Outcome and complications following modified prosthetic capsule technique for treatment of craniodorsal hip luxation in dogs.

Objective: The objective of this retrospective study was to report the clinical outcome of dogs with craniodorsal hip luxation (CDHL) treated with a modified prosthetic capsule technique (mPCT). Animals and procedure: Retrospective study of medical records from dogs with CDHL treated with mPCT between 2012 and 2018. Results: Sixty-four dogs were included. All luxations were reduced successfully. No intraoperative complications were observed. The postoperative complication rate was 28% (n = 18), with 14% (n = 9) major and 14% (n = 9) minor complications, and the majority occurring within 1 mo after surgery. Complications included reluxation (9.4%), severe lameness (3%), osteomyelitis (1.6%), and intermittent lameness or stiffness (14%). Of dogs without major complication (33/55 dogs), long-term owner follow-up assessment (> 6 mo) (median: 39 mo, range: 19 to 51 mo) revealed an excellent or good quality of life, although 5 dogs had intermittent lameness or stiffness. Radiographs of 13/33 dogs (median: 27 mo, range: 10 to 46 mo) showed no or mild osteoarthritis progression. Conclusion and clinical relevance: The mPCT is an effective technique for surgical treatment of CDHL in dogs. Further studies are required to objectively evaluate limb use and long-term radiographic changes.

Résultat et complications après une technique de capsule prosthétique modifiée pour le traitement de la luxation cranio-dorsale de la hanche chez le chien. Objectif: L'objectif de cette étude rétrospective était de rapporter les résultats cliniques des chiens atteints de luxation craniodorsale de la hanche (CDHL) traités avec une technique de capsule prosthétique modifiée (mPCT). Animaux et procédure: Étude rétrospective des dossiers médicaux de chiens atteints de CDHL traités par mPCT entre 2012 et 2018. Résultats: Soixante-quatre chiens ont été inclus. Toutes les luxations ont été réduites avec succès. Aucune complication peropératoire n'a été observée. Le taux de complications postopératoires était de 28 % (n = 18), avec 14 % (n = 9) de complications majeures et 14 % (n = 9) de complications mineures, la majorité survenant dans le mois suivant la chirurgie. Les complications comprenaient la reluxation (9,4 %), la boiterie sévère (3 %), l'ostéomyélite (1,6 %) et la boiterie ou la raideur intermittente (14 %). Parmi les chiens sans complication majeure (33/55 chiens), l'évaluation de suivi à long terme du propriétaire (> 6 mois) (médiane : 39 mois, intervalle : 19 à 51 mois) a révélé une excellente ou bonne qualité de vie, bien que 5 chiens avaient une boiterie ou une raideur intermittente. Les radiographies de 13/33 chiens (médiane : 27 mois, intervalle de 10 à 46 mois) n'ont montré aucune progression ou une légère progression de l'arthrose. Conclusion et pertinence clinique: Le mPCT est une technique efficace pour le traitement chirurgical du CDHL chez le chien. D'autres études sont nécessaires pour évaluer objectivement l'utilisation des membres et les modifications radiographiques à long terme.(Traduit par Dr Serge Messier).

Long-Term Safety and Efficacy of Single or Repeated Intra-Articular Injection of Allogeneic Neonatal Mesenchymal Stromal Cells for Managing Pain and Lameness in Moderate to Severe Canine Osteoarthritis Without Anti-inflammatory Pharmacological Support: Pilot Clinical Study.

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.

Cholecystopexy and Pericardial Pseudocyst Removal in a Dog with a Congenital Peritoneopericardial Diaphragmatic Hernia.

A 4 mo old spayed female golden retriever was presented with a peritoneopericardial diaphragmatic hernia (PPDH) that was diagnosed during neutering. Echocardiography revealed a fluid-filled structure and parts of the liver in the pericardial cavity. Computed tomography confirmed the existence of the PPDH and the herniation of the right medial liver lobe and the gallbladder. Cystic masses were observed in the pericardial and the peritoneal cavities, possibly communicating through the PPDH. A median laparotomy revealed a single lobulated cystic lesion extending into both the pericardial and peritoneal cavities through the PPDH. Because of the nonviable aspect of some parts of the liver parenchyma, the gallbladder was dissected from the fossa, and the central division of the liver was resected. A cholecystopexy was performed on the diaphragm to limit gallbladder mobility. The PPDH was closed in the standard fashion. Histopathology of the cystic structure was compatible with a pericardial pseudocyst. Two months postoperatively, the dog was healthy, and the results of blood biochemistry and abdominal ultrasonography were normal. A pericardial pseudocyst can be associated with a PPDH in young dogs. Moreover, cholecystopexy appears to be a safe and effective method of limiting gallbladder mobility after resection of the central hepatic division.

Evaluation of the Effect of a Single Intra-articular Injection of Allogeneic Neonatal Mesenchymal Stromal Cells Compared to Oral Non-Steroidal Anti-inflammatory Treatment on the Postoperative Musculoskeletal Status and Gait of Dogs over a 6-Month Period after Tibial Plateau Leveling Osteotomy: A Pilot Study.

OBJECTIVE: Compare the clinical and pressure walkway gait evolution of dogs after a tibial plateau leveling osteotomy (TPLO) for a cranial cruciate ligament rupture (CrCLR) and treatment with either a 1-month course of non-steroidal anti-inflammatory drugs (NSAIDs) or a single postoperative intra-articular (IA) injection of allogeneic neonatal mesenchymal stromal cells (MSCs). STUDY DESIGN: Prospective, double-blinded, randomized, controlled, monocentric clinical study. ANIMALS: Sixteen client-owned dogs. MATERIALS AND METHODS: Dogs with unilateral CrCLR confirmed by arthroscopy were included. Allogeneic neonatal canine MSCs were obtained from fetal adnexa retrieved after C-section performed on healthy pregnant bitches. The dogs were randomly allocated to either the "MSCs group," receiving an IA injection of MSCs after TPLO, followed by placebo for 1 month, or the "NSAIDs group," receiving IA equivalent volume of MSCs vehicle after TPLO, followed by oral NSAID for 1 month. One of the three blinded evaluators assessed the dogs in each group before and after surgery (1, 3, and 6 months). Clinical score and gait and bone healing process were assessed. The data were statistically compared between the two groups for pre- and postoperative evaluations. RESULTS: Fourteen dogs (nine in the MSCs group, five in the NSAIDs group) completed the present study. No significant difference was observed between the groups preoperatively. No local or systemic adverse effect was observed after MSCs injection at any time point considered. At 1 month after surgery, bone healing scores were significantly higher in the MSCs group. At 1, 3, and 6 months after surgery, no significant difference was observed between the two groups for clinical scores and gait evaluation. CONCLUSION: A single IA injection of allogeneic neonatal MSCs could be a safe and valuable postoperative alternative to NSAIDs for dogs requiring TPLO surgery, particularly for dogs intolerant to this class of drugs.

Evaluation of a new method to determine the tibial tuberosity advancement distance required to reduce the patellar tendon-tibial plateau angle to 90° with the modified Maquet technique in dogs.

OBJECTIVE To assess use of a new radiographic method to determine the distance by which the tibial tuberosity should be advanced to reduce the patellar tendon-tibial plateau angle (PTA) to 90° by means of the modified Maquet technique (MMT) in dogs. SAMPLE 24 pelvic limbs from 12 adult medium-sized to large-breed canine cadavers. PROCEDURES Radiographs of stifle joints at 135° extension in true lateral position were used to determine tibial tuberosity advancement distances for use in the MMT. A method was devised to incorporate the planned osteotomy axis; distal patellar translations of 0, 3, 5, or 10 mm; and advancement cage implant application level along the osteotomy site in advancement planning measurements. Concordance correlation coefficients (CCCs) were calculated to compare these adjusted advancement measurements with true advancement measurements obtained for the same joints in another study after treatment by MMT. Intraobserver, interobserver, and total agreement for selected measurements were determined by assessment of CCCs for results obtained by 3 blinded observers. RESULTS Agreement between true advancement measurements and measurements obtained with osteotomy axis and cage position method calculations that incorporated a 5-mm distal patellar translation distance was excellent (CCC, 0.96). Intraobserver and interobserver agreements for the planning measurements evaluated were good to excellent (CCC, 0.83 to 0.96). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the osteotomy axis and cage position method incorporating a 5-mm distal patellar translation distance has the potential to improve success rates for achieving a PTA of 90° in medium-sized to large-breed dogs undergoing MMT for treatment of cranial cruciate ligament rupture. Further research is warranted.

Placement of subcutaneous ureteral bypasses without fluoroscopic guidance in cats with ureteral obstruction: 19 cases (2014-2016).

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.

Comparison of desired radiographic advancement distance and true advancement distance required for patellar tendon-tibial plateau angle reduction to the ideal 90° in dogs by use of the modified Maquet technique.

OBJECTIVE To evaluate the validity of 2 radiographic methods for measurement of the tibial tuberosity advancement distance required to achieve a reduction in patellar tendon-tibial plateau angle (PTA) to the ideal 90° in dogs by use of the modified Maquet technique (MMT). SAMPLE 24 stifle joints harvested from 12 canine cadavers. PROCEDURES Radiographs of stifle joints placed at 135° in the true lateral position were used to measure the required tibial tuberosity advancement distance with the conventional (AM) and correction (AE) methods. The MMT was used to successively advance the tibial crest to AM and AE. Postoperative PTA was measured on a mediolateral radiograph for each advancement measurement method. If none of the measurements were close to 90°, the advancement distance was modified until the PTA was equal to 90° within 0.1°, and the true advancement distance (TA) was measured. Results were used to determine the optimal commercially available size of cage implant that would be used in a clinical situation. RESULTS Median AM and AE were 10.6 mm and 11.5 mm, respectively. Mean PTAs for the conventional and correction methods were 93.4° and 92.3°, respectively, and differed significantly from 90°. Median TA was 13.5 mm. The AM and AE led to the same cage size recommendations as for TA for only 1 and 4 stifle joints, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Both radiographic methods of measuring the distance required to advance the tibial tuberosity in dogs led to an under-reduction in postoperative PTA when the MMT was used. A new, more accurate radiographic method needs to be developed.

Evaluation of intraoperative fluorescence imaging-guided surgery in cancer-bearing dogs: a prospective proof-of-concept phase II study in 9 cases.

The objective was to prospectively evaluate the application of intraoperative fluorescence imaging (IOFI) in the surgical excision of malignant masses in dogs, using a novel lipid nanoparticle contrast agent. Dogs presenting with spontaneous soft-tissue sarcoma or subcutaneous tumors were prospectively enrolled. Clinical staging and whole-body computed tomography (CT) were performed. All the dogs received an intravenous injection of dye-loaded lipid nanoparticles, LipImage 815. Wide or radical resection was realized after CT examination. Real-time IOFI was performed before skin incision and after tumor excision. In cases of radical resection, the lymph nodes (LNs) were imaged. The margin/healthy tissues fluorescence ratio or LN/healthy tissues fluorescence ratio was measured and compared with the histologic margins or LN status. Nine dogs were included. Limb amputation was performed in 3 dogs, and wide resection in 6. No adverse effect was noted. Fluorescence was observed in all 9 of the tumors. The margins were clean in 5 of 6 dogs after wide surgical resection, and the margin/healthy tissues fluorescence ratio was close to 1.0 in all these dogs. Infiltrated margins were observed in 1 case, with a margin/healthy tissues fluorescence ratio of 3.2. Metastasis was confirmed in 2 of 3 LNs, associated with LN/healthy tissues fluorescence ratios of 2.1 and 4.2, whereas nonmetastatic LN was associated with a ratio of 1.0. LipImage 815 used as a contrast agent during IOFI seemed to allow for good discrimination between tumoral and healthy tissues. Future studies are scheduled to evaluate the sensitivity and specificity of IOFI using LipImage 815 as a tracer.

Phase-0/phase-I study of dye-loaded lipid nanoparticles for near-infrared fluorescence imaging in healthy dogs.

Near-infrared (NIR) fluorescence imaging using FDA-approved indocyanine green (ICG) has been the subject of numerous studies during the past few years. It could constitute a potentially exciting new paradigm shift in veterinary oncology, especially to develop in vivo fluorescence imaging diagnostics and surgery guidance methods. The objective of this study was to evaluate the pharmacologic and toxicological characteristics in healthy beagle dogs of LipImage™ 815, a formulation made of NIR-dye-loaded lipid nanoparticles. The initial dosage for the evaluation of biodistribution was extrapolated from data in mice and then adapted to define the more adapted dose (MAD) according to the fluorescence results obtained in 5 dogs using a Fluobeam® 800 imaging device (phase 0 study). A single dose acute toxicity study was then performed (3 dogs, phase I study). Before the systemic administration of LipImage™ 815, the dogs presented a very mild residual fluorescence, particularly in the liver and kidneys. After injection, the plasma fluorescence continuously decreased, and the signal was relatively homogeneously distributed throughout the different organs, though more pronounced in the liver and to a lesser extent in the steroid-rich organs (adrenal, ovaries), intestines, lymph nodes and kidneys. A MAD of 2.0µg/kg was found. No evidence of acute or delayed general, hepatic, renal or hematologic toxicity was observed at 1-fold, 5-fold or 10-fold MAD. The results of this phase-0/phase-I study showed that an optimal dosage of LipImage™ 815 of 2.0µg/kg allowed the achievement of a fluorescence signal suitable for surgery guidance application without any acute side effects.

Digital flexor tendon contracture treated by tenectomy: different clinical presentations in three cats.

CASE SERIES SUMMARY: Three cats, Siamese or Siamese cross, were presented with a chronic thoracic limb weightbearing lameness. Previous anti-inflammatory administrations were unable to improve lameness consistently in the three cats. Two of the three cats had undergone onychectomy several years before presentation. A permanent flexion of the proximal interphalangeal joint of one or more digits, associated with a difficult and painful extension of the proximal interphalangeal joint, was noticed during orthopedic examination. A digital flexor tendon contracture was suspected and confirmed with radiographic examination. Surgical exploration was then performed. For all cats, treatment consisted of a tenectomy or tenotomy of the superficial and deep digital flexor tendons in order to release the contracture. The three cats responded well to the surgical treatment and became sound around 2-4 weeks after surgery. RELEVANCE AND NOVEL INFORMATION: Digital flexor tendon contracture is rarely reported as a cause of lameness in cats. It should be considered in a differential diagnosis of feline lameness whenever onychectomy has been performed in the past. The precise etiology that explains this tendon contracture is unknown, but trauma or breed predisposition could represent potential causes.

Iliopsoas muscle injury in dogs.

The iliopsoas muscle is formed by the psoas major and iliacus muscles. Due to its length and diameter, the iliopsoas muscle is an important flexor and stabilizer of the hip joint and the vertebral column. Traumatic acute and chronic myopathies of the iliopsoas muscle are commonly diagnosed by digital palpation during the orthopedic examination. Clinical presentations range from gait abnormalities, lameness, and decreased hip joint extension to irreversible fibrotic contracture of the muscle. Rehabilitation of canine patients has to take into account the inciting cause, the severity of pathology and the presence of muscular imbalances.