Monocephalus dipygus dibrachius em cadela Shih Tzu / Monocephalus dipygus dibrachius in a Shih Tzu bitch

Background: Congenital anomalies are structural, functional, or metabolic defects caused by a combination of environmental, genetic, or even iatrogenic factors. Genetic defects, which can be inherited, are more common in purebred dogs. Teratogenic factors such as radiation, toxins, chemical agents, infectious diseases, mechanical influences, drugs given to the mother, and nutrition can affect the litter during gestational development. The incomplete division of a fertilized egg results in monozygotic, conjoined or Siamese twins, which are animals with complete or incomplete duplications. This paper reports on an adult bitch with monocephalus dipygus dibrachius and the surgical procedures. Case: A 2-year-old female Shih Tzu weighing 5 kg was admitted to a veterinary clinic, presenting with swelling and myiasis near the anus and several development disorders, characterized by 2 pelvises, 2 anuses, 2 vulvas, 2 forelimbs and 6 hindlimbs. Her physiological parameters were otherwise normal. Only the dog's myiasis was treated at this time due to the owner's financial straits. After 5 months, the owner brought the bitch back to the veterinary clinic because the animal presented with fecaloma in 1 of the anuses. Radiography revealed numerous alterations: seven lumbar vertebrae with marked vertebral axis deviation, reduced disc space, as well as ankylosis and fused ventral spondylosis at L6 and L7. Two pelvises fused medially by the wings of the ileum, with slight deviation and thinning of pelvic bones. Four hip joints and medial joints with pelvic avulsion and bone remnants of the pelvic limbs. Acetabular tearing slightly flattened femoral head and thickened femoral neck. Caudal vertebrae and vertebral axis located in left pelvis. Left lateral patella inserted in the trochlear groove and lateral dislocation of right patella. Right patellofemoral joint with smooth surface, preserved intra-articular density and cranial displacement of the tibia relative to the femoral condyles (cranial cruciate ligament rupture). An ultrasound analysis revealed 2 bladders. Two months later surgery was performed due to recurrent complications. During laparotomy 2 uteruses, 2 bladders and bifurcation of the intestine were observed. Ovariosalpingohysterectomy was performed in both uterus and enterectomy of the problematic intestinal portion. After 2 days of the surgery, blood transfusion was performed. After 2 days of the transfusion, there was extravasation of yellow fluid from the surgical cut and abdominal palpation was indicative of bladder rupture, so the patient was sent to emergency surgery. Unilateral nephrectomy and ureterectomy, and ruptured bladder cystectomy were performed. The dog remained hospitalized for 24 days after surgery, before it was released. Discussion: The classification of conjoined twins is based on the location of the junction and the number of limbs. Monocephalus dipygus dibrachius was diagnosed based on the fact that the dog had 1 skull, 2 thoracic limbs and 4 pelvic limbs, as well as the corresponding genitourinary and gastrointestinal tract alterations. Imaging scans are extremely important for a proper diagnosis to ensure appropriate surgery planning. The bitch was the result of inbreeding between a male dog and its offspring, which probably contributed to this malformation. There are very few reports of surviving adult conjoined animals, and even fewer descriptions of successful surgical treatments. To the best of knowledge of the authors, there are no previous reports of a surviving adult dog suffering from this malformation.

Technique proposition and material comparison for surgery rope making / Proposição de técnica e comparação de materiais para confecção de corda cirúrgica

The most tension resistant, nonmetallic, surgical suture is 5 polyester. Comparing its resistance to those of the dogs cranial cruciate ligament and the canine gastrocnemius tendons up until they rupture, its possible to detect a considerably inferior resistance on the implants part. With the goal of achieving high mechanical resistances from sutures, these were grouped and twisted, resulting in a surgical rope that is adjustable to the patients needs. We analyzed manufacturing methodology, final conformation and tension resistance, based on three sutures models: A (1 polyglactin 910), B (1 polyester) and C (5 polyester). Considering averages of thickness and final load, the B implants obtained lower values than A, indicating that polyglactin 910 ropes are more resistant than those of polyester. Moreover, the C implants resulted in the highest values of load and thickness, indicating that final thickness is predictive towards tension resistance. Size 1 Polyester was the only one to generate linear regression for supported load, ensuring the 25,34 Newtons (N) increment to every suture added to the implant, which suggests its use for the creation of non absorbable ropes. The use of 1 polyglatctin 910 promotes load averages superior to 1 polyester;therefore, it is indicated for making absorbable surgical ropes.(AU)

O fio cirúrgico não metálico com maior resistência à tração é o poliéster nº 5. Comparando a sua resistência com a do ligamento cruzado cranial de cães e do tendão gastrocnêmico canino até suas rupturas, é possível perceber uma resistência consideravelmente inferior da parte do implante. Com objetivo de alcançar grandes resistências mecânicas a partir de fios de sutura, estes foram agrupados e torcidos, resultando em uma corda cirúrgica ajustável de acordo com a necessidade do paciente. Foram analisadas a metodologia de confecção, a conformação final e a resistência à tração, baseados em três modelos de fios: A (poliglactina 910 nº 1), B (poliéster nº 1) e C (poliéster nº 5). Considerando as médias de espessura e carga final, os implantes B obtiveram menores valores do que A, indicando que cordas de poliglactina 910 são mais resistentes que as de poliéster. Ademais, os implantes C resultaram nos maiores valores de carga e espessura, indicando que a espessura final é preditiva para resistência à tração. O poliéster nº 1 foi o único a gerar regressão linear para carga suportada, garantindo o incremento de 25,34 Newtons (N) a cada fio acrescido ao implante, o que sugere seu uso para criação de cordas não absorvíveis. A utilização da poliglactina 910 nº 1 promove médias de carga superiores ao poliéster nº 1, portanto, é indicada para confecção de cordas cirúrgicas absorvíveis.(AU)

Diagnosis of canine rheumatoid arthritis / Diagnóstico da artrite reumatoide canina

Canine rheumatoid arthritis is a chronic inflammatory disease that affects the joints of dogs. The inflammation can cause damage to cartilage and bones and early diagnosis is the main factor determining treatment success. This report describes an unusual case of rheumatoid arthritis in a dog, highlighting the relevance of radiographic examination in association with histopathology in the definitive diagnosis. An 8 year old, male German Spitz dog, weighing 5kg was admitted with a history of cruciate ligament rupture and grade IV patella dislocation. Previously, surgery had been performed to correct the cranial cruciate ligament rupture, without success. On physical examination, the dog showed a palmigrade stance, severe pelvic limb lameness, and pain on palpation of all joints. Blood count and biochemical analysis were within normal ranges. Orthogonal radiographs of the joints of the pelvic and thoracic limbs were performed. The lesions were bilaterally symmetrical. Samples were taken from the patellofemoral joints for cytology, microbiology, and histopathologic analysis. Rheumatoid factor antibody assay was negative. In conclusion, the combination of more than one clinical sign and diagnostic tests, such as radiographs suggestive of rheumatoid arthritis, histopathologic analysis of the joints, and rheumatoid factor testing is required to reach a definitive diagnosis of rheumatoid arthritis.

A artrite reumatóide canina é por definição uma doença crônica inflamatória que acomete as articulações de cães. Como resultado, a artrite reumatoide pode causar lesões na cartilagem e nos ossos e o diagnóstico precoce é o principal fator para o sucesso do tratamento ideal. Este relato de caso objetivou descrever um caso incomum de artrite reumatóide em um cão, destacando a relevância do exame radiográfico associado à histopatologia no diagnóstico definitivo. Foi atendido um cão da raça Spitz Alemão, 8 anos, com 5kg de peso. Anteriormente, foi realizada procedimento cirúrgico para correção da ruptura bilateral de ligamento cruzado e luxação de patela grau IV, porém sem sucesso. Ao exame físico, o cão apresentava posição palmígrada, intensa claudicação dos membros pélvicos e sensibilidade dolorosa de todas as articulações à palpação. As análises de hemograma e bioquímica sérica básica estavam dentro dos limites normais. Foram realizadas radiografias ortogonais das articulações dos membros pélvicos e torácicos. A distribuição das lesões foi simétrica e em ambos os lados. Considerando esses achados, foram obtidas amostras biológicas das articulações para análise citológica, microbiológica e análise histopatológica. O anticorpo fator reumatóide também foi realizado e o resultado foi negativo. Diante do exposto, é necessária a associação de mais de um sinal clínico e diferentes exames, como por exemplo, radiografias sugestivas de artrite reumatóide, análise histopatológica das articulações e anticorpo fator reumatóide para alcançar o diagnóstico definitivo de artrite reumatóide.

Diagnosis of canine rheumatoid arthritis / Diagnóstico da artrite reumatoide canina

Canine rheumatoid arthritis is a chronic inflammatory disease that affects the joints of dogs. The inflammation can cause damage to cartilage and bones and early diagnosis is the main factor determining treatment success. This report describes an unusual case of rheumatoid arthritis in a dog, highlighting the relevance of radiographic examination in association with histopathology in the definitive diagnosis. An 8 year old, male German Spitz dog, weighing 5kg was admitted with a history of cruciate ligament rupture and grade IV patella dislocation. Previously, surgery had been performed to correct the cranial cruciate ligament rupture, without success. On physical examination, the dog showed a palmigrade stance, severe pelvic limb lameness, and pain on palpation of all joints. Blood count and biochemical analysis were within normal ranges. Orthogonal radiographs of the joints of the pelvic and thoracic limbs were performed. The lesions were bilaterally symmetrical. Samples were taken from the patellofemoral joints for cytology, microbiology, and histopathologic analysis. Rheumatoid factor antibody assay was negative. In conclusion, the combination of more than one clinical sign and diagnostic tests, such as radiographs suggestive of rheumatoid arthritis, histopathologic analysis of the joints, and rheumatoid factor testing is required to reach a definitive diagnosis of rheumatoid arthritis.(AU)

A artrite reumatóide canina é por definição uma doença crônica inflamatória que acomete as articulações de cães. Como resultado, a artrite reumatoide pode causar lesões na cartilagem e nos ossos e o diagnóstico precoce é o principal fator para o sucesso do tratamento ideal. Este relato de caso objetivou descrever um caso incomum de artrite reumatóide em um cão, destacando a relevância do exame radiográfico associado à histopatologia no diagnóstico definitivo. Foi atendido um cão da raça Spitz Alemão, 8 anos, com 5kg de peso. Anteriormente, foi realizada procedimento cirúrgico para correção da ruptura bilateral de ligamento cruzado e luxação de patela grau IV, porém sem sucesso. Ao exame físico, o cão apresentava posição palmígrada, intensa claudicação dos membros pélvicos e sensibilidade dolorosa de todas as articulações à palpação. As análises de hemograma e bioquímica sérica básica estavam dentro dos limites normais. Foram realizadas radiografias ortogonais das articulações dos membros pélvicos e torácicos. A distribuição das lesões foi simétrica e em ambos os lados. Considerando esses achados, foram obtidas amostras biológicas das articulações para análise citológica, microbiológica e análise histopatológica. O anticorpo fator reumatóide também foi realizado e o resultado foi negativo. Diante do exposto, é necessária a associação de mais de um sinal clínico e diferentes exames, como por exemplo, radiografias sugestivas de artrite reumatóide, análise histopatológica das articulações e anticorpo fator reumatóide para alcançar o diagnóstico definitivo de artrite reumatóide.(AU)

Uso do plasma rico em plaquetas como adjuvante no tratamento de lesão meniscal e tendinose de calcâneo em um cão / Use of platelet-rich plasma as an adjuvant on treatment of meniscal lesion and tendinosis of calcaneus in a dog

O objetivo deste trabalho é relatar o caso de um cão com lesão meniscal associado à tendinose de calcâneo tratado com aplicação única de plasma rico em plaquetas (PRP) intraarticular e intratendínea. Foi atendido um cão da raça Boxer com dificuldade de deambulação há três meses. Observou-se claudicação grau II/IV em ambos os membros pélvicos, atrofia muscular bilateral, dor e leve crepitação em joelho esquerdo, discreta instabilidade aos testes de gaveta e tibial cranial, com intensa fibrose medial à articulação e espessamento/rigidez do tendão calcâneo direito. O estudo radiográfico demonstrou artrose moderada no joelho esquerdo e, ao exame ultrassonográfico, constatou-se áreas de hipoecogenicidade em menisco medial esquerdo e ruptura de fibras musculares do tendão calcâneo direito. Sendo assim, o paciente foi diagnosticado com insuficiência do ligamento cruzado cranial crônica, com estabilidade fibrótica periarticular, e lesão meniscal em joelho esquerdo e tendinose de calcâneo direito. Foram prescritos condroprotetores, diacereína, fisioterapia e uma aplicação de PRP intra-articular e intratendínea. Para a concentração do PRP, foram coletados 50mL de sangue autólogo, os quais foram depositados em frascos contendo citrato de sódio. Foi realizada dupla centrifugação, sendo a primeira com força de120g e a segunda 240g, ambas por dez minutos. Ao final, obteve-se 2mL de PRP com246.000 plaquetas/µL (antes da concentração o sangue tinha 141.000 plaquetas/µL). A aplicação ocorreu de forma asséptica, sob anestesia geral e guiada por ultrassom. Foram injetados 1ml intra-articular em joelho esquerdo, 0,25mL em região perilesional e 0,75mLintralesional em tendão calcâneo direito. Após 14 dias, notou-se grau de claudicação I/IV e discreto fortalecimento muscular. Foi mantido o tratamento clínico com fisioterapia e condroprotetores com retornos periódicos para acompanhamento da evolução. Conclui-se que o uso do PRP foi importante adjuvante na terapia clínica empregada.

The aim of this paper is to report the case of a dog with meniscal lesion associated with calcaneal tendinosis treated with single application of intra-articular and intratendinous platelet rich plasma (PRP). A dog of the Boxer racer with difficulty walking was treated three months ago. Grade II/IV lameness was observed in both pelvic limbs, bilateral muscle atrophy, pain and slight crepitation in the left knee, slight instability to the drawer and cranial tibial tests, with intense medial fibrosis to the joint and right calcaneal tendon thickening/stiffness. The radiographic study showed moderate arthrosis in the left knee, and ultrasound examination revealed areas of hypoechogenicity in the left medial meniscus and rupture of the right calcaneal tendon muscle fibers. Thus, the patient was diagnosed with chronic cranial cruciate ligament insufficiency, periarticular fibrotic stability, and left meniscal injury and right calcaneal tendinosis. Chondroprotectors, diacerein, physiotherapyand an application of intra-articular and intratendinous PRP were prescribed. For the PRP concentration, 50mL of autologous blood were collected and deposited in vials containing sodium citrate. A double centrifugation was performed, the first strength of 120g and the second 240g, both for ten minutes. At the end, 2mL of PRP was obtained with 246.000platelets/µL (before concentration the blood had 141.000 platelets/µL). The application occurred aseptically, under general anesthesia and guided by ultrasound. We injected 1mlintra-articular in the left knee, 0.25mL in the perilesional region and 0.75mL intralesional in the right calcaneal tendon. After 14 days, I/IV lameness and slight muscle strengthening were noted. Clinical treatment with physiotherapy and chondroprotectors was maintained, with periodic returns to follow the evolution. It was concluded that the use of PRP was an important adjuvant in the clinical therapy employed.

Uso do plasma rico em plaquetas como adjuvante no tratamento de lesão meniscal e tendinose de calcâneo em um cão / Use of platelet-rich plasma as an adjuvant on treatment of meniscal lesion and tendinosis of calcaneus in a dog

O objetivo deste trabalho é relatar o caso de um cão com lesão meniscal associado à tendinose de calcâneo tratado com aplicação única de plasma rico em plaquetas (PRP) intraarticular e intratendínea. Foi atendido um cão da raça Boxer com dificuldade de deambulação há três meses. Observou-se claudicação grau II/IV em ambos os membros pélvicos, atrofia muscular bilateral, dor e leve crepitação em joelho esquerdo, discreta instabilidade aos testes de gaveta e tibial cranial, com intensa fibrose medial à articulação e espessamento/rigidez do tendão calcâneo direito. O estudo radiográfico demonstrou artrose moderada no joelho esquerdo e, ao exame ultrassonográfico, constatou-se áreas de hipoecogenicidade em menisco medial esquerdo e ruptura de fibras musculares do tendão calcâneo direito. Sendo assim, o paciente foi diagnosticado com insuficiência do ligamento cruzado cranial crônica, com estabilidade fibrótica periarticular, e lesão meniscal em joelho esquerdo e tendinose de calcâneo direito. Foram prescritos condroprotetores, diacereína, fisioterapia e uma aplicação de PRP intra-articular e intratendínea. Para a concentração do PRP, foram coletados 50mL de sangue autólogo, os quais foram depositados em frascos contendo citrato de sódio. Foi realizada dupla centrifugação, sendo a primeira com força de120g e a segunda 240g, ambas por dez minutos. Ao final, obteve-se 2mL de PRP com246.000 plaquetas/µL (antes da concentração o sangue tinha 141.000 plaquetas/µL). A aplicação ocorreu de forma asséptica, sob anestesia geral e guiada por ultrassom. Foram injetados 1ml intra-articular em joelho esquerdo, 0,25mL em região perilesional e 0,75mLintralesional em tendão calcâneo direito. Após 14 dias, notou-se grau de claudicação I/IV e discreto fortalecimento muscular. Foi mantido o tratamento clínico com fisioterapia e condroprotetores com retornos periódicos para acompanhamento da evolução. Conclui-se que o uso do PRP foi importante adjuvante na terapia clínica empregada.(AU)

The aim of this paper is to report the case of a dog with meniscal lesion associated with calcaneal tendinosis treated with single application of intra-articular and intratendinous platelet rich plasma (PRP). A dog of the Boxer racer with difficulty walking was treated three months ago. Grade II/IV lameness was observed in both pelvic limbs, bilateral muscle atrophy, pain and slight crepitation in the left knee, slight instability to the drawer and cranial tibial tests, with intense medial fibrosis to the joint and right calcaneal tendon thickening/stiffness. The radiographic study showed moderate arthrosis in the left knee, and ultrasound examination revealed areas of hypoechogenicity in the left medial meniscus and rupture of the right calcaneal tendon muscle fibers. Thus, the patient was diagnosed with chronic cranial cruciate ligament insufficiency, periarticular fibrotic stability, and left meniscal injury and right calcaneal tendinosis. Chondroprotectors, diacerein, physiotherapyand an application of intra-articular and intratendinous PRP were prescribed. For the PRP concentration, 50mL of autologous blood were collected and deposited in vials containing sodium citrate. A double centrifugation was performed, the first strength of 120g and the second 240g, both for ten minutes. At the end, 2mL of PRP was obtained with 246.000platelets/µL (before concentration the blood had 141.000 platelets/µL). The application occurred aseptically, under general anesthesia and guided by ultrasound. We injected 1mlintra-articular in the left knee, 0.25mL in the perilesional region and 0.75mL intralesional in the right calcaneal tendon. After 14 days, I/IV lameness and slight muscle strengthening were noted. Clinical treatment with physiotherapy and chondroprotectors was maintained, with periodic returns to follow the evolution. It was concluded that the use of PRP was an important adjuvant in the clinical therapy employed.(AU)

Estudo da técnica intracapsular assistida por artroscopia para o tratamento da ruptura do ligamento cruzado cranial em cadáveres de cães / Study in dog's cadavers of the assisted by arthroscopy intracapsular technique for the treatment of the cranial cruciate ligament rupture in the dog

O objetivo foi estudar e aprimorar a técnica intracapsular de reparação do ligamento cruzado cranial assistida por artroscopia em cadáveres de cães com a confecção dos túneis tibial e femoral e utilização de autoenxerto osso-tendão patelar-osso. Foram utilizados 10 membros pélvicos de cães > 20kg. Os túneis ósseos foram confeccionados de forma independente e na posição anatômica original dos locais de inserção do ligamento cruzado cranial. Foram realizados estudo radiográfico e tomográfico para avaliar a articulação. A coleta das porções ósseas do enxerto foi feita com osteótomo e martelo. Ocorreram fratura em três patelas e em três tuberosidades tibiais. Os enxertos apresentaram comprimento médio 7,56cm. Os túneis tibiais e os túneis femorais foram confeccionados no local de inserção do ligamento cruzado cranial em 80% e 90% das articulações, respectivamente. Os túneis tibiais apresentaram ângulo médio de 62,95º mensurado por tomografia computadorizada. Os túneis femorais foram confeccionados em posição 13hs para o joelho esquerdo (100%) e 11hs para o direito (100%). Ao final do procedimento, obteve-se gaveta negativo em 100% das articulações. Pode-se concluir que a técnica proposta é viável de ser realizada no cão, porém faz-se necessário instrumental específico devido ao pequeno tamanho da articulação canina para obter melhor acurácia.

The aim was study and improve the intra-articular technique assisted by arthroscopy of the cranial cruciate ligament repair in dog's cadavers. The bone-patelar tendon-bone was used as a graft and were made the femoral and tibial tunnels. The hindlimb of 10 dogs cadavers weighing > 20kg were harvested. The femoral and tibial tunnels were made independent of each other, in the footprint of the original cranial cruciate ligament. Radiographic and tomographic studies were performed to evaluate the joint. The osseous portions of the graft were were harversted with osteotome and hammer. Fractures occurred in 3 patellas and 3 tibial tuberosities. The medium lenght of the grafts was 7,56cm. Tibial and femoral tunnels were in the footprint of the cranial cruciate ligament in 80% and 90% of the joints, respectively. The tibial tunnel had an average angle of 62,95º measured by computer tomography. The femoral tunnel was at 13h in the left knee and at 11h in the right knee in all joints (100%). At the end of the procedure the drawer test was negative in all joints (100%). It can be concluded that the proposed technique is feasible to be performed in the dog. But because to the small size of the canine joint it is necessary specific instruments in order to obtain better acuracy.

Estudo da técnica intracapsular assistida por artroscopia para o tratamento da ruptura do ligamento cruzado cranial em cadáveres de cães / Study in dog's cadavers of the assisted by arthroscopy intracapsular technique for the treatment of the cranial cruciate ligament rupture in the dog

O objetivo foi estudar e aprimorar a técnica intracapsular de reparação do ligamento cruzado cranial assistida por artroscopia em cadáveres de cães com a confecção dos túneis tibial e femoral e utilização de autoenxerto osso-tendão patelar-osso. Foram utilizados 10 membros pélvicos de cães > 20kg. Os túneis ósseos foram confeccionados de forma independente e na posição anatômica original dos locais de inserção do ligamento cruzado cranial. Foram realizados estudo radiográfico e tomográfico para avaliar a articulação. A coleta das porções ósseas do enxerto foi feita com osteótomo e martelo. Ocorreram fratura em três patelas e em três tuberosidades tibiais. Os enxertos apresentaram comprimento médio 7,56cm. Os túneis tibiais e os túneis femorais foram confeccionados no local de inserção do ligamento cruzado cranial em 80% e 90% das articulações, respectivamente. Os túneis tibiais apresentaram ângulo médio de 62,95º mensurado por tomografia computadorizada. Os túneis femorais foram confeccionados em posição 13hs para o joelho esquerdo (100%) e 11hs para o direito (100%). Ao final do procedimento, obteve-se gaveta negativo em 100% das articulações. Pode-se concluir que a técnica proposta é viável de ser realizada no cão, porém faz-se necessário instrumental específico devido ao pequeno tamanho da articulação canina para obter melhor acurácia.(AU)

The aim was study and improve the intra-articular technique assisted by arthroscopy of the cranial cruciate ligament repair in dog's cadavers. The bone-patelar tendon-bone was used as a graft and were made the femoral and tibial tunnels. The hindlimb of 10 dogs cadavers weighing > 20kg were harvested. The femoral and tibial tunnels were made independent of each other, in the footprint of the original cranial cruciate ligament. Radiographic and tomographic studies were performed to evaluate the joint. The osseous portions of the graft were were harversted with osteotome and hammer. Fractures occurred in 3 patellas and 3 tibial tuberosities. The medium lenght of the grafts was 7,56cm. Tibial and femoral tunnels were in the footprint of the cranial cruciate ligament in 80% and 90% of the joints, respectively. The tibial tunnel had an average angle of 62,95º measured by computer tomography. The femoral tunnel was at 13h in the left knee and at 11h in the right knee in all joints (100%). At the end of the procedure the drawer test was negative in all joints (100%). It can be concluded that the proposed technique is feasible to be performed in the dog. But because to the small size of the canine joint it is necessary specific instruments in order to obtain better acuracy.(AU)

Avaliação ultrassonográfica de cães com ruptura do ligamento cruzado cranial submetidos a artrotomia / Ultrasonographic evaluation of dogs with cranial cruciate ligament rupture undergoing to arthrotomy

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. Oneof the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which isa frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the meniscifrom human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was tocompare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscusof dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. Theultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. Inthe joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively threeand four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the twotechniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscaltears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absenceof meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicityand echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated byultrasound were the presence of effusion and synovial membrane thickening...

Avaliação ultrassonográfica de cães com ruptura do ligamento cruzado cranial submetidos a artrotomia / Ultrasonographic evaluation of dogs with cranial cruciate ligament rupture undergoing to arthrotomy

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. Oneof the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which isa frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the meniscifrom human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was tocompare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscusof dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. Theultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. Inthe joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively threeand four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the twotechniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscaltears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absenceof meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicityand echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated byultrasound were the presence of effusion and synovial membrane thickening...(AU)

Técnica de avanço e transposição da tuberosidade tibial (TTTA) com uso de espaçador único de TTA-Maquet em cão / Technique of tibial tuberosity transposition and advancement (TTTA) with use of TTA-Maquet cage-only in dog

Background: The most common conditions that compromise the stifle joint in dogs are medial patellar luxation (MPL) and cranial cruciate ligament (CCL) rupture. Surgical procedures are usually indicated for the treatment of these diseases. One ordinarytechnique for the treatment of MPL is the tibial tuberosity transposition, and one prominent technique for CCL rupture is the tibialtuberosity advancement. These techniques can be associated in one surgical procedure called tibial tuberosity transposition andadvancement (TTTA) for the simultaneous treatment of both stifle diseases. The aim of this study is to report the surgical treatmentof a dog with MPL and CCL rupture affecting the same joint by the TTTA technique with the use of a TTA-Maquet cage-only.Case: A 3-year-old Pitbull dog weighing 39 kg was attended at Veterinary Hospital with a history of marked lameness in theleft pelvic limb. The orthopedic examination showed positive results for cranial drawer motion and tibial compression tests,and a complete CCL rupture was diagnosed. The presence of patellar luxation was evaluated by manual pressure on the patella, and grade 3 of MPL was diagnosed. Both conditions were affecting the same stifle joint. In addition, survey radiographsof the affected joint were performed. Surgical treatment was indicated by the TTTA technique. Radiographic measurementswere taken to calculate the cranial tibial tuberosity advancement by the tibial plateau and the common tangent methods, and atitanium TTA-Maquet cage-only of 10.5 x 20.0 mm was selected. Linear osteotomy was performed on the tibial tuberosity withthe aid of an oscillating saw, based on the Maquet hole technique. The tibial tuberosity was carefully displaced cranially and thecage was inserted at the site of osteotomy. The cage ears were molded on the tibial surface and fixed with 2.4 mm self-tappingcortical screws...

Técnica de avanço e transposição da tuberosidade tibial (TTTA) com uso de espaçador único de TTA-Maquet em cão / Technique of tibial tuberosity transposition and advancement (TTTA) with use of TTA-Maquet cage-only in dog

Background: The most common conditions that compromise the stifle joint in dogs are medial patellar luxation (MPL) and cranial cruciate ligament (CCL) rupture. Surgical procedures are usually indicated for the treatment of these diseases. One ordinarytechnique for the treatment of MPL is the tibial tuberosity transposition, and one prominent technique for CCL rupture is the tibialtuberosity advancement. These techniques can be associated in one surgical procedure called tibial tuberosity transposition andadvancement (TTTA) for the simultaneous treatment of both stifle diseases. The aim of this study is to report the surgical treatmentof a dog with MPL and CCL rupture affecting the same joint by the TTTA technique with the use of a TTA-Maquet cage-only.Case: A 3-year-old Pitbull dog weighing 39 kg was attended at Veterinary Hospital with a history of marked lameness in theleft pelvic limb. The orthopedic examination showed positive results for cranial drawer motion and tibial compression tests,and a complete CCL rupture was diagnosed. The presence of patellar luxation was evaluated by manual pressure on the patella, and grade 3 of MPL was diagnosed. Both conditions were affecting the same stifle joint. In addition, survey radiographsof the affected joint were performed. Surgical treatment was indicated by the TTTA technique. Radiographic measurementswere taken to calculate the cranial tibial tuberosity advancement by the tibial plateau and the common tangent methods, and atitanium TTA-Maquet cage-only of 10.5 x 20.0 mm was selected. Linear osteotomy was performed on the tibial tuberosity withthe aid of an oscillating saw, based on the Maquet hole technique. The tibial tuberosity was carefully displaced cranially and thecage was inserted at the site of osteotomy. The cage ears were molded on the tibial surface and fixed with 2.4 mm self-tappingcortical screws...(AU)

Carcinoma adrenocortical incidental em cão: aspectos clínicos, tomográficos e histopatológicos / Incidental adrenocortical carcinoma in dog: clinical, tomographic and histopathological aspects

Background: Adrenal incidentalomas are masses accidentally discovered during imaging examinations performed whenthere is no suspicion of adrenal disease. Even with a low prevalence, it is important to perform a reliable evaluation observing biological behavior and determining whether the hormonal activity is stimulated. Frequently, these masses are notfunctional, but in some cases, there is increased cortisol activity, and patients with adrenal incidentalomas may presenthyperadrenocorticism. This report aims to describe the clinical, tomographic, and histopathological aspects of a case ofadrenal incidentaloma detected in a routine abdominal ultrasound.Case: An 8-year-old, male, maltese dog with occasional emesis, halitosis, claudication of the left pelvic limb, and previous compensated and untreated cardiomyopathy was treated at the Veterinary Hospital of the Federal University of MatoGrosso (HOVET-UFMT). Physical examination revealed arterial hypertension and claudication, with the positive posteriordrawer test suggesting rupture of the cruciate ligament. The blood count showed no alteration, and the serum biochemistryrevealed a slight increase in the activity of alanine aminotransferase. In order to investigate this increase, an abdominalultrasound was performed. Slight hepatomegaly and a heterogeneous mass of irregular edges were observed with a moderate and difficult-to-delimit vascularization of the adrenal gland. Left knee radiography raised the suspicion of rupture ofthe cranial cruciate ligament due to the cranial displacement of the tibia in relation to the femur. Computed tomographywas performed to define the extent and delimitation of the mass, which was compatible with a tumor of the right adrenalgland characterized by the visualization of an abdominal mass...(AU)

Carcinoma adrenocortical incidental em cão: aspectos clínicos, tomográficos e histopatológicos / Incidental adrenocortical carcinoma in dog: clinical, tomographic and histopathological aspects

Background: Adrenal incidentalomas are masses accidentally discovered during imaging examinations performed whenthere is no suspicion of adrenal disease. Even with a low prevalence, it is important to perform a reliable evaluation observing biological behavior and determining whether the hormonal activity is stimulated. Frequently, these masses are notfunctional, but in some cases, there is increased cortisol activity, and patients with adrenal incidentalomas may presenthyperadrenocorticism. This report aims to describe the clinical, tomographic, and histopathological aspects of a case ofadrenal incidentaloma detected in a routine abdominal ultrasound.Case: An 8-year-old, male, maltese dog with occasional emesis, halitosis, claudication of the left pelvic limb, and previous compensated and untreated cardiomyopathy was treated at the Veterinary Hospital of the Federal University of MatoGrosso (HOVET-UFMT). Physical examination revealed arterial hypertension and claudication, with the positive posteriordrawer test suggesting rupture of the cruciate ligament. The blood count showed no alteration, and the serum biochemistryrevealed a slight increase in the activity of alanine aminotransferase. In order to investigate this increase, an abdominalultrasound was performed. Slight hepatomegaly and a heterogeneous mass of irregular edges were observed with a moderate and difficult-to-delimit vascularization of the adrenal gland. Left knee radiography raised the suspicion of rupture ofthe cranial cruciate ligament due to the cranial displacement of the tibia in relation to the femur. Computed tomographywas performed to define the extent and delimitation of the mass, which was compatible with a tumor of the right adrenalgland characterized by the visualization of an abdominal mass...

Estudo comparativo entre métodos manual e digital no cálculo do ângulo do platô tibial em cães / Comparative study of manual and digital method in the calculation of the tibial plateau angle in dogs

São poucos os dados publicados sobre a aplicabilidade ou a confiabilidade dos métodos digitais para mensuração do ângulo do platô tibial (APT) em comparação à mensuração manual. O objetivo deste estudo foi comparar o APT obtido pelo cálculo manual padrão, em filmes radiográficos, com os valores obtidos por cálculos em imagens digitais, por meio do software do computador. Foram analisadas radiografias digitais do membro pélvico, direito e esquerdo, em perfil verdadeiro, de 20 cães saudáveis, com idade superior a um ano. Três observadores com graus de experiência semelhantes em cálculo do APT realizaram as mensurações em cada radiografia. Primeiramente, foram calculados os ângulos dos platôs tibiais manualmente nas películas radiográficas e, posteriormente, os cálculos foram realizados na imagem digital, por meio do software para medicina veterinária do sistema de raios X digital. Os resultados do presente estudo demonstraram diferenças significativas entre os métodos, com valor das médias do cálculo digital 20,48±3.71 e do cálculo manual 23.90±4.02. Valor de P foi < 0,01 na comparação entre médias dos dois grupos. Na avaliação interobservadores, houve diferença significativa no cálculo manual no perfil direito, o que sugere maior variação no cálculo manual quando comparado ao digital. O cálculo realizado pelo software apresentou menor variação nos valores interobservadores. Acredita-se que a menor variação obtida nos resultados aqui apresentados se dê em razão das facilidades proporcionadas pelo software. Conclui-se que houve diferença entre os valores obtidos por meio dos métodos convencional e digital no cálculo do ângulo do platô tibial, sendo os valores digitais menores entre os observadores, e que o método digital no cálculo do ângulo do platô tibial levou à menor variação quando comparado ao método manual.(AU)

There are few published data on the applicability and reliability of digital methods for measuring the TPA compared with manual measurement. The objective of this study was to compare the TPA obtained by calculating standard manual on conventional radiographs, with the values obtained by calculations in digital images through a computer program. Bilateral digital radiographs of hind limb were analyzed in true profile for 20 healthy dogs older than two years. Three observers with similar levels of experience in calculating the TPA conducted measurements on each radiograph. First we calculated the angle of the tibial plateaus manually in x-ray film and then the calculations were made through the program offered by the computer program in the digital image. The results of this study showed significant differences between the methods, with average value of 20.48±3.71 digital calculating average and 23.90±2.4 in the manual calculation. P value was < 0.01 when comparing averages. No significant difference in manual calculation in right profile were found between interobserver assessments, suggesting greater variation in manual calculation compared to digital. The calculation performed by the software showed less variation in values. The slight variation obtained in our results is believed to be due to the facilities provided by the software. There was a difference between the values obtained by means of conventional and digital methods for calculating the angle of the tibial plateau, and the smaller digital values between the observers and the digital method in the calculation of the tibial plateau angle led to less variation when compared to the manual method.(AU)

Prospective clinical assessment of tibial tuberosity advancement for the treatment of cranial cruciate ligament rupture in dogs

Purpose: To evaluate clinically dogs that underwent tibial tuberosity advancement (TTA) six months previously. Methods: Dogs of various breeds, gender, weight, and age that had CCL rupture and underwent TTA for treatment were included in this study. Parapatellar arthrotomy was performed in all patients to assess the joint for a ruptured ligament and meniscal injury before the TTA. The appropriate cage for the TTA was chosen with planning surgery. The surgical procedure was performed according to the literature, using a modified Maquet technique. Six months after surgery, lameness during walking; muscular atrophy; crepitation, cranial drawer and tibial compression tests and quality of life based on owners evaluation were assessed. Results: Postoperative complications were observed in only one knee (4.76%), with a surgical site seroma. The mean lameness score at walking was 0.29 (± 0.64). The mean score regarding muscular atrophy was 0.95 (± 1.56). The mean score of the cranial drawer test, in a range from 0 to 5, was 1.52 (± 1.54). The owners rated the dogs quality of life as excellent in 44%, good in 30%, and moderate in 17%. Conclusion: This clinical study supports the affirmation that patients who undergo TTA for treatment of CCL rupture have an acceptable response.(AU)

Short-term evaluation of an intra-articular technique for cranial cruciate ligament rupture in dogs using nylon or polyester / Avaliação a curto prazo da técnica intra-articular utilizando fio de náilon ou poliéster para correção da ruptura do ligamento cruzado cranial em cães

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed...

A Ruptura do Ligamento Cruzado Cranial (RLCCr) é uma afecção comumente vista na clínica de pequenos animais e, nos cães, pode ser decorrente de traumas, obesidade, fatores genéticos e osteoartrite (OA) primária. Todos os casos apresentam instabilidade articular e quando não tratados podem evoluir para OA secundária e perda funcional do membro. O objetivo do presente trabalho foi comparar os resultados, a curto prazo, da técnica intra-articular utilizando o botão cirúrgico associado ao fio de poliéster 5 (Grupo A), botão cirúrgico associado ao fio de náilon 5 (Grupo B), e grampo cirúrgico associado ao fio de poliéster 5 (Grupo C), para a estabilização da articulação do joelho após a RLCCr. Foram utilizados 18 cães com RLCCr, com peso variando entre 5 e 35 kg, com raça e sexo aleatórios. Os cães foram aleatoriamente divididos em três grupos de 6 indivíduos. Foram avaliados o grau de OA radiográfico, grau de claudicação pré e pós-operatório, o tempo cirúrgico e o aspecto macroscópico da cartilagem. Foi realizada a técnica cirúrgica intra-articular, utilizando-se fio para estabilização através de dois túneis cirúrgicos, um no côndilo lateral do fêmur e outro na crista da tíbia. Doze animais evoluíram de forma favorável, recuperando o apoio normal do membro após 15 dias da cirurgia. Quatro animais do grupo B apresentaram complicações sendo duas rupturas do fio após 30 dias de...

Short-term evaluation of an intra-articular technique for cranial cruciate ligament rupture in dogs using nylon or polyester / Avaliação a curto prazo da técnica intra-articular utilizando fio de náilon ou poliéster para correção da ruptura do ligamento cruzado cranial em cães

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed...(AU)

A Ruptura do Ligamento Cruzado Cranial (RLCCr) é uma afecção comumente vista na clínica de pequenos animais e, nos cães, pode ser decorrente de traumas, obesidade, fatores genéticos e osteoartrite (OA) primária. Todos os casos apresentam instabilidade articular e quando não tratados podem evoluir para OA secundária e perda funcional do membro. O objetivo do presente trabalho foi comparar os resultados, a curto prazo, da técnica intra-articular utilizando o botão cirúrgico associado ao fio de poliéster 5 (Grupo A), botão cirúrgico associado ao fio de náilon 5 (Grupo B), e grampo cirúrgico associado ao fio de poliéster 5 (Grupo C), para a estabilização da articulação do joelho após a RLCCr. Foram utilizados 18 cães com RLCCr, com peso variando entre 5 e 35 kg, com raça e sexo aleatórios. Os cães foram aleatoriamente divididos em três grupos de 6 indivíduos. Foram avaliados o grau de OA radiográfico, grau de claudicação pré e pós-operatório, o tempo cirúrgico e o aspecto macroscópico da cartilagem. Foi realizada a técnica cirúrgica intra-articular, utilizando-se fio para estabilização através de dois túneis cirúrgicos, um no côndilo lateral do fêmur e outro na crista da tíbia. Doze animais evoluíram de forma favorável, recuperando o apoio normal do membro após 15 dias da cirurgia. Quatro animais do grupo B apresentaram complicações sendo duas rupturas do fio após 30 dias de...(AU)

Radiographic assessment of the proximal tibial angles in dogs and cats with and without cranial cruciate ligament rupture

ABSTRACT: The influence of the proximal tibial angles in the cranial cruciate ligament (CCL) rupture in dogs is still controversial, and little is known regarding this topic in cats. The aim of this study was to evaluate and compare the angles of the proximal portion of the tibia in dogs and cats with and without CCL rupture. Retrospective and prospective radiographs of the stifle joints were obtained and divided into four groups. Group 1 was composed of 70 stifle joint images of dogs without orthopedic disorders (healthy dogs), group 2 had 70 stifle joint images of dogs with CCL rupture, group 3 had 50 stifle joint images of cats without orthopedic disorders (healthy cats) and group 4 had 25 stifle joint images of cats with CCL rupture. Radiographs were taken with the stifle joint in the mediolateral projection, positioned at the angle of hind limb support. Between the two groups of dogs evaluated, the dogs with CCL rupture had statistically greater tibial plateau angle (TPA) compared with healthy dogs. No difference was shown in relation to the TPA between healthy cats and cats with CCL rupture. In relation to the patellar ligament angle by tibial plateau method the values for the healthy dogs were significantly higher than those for the CCL ruptured dogs. Similarly, healthy cats had significantly higher mean values than cats with CCL rupture. In the patellar ligament angle by common tangent method there was no significantly difference between the two groups of dogs. Between the two groups of cats, animals with CCL rupture had statistically higher mean values than healthy cats. In general, the groups of dogs showed higher mean values than the groups of cats. For the patellar ligament insertion angle (PLIA) healthy dogs showed a significantly higher mean than dogs with CCL rupture. There was no significant difference between the groups of cats. In conclusion, the TPA and the PLIA possibly influence the etiology of CCL rupture in dogs but not in cats. The low patellar ligament angle measured by common tangent method may favorably influence the reduced incidence of CCL rupture in cats.

RESUMO: A influência dos ângulos da parte proximal da tíbia sobre a ruptura do ligamento cruzado cranial (LCC) em cães é ainda controversa, e pouco é descrito sobre este tópico em gatos. O objetivo deste estudo foi avaliar e comparar os ângulos da tíbia proximal em cães e gatos, ambas as espécies com e sem ruptura do LCC. Foram obtidos exames radiográficos retrospectivos e prospectivos das articulações do joelho e divididos em quatro grupos: no grupo 1 foram incluídas 70 imagens radiográficas da articulação do joelho de cães sem distúrbios ortopédicos (cães saudáveis), no grupo 2 foram 70 imagens radiográficas articulação do joelho de cães com ruptura do LCC, no grupo 3 foram 50 imagens radiográficas da articulação do joelho de gatos sem distúrbios ortopédicos (gatos saudáveis), e no grupo 4 foram 25 imagens radiográficas articulação do joelho de gatos com ruptura do LCC. As imagens radiográficas da articulação do joelho foram obtidas na projeção mediolateral, mantendo-se a articulação posicionada na angulação de apoio do membro pélvico. Em relação ao ângulo do platô tibial (APT), os cães com ruptura do LCC tiveram estatisticamente maiores valores médios do APT quando comparados aos cães saudáveis. Não foi observada diferença significativa em relação ao APT entre os gatos saudáveis e os gatos com ruptura do LCC. Em relação ao ângulo do ligamento patelar mensurado pelo método do platô tibial, os valores médios observados para os cães saudáveis foram significativamente mais elevados do que os valores encontrados para os cães com ruptura do LCC. De forma semelhante, os gatos saudáveis também apresentaram valores médios mais elevados do que os gatos com ruptura do LCC. Para o ângulo do ligamento patelar mensurado pelo método da tangente comum, não foram observadas diferenças significativas entre os dois grupos de cães. No entanto, entre os dois grupos de gatos, os animais com ruptura do LCC apresentaram valores médios significativamente mais elevados do que os gatos saudáveis. Em geral, os grupos de cães demonstraram valores médios mais elevados quando comparados aos grupos de gatos. Em relação ao ângulo de inserção do ligamento patelar (AILP), os cães saudáveis apresentaram valores médios significativamente mais elevados do que os cães com ruptura do LCC. No entanto, não foi observada diferença significativa entre os dois grupos de gatos. Em conclusão, o APT e o AILP possivelmente exercem influência na etiologia da ruptura do LCC em cães, mas não influenciam nos gatos. Em gatos, os reduzidos ângulos do ligamento patelar observados pelo método da tangente comum podem influenciar favoravelmente na baixa incidência da ruptura do LCC nessa espécie.

Técnica de TightRope modificada no tratamento da doença do ligamento cruzado cranial em cães: resultados a longo prazo / Modified TightRope technique for treatment of the cranial cruciate ligament disease in dogs: long term outcomes

O objetivo deste estudo foi descrever os resultados a longo prazo do uso da técnica extracapsular TightRope (TR) modificada no tratamento da doença do ligamento cruzado cranial (LCCr) em oito cães (10 articulações) com peso corporal variando entre 4kg e 28kg. Todos os animais selecionados foram submetidos aos exames ortopédicos específicos, sendo diagnosticada ruptura completa do LCCr pelos testes de gaveta e de compressão tibial. Realizaram-se exames radiográficos convencionais e em posição de estresse das articulações. A técnica TR foi modificada utilizando-se o fio de náilon substituindo o fio de fibra empregado na técnica original, facilitando a disponibilidade de obtenção do material. Houve também modificação na origem da perfuração do túnel tibial, sendo realizada imediatamente cranial ao sulco do tendão extensor digital longo. Todos os cães foram submetidos ao exame radiográfico tanto no pós-operatório imediato como no tardio. Aos 30 dias após a intervenção cirúrgica, os pacientes apresentavam claudicação nos membros pélvicos operados de grau discreto a moderado. Foi observado discreto movimento de gaveta cranial em 60% das articulações acometidas. Aos três meses após o procedimento cirúrgico, os animais apresentaram ausência de dor e discreta redução na amplitude dos movimentos articulares. Em duas articulações (20%) observou-se discreto deslocamento cranial da tíbia no teste de gaveta. Nesta fase, 80% dos membros avaliados apresentavam apoio normal. Um ano após a intervenção cirúrgica, observou-se ao exame radiográfico discreta progressão da doença articular degenerativa em 50% das articulações operadas. Das oito articulações avaliadas a longo prazo, em apenas um membro operado observou-se discreta claudicação com reduzida transferência de peso para o membro contralateral. Os demais membros pélvicos avaliados (87,5%) demonstraram ausência de claudicação e adequada recuperação da função articular. Concluiu-se que a técnica cirúrgica extracapsular TR modificada mostrou-se efetiva como opção de tratamento para doença do LCCr em cães de porte pequeno e médio, não apresentando complicações. As modificações do fio cirúrgico e da perfuração da tíbia na técnica TR parecem ter efeitos positivos na estabilização da articulação do joelho.(AU)

The aim of the study was to describe the long term outcomes of the modified extracapsular TightRope (TR) technique in the treatment of the cranial cruciate ligament (CCL) disease in eight dogs (10 joints) with a body weight ranging from 4kg to 28kg. The animals were submitted to specific orthopedic examinations and were diagnosed with total CCL rupture by drawer and tibial compression tests. Conventional and stress positional radiographic examinations of the affected joints were performed. The TR technique was modified using the nylon suture thread replacing the fiber suture used in the original technique, which facilitated the availability of obtaining the material. There was also modification in the origin of the tibial tunnel perforation that was performed immediately cranial to the groove of the long digital extensor tendon. The dogs underwent radiographic examination in the immediate postoperative and in later periods. At one month after surgical procedure, the animals showed mild or moderate lameness in the affected pelvic limbs. Mild cranial tibial drawer was observed in 60% of the operated joints. At three months after the procedure, the animals have mild decrease in the range of joint motion, but without signs of pain. Two stifle joints (20%) showed a slight cranial displacement of the tibia in the drawer test. In this period, 80% of the affected joints showed normal limb support. At one year after the procedure, radiographic examination showed a discrete progression of the degenerative joint disease in 50% of the operated joints. The long term outcomes were obtained from eight joints and in only one pelvic limb was observed mild lameness with slight weight transfer to the normal contralateral limb. All other evaluated pelvic limbs (87.5%) showed no lameness and proper recovery of joint function. In conclusion, the modified TR extracapsular surgical technique proved to be effective as a treatment option for CCL disease in small and medium dogs, with no complications. Modifications of the surgical suture thread and the tibial site perforation of the TR technique seem to have positive effects on stabilization of the stifle joint.(AU)