Risk factors for tibial damage associated with the modified Maquet technique in 174 stifles.

OBJECTIVE: To identify risk factors for tibial damage associated with the modified Maquet technique (MMT) in dogs with cranial cruciate ligament (CCL) disease. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred and seventy-four stifles from 147 client-owned dogs. METHODS: Medical records of dogs diagnosed with CCL disease and treated with the current version of MMT were reviewed. Dogs were included if immediate postoperative radiographs were available. Cortical hinge fracture or fissure, tibial tuberosity fracture, and diaphyseal fractures of the tibia were recorded. Age, body weight (BW), thickness of the tibial cortical hinge, and angle of opening of the osteotomy were tested as potential risk factors for tibial damage by univariate logistic regression analysis. RESULTS: Tibial damage included intraoperative tibial fissures in 37% of MMTs, intraoperative fractures of the cortical hinge in 3.4% of MMTs, postoperative tibial fractures in 14% of MMTs. Risk factors for intraoperative fissure included BW (P = .0153) and thickness of cortical hinge (P = .0006). The angle of opening of the osteotomy was identified as a risk factor for intraoperative cortical hinge fracture (P = .0034), angles below 11° being preventive. No risk factor was identified for postoperative fracture. CONCLUSION: Based on these results, preventive measures against tibial damage associated with MMT should include: a thickness of cortical hinge based on the equation related to the BW; a length of osteotomy adjusted to the amount of TTA with an osteotomy angle below 10°; and slow advancement of the tibial tuberosity.

Long-term prospective evaluation of intestinal anastomosis using stainless steel staples in 14 dogs.

This prospective clinical study evaluated the use, complications, and clinical and ultrasonographic follow-ups of end-to-end intestinal anastomoses with skin staples in naturally occurring diseases in canine small and large intestines. Intestinal anastomoses were performed in 14 dogs and pre-, peri-, and postoperative data were recorded. Postoperative clinical and ultrasound evaluations were performed at regular intervals for 1 year. The mean time taken to construct the anastomosis was 5 min. There were no intraoperative complications. Hemorrhage and colonic stricture were the main postoperative complications. Staple loss occurred in 2 cases. Absence of wall layering and focal wall thickening were observed in all cases at each ultrasonographic follow-up. Hyperechoic fat was observed in all but 1 of the cases at month 1. Nine dogs were alive with normal digestive function at the end of the study. The skin stapler technique enabled rapid construction of consistent anastomoses with inexpensive stapling material.

Évaluation prospective à long terme de l'anastomose utilisant des agrafes en acier inoxydable chez 14 chiens. Cette étude clinique prospective a évalué l'utilisation, les complications ainsi que les suivis cliniques et échographiques d'anastomoses termino-terminales utilisant des agrafes chirurgicales lors de pathologies naturelles du petit et gros intestins chez des chiens. Des anastomoses intestinales ont été réalisées chez 14 chiens et des données préopératoires, peropératoires et postopératoires ont été consignées. Des évaluations cliniques et échographiques postopératoires ont été réalisées à des intervalles réguliers pendant 1 an. La durée moyenne de la construction de l'anastomose était de 5 minutes. Il n'y a pas eu de complications peropératoires. L'hémorragie et le rétrécissement du côlon étaient les principales complications postopératoires. La perte de l'agrafe s'est produite dans deux cas. L'absence de couches de la paroi et un épaississement concentrique de la paroi ont été observés dans tous les cas à chaque suivi échographique. Le gras hyperéchogène a été observé dans tous les cas sauf un au mois 1. Neuf chiens étaient vivants avec une fonction digestive normale à la fin de l'étude. La technique de l'agrafeuse chirurgicale a permis la construction rapide d'anastomoses uniformes avec du matériel d'agrafage bon marché.(Traduit par Isabelle Vallières).

Presumed concurrent medial coronoid process fracture is a frequent radiographic finding in dogs and cats with humeral condylar fractures.

OBJECTIVE: To report the prevalence of presumed concurrent medial coronoid process fractures in a series of cases of humeral condylar fractures and evaluate factors influencing the presence of a suspected fracture of the medial coronoid process. ANIMALS: 48 dogs and 7 cats, with a total of 57 humeral fractures. METHODS: Medical records of dogs and cats diagnosed with a humeral condylar fracture with radiographs were reviewed between October 2013 and March 2022. Species, sex, neutered status, age, weight, and the nature of the trauma were noted. Radiographs were assessed for the configuration of humeral condylar fracture, the presence of a suspected fractured medial coronoid process (MCP), number of MCP fragments, nature of fracture, degree of radioulnar incongruity, soft tissue swelling, and elbow luxation/subluxation. RESULTS: A presumed fracture of the MCP was seen in 26 of 57 cases. Comminution of the condylar fracture was the only parameter that had a positive effect on the presence of a possible fractured MCP. Body weight was significantly associated with size of the suspected fractured MCP. The presence of this fracture was not associated with the type of humeral condylar fracture. The size of the presumed fractured MCP fragment was positively correlated with body weight. CLINICAL RELEVANCE: There was a high prevalence of presumed fractured MCPs in dogs with humeral condylar fractures (almost 50%) and even more so in animals with comminuted fractures. The consequences of suspected fractured MCP associated with humeral condylar fractures and whether dogs and cats would benefit from removal of the fragment remain unknown.

Zygomatic salivary gland diseases in the dog: three cases diagnosed by MRI.

This article describes three original cases of zygomatic gland disease in the dog diagnosed by low-field MRI and treated by a modified lateral orbitotomy with zygomatic osteotomy. Presenting complaints included exophthalmia, protrusion of the third eyelid, and periorbital swelling without any history of trauma. Low-field MRI allowed for adequate diagnosis of zygomatic gland disease in all cases and provided detailed information about both the specific tissue characteristics of each lesion and extension into surrounding structures. MRI findings were also helpful for surgical planning and dictated the choice of a modified lateral orbitotomy without removal of the orbital ligament. Histopathologic diagnosis for each of the three dogs was a mucocele, a malignant mixed salivary tumor, and sialadenitis.

Nasal-skin-fold transposition flap for upper lip reconstruction in a French bulldog.

Upper-lip reconstruction after mast-cell tumor-resection in a French bulldog was achieved by using a transposition flap from the nasal-skin-fold and an oral mucosal flap. The new technique is an alternative for reconstruction of extensive upper-lip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results.

Lambeau de transposition provenant du repli cutané nasal pour une reconstruction de la lèvre supérieure chez un Bouledogue français. Une reconstruction de la lèvre supérieure après une résection d'une tumeur à mastocytes chez un Bouledogue français a été réalisée en utilisant un lambeau de transposition provenant du repli cutané nasal et un lambeau oral des muqueuses. La nouvelle technique représente une option pour la reconstruction de défauts importants de la lèvre supérieure chez les chiens brachycéphaliques et donne des résultats fonctionnels et esthétiques satisfaisants.(Traduit par Isabelle Vallières).

Bilateral contracture of the carpal and digital flexor muscles resulting in carpal flexural deformity in a cat.

Case summary: A 12-year-old neutered female domestic shorthair cat was presented with bilateral progressive forelimb lameness that was unresponsive to anti-inflammatory drugs. Bilateral carpal flexural deformity with hyperflexion of multiple toes of the right forelimb was observed. In the absence of abnormalities detected on radiographs and ultrasound, a bilateral contracture of the carpal and digital flexor muscles was diagnosed. Treatment consisted of single-session bilateral selective tenectomies (5 mm) of the flexor carpi ulnaris, flexor carpi radialis and superficial digital flexor muscle tendons on the left forelimb and tendons of the flexor carpi ulnaris muscle, and branches of the third and fourth digit of the deep digital flexor muscle on the right forelimb. Two months postoperatively, selective tenectomies (10 mm) were performed due to contracture recurrence on the left forelimb. The subjective outcome was rated as good 6 months postoperatively. Relevance and novel information: Digital and/or carpal contractures are rarely described in (feline) veterinary medicine and are limited to a few case reports. The exact aetiology remains unknown. A traumatic/iatrogenic origin seems to be the most likely cause. Surgery is indicated, consisting of selective tenectomy and/or tenotomy, and is associated with minor complications and an excellent outcome. This case report describes the presence, treatment and successful outcome of a cat with bilateral carpal and digital flexor muscle contractures resulting in carpal flexural deformity with valgus deviation treated with selective tenectomies.

49-month survival following caval venectomy without nephrectomy in a dog with a pheochromocytoma.

An 11 yr old spayed female Labrador retriever was diagnosed with a right adrenal tumor. At surgery, adhesions to the right kidney were dissected, allowing the right kidney to be preserved. The tumor showed extensive invasion into the suprarenal vena cava. It was felt that thrombus removal via venotomy could not be performed. Instead, the vena cava was ligated caudal to the liver and cranial to the right renal vein. The neoplastic gland was then excised en bloc together with the portion of the invaded caudal vena cava. Hind limb edema had developed preoperatively and increased transiently in the first days postoperatively. The animal was discharged 6 days postoperatively with no other clinical disorders, and hind limb edema resolved over time. Histopathology identified a pheochromocytoma. The dog died 49 mo later. A neoplastic thrombus of the vena cava may require venotomy to allow thrombus removal. Occasionally, removal of the thrombus by venotomy may prove impossible. In such a situation, en bloc removal of the concerned portion of the vena cava may be performed with a good long-term outcome provided that gradual occlusion of the vena cava by the thrombus has allowed time for collateral circulation to develop.

Tibial Plateau Leveling Following Tibial Tuberosity Advancement: A Case Series.

Persistent stifle instability is a recognized complication following tibial tuberosity advancement techniques (TTAT). The aim of this study is to report the feasibility and outcome of tibial plateau leveling techniques (TPLT) to treat dogs with persistent lameness, suspected to be secondary to persistent stifle instability, following (TTAT). Medical records of dogs presented for persistent lameness after TTAT were reviewed. Preoperative data included orthopedic examination, lameness score and radiographs. Inclusion criteria included performance of a surgery to address persistent lameness and suspected instability. Short-term follow up data included orthopedic examination and radiographs of the stifle. Long-term follow up was based on postoperative Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Seven dogs were included in the study. Mean subjective preoperative lameness score was 3 ± 1.53. Mean preoperative patellar ligament angle relative to the tibial plateau (PLATP) was 94° and mean tibial plateau angle (TPA) was 28°. Six dogs had tibial plateau leveling osteotomy and one had modified cranial closing wedge ostectomy. Mean postoperative PLATP was 79° and mean TPA was 5°. Mean subjective lameness score at follow up was 0.57 ± 0.49. Minor complications were present in 2 dogs and major complication in 1 dog. Mean LOAD questionnaire score was 6.6/52. TPLT can be performed after TTAT and may improve clinical function and stability in these cases in which persistent instability is suspected.

Anatomic study of the canine stifle using low-field magnetic resonance imaging (MRI) and MRI arthrography.

OBJECTIVE: To investigate the use of low-field magnetic resonance imaging (MRI) and MR arthrography in normal canine stifles and to compare MRI images to gross dissection. STUDY DESIGN: Descriptive study. SAMPLE POPULATION: Adult canine pelvic limbs (n=17). METHODS: Stifle joints from 12 dogs were examined by orthopedic and radiographic examination, synovial fluid analysis, and MRI performed using a 0.2 T system. Limbs 1 to 7 were used to develop the MR and MR arthrography imaging protocol. Limbs 8-17 were studied with the developed MR and MR arthrography protocol and by gross dissection. Three sequences were obtained: T1-weighted spin echo (SE) in sagittal, dorsal, and transverse plane; T2-weighted SE in sagittal plane and T1-gradient echo in sagittal plane. RESULTS: Specific bony and soft tissue structures were easily identifiable with the exception of articular cartilage. The cranial and caudal cruciate ligaments were identified. Medial and lateral menisci were seen as wedge-shaped hypointense areas. MR arthrography permitted further delineation of specific structures. MR images corresponded with gross dissection morphology. CONCLUSIONS: With the exception of poor delineation of articular cartilage, a low-field MRI and MR arthrography protocol provides images of adequate quality to assess the normal canine stifle joint.

Use of the Kishigami Atlantoaxial Tension Band in eight toy breed dogs with atlantoaxial subluxation.

OBJECTIVE: To determine the applicability, complications, and long-term functional outcome of the Kishigami Atlantoaxial Tension Band (Kishigami AATB) for management of congenital and traumatic atlantoaxial (AA) instability in toy breed dogs. STUDY DESIGN; Case series. ANIMALS: Toy breed dogs (n=8) with congenital or traumatic AA instability. METHODS: The AA joint of each dog was surgically stabilized through a dorsal approach using the original or a modified version of the Kishigami AATB. Pre- and postoperative neurologic status, radiographs, and complications were reviewed. Follow-up examination was performed at 1 and 12 months. RESULTS: Functional improvement occurred in 5 dogs; 1 dog did not improve or worsen and 2 dogs were euthanatized at owner request. Adequate reduction and stabilization was achieved in 7 dogs based on immediate postoperative radiographs; failure of reduction was evident in 1 dog. No relevant complications occurred. CONCLUSIONS: Kishigami AATB may be acceptable as an alternative method for dorsal stabilization of AA subluxation in toy breed dogs in which use of ventral screws or pins is challenging. Experience with this technique in a larger population is necessary to compare our results to those reported by ventral approach. CLINICAL RELEVANCE; The surgical technique described is effective, safe, and simple in the surgical treatment of AA subluxation in toy breed dogs.

Laparoscopic adrenalectomy for treatment of unilateral adrenocortical carcinomas: technique, complications, and results in seven dogs.

OBJECTIVE: To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma. STUDY DESIGN: Case series. ANIMALS: Dogs (n=7) with Cushing's syndrome caused by unilateral adrenocortical carcinoma. METHODS: Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5-12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site. RESULTS: Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months). CONCLUSIONS: Laparoscopic adrenalectomy is feasible in dogs with either right- or left-sided adrenocortical carcinoma not involving the caudal vena cava. CLINICAL RELEVANCE: When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs.

A retrospective study of 40 dogs with polyarthritis.

OBJECTIVE: To characterize the epidemiologic, clinical, laboratory, and radiographic findings from dogs with polyarthritis (PA). STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Forty dogs. METHODS: Medical records of 40 dogs with a diagnosis of PA were reviewed. Retrieved data included breed, age at admission, sex, weight, clinical signs, and the results of synovial fluid analysis, complete blood count, serum chemistry profile, urinalysis, serologic screening tests for infectious diseases, and radiographic examination of affected joints. RESULTS: The incidence of PA was 0.37%. Twenty-nine breeds were represented; 16 dogs were male, and 24 were female. Mean body weight was 20.1 +/- 15 kg. The mean age at admission was 5.6 +/- 4 years. Eighty percent of dogs with PA had difficulty or reluctance walking, 35% were lame, 33% had spontaneous vocalization without any obvious reason, 20% had exercise intolerance, 18% were febrile, and 7.5% had an inability to rise or move. Joint pain was identified in 40% of dogs. Synovial fluid color varied from colorless (36%) to yellow-tinged (36%) or hemorrhagic (28%). Synovial fluid mean cell count varied from 10 cells (400x) to 50 cells (1,000x). Leukocytosis occurred in 59% of the dogs and was more frequently identified in dogs with very severe synovial inflammation. Thirty-one percent of affected dogs were anemic. Serum biochemical profiles were considered abnormal in 13% of the dogs. Joint radiography did not identify erosive arthritis. CONCLUSIONS: PA is a common cause of locomotor abnormalities in dogs; however, true lameness and articular pain are not common clinical findings in dogs with PA. CLINICAL RELEVANCE: PA should be considered in the differential diagnosis for all dogs with difficulty walking.

Use of laparotomy in a staged approach for resolution of bilateral or complicated perineal hernia in 41 dogs.

OBJECTIVE: To evaluate the value of laparotomy as the initial step in the treatment of bilateral or complicated perineal hernia (PH) in dogs. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: Forty-one dogs with PH. METHODS: Dogs with bilateral or complicated PH treated by a 2-step approach between November 1997 and December 2001 were studied. Inclusion criteria for complicated PH were: recurrence of PH, unilateral PH with a major rectal dilatation, PH with a concurrent surgical prostatic disease, and PH with retroflexed bladder. Colopexy, vas deferens pexy, cystopexy, and prostatic omentalization were performed during laparotomy as needed. Later, PH was performed by internal obturator muscle flap (IOMF) or if there was a perineal rent or weakness on the contralateral side, appositional herniorrhaphy was performed. Outcome was followed for >/=6 months. RESULTS: PH were bilateral (20 dogs) or unilateral (21). Twenty-one (51%) dogs had prostatic disease (clinical or ultrasonography diagnosis; 17 confirmed histologically) and 12 (29%) had urinary bladder retroflexion. Forty-one colopexies, 32 vas deferens pexies, 6 cystopexies, and 9 prostatic surgeries (omentalization or perineal cyst resection) were performed. PH was performed 2-20 days (median, 6 days) later: 61 IOMF transpositions, 13 appositional. Mean follow-up time was 26.6 months (range, 6-54 months, median, 27 months). PH was resolved in 37 (90%) dogs; 4 dogs had recurrence, and all occurred within 6 months. Thirty-eight (92%) dogs had an improved quality of life (good in 34 dogs, fair in 4 dogs). Wound complications occurred in 7 dogs (17%). Postoperative urine dribbling occurred in 15 dogs (37%) and was irreversible in 7 dogs (17%). Postoperative fecal straining persisted in 18 dogs (44%), and was permanent in 4 dogs (10%). Fecal incontinence did not occur. CONCLUSIONS: In bilateral or complicated PH, fixation of the urinary bladder and colon, and treatment of prostatic disease increase the chances of resolution. Emptying of the perineal space by organ pexy allows improved observation during herniorrhaphy. Despite a 90% clinical resolution, dogs with complicated PH treated by a 2-step protocol may have persistent urinary and fecal disorders. CLINICAL RELEVANCE: To improve the prognosis of bilateral or complicated PH, investigation and treatment of concomitant lesions (rectal, prostatic, bladder) should be part of a rational surgical strategy using a 2-step protocol.

Thoracoscopic treatment of bullous emphysema in 3 dogs.

OBJECTIVE: To report thorascopic partial lobectomy for treatment of bullous emphysema in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: Three dogs with spontaneous pneumothorax. METHODS: Thoracoscopy without pulmonary exclusion was used to identify bulla. The thorascope was introduced into the thorax lateral to the xyphoid process, and instrument portals were made at different levels along the thoracic wall between the third and tenth intercostal spaces. The thorascope was passed through the mediastinum to view the opposite pleural cavity. After identification of bullae, the affected lung was excised using an endoscopic stapler, and the incision line was checked for air leakage. Thoracic drains were used for air aspiration for 2 days after surgery. RESULTS: Bullae were confirmed histologically as emphysematous lesions. Lung inflation did not interfere with identification of bullae or with surgery. All dogs had full recovery without recurrence for 18 to 29 months after surgery. CONCLUSIONS: Identification and ablation of bulla can be performed thoracoscopically without pulmonary exclusion in dogs. CLINICAL RELEVANCE: Thoracoscopy offers several advantages compared with thoracotomy for treatment and diagnosis of idiopathic pneumothorax, including ease of identification of bullae and reduced postoperative pain and morbidity.