Delayed Life-Threatening Hemorrhage Caused by Cranial Tibial Artery Pseudoaneurysm in Two Dogs.

Two adult dogs were presented at 25 and 30 days following tibial external skeletal fixator placement (case 1) and tibial plateau leveling osteotomy (case 2), respectively. Clinical signs at presentation for each of them included acute onset lethargy, non-weight-bearing lameness, and hemorrhage at the surgical site with large hematoma formation. On admission, emergency whole blood transfusion was required in case 2 with a preoperative packed cell volume of 13%. Both dogs were diagnosed with pseudoaneurysm of the cranial tibial artery based on color Doppler ultrasonography. Additionally, computed tomography angiography was performed in one dog. Surgical treatment of the dogs included ligation of the cranial tibial artery supplying the pseudoaneurysm and curettage of hematoma. The surgery was completed without complications in case 1, but case 2 experienced inadvertent rupture of pseudoaneurysm with significant blood loss, which required another whole blood transfusion during the procedure. Both dogs had excellent functional recovery with no recurrence of clinical signs. We hypothesized that pseudoaneurysms were primarily caused by trauma secondary to placement of surgical implants or osteotomy. For orthopedic surgeons, it is important to recognize clinical signs of a potential tibial arterial pseudoaneurysm, as early surgical intervention may prevent loss of limb or life.

Complications and Long-Term Outcomes after Combined Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition for Treatment of Concurrent Cranial Cruciate Ligament Rupture and Grade III or IV Medial Patellar Luxation.

OBJECTIVES: This study aims to report complications and long-term outcomes of combined tibial plateau leveling osteotomy and tibial tuberosity transposition (TPLO-TTT) for treatment of concurrent cranial cruciate ligament rupture and medial patellar luxation (MPL). STUDY DESIGN: This is a retrospective study. Dogs that underwent TPLO-TTT for treatment of combined cranial cruciate ligament rupture and grade III or IV MPL were included. Signalment, fixation method, and complications were recorded. Long-term outcome assessment (minimum 1 year postoperatively) was performed through clinical and radiographic reexamination at the authors' institution. RESULTS: Twenty-four stifles (22 dogs) were included. Twenty-one stifles had a grade III MPL, and 3 stifles had grade IV MPL. Four major complications consisting of surgical site infection (n = 3) and recurrent grade II MPL (n = 1) were observed. Dogs with surgical site infections were successfully treated with implant removal and oral antibiotics. No additional surgery was performed for the patient with recurrent MPL as no signs of lameness were observed. Minor complications occurred in five cases. At long-term evaluation (median: 27 months; range: 12-67 months), 21/22 dogs were clinically sound and 23/24 stifles had a complete resolution of MPL. CONCLUSION: TPLO-TTT can be considered as an effective surgical option to treat patients with concurrent cranial cruciate ligament rupture and MPL with a relatively low major complication rate. Owners should be warned of the potential need for implant removal.

Complications and Long-Term Outcomes After Prosthetic Capsule Replacement in 15 Dogs with Traumatic Hip Luxation.

Complications and long-term clinical outcomes for 15 dogs surgically treated for traumatic craniodorsal hip luxation by prosthetic capsule replacement (PCR) with a prosthetic ligament were retrospectively reviewed. A PCR technique with capsulorrhaphy was performed in all dogs using acetabular screws with washers and a femoral tunnel as anchor points for the polyester prosthetic ligament. A non-weight-bearing sling was not placed. Minimum 1 yr follow-up period was required for study inclusion. Two major complications (13.3%) consisting of craniodorsal hip reluxation (n = 1) and capital physeal fracture (n = 1) were observed. Minor complications (superficial skin necrosis) occurred in one case (6.7 %). The patient with craniodorsal hip reluxation underwent femoral head and neck ostectomy and was excluded from long-term analysis. In the 11 cases that returned for long-term (median, 3.8 yr; range, 19-75 mo) evaluation at the authors' institution, 10/11 of the dogs were clinically sound. Three dogs did not return for long-term evaluation. However, telephone interview with owners minimum1 yr after surgery indicated normal limb function and absence of complications in all three cases. These results suggest that PCR with polyester prosthetic ligament can be successful in maintaining hip reduction in dogs with craniodorsal hip luxation.

Long-term outcome of tibial plateau leveling osteotomy using an antimicrobial silver-based coated plate in dogs.

OBJECTIVES: To evaluate long-term outcome using the BioMedtrix™ TPLO Curve® plate in dogs with cranial cruciate ligament disease (CrCLd) treated by tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Retrospective case study. ANIMALS: Dogs (n = 323, 337 stifles). METHODS: Medical records were searched for dogs presented with CrCLd and treated by TPLO with the BioMedtrix™ TPLO Curve® plate for 3.5 mm screws between March 2018 and December 2020. Tibial plateau angles (TPA) were measured on preoperative, postoperative, and follow-up radiographs. Changes in TPA between postoperative and follow-up radiographs (ModTPA) were calculated. Radiographic bone healing was scored. Complications were evaluated. Surgical site infections (SSI) were compared to a control group of dogs treated with the Synthes™ TPLO plate between January and December 2017. Owners of both groups were contacted by telephone at least 1 year postoperatively. RESULTS: The BioMedtrix™ group was composed of 237 dogs (248 stifles), the control group was composed of 86 dogs (89 stifles). In the BioMedtrix™ group, radiographic follow-up was performed at a median of 48 days. Average ModTPA was 1.2°. Bone healing was graded as complete, good, poor, and none in 18%, 62%, 20%, and 0%, respectively. At a median of 786 days postoperatively, minor and major postoperative complications were observed in 6 (2.4%) and 32 (12.9%) cases in this group, respectively. During the first year following the surgery, 23 (9.3%) and 12 (13.5%) cases suffered a SSI, of which 12 (4.8%) and 7 (7.9%) had their implant explanted in the BioMedtrix™ group and the control group, respectively. There was no significant difference between groups for SSI and implant explantations (p = 0.31 and p = 0.29, respectively). CONCLUSION: The BioMedtrix™ TPLO Curve® plate provided a reliable fixation system for osteotomy healing after TPLO. Bone healing and long-term complication rates were similar to previous studies using other implants. SSI rates were similar between the BioMedtrix™ group and the control group. The antimicrobial HyProtect® coating of the plate did not reduce SSI in this study. CLINICAL SIGNIFICANCE: The BioMedtrix™ TPLO Curve® plate can be safely used for TPLO. The value of the antimicrobial HyProtect® coating of the plate may be questioned, as SSI rate was not lower in this study compared to the control group or previous reports.

Arthroscopic removal of an intra-articular screw causing joint impingement after distal femoral fracture repair in a dog.

The use of lag screws to treat femoral condyle fractures is common, and their placement in surgery is technically demanding. Intra-articular screw impingement is a serious complication that may occur during surgical treatment of femoral condyle fractures. Here, we describe the case of a 3-year-old 40-kg dog which experienced recurrent lameness 6 mo after successful surgical treatment of a comminuted medial femoral condyle fracture due to an intra-articular non-loosening screw causing joint impingement. Removal of the conflicting screw was performed arthroscopically, based on its ability to offer minimally invasive access to the stifle joint. Six months after removal of the screw, the dog had full recovery without limitations to range of motion or stifle pain. To our knowledge, this is the first report on the use of arthroscopy to remove an intra-articular screw causing joint impingement after distal femoral fracture repair in a dog.

Retrait par arthroscopie d'une vis causant un empiètement intra-articulaire après une ostéosynthèse du fémur distal chez un chien. Les fractures fémorales condyliennes sont communément stabilisées au moyen de vis de traction dont le placement peut s'avérer techniquement difficile. L'empiètement intra-articulaire induit par une vis est une complication sérieuse du traitement des fractures fémorales condyliennes. Nous décrivons dans le présent article le cas d'un chien de 3 ans et de 40 kg présenté pour une boiterie récidivante, 6 mois après le traitement d'une fracture comminutive du condyle fémoral médial, due à une vis causant un empiètement intraarticulaire. Le retrait de la vis est effectuée par arthroscopie étant donné que cela permettait un accès minimalement invasif au grasset. Six mois après l'arthroscopie, le chien présente une récupération orthopédique pleine sans douleur ni diminution de l'amplitude articulaire du grasset. Il s'agit du premier cas de retrait par arthroscopie d'une vis causant un empiètement intra-articulaire après une ostéosynthèse d'une fracture fémorale distale chez un chien.(Traduit par l'auteur).

Laparoscopic retrieval of a hepatic foreign body in a dog.

A 4-year-old female pointer dog was presented with a 10-day history of tensed abdomen. Migration of a metallic foreign body to the liver was diagnosed using radiography and ultrasonography. Surgical retrieval of a sewing needle was successfully performed by laparoscopy using a 3-trocar technique, thus avoiding laparotomy. No intra- or post-operative complications occurred. The dog was discharged 24 hours after surgery. Ten months after surgery, the dog was in excellent physical condition with no recurrence of clinical signs. This is the first reported case of laparoscopic retrieval of a hepatic foreign body in a dog.

Retrait d'un corps étranger dans le foie par laparoscopie chez un chien. Une femelle pointer de 4 ans fut présentée avec un historique d'inconfort abdominal et d'abdomen tendu. Un corps étranger métallique dans le foie a été identifié par radiographie et échographie. Le retrait d'une aiguille de couture fut réalisé par laparoscopie au moyen de trois ports instrumentaux, évitant ainsi le recours à une laparotomie. Aucune complication per ou post opératoire n'est survenue. La sortie de l'hôpital a eu lieu 24 heures après la chirurgie. Dix mois après la chirurgie, le chien était en excellent état général sans récidive des signes cliniques. Il s'agit du premier cas de retrait par laparoscopie d'un corps étranger dans le foie chez un chien.(Traduit par l'auteur).

Gastric dilatation and volvulus in a 5-month-old Bernese mountain dog.

A 5-month-old Bernese mountain dog was presented for unproductive vomitus and abdominal distension. A gastric dilatation and volvulus was diagnosed. The dog underwent gastric derotation and incisional gastropexy. No intra- or post-operative complications occurred. Eight months following surgery, the dog was in excellent physical condition with no recurrence of clinical episodes of gastric dilatation. To the authors' knowledge, gastric dilatation and volvulus has not been previously reported in a puppy. This report underlines the importance of considering a prophylactic gastropexy in juvenile dogs with a known breed predisposition for gastric dilatation and volvulus.

Syndrome de dilatation torsion de l'estomac chez un Bouviers Bernois de 5 mois. Un Bouviers Bernois de 5 mois a été présenté pour des efforts de vomissements improductifs associés à une dilatation abdominale. Un syndrome de dilatation torsion de l'estomac a été diagnostiqué. Une dérotation gastrique et une gastropexie incisionnelle ont été réalisées. Aucune complication per- ou postopératoire n'est survenue. Huit mois après l'intervention chirurgicale, le chien présente un excellent état général sans récidive d'épisodes cliniques de dilatation gastrique. Il s'agit de la première description d'un syndrome de dilatation torsion de l'estomac chez un chiot. Ce cas souligne l'importance de considérer une gastropexie prophylactique précoce chez les chiens jeunes avec une prédisposition connue pour une dilatation torsion de l'estomac.(Traduit par les auteurs).

Intraobserver and interobserver reliability of computed tomography measurements of the soft palate in French bulldogs.

BACKGROUND: CT imaging has been used to document the soft palate dimensions in brachycephalic dogs but reliability of such measurements has not been evaluated. The aims of this study were to propose a method of measurements of the soft palate in French bulldogs and determine its reliability. METHODS: Thirty French bulldogs were prospectively included. Five measurements of the soft palate were performed on soft tissue and bone window mid-sagittal images: length, thickness at 25, 50 and 75 per cent of its length and sagittal plane cross-sectional area. Three sets of data were separately acquired by three observers. Intraobserver and interobserver reliability for all measurements was assessed using intraclass correlation coefficient (ICC). RESULTS: The median ICCs showed excellent reliability (0.90 to 0.99) for all intraobserver measurements except for thickness at 75 per cent which showed good (0.80 to 0.89) to excellent reliability. The median ICC showed excellent reliability for all interobserver measurements. CONCLUSION: The soft palate measurements on a single CT image are reproducible and repeatable. Further study is needed to assess the reliability of these measurements in the same patient with different endotracheal tube positions.

Percutaneous Screw Fixation of Incomplete Ossification of the Humeral Condyle in Three Dogs (Four Elbows).

Transcondylar screw fixation was performed using a minimally invasive percutaneous technique on three dogs (four elbows) diagnosed with incomplete ossification of the humeral condyle. The technique was performed using an aiming device in all four elbow joints and assisted by intraoperative fluoroscopy in one. All screws were successfully placed on first attempt and no elbow joint required repositioning of the transcondylar screw. On immediate postoperative radiographs, median transcondylar screw angulation was 2.9° and median percentage of screw eccentricity relative to the theoretical center of the humeral condyle was 14%. No short-term postoperative complications (<1 mo) were observed. The surgical technique described is a feasible option for surgical management of incomplete ossification of the humeral condyle in dogs that allowed accurate transcondylar screw placement and orientation.

Effects of urinary bladder retroflexion and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia: 41 cases (2002-2009).

OBJECTIVE: To evaluate the effects of urinary bladder retroflexion (UBR) and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia. DESIGN: Retrospective case series. ANIMALS: 41 client-owned dogs with perineal hernia that underwent surgery between November 2002 and November 2009. PROCEDURES: Medical records were reviewed for information on dog signalment, history, physical examination findings, ultrasonographic findings, surgical techniques, intraoperative complications, duration of hospital stay, postoperative complications, and long-term outcome. RESULTS: 31 dogs had no UBR, and 10 dogs had UBR. Internal obturator muscle transposition (IOMT) was performed in 20 dogs, and a cystopexy or colopexy was performed before the IOMT (LapIOMT) in 21. Postoperative complications included tenesmus (n = 8) and urinary incontinence (1). Rates of postoperative complications were not significantly different between the no-UBR and UBR groups or between the IOMT and LapIOMT groups. Thirty-two dogs were free of clinical signs at the time of the study. The median disease-free interval did not differ significantly between dogs in the no-UBR and UBR groups, but it was significantly lower in the LapIOMT group than in the IOMT group. None of the 7 dogs with UBR that were treated without cystopexy developed recurrence of UBR. CONCLUSIONS AND CLINICAL RELEVANCE: UBR was not associated with an increased rate of postoperative complications relative to no UBR and had no effect on the long-term outcome in dogs with perineal hernia. The use of IOMT alone may be recommended for clinical use because LapIOMT offered no clear advantage.

Video-assisted thoracoscopic surgery for pneumothorax induced by migration of a K-wire to the chest.

A 2 yr old female English setter dog was admitted for acute dyspnea. The dog underwent treatment of a T9T10 thoracic vertebral fracture subluxation at the authors' institution 15 mo earlier. Upon admission, a chest X-ray revealed a pneumothorax and a metallic foreign body in the left hemithorax. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 4.6-mm long Kirschner wire that migrated from the thoracic vertebral column to the thoracic cavity. The operating time was 27 min. The dog made an uneventful recovery and was discharged on the third day after surgery. Pneumothorax should be considered in patients that develop acute dyspnea and have a history of wire fixation in the thoracic vertebral column. Video-assisted thoracoscopic surgery is a safe and effective treatment of this condition.

Urodynamic and morphologic changes in the lower portion of the urogenital tract after administration of estriol alone and in combination with phenylpropanolamine in sexually intact and spayed female dogs.

OBJECTIVE: To compare the urodynamic and morphologic effects of the administration of estriol alone and in combination with phenylpropanolamine on the lower portion of the urogenital tract in female dogs. ANIMALS: 3 sexually intact and 3 spayed female Beagles without urinary incontinence. PROCEDURE: Dogs received estriol (2 mg, PO) once daily for 7 days followed by estriol (2 mg, PO) and phenylpropanolamine (1.5 mg/kg, PO) once daily for 7 days. Urethral pressure profilometry, diuresis cystometry, and vaginourethrography were performed before treatment (day 0) and at days 7 and 14. The maximum urethral pressure (MUP) and closure pressure (MUCP), urethral functional and anatomic profile lengths, integrated pressure (IP), plateau, distance before MUP, maximum meatus pressure, threshold pressure, threshold volume, compliance, urethral length, and vaginal length and width were measured. RESULTS: Before treatment, no urodynamic differences were observed between the 2 groups; however, vaginal length and width were significantly shorter in spayed dogs. Compared with day 0 values, estriol treatment significantly increased MUP, MUCP, and IP values at day 7, but at day 14, this effect decreased despite phenylpropanolamine administration. No morphologic changes from baseline were detected after either treatment in any dog. CONCLUSIONS AND CLINICAL RELEVANCE: Data suggest that estriol mainly acts on the urethral sphincter mechanism by increasing urethral resistance in sexually intact and spayed female dogs without urinary incontinence. Administration of estriol and phenylpropanolamine did not increase the urethral resistance more than estriol alone. The urodynamic effects of estriol in female dogs with urinary incontinence remain to be elucidated.