Fixed bilateral endo-exo prostheses in feline femur - case report / Endo-exoprótese bilateral fixa em fêmur de felino - relato de caso

The use of endo-exo prosthesis is an alternative to improve the quality of life of amputees, allowing correct distribution of body weight, reducing skin problems and pain related to the implant, and reducing lameness. The aim of this paper is to report the use of a fixed bilateral endo-exo femur prostheses in a cat with amputation prior to treatment. The endoprostheses were made with titanium and the exoprostheses were made with 3D printing technology. A longitudinal craniolateral surgical approach was used and the skin incision was made over the knee-joint, then fascia lata incision, followed by biceps femoris and vastus lateralis muscles retraction, incision through the joint capsule to expose the tibiofemoral joint, disarticulation, and tibia and fibula removal. Afterwards, a femoral leveling osteotomy and insertion of the implant in the medullary canal were performed, being attached in the cis and trans cortical bone. The patient was evaluated in the immediate post-operative and periodically thereafter, showing satisfactory results, without macroscopic signs of rejection, wound dehiscence or infection, fracture, or injury of limbs, and presented adapted walking. Furthermore, it was observed the return to common behaviors for the species.

O uso de endoexoprótese é uma alternativa para melhoria na qualidade de vida de pacientes amputados, permitindo distribuição correta do peso corporal, redução de problemas de pele e dor ligadas ao implante e redução da claudicação. Este trabalho objetivou relatar a utilização de endoexoprótese bilateral fixa em fêmur em felino com amputação prévia ao atendimento. Foram modeladas endopróteses em titânio e exopróteses projetadas e impressas em 3D. O acesso cirúrgico, em ambos os membros, foi realizado por incisão craniolateral transarticular da pele, incisão da fáscia lata, rebatimento dos músculos bíceps femoral e vasto lateral, incisão da cápsula articular para exposição da articulação femorotibial, desarticulação e remoção cirúrgica da tibia e da fibula. Em seguida, realizou-se osteotomia niveladora femoral e inserção do implante no canal medular, sendo esse fixo nas corticais cis e trans. O paciente foi avaliado no pós-cirúrgico imediato e posteriormente de forma periódica, demonstrando resultados satisfatórios, sem sinais macroscópicos de rejeição, deiscência ou infecção da ferida cirúrgica, fratura ou lesão de membros, e apresentava deambulação adaptada. Além disso, foi observado o retorno de comportamentos comuns da espécie.

Tibial plateau leveling osteotomy in dogs: an ex vivo comparative study of knee's surrounding structures protection methods

Background: Cranial cruciate ligament failure is one of the leading causes of pelvic limb lameness in dogs and one of the most recommended treatments is tibial plateau leveling osteotomy (TPLO) surgery. However, this procedure may lead to some complications as fractures of the fibula, laceration in varying degrees of the popliteal vasculature and its branches, neuropraxia, neurotmeses, among others. The goals of this study were to compare the effectiveness of 8 methods used during TPLO, to prevent damage to the cranial tibial artery, fibula, tibial and fibular nerve (surgical compresses, specific surgical retractors I and II and an osteotomy technique variation). Materials, Methods & Results: A total of 40 canine cadavers weighing 25.9 ± 3.7 kg were submitted to TPLO. Animals were previously prepared with 1: 4 barium red latex solution, to provide radiopacity of arteries surrounding the knee (n = 80). TPLO was performed using 8 methods to protect the cranial tibial artery, fibula, and tibial and fibular nerves. Each method was used in one of the knees of 5 animals. The contralateral knee was maintained as a control (without protection). The knees were radiographed in orthogonal projections before and after the osteotomies and then anatomically dissected. The evaluated structures were photographed, and the images sent to four blind evaluators (visual macroscopy) to classify the possible injuries. The highest incidence of injuries was identified when protection methods were used. However, this difference was not significant (P > 0.05). No significant differences regarding efficacy were found between all 8 protection methods. Discussion: In this study, the total incidence of injuries following TPLO was 20% was much higher than that presented in the literature which indicates when considering only intraoperative injuries. The dogs cadavers tissue resistance and stiffened latex may have predisposed the osteotomy injury, as soft tissues with greater flexibility are less susceptible to trauma caused by the oscillatory saw. When compared to others cadaveric studies that also evaluated the efficacy of surgical dressings to protect the cranial tibial artery, during TPLO, we also find a higher incidence of damage. Maybe the limb's position was responsible for this difference, once in the after mentioned researches the limb was positioned suspended to simulate a dorsal decubitus position and we choose the limb position with the lateral face resting on the surface of the operating table, and this may have provided extra pressure from the structures towards the osteotomy saw, increasing the occurrence of those damages. Although the present study did not reveal a significant difference for the use of protection methods, we believe that the dimensions of the compresses used herein may have contributed to a higher incidence of injuries. They probably increased the tissue trauma needed for their allocation and led to a lower positioning accuracy for the isolation of these structures. Maybe for the same reason, the specific type II surgical retractor was the only shield that, observationally, did not increase the occurrence of injuries, once less dissection was required to allocate it. The difference in geometric dimensions between the retractors may justify the superiority of the retractor II, since it allows a more careful and apparently less traumatic allocation. Performing TPLO without adopting these protection methods did not lead to a higher risk of injury to the cranial tibial artery, fibula, and tibial and fibular nerves.

Leveling osteotomy of the tibial plateau at an inverted angle in a dog / Osteotomia de nivelamento do platô tibial em ângulo invertido em um cachorro

One dog, Golden Retriever, 5 months old, was seen complaining of lameness and pain in the left pelvic limb. Avulsion of the tibial crest was diagnosed by radiographic means, which was corrected with a tension band. The absence of postoperative radiographic monitoring and the non-removal of the apparatus led to the early closure of the cranial tibial physis with continuous flow growth, resulting in pain, functional loss of the limb after one year and at a 13.2º tibial plateau angle negative. The biomechanical alteration of the limb was corrected using the inverted TPLO technique, converting the angle of the tibial plateau to 5.3 positive, without a rockback evidenced in 30, 60, 90 days up to four months after the operation. The objective of this case report is to describe the surgical correction with the inverted TPLO technique in a case of angle of the negative tibial plateau secondary to not removing the tension band applied in avulsion of the growing tibial crest. After 120 days, the dog was presented fully recovery and weight-bearing without any complication.

Um cão, Golden Retriever, de 5 meses de idade, foi atendido com queixa de claudicação e dor em membro pélvico esquerdo. Diagnosticou-se por meio radiográfico a avulsão da crista da tíbia, a qual foi corrigida com banda de tensão. A ausência de acompanhamento radiográfico pós-operatório e a não retirada do aparato levou ao fechamento precoce da fise tibial cranial com crescimento contínuo da caudal, resultando em dor, perda funcional do membro após um ano e em um ângulo de platô tibial de 13,2º negativos. A alteração biomecânica do membro foi corrigida por meio da técnica de TPLO invertida, convertendo o ângulo do platô tibial em 5,3º positivos, sem rockback evidenciado em 30, 60, 90 dias até quatro meses de pós-operatório. O objetivo desse relato de caso é descrever a correção cirúrgica com a técnica de TPLO invertida em um caso de ângulo do platô tibial negativo secundário a não retirada de banda de tensão aplicada em avulsão da crista da tíbia em crescimento. Após 120 dias, o paciente apresentou recuperação total com adequado suporte do peso no membro, sem qualquer complicação.

Biomechanical comparison of a modified TPLO plate, a locking compression plate, and plate-rod constructs applied medially in a proximal gap model in canine synthetic tibias / [Comparação biomecânica entre placa de TPLO modificada, placa bloqueada e construção placa-pino intramedular aplicadas medialmente em modelo de fratura proximal em tíbias sintéticas caninas]

The aim of this study was to develop a modified tibial plateau leveling osteotomy (TPLO) plate and to compare its biomechanical properties with a locking compression plate (LCP) and plate-rod constructs for the stabilization of experimentally induced gap fractures in canine synthetic tibias. The tibial models were assigned to either repair with a modified TPLO plate (Group 1), locking compression plate construct (Group 2), or plate-rod construct (Group 3). The specimens were loaded to failure in axial compression, three-point mediolateral and craniocaudal bending. There was no statistical difference between the three groups regarding stiffness (N/mm) and deformation (mm) in axial compression. The modified TPLO plate achieved load to failure similar to the plate-rod construct in craniocaudal bending. There was no significant difference between groups on mediolateral bending tests regarding load to failure and deformation. Furthermore, there was no significant difference in stiffness between groups 1 and 2. In conclusion, the modified TPLO plate had similar mechanical properties to LCP and plate-rod construct in the axial compression and bending tests. Nonetheless, clinical studies with a large population of dogs are required to determine the value of this new implant in proximal tibial fracture repair.

Objetivou-se desenvolver uma placa de osteotomia niveladora do platô tibial (TPLO) modificada e compará-la biomecanicamente à placa de compressão bloqueada (LCP) e à construção placa-pino intramedular na estabilização da fratura cominutiva proximal em tíbias sintéticas caninas. Para tal, tíbias caninas sintéticas foram divididas em três grupos, sendo o grupo 1 formado pela placa de TPLO modificada, o grupo 2 por placas LCP e o grupo 3 pela construção placa-pino intramedular. Os espécimes foram submetidos à carga até a falha em compressão axial, flexão mediolateral e craniocaudal em três pontos. Não houve diferença estatística entre os três grupos quanto à rigidez (N/mm) e à deformação (mm) nos testes de compressão axial. A placa de TPLO modificada obteve carga até a falha semelhante à construção placa-pino intramedular em flexão craniocaudal. Não houve diferença significativa entre os grupos nos testes de flexão mediolateral em relação à carga até a falha e a deformação, e a variável rigidez não apresentou diferenças significativas entre os grupos 1 e 2. Em conclusão, a placa de TPLO modificada apresentou similaridade mecânica em comparação com a LCP e a construção placa-pino. No entanto, estudos clínicos são necessários para determinar o valor desse novo implante na fixação de fraturas tibiais proximais.

Treatment of a malunion of the tibia and fibula in a giant anteater (Myrmecophaga tridactyla) / Tratamento de má união de tíbia e fíbula em tamanduá-bandeira (Myrmecophaga tridactyla)

Vehicle collisions involving giant anteaters contribute significantly to the decline of this population. Although mortality rates at the time of trauma are high, many animals survive despite severe trauma and limb fractures. Treating these individuals is extremely challenging. This report describes the use of a corrective osteotomy to treat an angular deformity caused by inadequate healing of a tibial and fibular fracture in a young giant anteater. The animal was rescued on a highway by the Brazilian Institute for the Environment and Renewable Natural Resources (Ibama). He was presented at the University Veterinary Hospital with lameness of the left pelvic limb and edema in the middle region of the tibial shaft. The radiographic examination showed an exuberant callus and significant bone deviation in the middle third of the left tibia and fibula. Corrective wedge osteotomy and fixation with a 3.5mm locking plate and 2.5mm intramedullary pin were performed. In the immediate postoperative period, there was functional recovery of the limb and complete consolidation of the osteotomy was identified 60 days after the operation. The corrective wedge osteotomy technique was effective for the treatment of inadequate tibial consolidation in a young giant anteater, providing complete recovery of all limb functions.

As colisões de veículos envolvendo tamanduás-bandeira contribuem significativamente para o declínio dessa população. Embora as taxas de mortalidade no momento do trauma sejam altas, muitos animais sobrevivem apesar de traumas graves e fraturas de membros. O tratamento desses indivíduos é extremamente desafiador. Este relato descreve o uso de osteotomia corretiva para tratamento de uma deformidade angular causada por consolidação inadequada de fratura da tíbia e da fíbula em um tamanduá-bandeira jovem. O animal foi resgatado em uma rodovia pelo Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis (Ibama). Foi apresentado no Hospital Veterinário Universitário com claudicação do membro pélvico esquerdo e edema na região média da diáfise da tíbia. O exame radiográfico mostrou calo exuberante e importante desvio ósseo em terço médio da tíbia e da fíbula esquerdas. Foi realizada osteotomia corretiva em cunha e fixação com placa bloqueada de 3,5mm e pino intramedular de 2,5mm. No pós-operatório imediato, houve recuperação funcional do membro, e a consolidação total da osteotomia foi identificada aos 60 dias de pós-operatório. A técnica de osteotomia em cunha corretiva foi eficaz para o tratamento de consolidação inadequada de tíbia em um tamanduá-bandeira jovem, proporcionando a recuperação completa de todas as funções do membro.

Colesteatoma em orelha média de cão / Middle ear cholesteatoma in dog

Colesteatoma aural é um cisto epidermoide preenchido por material escamoso, com conteúdo queratinótico e que se desenvolve no ouvido médio. A etiopatogenia não é totalmente esclarecida, mas infere-se que seja uma rara complicação da otite crônica média ou externa. Desta forma, trata-se de uma afecção incomum e, logo, pouco relatada em cães. Os exames de imagem, em especial a tomografia computadorizada, são ferramentas importantes para a abordagem diagnóstica. No entanto, a confirmação do colesteatoma aural é dada por meio da avaliação histopatológica. A principal modalidade terapêutica para tal afecção é a remoção cirúrgica da lesão. Diante disso, o objetivo deste trabalho foi é descrever um caso de colesteatoma aural em uma cadela com histórico de otite recorrente. Os achados clínicos e da tomografia computadorizada permitiram o planejamento terapêutico e o diagnóstico. Sendo assim, foi realizada a ablação do conduto auditivo esquerdo e a osteotomia ventral da bula timpânica. A cirurgia permitiu a colheita de material para o exame histopatológico, o qual constatou colesteatoma aural. O tratamento possibilitou a remissão completa dos sinais clínicos e a resolução definitiva da otite recorrente.

Aural cholesteatoma is an epidermoid cyst filled with squamous material with keratinotic content that develops in the middle ear. The etiopathogenesis is not fully understood, but it is inferred that it is a rare complication of chronic otitis media or external. Thus, it is an uncommon condition and, therefore, little reported in dogs. Imaging tests, especially computed tomography, are important tools for the diagnostic approach. However, the confirmation of aural cholesteatoma is given through histopathological evaluation. The main therapeutic modality for this condition is the surgical removal of the lesion. Thus, this study aimed to describe a case of aural cholesteatoma in a bitch with a history of recurrent otitis. Clinical and computed tomography findings allowed for therapeutic and diagnostic planning. Therefore, the ablation of the left ear canal and the ventral osteotomy of the tympanic bulla were performed. The surgery allowed the collection of material for the histopathological examination, which determined cholesteatoma aural. The treatment allowed the complete remission of clinical signs and the definitive resolution of the recurrent otitis.

Osteotomia tripla da pelve por meio de acesso cirúrgico duplo em cães com displasia coxofemoral / Triple pelvic osteotomy through double surgical access in dogs with coxofemoral dysplasia / Triple osteotomía pélvica mediante doble acceso quirúrgico en perros con displasia coxofemoral

A displasia coxofemoral (DCF) é uma alteração ortopédica muito comum nos cães, caracterizada por frouxidão da articulação coxofemoral, com consequente osteoartrose. A osteotomia tripla da pelve (TPO) é um dos procedimentos ortopédicos elegíveis como tratamento da DCF. Por necessitar de três abordagens cirúrgicas, a TPO é considerada uma técnica complexa, não isenta de complicações na abordagem do isquio. Esta pesquisa teve por objetivo relatar e avaliar a realização da TPO através de apenas dois acessos cirúrgicos, possibilitando executar a osteotomia isquiática através do acesso púbico ventral. Foram operados 10 cães com diagnóstico clinico e radiológico de DCF. Para a secção da mesa isquiática utilizou-se um cinzel de rinotomia com a extremidade apoiada na borda isquiática da face caudal do forame obturador. Ante os bons resultados radiológicos e clínicos pós-operatórios, conclui- se que é possivel a realização da osteotomia do isquio na TPO, através do acesso púbico ventral, oferecendo proventos cirúrgicos. (AU)

Hip dysplasia (HD) is an ordinary dog orthopedic disorder concerning osteoarthritis following hip joint laxity. Among eligible procedures to treat this condition, triple pelvic osteotomy (TPO) is a complex technique involving three surgical interventions. This paper reports and evaluates TPO execution using only two surgical accesses to perform a sciatic osteotomy through the pelvic ventral area. Ten suitable for TPO surgery dogs, clinically and radiologically diagnosed were the subject of this study. For the section of the ischial surface, a rhinotome was used with the tip resting on the ischial edge of the caudal surface of the obturator foramen. The experience revealed pelvic ventral area access availability regarding TPO ischial ostectomy with good clinical and radiological outcomes.(AU)

La displasia de cadera (CHD) es un trastorno ortopédico muy común en perros, caracterizado por laxitud de esa articulación con la consiguiente osteoartrosis. La ostectomia pélvica triple (TPO) es uno de los procedimientos ortopédicos elegibles como tratamiento para la CHD. Al requerir tres abordajes quirúrgicos, la TPO se considera una técnica compleja, no exenta de complicaciones en el abordaje del isquion. Esta investigación tuvo como objetivo informar y evaluar la realización de la TPO a través de sólo dos accesos quirúrgicos, posibilitando la realización de la osteotomia isquiática a través del acceso ventral del pubis. Se operaron diez perros con diagnóstico clínico y radiológico de CHD. Para la sección de la mesa isquiática se utilizó un rinotomo con la punta apoyada en el borde isquiático de la superficie caudal del agujero obturador. En vista de los buenos resultados postoperatorios clínicos y radiológicos, se concluye que es posible realizar una osteotomia isquiática en la TPO, a través del acceso ventral púbico, ofreciendo beneficios quirúrgicos.(AU)

Mandibulectomia em um bovino - Relato de caso / Mandybulectomy in a bovine - Case report abstract / Mandibulectomia a en bovinos - Reporte de caso

A fratura é uma descontinuidade óssea, completa ou incompleta. Fraturas mandibulares em ruminantes são provocadas por malformações congênitas, neoplasias, manipulação obstétrica e traumas. Essas patologias causam defeitos segmentares da mandíbula que requerem interversões cirúrgicas. Relata-se caso de fratura completa bilateral em região de meridiano mandibular em um bezerro da raça Braford de vinte dias de idade, atendido no Hospital Veterinário de Grandes Animais da FAIT, Itapeva-SP. O animal apresentou protusão de língua, sialorreia, taquicardia, edema na região mandibular, odor fétido e secreção purulenta. Segundo a confirmação radiográfica e achados de termografia infravermelha, o tratamento consistiu na cirurgia de mandibulectomia bilateral. Conclui-se que a mandibulectomia, aplicada devido abordagem tardia e inviabilidade do tecido mole, não proporciona adaptação a dieta com volumoso, comprometendo a expectativa de vida do bovino.(AU)

Fracture is a bone discontinuity, complete or incomplete. Congenital malformations, neoplasms, obstetric manipulation andtrauma cause mandibular fractures in ruminants. These pathologies cause segmental defects of the mandible that require surgical interventions. We report a case of complete bilateral fracture in the region of the mandibular meridian in a twenty-day-old Braford calf, treated at the Large Animal Veterinary Hospital of FAIT, Itapeva-SP. The animal presented tongue protrusion, drooling, tachycardia, edema in the mandibular region, foul odor and purulent secretion. According to radiographic confirmation and infrared thermography findings, treatment consisted of bilateral mandibulectomy surgery.It is concluded that mandibulectomy, applied due to late approach and infeasibility of the soft tissue, does not provide adaptation to bulky feeds, compromising the life expectancy of the bovine.(AU)

La fractura es una discontinuidad ósea, completa o incompleta. Las fracturas mandibulares en rumiantes son causadas por malformaciones congénitas, neoplasias, manipulación obstétrica y traumatismos. Estas patologías provocan defectos segmentarios de la mandíbula que requieren intervenciones quirúrgicas. Presentamos un caso de fractura bilateral completa en la región del meridiano mandibular en un ternero de veinte días de edad atendido en el Hospital Veterinario de Grandes Animales de la FAIT, Itapeva-SP. El animal presentaba protrusión de la lengua, babeo, taquicardia, edema en la región mandibular, mal olor y secreción purulenta. Según la confirmación radiográfica y los hallazgos de la termografía infrarroja, el tratamiento consistió en una cirugía de mandibulectomía bilateral. Se concluye que la mandibulectomía, aplicada por abordaje tardío e inviabilidad de los tejidos blandos, no proporciona adaptación a la dieta con fibra, comprometiendo la expectativa de vida del bovino.(AU)

Femoral corrective osteotomy associated with trochlear prosthetics and tibial tuberosity transposition with a tool for treatment of canine patellar dislocation / Osteotomia corretiva de fêmur associada à prótese troclear do joelho e transposição da tuberosidade tibial por dispositivo para tratamento da luxação de patela canina

Patellar luxation is one of the main osteoarticular diseases described in the surgical routine of companion animals, whose treatment differs according to the degree of luxation based on the clinical alterations presented by each patient. The present report aims to describe the association of the femoral corrective osteotomy technique, total trochlear replacement of the knee by prosthesis and transposition of tibial tuberosity with device for correction of degree IV patella luxation in a 1.5 year old German Spitz canine with varus femoral deviation and external torsion of the tibia. The treatment allowed the correction of femoral bone deformation, realignment of the extensor mechanism of the quadriceps and permanent maintenance of the patella on the trochlear folds with early functional limb return, absence of pain and claudication.(AU)

luxação de patela é uma das principais enfermidades osteoarticulares descrita na rotina cirúrgica de animais de companhia, cujo tratamento difere de acordo com a graduação da luxação baseando-se nas alterações clínicas apresentadas por cada paciente. O presente relato tem como objetivo descrever a associação da técnica de osteotomia corretiva femoral, subs-tituição troclear total do joelho por prótese e transposição da tuberosidade tibial com dispositivo para correção de luxação de patela grau IV em uma canina da raça Spitz Alemão de 1,5 anos com desvio femoral varus e torção externa da tíbia. O trata-mento permitiu a correção da deformação óssea femoral, realinhamento do mecanismo extensor do quadríceps e manutenção permanente da patela sobre o sulco troclear protético com retorno funcional precoce do membro, ausência de dor e claudicação(AU)

Femoral corrective osteotomy associated with trochlear prosthetics and tibial tuberosity transposition with a tool for treatment of canine patellar dislocation / Osteotomia corretiva de fêmur associada à prótese troclear do joelho e transposição da tuberosidade tibial por dispositivo para tratamento da luxação de patela canina

Patellar luxation is one of the main osteoarticular diseases described in the surgical routine of companion animals, whose treatment differs according to the degree of luxation based on the clinical alterations presented by each patient. The present report aims to describe the association of the femoral corrective osteotomy technique, total trochlear replacement of the knee by prosthesis and transposition of tibial tuberosity with device for correction of degree IV patella luxation in a 1.5 year old German Spitz canine with varus femoral deviation and external torsion of the tibia. The treatment allowed the correction of femoral bone deformation, realignment of the extensor mechanism of the quadriceps and permanent maintenance of the patella on the trochlear folds with early functional limb return, absence of pain and claudication.

luxação de patela é uma das principais enfermidades osteoarticulares descrita na rotina cirúrgica de animais de companhia, cujo tratamento difere de acordo com a graduação da luxação baseando-se nas alterações clínicas apresentadas por cada paciente. O presente relato tem como objetivo descrever a associação da técnica de osteotomia corretiva femoral, subs-tituição troclear total do joelho por prótese e transposição da tuberosidade tibial com dispositivo para correção de luxação de patela grau IV em uma canina da raça Spitz Alemão de 1,5 anos com desvio femoral varus e torção externa da tíbia. O trata-mento permitiu a correção da deformação óssea femoral, realinhamento do mecanismo extensor do quadríceps e manutenção permanente da patela sobre o sulco troclear protético com retorno funcional precoce do membro, ausência de dor e claudicação

Double plating technique for fixing tibial plateau leveling osteotomy and modified cranial closing wedge ostectomy of the tibia in a dog with cranial cruciate ligament disease and excessive plateau angle: case report / [Técnica de placa dupla para fixação concomitante da osteotomia de nivelamento do platô tibial e ostectomia modificada em cunha de fechamento cranial da tíbia em um cão com doença do ligamento cruzado cranial e ângulo de platô tibial excessivo: relato de caso]

Tibial plateau leveling osteotomy (TPLO) associated to cranial wedge closing ostectomy (CCWO) has been one of the best options to manage cranial cruciate ligament (CCL) disease and excessive tibial plateau angle (TPA) in large dogs, however, the complication rate is potentially high. It is believed that a more robust fixation is necessary to stabilize them and decrease the risk of implant failure. A 6-year-old male American Pit Bull, weighing 36kg, with 90-day history of right hind limb lameness, was diagnosed with CCL disease. Due to the excessive tibial plateau angle (42°), TPLO was associated with a modified CCWO using a double plating technique. A final TPA of 12° was accomplished, and a restricted level of exercises and physiotherapy were recommended. The patient was followed monthly until the fifth month postoperatively, when radiographic bone consolidation and no lameness were observed. By the date of this submission, 3 years after the procedure, the owner has reported no complications. The double plating technique for fixing TPLO and modified CCWO proved to be effective for the treatment of CrCL deficiency in a large dog with an excessive TPA.(AU)

A osteotomia de nivelamento do platô tibial (TPLO) associada à ostectomia modificada em cunha de fechamento cranial da tíbia (CCWO) tem sido uma das melhores opções para tratamento de cães grandes com doença do ligamento cruzado cranial (DLCCr) e ângulo excessivo do platô tibial, mas o índice de complicações é alto. Acredita-se haver necessidade de fixação mais robusta para reduzir as chances de falha nos implantes. Um cão macho, seis anos, da raça American Pit Bull, 36kg, com histórico de claudicação em membro pélvico direito há 90 dias, foi diagnosticado com DLCCr. Devido ao ângulo excessivo do platô tibial (42°), a osteotomia de nivelamento do platô tibial foi associada à ostectomia modificada em cunha de fechamento cranial da tíbia (CCWO) por meio da técnica de placa dupla. No pós-operatório imediato, identificou-se TPA de 12°; exercícios controlados e fisioterapia foram recomendados e a evolução do quadro foi analisada mensalmente até o quinto mês pós-cirurgia. Com 150 dias de evolução, não houve alterações de locomoção e havia ocorrido completa consolidação radiográfica das osteotomias. Até o momento da submissão deste artigo, três anos pós-procedimento, o tutor relata ausência de complicações, via contato telefônico. Portanto, a técnica modificada mostrou-se eficaz no tratamento da DLCCr.(AU)

Concurrent hiatal hernia and megaesophagus secondary to a nasopharyngeal polyp in a 6-month-old cat

Background: Nasopharyngeal polyps are benign and inflammatory masses assumed to arise from the middle ear or the eustachian tube with extension into the pharynx. The most common clinical signs associated with nasopharyngeal polyps include respiratory stertor, dyspnea, and otic discharge. Neurological signs, including head tilt, facial nerve paralysis, and ataxia, might indicate concurrent involvement of the middle or inner ear. The objective of the current report is to describe a case of a feline nasopharyngeal polyp with a concurrent hiatal hernia and megaesophagus, both spontaneously resolved after removal of the polyp. Case: A 6-month-old female intact domestic shorthair cat was presented for evaluation of lethargy, anorexia, and upper respiratory signs, such as stridor, stertor, and dyspnea. A thoracic radiography revealed esophageal dilation caudal to the cardiac silhouette, suggestive of megaesophagus with gaseous filtration. An esophagram confirmed a hiatal hernia and megaesophagus. Computed tomography revealed a nasopharyngeal mass adjacent to the soft palate and a soft-tissue density in the right tympanic bulla. A tentative diagnosis of a nasopharyngeal polyp was made. After the ventral bulla osteotomy, the nasopharyngeal mass was removed by a gentle traction avulsion technique. Six days after the surgery, hiatal hernia and megaesophagus were spontaneously resolved. Based on histopathologic exam, the mass was found to be an inflammatory nasopharyngeal polyp. Two months after surgery, the owner reported that the patient's condition had returned to baseline with a good appetite, and the thoracic radiography was within normal limit. Discussion: For successful treatment of a nasopharyngeal polyp, traction avulsion of the polyp with or without a ventral bulla osteotomy is recommended. However, in patients with otitis media, a ventral bulla osteotomy followed by traction avulsion of the polyp is recommended in order to reduce the rate of polyp recurrence. Common clinical signs of a nasopharyngeal polyp are stertor, stridor, dyspnea, dysphagia, and open-mouth breathing, which are identified in a chronic upper airway obstruction. A hiatal hernia secondary to a nasopharyngeal polyp has not been reported so far. However, a relationship between chronic upper airway obstruction and hiatal hernias has been proposed previously. Moreover, hiatal hernia resolved spontaneously after removal of the nasopharyngeal polyp suggests that the occurrence of the hiatal hernia was secondary to the nasopharyngeal polyp. In addition to the hiatal hernia, megaesophagus was also identified in the present case. Megaesophagus secondary to a chronic upper airway obstruction from a nasopharyngeal obstruction has been reported. However, megaesophagus is also thought to occur secondary to hiatal hernias. Therefore, in the current study, it is unclear whether the megaesophagus was solely a result of the obstructive nature of the nasopharyngeal polyp or a combination of the hiatal hernia and the nasopharyngeal polyp. In conclusion, any cat with clinical signs of an upper airway obstruction and a concurrent hiatal hernia and megaesophagus should be thoroughly investigated for a nasopharyngeal polyp, as well as other gastrointestinal and systemic causes. Furthermore, this case suggests that the prognosis for a concurrent hiatal hernia and megaesophagus is good in cats if the nasopharyngeal polyp is properly removed.

Tratamento do rádio curvo em cão jovem com associação das técnicas de grampeamento fisário radial, ostectomia ulnar e fixador externo dinâmico transarticular / Treatment of radius curvus in a young dog with association of radial physeal stapling, ulnar ostectomy and transarticular dynamic external fixator techniques

Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...

Tratamento do rádio curvo em cão jovem com associação das técnicas de grampeamento fisário radial, ostectomia ulnar e fixador externo dinâmico transarticular / Treatment of radius curvus in a young dog with association of radial physeal stapling, ulnar ostectomy and transarticular dynamic external fixator techniques

Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...(AU)

Mandibulectomia em felino com osteomielite fibrosante bacteriana / Mandibulectomy in feline with bacterial fibrosing osteomyelitis

Background: Fibrosing osteomyelitis is a chronic inflammatory process caused by infectious agents that lead to the destructionand replacement of bone tissue by fibroblasts. The diagnosis is based especially on histopathological and bacterial culture. Incases where extensive and irreversible injuries are observed, surgical treatment may be indicated. The objective of this work isto report the clinical, radiographic, histopathological, and microbiological aspects of a cat presenting fibrosing osteomyelitis.Case: A 10-year-old male feline, no defined breed, weighing 3.9 kg was referred to one Private Veterinary Clinic of Fortaleza,CE, Brazil with a history of left mandibular enlargement, presenting dysphagia, sialorrhea, an increase in firm consistencyalong of the left mandibular body, temporomandibular arthralgia and decreased joint motion range. On cranium radiograph,signs of proliferative osteopathy of irregular contours were observed in the branch and body of the left mandible and extending to the rostral region of the right mandible, suggesting a neoplastic process. After anesthesia, for better assessment ofthe oral cavity, a sample was collected by incisional biopsy, however, the histopathological result was nonspecific. In viewof the inconclusive condition, it was decided to perform left hemimandibulectomy combined with right partial mandibulectomy. Tissue samples were obtained and sent for microbiological and histopathological analyses. The last test revealedan inflammatory reaction consisting of neutrophils and plasma cells, associated with a large amount of fibrous connectivetissue, multifocal bacterial aggregates, necrosis and bone resorption. Based on the findings, the diagnosis of chronic bacterial osteomyelitis was concluded. The microbiological culture demonstrated the growth of the bacterium Pseudomonasaeruginosa, with sensitivity to cefovecin, which was administered to the treatment in....

Mandibulectomia em felino com osteomielite fibrosante bacteriana / Mandibulectomy in feline with bacterial fibrosing osteomyelitis

Background: Fibrosing osteomyelitis is a chronic inflammatory process caused by infectious agents that lead to the destructionand replacement of bone tissue by fibroblasts. The diagnosis is based especially on histopathological and bacterial culture. Incases where extensive and irreversible injuries are observed, surgical treatment may be indicated. The objective of this work isto report the clinical, radiographic, histopathological, and microbiological aspects of a cat presenting fibrosing osteomyelitis.Case: A 10-year-old male feline, no defined breed, weighing 3.9 kg was referred to one Private Veterinary Clinic of Fortaleza,CE, Brazil with a history of left mandibular enlargement, presenting dysphagia, sialorrhea, an increase in firm consistencyalong of the left mandibular body, temporomandibular arthralgia and decreased joint motion range. On cranium radiograph,signs of proliferative osteopathy of irregular contours were observed in the branch and body of the left mandible and extending to the rostral region of the right mandible, suggesting a neoplastic process. After anesthesia, for better assessment ofthe oral cavity, a sample was collected by incisional biopsy, however, the histopathological result was nonspecific. In viewof the inconclusive condition, it was decided to perform left hemimandibulectomy combined with right partial mandibulectomy. Tissue samples were obtained and sent for microbiological and histopathological analyses. The last test revealedan inflammatory reaction consisting of neutrophils and plasma cells, associated with a large amount of fibrous connectivetissue, multifocal bacterial aggregates, necrosis and bone resorption. Based on the findings, the diagnosis of chronic bacterial osteomyelitis was concluded. The microbiological culture demonstrated the growth of the bacterium Pseudomonasaeruginosa, with sensitivity to cefovecin, which was administered to the treatment in....(AU)

Ablação total do conduto auditivo em cão com otite crônica / Total ablation of hearing conduct in dog with chronic otite

A otite é uma inflamação do canal auditivo que pode acometer o ouvido externo e médio, sendo sua patogenia dividida em fatores perpetuadores, predisponentes e primários. Os sinais clínicos mais comuns são eritema, dor a palpação, prurido e exsudação. Além do hitórico e anamnese, radiografia, otoscopia e biopsia podem auxiliar no diagnóstico. O tratamento inicial tem o objetivo de controlar os fatores perpetuadores, eliminar os fatores predisponentes e fazer o controle da causa base. Nos casos de otite externa crônica recidivante, estenose do canal auditivo, deformidades auriculares, pólipos e neoplasias, indica-se fazer o tratamento cirúrgico. O presente trabalho relata o caso de um canino sem raça definida, com treze anos de idade, atendido no Hospital Veterinário da Universidade Federal Rural do Semi-árido (UFERSA), apresentando odor fétido no pavilhão auricular, excesso de cerúmen de coloração escura, eritema, prurido e dor aguda a palpar-se a base do pavilhão auricular esquerdo. Através da anamnese, exame físico e dos exames complementares como a radiografia, o animal foi diagnosticado com otite crônica. Optouse, então, pelo tratamento cirúrgico de ablação total do conduto auditivo (TECA), que consiste na retirada do canal vertical e horizontal do ouvido, associado à osteotomia lateral da bula timpânica. O procedimento cirúrgico foi eficaz no tratamento da otite crônica não responsiva ao tratamento medicamentoso realizado previamente nos últimos cinco anos feito de forma intermitente pelo tutor.

Otitis is an inflammation of the ear canal that can affect the outer and middle ear, and its pathogenesis is divided into perpetuating, predisposing and primary factors. The most common clinical signs are erythema, pain on palpation, itching and oozing. In addition to the history and anamnesis, radiography, otoscopy and biopsy can assist in the diagnosis. The initial treatment aims to control the perpetuating factors, eliminate predisposing factors and control the underlying cause. In cases of recurrent chronic external otitis, stenosis of the ear canal, ear deformities, polyps and neoplasms, surgical treatment is indicated. The present work reports the case of a 13-year-old mixed breed canine, attended at the Veterinary Hospital of the Federal Rural University of the Semi-arid (UFERSA), with a foul odor in the ear, excess of dark colored cerumen, erythema, itching and acute pain palpating the base of the left ear. Through anamnesis, physical examination and complementary tests such as radiography, the animal was diagnosed with chronic otitis. Then, we opted for the surgical treatment of total ablation of the auditory canal (TECA), which consists of the removal of the vertical and horizontal ear canal, associated with lateral osteotomy of the tympanic bulla. The surgical procedure was effective in the treatment of chronic otitis unresponsive to drug treatment previously performed in the last five years, done intermittently by the tutor.

Ablação total do conduto auditivo em cão com otite crônica / Total ablation of hearing conduct in dog with chronic otite

A otite é uma inflamação do canal auditivo que pode acometer o ouvido externo e médio, sendo sua patogenia dividida em fatores perpetuadores, predisponentes e primários. Os sinais clínicos mais comuns são eritema, dor a palpação, prurido e exsudação. Além do hitórico e anamnese, radiografia, otoscopia e biopsia podem auxiliar no diagnóstico. O tratamento inicial tem o objetivo de controlar os fatores perpetuadores, eliminar os fatores predisponentes e fazer o controle da causa base. Nos casos de otite externa crônica recidivante, estenose do canal auditivo, deformidades auriculares, pólipos e neoplasias, indica-se fazer o tratamento cirúrgico. O presente trabalho relata o caso de um canino sem raça definida, com treze anos de idade, atendido no Hospital Veterinário da Universidade Federal Rural do Semi-árido (UFERSA), apresentando odor fétido no pavilhão auricular, excesso de cerúmen de coloração escura, eritema, prurido e dor aguda a palpar-se a base do pavilhão auricular esquerdo. Através da anamnese, exame físico e dos exames complementares como a radiografia, o animal foi diagnosticado com otite crônica. Optouse, então, pelo tratamento cirúrgico de ablação total do conduto auditivo (TECA), que consiste na retirada do canal vertical e horizontal do ouvido, associado à osteotomia lateral da bula timpânica. O procedimento cirúrgico foi eficaz no tratamento da otite crônica não responsiva ao tratamento medicamentoso realizado previamente nos últimos cinco anos feito de forma intermitente pelo tutor.(AU)

Otitis is an inflammation of the ear canal that can affect the outer and middle ear, and its pathogenesis is divided into perpetuating, predisposing and primary factors. The most common clinical signs are erythema, pain on palpation, itching and oozing. In addition to the history and anamnesis, radiography, otoscopy and biopsy can assist in the diagnosis. The initial treatment aims to control the perpetuating factors, eliminate predisposing factors and control the underlying cause. In cases of recurrent chronic external otitis, stenosis of the ear canal, ear deformities, polyps and neoplasms, surgical treatment is indicated. The present work reports the case of a 13-year-old mixed breed canine, attended at the Veterinary Hospital of the Federal Rural University of the Semi-arid (UFERSA), with a foul odor in the ear, excess of dark colored cerumen, erythema, itching and acute pain palpating the base of the left ear. Through anamnesis, physical examination and complementary tests such as radiography, the animal was diagnosed with chronic otitis. Then, we opted for the surgical treatment of total ablation of the auditory canal (TECA), which consists of the removal of the vertical and horizontal ear canal, associated with lateral osteotomy of the tympanic bulla. The surgical procedure was effective in the treatment of chronic otitis unresponsive to drug treatment previously performed in the last five years, done intermittently by the tutor.(AU)

Comparação clínica entre dois métodos de estabilização em desvio angular distal de tíbia corrigido pela metodologia CORA / Clinical comparison between two stabilization methods in distal tibial angular deviation corrected by the CORA method

Background: Angular deformity is characterized by the deviation of part of the bone that can occur in three different planes, frontal, sagittal and transverse. Trauma on physeal plates is the most common cause of angular deviations of the limbs in dogs. Currently the CORA (Center of Rotation of Angulation) methodology is the best way to evaluate and surgically correct these deformities. The objective of this study is to describe the surgical procedures performed to treat the uniapical valgus deviation affecting both tibial bones in a dog, comparing the outcomes of hybrid external skeletal fixator used in the right pelvic limb in relation to the locking plate used in the left pelvic limb. Case: A 10-month old Border Collie dog was attended at the University Veterinary Hospital with history of lameness and deviation of both pelvic limbs. In the orthopedic examination, it was possible to identify bilateral valgus deviation in the region of the tibio-tarsal joints and moderate lameness, with absence of pain or joint crepitation. Radiographic examination showed that the deformity was only uniapical in the frontal plane, affecting both tibial bones of the dog. Signs of osteoarthrosis were not observed and the preoperative examinations were within the normal limits for the species. The deformities were corrected in two surgical times starting with the procedure in the right tibia, which appeared to be clinically worse. Due to the fact that it was a bilateral affection and there was not a healthy pelvic limb to obtain the normal angles values of this dog, for planning according to the CORA methodology, the values of the tibial mechanical angles for dogs of similar size were taken from the literature. For surgical correction of the right tibia, a closed wedge osteotomy was performed following the second rule of Paley

Comparação clínica entre dois métodos de estabilização em desvio angular distal de tíbia corrigido pela metodologia CORA / Clinical comparison between two stabilization methods in distal tibial angular deviation corrected by the CORA method

Background: Angular deformity is characterized by the deviation of part of the bone that can occur in three different planes, frontal, sagittal and transverse. Trauma on physeal plates is the most common cause of angular deviations of the limbs in dogs. Currently the CORA (Center of Rotation of Angulation) methodology is the best way to evaluate and surgically correct these deformities. The objective of this study is to describe the surgical procedures performed to treat the uniapical valgus deviation affecting both tibial bones in a dog, comparing the outcomes of hybrid external skeletal fixator used in the right pelvic limb in relation to the locking plate used in the left pelvic limb. Case: A 10-month old Border Collie dog was attended at the University Veterinary Hospital with history of lameness and deviation of both pelvic limbs. In the orthopedic examination, it was possible to identify bilateral valgus deviation in the region of the tibio-tarsal joints and moderate lameness, with absence of pain or joint crepitation. Radiographic examination showed that the deformity was only uniapical in the frontal plane, affecting both tibial bones of the dog. Signs of osteoarthrosis were not observed and the preoperative examinations were within the normal limits for the species. The deformities were corrected in two surgical times starting with the procedure in the right tibia, which appeared to be clinically worse. Due to the fact that it was a bilateral affection and there was not a healthy pelvic limb to obtain the normal angles values of this dog, for planning according to the CORA methodology, the values of the tibial mechanical angles for dogs of similar size were taken from the literature. For surgical correction of the right tibia, a closed wedge osteotomy was performed following the second rule of Paley…(AU)