterally. The scarcity of soft tissue coverage and the simple anatomy of meta-bones make these fractures amenable to fixation by using minimally invasive techniques. This practice should reduce morbidity and enhance healing time.

Objective To (1) determine suction tip (intermittent and continuous mode) contamination rate in orthopedic surgery in dogs and cats; (2) examine the effect of surgical time on contamination; and (3) report bacteria isolated. Study Design Clinical study. Sample Population Clean orthopedic surgeries (n = 50). Methods Surgical procedures were assigned to 1 of 2 groups: (1) continuous (n = 25) or (2) intermittent suction (n = 25). A control suction was operated in each surgery. Samples for aerobic and anaerobic bacteriologic examination were collected from the surgical suction at 0, 20, 60 minutes, and at the end of surgery, and from the control suction at the end of the surgery only. Comparison of continuous and intermittent suction data, and the effect of surgical time on contamination rate were analyzed using a Kaplan-Meier survival analysis followed by a Cox proportional hazards model. P < .05 was considered significant. Results Aerobic contamination occurred in 22 of 50 surgical procedures and there was no anaerobic growth. There was no significant difference between continuous and intermittent suction mode groups (P = .40). Surgical time did not influence the contamination rate (P = .79). Bacterial cultures mainly revealed coagulase-negative Staphylococci, however multiresistant bacteria were isolated. Conclusions We failed to find superiority of the intermittent operation mode of the suction tip over the continuous mode. A safe time frame before contamination of the suction tip occurs that could not be defined.

SummaryThe medical records of three cats that were presented with severe carpal injury requiring radiocarpal arthrodesis were reviewed. Medial plating using the Compact 2.0 LOCKTM system a was performed in all three cases. Although screw positioning may be difficult because of the large distance between the holes of the plate and the relatively large size of screws, plate loosening or metacarpal fractures did not occur. Long-term clinical and radiographic follow-up (6 months to 4.5 years) revealed excellent outcome in two cats. In the third cat, the radiocarpal joint did not undergo complete fusion. At four and a half years following surgery, recurrence of forelimb lameness was associated with breakage of the plate.

Objective To evaluate the results of application, and identify complications, of the 2nd generation of Zurich Cementless Total Hip Replacement (ZCTHR). Study design Case series. Animals Client-owned dogs (n=60) that had ZCTHR (n=65). Methods Dogs with ZCTHR (2001-2003) with a minimum follow-up > or =6 months were evaluated. Data included signalment, cup position, longest follow-up, complications, management of complications and outcome. Results Mean follow-up was 22.68 months. Eleven cases (17%) had postoperative complications: femoral fracture (n=1; 1.5%), prosthesis luxation (7; 11%), cup loosening (2; 3%), and implant failure (1; 1.5%); 9 cases were successfully revised. Explantation of implants was performed in 1 case because of infection, and 1 dog was euthanatized after reluxation. Conclusions ZCTHR can restore function in dogs affected by disabling diseases of the coxofemoral joint. The press-fit fixation of the cup allowed for corrections in cases of incorrect positioning. Cases with aseptic loosening were revised successfully by impacting larger cups. Newer stems of this generation are shot peening treated to increase their resistance to breakage. In our cases, infection is a disastrous event, leading to implant removal. After resolution of complications, a successful final outcome was achieved in 97% of THR. Clinical relevance ZCTHR offers a reliable alternative for treating dogs with disabling diseases of the hip joints.

SummaryThis study describes the appearance of ‘joint mice’ in the sheath of the deep digital flexor muscle tendon (DDFT) due to osteochondritis dissecans (OCD) lesions in the talocrural joint of 12 dogs. Surgical excision of all free fragments in the DDFT sheath was performed in five dogs, and their clinical progression was documented. The excision of free fragments from the DDFT sheath, but not arthro-tomy, proved clinically beneficial despite the presence of degenerative joint disease. The anatomical communication between the talocrural joint and the DDFT sheath and its dimensions are further illustrated with the use of contrast media and dissection of cadaver limbs.