Spontaneous external biliary fistula in a dog.

CASE DESCRIPTION: A 10-year-old sexually intact female dog was examined because of a static, well-circumscribed subcutaneous mass and associated fistulous draining tract located along the right ventrolateral aspect of the thoracic body wall of 15 months' duration. CLINICAL FINDINGS: Results of computed tomography and fistulography confirmed the presence of the fistulous tract. Computed tomography also revealed a focal, hypodense region in the right ventral portion of the liver that was adjacent to but not clearly associated with the fistulous tract. TREATMENT AND OUTCOME: Surgical exploration of the tract revealed that it passed into the right hemithorax to the diaphragm; entered the right medial lobe of the liver; and terminated in a well-encapsulated, cystic liver lesion. The right medial liver lobe and all affected tissues were removed. Histologically, the liver lesion consisted of a fibrotic, dilated bile duct. The dilated bile duct and fistula were lined with biliary epithelium. On the basis of these findings, a diagnosis of spontaneous external biliary fistula was made. Five months after surgery, the dog was clinically normal. CLINICAL RELEVANCE: To the authors' knowledge, spontaneous external biliary fistula in a dog has not been reported in the veterinary medical literature. Despite the rarity of this condition, it should be considered in a dog with similar clinical findings. Clinical findings and results of appropriate diagnostic imaging procedures may provide valuable information in making this diagnosis and in planning surgical treatment.

Transverse ulnar bone transport osteogenesis: a new technique for limb salvage for the treatment of distal radial osteosarcoma in dogs.

OBJECTIVE: To develop instrumentation and a technique for transverse ulnar bone transport osteogenesis in dogs. STUDY DESIGN: Cadaveric study and in vivo validation (1 dog). SAMPLE POPULATION: Paired cadaveric antebrachii (n=10 dogs) and 1 live dog. METHODS: Circular fixator constructs were applied and fitted with reeling or linear motors designed to transport an ulnar segment transversely into a defect created by excising the distal 50% of the ipsilateral radius. A longitudinal osteotomy of the adjacent ulna was created and the segment was transported across the radial defect. Pre- and post-distraction CT scans were used to compare the efficacy of each construct. The procedure was performed unilaterally in a live dog using the reeling motor (RM) construct. RESULTS: Both constructs effectively transported the ulnar segment into the defect. Subjectively, the RMs were easier to apply and operate. No significant differences were observed in the objective measures of efficacy between the 2 construct types. The live dog produced viable regenerate bone after transverse ulnar bone transport. CONCLUSIONS: Transverse ulnar bone transport should be considered a potential method for limb salvage in dogs with osteosarcoma (OSA) of the distal radius. The RMs were effective and clinically applicable. CLINICAL RELEVANCE: Transverse ulnar bone transport osteogenesis affords the benefits of longitudinal radial bone transport osteogenesis, allowing resolution of large longitudinal radial defects in a substantially less time as a result of shortening the transport distance. This would be beneficial when treating conditions such as OSA where minimizing convalescence and maximizing quality of life is a priority.

Limited open reduction and stabilization of sacroiliac fracture-luxations using fluoroscopically assisted placement of a trans-iliosacral rod in five dogs.

OBJECTIVE: To describe percutaneous fluoroscopically assisted placement of a trans-iliosacral rod to stabilize sacroiliac fracture-luxations after limited open reduction. STUDY DESIGN: Retrospective clinical case series. ANIMALS: Dogs (n=5) with sacroiliac fracture-luxations. METHODS: Medical records and radiographs were reviewed to evaluate implant placement, fracture reduction, pelvic canal diameter ratio, maintenance of reduction, implant stability, assessment of union, and to identify any complications. Owners were contacted to obtain long-term assessment of limb function. RESULTS: Dogs weighed between 6 and 31 kg. Trans-iliosacral rods were placed correctly traversing the sacral body. Mean (+/-SD) percent reduction of the sacroiliac joint was 92.9+/-6.6%. Pelvic canal diameter ratio did not differ significantly between time periods. With the exception of 1 dog, which died in the early postoperative period, all sacroiliac fracture-luxations healed without appreciable complications. Three dogs were sound and 1 dog had a subtle lameness at final physical and radiographic examination (mean+/-SD: 217+/-205 days). Owners assessed their dog's limb function (mean+/-SD: 355+/-205 days) as good or excellent. CONCLUSIONS: Trans-iliosacral rods can be accurately placed using intraoperative fluoroscopy after limited open reduction of sacroiliac fracture-luxations. Trans-iliosacral rods provided bilateral secure fixation, allowed early weight-bearing and dogs consistently had good long-term clinical results. CLINICAL RELEVANCE: Trans-iliosacral rods are suitable implants for the stabilization of sacroiliac fracture-luxations, particularly in dogs with bilateral fracture-luxations and/or concurrent musculoskeletal injuries.

Usefulness, completeness, and accuracy of Web sites providing information on osteoarthritis in dogs.

OBJECTIVE: To evaluate the quality of information regarding osteoarthritis (OA) in dogs currently available on the World Wide Web. DESIGN: Survey study. PROCEDURE: 5 search engines were searched with the keywords "dog," "degenerative joint disease," "canine," and "osteoarthritis," and the first 50 sites listed by each search engine were analyzed. Unique Web site addresses were distributed to 3 diplomates of the American College of Veterinary Surgeons, who provided a standardized evaluation of each site. RESULTS: 30 unique Web sites were evaluated. Twenty (66%) provided information consistent with conventional knowledge as outlined in textbooks and peer-reviewed literature, 8 (27%) provided experimental or anecdotal information in addition to conventional knowledge, and 2 (7%) provided misleading information. Mean scores for overall usefulness of the information provided in regard to clinical features of and treatment for OA were 1.3 and 1.5, respectively (1 = information of minimal use; 5 = very useful information). Twenty-three (77%) sites encouraged pet owners to seek the advice of a veterinarian. Twenty-three (77%) sites were given overall quality scores < 2, and 7 (23%) were given scores between 2 and 3 (1 = site was counterproductive; 5 = site was very valuable). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the quality of information currently available on the Web that addresses OA in dogs is questionable. Although most of the sites conveyed some conventional information with reasonable accuracy, the information was incomplete, of minimal use, and often considered counterproductive.

The effects of femur and implant position on the radiographic assessment of total hip femoral implants in dogs.

OBJECTIVE: To determine the effect of femur positioning and femoral implant placement on the radiographic assessment of total hip femoral implants in dogs. STUDY DESIGN: Cadaveric study. ANIMALS: Five canine femurs. METHODS: Five canine femurs were fitted with total hip implants, in predetermined locations, postmortem. Each femur was moved through a defined range of motion and radiographed at specific intervals. Radiographs were then digitized, and implant position was measured using previously described methods. Regression analysis was conducted to determine whether varied femoral position resulted in a consistent (linear) pattern of change in the value of each particular measurement. RESULTS: Change in the position of the femur relative to the film cassette caused significant variation in the perceived position of the implant. The placement of the implant within the femur determined which measurements were affected and to what degree. CONCLUSIONS: The information obtained from standard clinical radiographs and conventional methods of quantitative analysis does not consistently provide an accurate assessment of the placement of the femoral implant within the femoral canal. Such data cannot be used to correlate implant position with implant failure.

Orthogonal view analysis for evaluating the femoral component position of total hip implants in dogs using postoperative radiographs.

OBJECTIVE: To show the ability to obtain repeatable, accurate, quantitative data to assess the position of the femoral component of canine total hip implants using postoperative radiographs. STUDY DESIGN: Cadaveric study and clinical trial. ANIMALS: Five cadaveric canine femurs and 4 patients. METHODS: Femoral implants were placed into 5 cadaveric canine femurs in predetermined locations. Orthogonal radiographs were taken of each femur at 10 degrees intervals as they were moved through a natural range of hip motion. An assessment of implant position was made with each set of radiographs and analyzed to observe significant inconsistencies in the values obtained when the femur was repositioned. Three investigators positioned and radiographed the hips of 4 client-owned dogs that had total hip arthroplasty (THA). Each investigator obtained a set of orthogonal radiographic views from which implant position was measured. The measurements obtained from each investigator's set of radiographs were statistically analyzed to evaluate for interobserver differences. RESULTS: The methods described indicate that consistent data regarding femoral implant placement can be obtained from postoperative radiographs of THA patients. Under most circumstances, change in position of the femur did not significantly affect femoral implant measurements. There were no significant differences noted among values obtained by different investigators. CONCLUSIONS: Measurements based on the femoral and implant axes obtained from orthogonal radiographic views of the femur provide a means for obtaining accurate and consistent quantitative data regarding femoral implant position using postoperative radiographs of canine THA patients. CLINICAL RELEVANCE: Acquisition of quantitative information about femoral implant position using postoperative radiographs will facilitate development of a readily available data source. This information, attainable in a clinical setting, may help identify elements of implant position that are important in determining the clinical outcome of THA in dogs.