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.

Comparison of Early Measurements of the Distraction Index, Norberg Angle on Distracted View and the Official Radiographic Evaluation of the Hips of 215 Dogs from Two Guide Dog Training Schools.

OBJECTIVES: The main purpose of this article is to evaluate the correlation between the distraction index (DI) and Norberg angle values in distracted hips (distraction Norberg angle, DNA) at 4 months of age and the official hip score based on the Fédération Cynologique Internationale (FCI) grid at 12 months of age. METHODS: For dogs (n = 215) from two guide dog training organizations, the DI and DNA were measured by a single expert on distraction radiographs performed at 4 months of age. The FCI score was determined by the same expert at 12 months of age on a standard hip-extended view.Statistical analysis included receiver operating characteristic curve analysis and concordance correlation coefficient calculation. RESULTS: The mean DI was 0.48, the mean DNA was 86.5° and 59.5% of hips had an A FCI score. The concordance correlation coefficient of DI and DNA was 0.78. The DI threshold for D- and E-scored hips that was associated with the least misclassification was 0.58 (sensitivity [Se] = 0.6, specificity [Sp] = 0.82). The DNA threshold that was associated with the least misclassification was 85° (Se = 0.83, Sp = 0.68). CLINICAL SIGNIFICANCE: DNA has a fair correlation with DI at 4 months and reflects hip passive laxity. D and E FCI scores at 12 months cannot be reliably predicted from the 4 months value of DI or DNA but 96% of hips with DI < 0.58 at 4 months had an A, B or C FCI score at 12 months of age. Similarly, 98% of hips with DNA > 85° at 4 months had an A, B or C FCI score at 12 months of age.

Safe corridor for the implantation of thoracolumbar pedicle screws in growing pigs: A morphometric study.

The pig spine is widely used as a large animal model for preclinical research in human medicine to test new spinal implants and surgical procedures. Among them, pedicle screw is one of the most common method of fixation of those implants. However, the pedicle of the porcine vertebra is not as well defined and not as large as the pedicle of the human vertebra. Therefore, the position of the screw should be adapted to the pig and not merely transposed based on the literature on humans. The purpose of this study is to determine the characteristics of the optimum implantation corridors for pedicle screws in the thoracolumbar spine of piglets of different ages using computed tomography (CT) and to determine the size and length of these corridors in pigs of different ages. CT scans from five groups of age: 6, 10, 14, 18, and 26 weeks were reviewed. For each thoracolumbar vertebrae, the pedicle width, pedicle axis length, and the pedicle angle was measured for the left and right pedicle. A total of 326 thoracic vertebrae and 126 lumbar vertebrae were included in the study. Pedicles are statistically larger but not longer for the lumbar vertebrae. An important variation of the pedicle angle is observed along the spine. In all pigs, an abrupt modification of the pedicle angle between T10 and T11 was observed, which corresponds to the level of the anticlinal vertebra which is the vertebra for which the spinous process is nearly perpendicular to the vertebral body. In conclusion, this study provides a quantitative database of pedicle screw implantation corridors in pigs of different ages. When using pedicle screws in experimental studies in pigs, these results should be considered for selecting the most suitable implants for the study but also to ensure a correct and safer screw position. Improving study procedures may limit postoperative complications and pain, thereby limiting the use of live animals.

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.

Spinal neurenteric cyst in a dog.

A 2-year-old female crossbreed dog was presented with progressive ataxia and paraparesis. A T3-L3 spinal lesion was determined by neurological examination. Magnetic resonance imaging (MRI) revealed an ovoid-shaped, well-circumscribed mass affecting the spinal cord at the level of the T9 vertebra. A left hemilaminectomy and a durotomy at the level of T9 allowed discovery of an ovoid deformation of the meninges with a cystic appearance. En bloc removal was performed and appeared to be complete. Pathological analysis showed a voluminous cystic lesion lined by a heterogeneous epithelium. Three types of epithelium were present: a pseudostratified columnar epithelium, a stratified squamous epithelium and a transitional epithelium. Mucus production, the morphology of some cells with microvilli at the apical pole and immunohistochemical assays were highly in favor of an endodermal origin of the cyst. The age of the dog, anamnesis, MRI study and histological findings were consistent with an intradural neurenteric cyst as described in humans. Total surgical removal led to a progressive clinical improvement with no recurrence at 18 months. We report an unusual intradural extramedullary cyst, called a neurenteric cyst, in a 2-year-old female crossbreed dog. This type of cyst is well-known in humans but has never been described in dogs. We propose that neurenteric cysts should be included in the differential diagnoses for tumor-like or cystic intradural lesions in the young dog. Prognosis for this type of cyst seems to be good, as total surgical removal led to a progressive clinical improvement with no recurrence at 18 months.