Repair of chronic rupture of the insertion of the gastrocnemius tendon in the dog using a polyethylene terephthalate implant. Early clinical experience and outcome.

OBJECTIVES: Chronic degeneration of the gastrocnemius tendon results in scar tissue formation at the insertion of the tendon, and detachment from the calcaneus. In severe cases, excision of this tissue makes repositioning of the tendon to the calcaneus extremely difficult. A polyethylene terephthalate implant, used to aide repair by bridging gaps and allowing tissue ingrowth, was evaluated. METHODS: In this retrospective study, clinical records were evaluated to assess long-term outcomes and complications. The surgical technique is also described. The implant was sutured proximally into the gastrocnemius at the myotendinous junction, and secured into the calcaneus using an interference screw. RESULTS: The implant was used in 10 patients; of which seven returned to full function. Major complications, due to infection, were identified in two of the 10 patients. Minor complications occurred in five of the 10 patients. These were associated with external coaptation in three of the patients in the immediate postoperative period. One minor infection was reported. These all resolved without further complication. Long-term outcome was available in eight patients, with six of these eight dogs returning to normal exercise. CLINICAL SIGNIFICANCE: This implant may be suitable for use in canine patients with severe gastrocnemius tendon degeneration. Ongoing evaluation is warranted.

Variation in position of the medial fabella in West Highland white terriers and other dogs.

OBJECTIVES: To investigate whether West Highland white terriers exhibit significant variation in the position of the medial fabella compared to both small and large breed dogs. METHODS: Criteria for the normal location of the medial fabella on a caudocranial radiograph were established. A retrospective analysis was undertaken of a consecutive series of bilateral caudocranial stifle joint radiographs from 70 West Highland white terriers, 100 small and 100 large control dogs by three reviewers. Medial fabellar location, cruciate ligament disease and medial patellar luxation were examined within and between groups. RESULTS: Abnormal medial fabellar location was identified in 70 per cent, 9 per cent and 0 per cent of West Highland white terriers, small dogs and large dogs, respectively. In the vast majority of the affected dogs, the fabella was found in a mediodistal location. Presence of concurrent cranial cruciate ligament disease or medial patellar luxation and body weight was excluded as confounding factors. CLINICAL SIGNIFICANCE: West Highland white terriers appear predisposed to, and have a high prevalence of, an abnormal mediodistal location of the medial fabella. The authors suggest this is an incidental finding and should not be confused with true pathological fabellar displacement.

Cauda equina syndrome treated by lumbosacral stabilisation in a cat.

In this case report, a case of cauda equina syndrome arising from lumbosacral disease in an eight-year-old Burmese cat is described. The cat had a history of chronic right pelvic limb lameness. Neurological evaluation was consistent with a lesion involving the cauda equina. Radiographic findings were consistent with a diagnosis of lumbosacral disease. Due to perceived dorsoventral lumbosacral instability, dorsal decompression and stabilisation of the lumbosacral junction was performed. An original method of spinal stabilisation for this indication is described. The cat had a successful long-term outcome with complete resolution of its presenting clinical signs.

Use of biochemical markers of osteoarthritis to investigate the potential disease-modifying effect of tibial plateau levelling osteotomy.

OBJECTIVES: To evaluate the hypothesis that the concentration of the 1/20/5D4 epitope of keratan sulphate, cartilage oligomeric matrix protein and total sulphated glycosaminoglycans in synovial fluids from dogs with cranial cruciate ligament disease would be affected by tibial plateau levelling osteotomy. In addition, to evaluate the hypothesis that medial meniscal release or meniscal injury would alter the expression of these candidate biomarkers. METHODS: Forty-one dogs with naturally occurring cranial cruciate ligament disease were recruited prospectively. Synovial fluids were collected from the index joint before surgery and six weeks and six months postsurgery. Following tibial plateau levelling osteotomy, synovial fluids were assayed for 1/20/5D4 epitope of keratan sulphate and cartilage oligomeric matrix protein concentration using an inhibition ELISA and for sulphated glycosaminoglycans using a direct dye-binding assay. RESULTS: The sulphated glycosaminoglycans ratio did not change significantly during the study. Medial meniscal injury at entry was associated with lower concentrations of synovial fluid cartilage oligomeric matrix protein (P<0.05, unpaired t test). There was no association between medial meniscal release and the changes in marker concentrations, either from 0 to six weeks or 0 to six months. CLINICAL SIGNIFICANCE: Tibial plateau levelling osteotomy did not significantly alter the expression of the named candidate biomarkers. These findings reflect the limited nature of the arthrotomy or indicate that tibial plateau levelling osteotomy does not influence the progression of osteoarthritis (OA). From these studies, there is no evidence that tibial plateau levelling osteotomy affects cartilage metabolism.

Progression of osteoarthritis following TPLO surgery: a prospective radiographic study of 40 dogs.

The aim of this prospective study was to assess the progression of osteoarthritis following tibial plateau levelling osteotomy (TPLO) surgery. Osteoarthritis was monitored radiographically by means of an osteophyte scale on entry to the study, and at six weeks and six months following surgical intervention. Forty dogs were recruited to the study. At each visit, animals were assessed clinically, radiographically, by force platform analysis and by synovial fluid sampling. The radiographic data is the subject of this report. A significant increase in mean osteophyte score was noted between the entry and six-month examination time point. This increase in the mean osteophyte score was due to the increased score recorded in 16 dogs. However, in the majority of dogs, there was no progression of osteophytosis during the course of this study.

Acute onset quadriparesis as a sequela to an oropharyngeal stick injury.

A three-year-old male neutered crossbred dog was referred for investigation of acute onset quadriparesis, which had occurred following an oropharyngeal stick injury. Myelography revealed a right-sided extradural lesion overlying the C5/6 intervertebral disc space. A dorsolateral hemilaminectomy was performed at this site and two fragments of wood were removed from the vertebral canal adjacent to the spinal cord. The dog was ambulatory with right-sided forelimb monoparesis within a week of surgery and improved further following discharge. Three months following surgery, the dog was exercising freely with only mild right forelimb lameness.