Complications and owner satisfaction associated with limb amputation in cats: 59 cases (2007-2017).

BACKGROUND: Limb amputation may be recommended in domestic cats following a severe injury or disease. The purpose of the study was to report the signalment, the complications, recovery outcome, owner satisfaction and expectations of domestic cats following limb amputation. RESULTS: Medical records of 3 specialty hospitals were reviewed for cats that received a single limb amputation in a 10 year period (2007-2017). These cat owners were contacted, and 59 owners completed surveys, comprising the study population. The most common reasons for limb amputation were neoplasia (54.2%, 32/59), traumatic injury (40.7%, 24/59), bone or joint infection (3.4%, 2/59), and thromboembolism (1.7%, 1/59). Thirty-four cats (57.6%) had postoperative complications. Of the fifty-nine surveys, 52.5% reported minor complications and 5.1% reported major complications. There were no differences in postoperative complication rates for thoracic versus pelvic limb amputations. All owners reported either excellent (77.9%, 46/59), good (20.3% 12/59), or fair (1.7%, 1/59) satisfaction with the procedure. Based on their previous experiences, 84.7% (50/59) of owners would elect limb amputation if medically warranted for another pet. The remaining 15.3% of owners who would not elect limb amputation again had experienced death of their pet with a median survival time of 183 days. CONCLUSION: Owners reported a positive satisfaction when considering complications, recovery outcome, and expectations. This study can be used by veterinarians to guide cat owners in the decision making process of limb amputation.

Medical Infrared Imaging of Normal and Dysplastic Elbows in Dogs.

OBJECTIVE: To investigate the ability of medical infrared imaging to differentiate between normal canine elbows and those with abnormal elbows (elbow dysplasia). STUDY DESIGN: Prospective cohort study. ANIMALS: Dogs with normal (n = 15) and abnormal (n = 14) elbows. METHODS: Infrared imaging was performed on all dogs and data analyzed via descriptive statistics and image pattern analysis software. Animals with elbow dysplasia had arthroscopic procedures to confirm the presence of elbow disease. RESULTS: Computer recognition pattern analysis was up to 100% correct in identifying abnormal elbows and normal elbows, with the medial images most consistent. The caudal, lateral, and cranial images correctly identified 83-100% abnormal elbows. The caudal and lateral images correctly identified 83% normal elbows. A significant difference in temperature was found between normal and abnormal elbows for the cranial full region of interest, lateral images, and each quadrant. CONCLUSION: Medical infrared imaging was able to correctly identify known abnormal and known normal elbows in dogs.

Severe hyperthermia, hypernatremia, and early postoperative death after transethmoidal cavitron ultrasonic surgical aspirator (CUSA)-assisted diencephalic mass removal in 4 dogs and 2 cats.

OBJECTIVE: To report clinical findings including severe hyperthermia and hypernatremia after transethmoidal Cavitron ultrasonic surgical aspirator (CUSA)-assisted diencephalic mass removal. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 4) and 2 cats. METHODS: Medical records (1997-2003) of dogs and cats that had transethmoidal CUSA-assisted diencephalic mass removal were reviewed. Retrieved data were: history, signalment, blood work, neurologic examination findings, MRI results, histopathology, postoperative complications, pre- and postoperative medical therapy, and outcome. RESULTS: Tumor types included: meningioma (n = 3), choroid plexus papilloma (1), astrocytoma (1), and pituitary macroadenoma (1). Median onset of hyperthermia was 3.5 hours (range: 1-6 hours) after extubation; median high temperature at onset was 40.3°C, (range: 39.6-41.7°C). Median onset of hypernatremia (median, 172 mmol/L; range: 168-196 mmol/L) was 4.5 hours (range: 1-9 hours) after extubation. Median time of death after hyperthermia was 10.5 hours (range: 6-13 hours) and after extubation was 13.5 hours (range: 11-15 hours). CONCLUSIONS: Transethmoidal CUSA-assisted diencephalic mass removal is associated with early postoperative hyperthermia, hypernatremia, and death, and cannot be recommended.

Medical infrared imaging (thermography) of type I thoracolumbar disk disease in chondrodystrophic dogs.

OBJECTIVE: To: (1) determine the success of medical infrared imaging (MII) in identifying dogs with TLIVDD, (2) compare MII localization with magnetic resonance imaging (MRI) results and surgical findings, and (3) determine if the MII pattern returns to that of normal dogs 10 weeks after decompression surgery. STUDY DESIGN: Prospective case series. ANIMALS: Chondrodystrophic dogs (n = 58) with Type I TLIVDD and 14 chondrodystrophic dogs with no evidence of TLIVDD. METHODS: Complete neurologic examination, MII, and MRI studies were performed on all dogs. Dogs with type I TLIVDD had decompressive surgery and follow-up MII was performed at 10 weeks. Pattern analysis software was used to differentiate between clinical and control dogs, and statistical analysis using anatomic regions of interest on the dorsal views were used to determine lesion location. Recheck MII results were compared with control and pre-surgical images. RESULTS: Computer recognition pattern analysis was 90% successful in differentiating normal dogs from dogs affected by TLIVDD and 97% successful in identifying the abnormal intervertebral disc space in dogs with TLIVDD. Statistical comparisons of the ROI mean temperature were unable to determine the location of the disc herniation. Recheck MII patterns did not normalize and more closely resembled the clinical group. CONCLUSIONS: MII was 90% successful differentiating between normal dogs and 97% successful in identifying the abnormal intervertebral disc space in dogs with TLIVDD. Abnormal intervertebral disc space localization using ROI mean temperature analysis was not successful. MII patterns 10 weeks after surgery do not normalize.

Evaluation of an ultrasound-guided freeze-core biopsy system for canine and feline brain tumors.

Objective: To determine if a single brain biopsy utilizing a freeze-core needle harvest system Cassi II under ultrasound guidance provides a diagnostic sample; to evaluate the technique's efficacy in procuring diagnostic samples in comparison with "open" surgical biopsies; and to describe intraoperative complications associated with the technique. Study design: Experimental clinical study. Animals: Seventeen dogs and four cats with magnetic resonance imaging (MRI) diagnoses of readily surgically accessible intracranial masses. Methods: Immediately prior to surgical biopsy (SB), freeze-core biopsy (FCB) sample was obtained from each patient under ultrasound guidance. Results: Histopathology results from single FCB samples were found to be in 100% agreement with the SB samples. Freezing artifact was minimal and did not interfere with histopathologic interpretation. There were no intraoperative complications specifically attributable to the use of the FCB system. Conclusion: Based on the results of this small experimental study, the FCB system is expected to safely yield diagnostic quality intracranial masses biopsy specimens. Clinical significance: This system has the potential of obtaining diagnostic biopsies of more deeply seated brain lesions (i.e., intra-axial tumors considered inaccessible or with large risks/difficulties by standard surgical means) which would provide a definitive diagnosis to guide appropriate therapy.

Micro total hip replacement in dogs and cats.

OBJECTIVE: To describe the surgical technique using power-assisted femoral preparation and clinical outcome in 41 dogs and 2 cats surgically treated with the micro total hip prosthesis. STUDY DESIGN: Retrospective case series ANIMALS: Dogs (n = 41) and 2 cats METHODS: Medical records (January 2007-March 2010) of dogs and cats that had MicroTHR were reviewed. Data regarding implant position, cement mantle quality, concurrent surgery, intra- and postoperative complications, operative time, 3-week and 3-month recheck physical examinations, 3-month pelvic radiograph findings, and interval from surgery to any complication were retrieved. RESULTS: Six dogs had staged bilateral MicroTHR, 35 dogs and 2 cats had unilateral MicroTHR. Median body weight was 8.2 kg (range, 2.1-14.2 kg) whereas for those that had complications (fracture or luxation) it was 8.6 kg (range, 6.6-14.1 kg). Median operative time was 71 minutes (range, 55-105 minutes). Complications included luxations (5 of 49; 10%) and femoral fracture (1; 2%). Lameness grades assigned at the 3-month recheck examination: 39 (80%) animals were grade 1, 6 (12%) were grade 2, and 4 (8%) were grade 3. Forty-five animals (92%) had good or excellent results. CONCLUSIONS: MicroTHR is a practical and effective surgery in small breed dogs and cats with coxofemoral disease.

Risk factors and clinical relevance of positive intraoperative bacterial cultures in dogs with total hip replacement.

OBJECTIVE: To report incidence and relevance of positive intraoperative total hip replacement (THR) bacterial cultures taken at the time of surgical closure in dogs having unilateral THR. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 100) with cemented (CFX), cementless (BFX), or hybrid THR. METHODS: Medical records (January 2007-March 2010) of dogs that had THR were reviewed. Signalment, type and side of THR, concurrent surgery, operative and anesthetic times, intraoperative coxofemoral closing (CC) bacterial culture results, organism cultured, duration of postoperative antibiotic administration, physical examination findings at 3 weeks, 3 months, and at 6 months to 1 year after surgery, radiographic findings at 3 months and between 6 months and 1 year after surgery, and incidence of complications were retrieved. RESULTS: There was a significant difference in duration of surgery between CC culture negative and CC culture positive groups (103.27 minutes versus 122.50 minutes, respectively, P < .038) and in total anesthetic time between CC culture negative and culture positive groups (165.20 minutes versus 189.50 minutes, respectively, P < .038). There was no significant difference between CC culture negative and culture positive groups for median age (30 months versus 39 months, respectively, P < .75), median weight (36.91 kg versus 35.68 kg, respectively, P < .61), median clinical signs (4 months versus 3.5 months, respectively, P < .65), sex (males 44.32% versus females 25.00%, respectively, P < .20), laterality (left 55.68% versus right 50.00%, respectively, P < .71), concurrent surgery (extracapsular lateral imbrication/medial patella luxation/lateral patella luxation [ECLI/MPL/LPL] 22.73% versus none 25.00%, respectively, P < 1.00), and THR type (hybrid 17.05% versus 25.00% respectively; CFX 60.23% versus 75.0%; BFX 22.73% versus 0.0%; Fisher's exact test P < .17). CONCLUSIONS: Surgical and anesthetic duration were significantly associated with positive CC culture results. Positive CC culture results were not associated with adverse results at 3 months and at 6-month to 1-year follow-up evaluation.

Biopsy and histologic findings of the dura mater at the level of the foramen magnum in 121 CKCS with Chiari-like malformation.

To describe histopathologic features found in dural biopsies of Cavalier King Charles Spaniels (CKCS) with Chiari-like malformation (CM) and identify any associations between age, duration of clinical signs, syrinx location or syringomyelia (SM, and quality of life (QOL). The medical records of 121 consecutive client owned CKCS with CM and SM, confirmed by whole body magnetic resonance imaging (MRI), that underwent foramen magnum decompression (FMD) with cranioplasty and durectomy with biopsy from 2006 to 2016 were retrospectively reviewed. Dural biopsies were submitted to a board-certified veterinary pathologist for histopathologic interpretation. The chi-square test was used to analyze associations between histologic findings and categorical variables. For continuous measures, the Kruskal-Wallis non-parametric test was used to compare distributions across pathology categories. A result was considered statistically significant at the p < 0.05 level of significance. The mean age, duration of pre-surgical clinical signs, and pre-operative QOL (1-5 scale) were 44.27 months, 44.78 weeks, and 2.72, respectively. Syringomyelia was found in the cervical region only in 39 of 121 (32.23%) of dogs, in the cervical and thoracic region only in 17 of 121 (14.05%) of dogs, and in the cervical, thoracic, and lumbar region combined in 65 of 121 (53.72%) of dogs. Sixty-six of one hundred twenty-one (54.55%) dural biopsy specimens had histopathology changes; fifty-five (45.45%) did not. Forty-three of one hundred twenty-one (35.54%) dural biopsy specimens had osseous metaplasia, 16 of 121 (13.22%) had evidence of fibrosis, 4 of 121 (3.31%) had arachnoid hyperplasia, and 3 of 121 (2.48%) had evidence of mineralization. Most dogs with CM were found to have histopathologic changes in the dura at the time of FMD cranioplasty was performed. These dural changes can be observed in dogs experiencing clinical signs for a time period as short as 4 weeks prior to presentation. The histopathologic changes were not associated with age, breed, duration of clinical signs, the location of syringomyelia or QOL. The influence of histopathologic changes on long-term prognosis in dogs without dural decompression is unknown since all dogs in this study had dural resection.

The Effects of Mycophenolate on the Formation of Granulation Tissue Post-operatively in Canine Tracheal Stent Patients (2014-2020).

Objectives: To determine if mycophenolate mofetil reduces the incidence and severity of granulation tissue in-growth in canine tracheal stent patients. Study design: Randomized clinical trial. Animals: 111 dogs from the hospital population. Methods: Client-owned dogs that received an endoluminal self-expanding tracheal stent for canine tracheal collapse between 2014 and 2020 were randomly assigned into one of two treatment groups. Control group medication protocol consisted of prednisone 0.5 mg/kg PO BID/SID/EOD × 30 days, hydrocodone 0.25 mg/kg PO TID × 30 days, and cefovecin 8 mg/kg SQ post-placement. Mycophenolate group medication protocol was identical to the control group medication protocol with the addition of mycophenolate mofetil 10 mg/kg PO BID × 30 days, SID for life. Recheck tracheoscopy was performed at 1, 3, and 6 months post-stent placement. Presence and severity of granulation tissue were determined by tracheoscopy and were recorded as a percentage of tracheal lumen obstruction by blinded evaluators (none present, <25%, >25-50%, and >50%). Results: At none of the three time points was there a statistically significant difference in grade between controls and those receiving mycophenolate (p = 0.467, p = 0.330, and p = 0.410). Conclusions and Clinical Significance: Our results suggest that mycophenolate can be safely given to these patients but do not support that its administration will reduce the incidence and severity of granulation tissue. Although a difference was observed in the severity of granulation tissue between the two groups, loss to follow-up may have influenced conclusions. A larger study would be warranted to further evaluate the effect of mycophenolate on the development of granulation tissue.

Diagnostic imaging of the canine stifle: a review.

The stifle joint, a common location for lameness in dogs, is a complex arrangement of osseous, articular, fibrocartilaginous, and ligamentous structures. The small size of its component structures, restricted joint space, and its intricate composition make successful diagnostic imaging a challenge. Different tissue types and their superimposition limit successful diagnostic imaging with a single modality. Most modalities exploit the complexity of tissue types found in the canine stifle joint. Improved understanding of the principles of each imaging modality and the properties of the tissues being examined will enhance successful diagnostic imaging.

Thermal imaging of normal and cranial cruciate ligament-deficient stifles in dogs.

OBJECTIVE: To investigate the capability of thermography for differentiation between normal stifles and those with cranial cruciate ligament (CCL) rupture in dogs, initially with a full hair coat and 1 hour after clipping the hair coat. STUDY DESIGN: Prospective study. ANIMALS: Labrador Retrievers (n=6) with normal stifle joints (controls) and adult dogs (n=10) with CCL rupture. METHODS: Thermography was performed before, and 60 minutes after, clipping the hair coat from the pelvic limb. Stifle images were classified as normal or abnormal, then subclassified as clipped and unclipped hair coat. CCL deficiency was confirmed at surgery and thermographic images subsequently classified as abnormal before analysis with image processing software. RESULTS: Using image recognition analysis, differentiation between normal and CCL-deficient stifles in both clipped and unclipped dogs was 85% successful on cranial images, medial, caudal, and lateral images were between 75% and 85% successful. Although there were significant increases in skin temperature after clipping in both groups (P<.0002-.0001), there were no significant temperature differences between normal and CCL-deficient stifles when the entire stifle was examined. CONCLUSION: Thermography was successful in differentiating naturally occurring CCL-deficient stifles in dogs, with a success rate of 75-85%. Clipping is not necessary for successful thermographic evaluation of the canine stifle. CLINICAL RELEVANCE: Thermography may be a useful imaging modality for diagnosis of CCL deficiency in dogs when CCL rupture is suspected but stifle laxity is not evident.

Delayed primary surgical treatment in a dog with a persistent right aortic arch.

A 5-year-old, 1.36-kg, neutered male Yorkshire terrier was referred for evaluation of a persistent right aortic arch with concurrent megaesophagus. The dog was 3 months old when clinical signs were first noted, 2 years of age when diagnosed with megaesophagus, and 4 years of age when diagnosed with vascular ring anomaly (VRA). Surgical correction of the VRA was performed when the dog was 5 years of age, after gastrostomy tube feeding for 1 year to maintain nutritional requirements and mitigate the degree and duration of the esophageal distention. Thirteen months after surgery, the dog was eating soft dog food with no vomiting or regurgitation.

Histopathologic characteristics of biopsies from dogs undergoing surgery with concurrent gross splenic and hepatic masses: 125 cases (2012-2016).

OBJECTIVE: To investigate the histopathologic characteristics of concurrent splenic and liver masses in dogs undergoing splenectomy and liver mass biopsy/resection. Medical records of 125 client-owned dogs found to have splenic mass or masses and a liver mass or masses during surgery were examined. Signalment (age, sex, breed), body weight, and results of histopathology were recorded for all dogs. RESULTS: Twenty-seven percent (34/125) of the dogs in this study had no evidence of malignancy in either the liver or the spleen. Sixty of 125 dogs (48.0%) had malignancy in the spleen and liver, and 56 (56/60, 93.3%) of those dogs had the same malignancy in both organs. Signalment was similar to that in other reports of splenic pathology. In this clinical population of dogs, 27% of dogs with concurrent gross splenic and liver masses discovered intraoperatively had benign lesions in both locations and therefore had a favorable prognosis.

Evaluation of thermographic imaging of the limbs of healthy dogs.

OBJECTIVE: To describe a thermographic imaging protocol, identify normal thermographic patterns (ie, color map reflecting the skin temperature distribution) for various regions of interest (ROIs) of dog limbs, and evaluate effects of clipping the coat on thermographic patterns and limb temperature in healthy dogs. ANIMALS: 10 healthy dogs. PROCEDURES: Each dog was thermographically evaluated in the same room (ambient temperature, 21 degrees C) via ROIs that included cranial and caudal views of the body, full lateral body views, full views of the limbs, and views of various limb regions. After initial imaging, the coat was clipped on the forelimbs and hind limbs only. Each dog was then evaluated 15 and 60 minutes and 24 hours after clipping by use of the same protocol. RESULTS: For each ROI within a category (intact coat and each time point after clipping), mean temperatures were similar among the 10 dogs. Pairwise comparisons for 15 and 60 minutes and 24 hours established patterns of temperature stabilization among the 3 time points. Temperatures did not differ significantly between the left and right limbs. There was a mean success rate of 75% for use of image pattern analysis for recognition of similar thermographic patterns in the forelimbs and hind limbs. CONCLUSIONS AND CLINICAL RELEVANCE: Thermography can be a viable, noninvasive imaging modality that provides consistent images with reproducible thermal patterns in ROIs examined in healthy dogs. Although the coat had a predictable influence to decrease the mean temperature, thermal patterns remained fairly consistent after the coat was clipped.

Foramen magnum decompression with cranioplasty for treatment of caudal occipital malformation syndrome in dogs.

OBJECTIVES: To describe a cranioplasty procedure used in conjunction with foramen magnum decompression (FMD) for the treatment of canine caudal occipital malformation syndrome (COMS), and to evaluate the clinical outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Dogs (n=21) with COMS diagnosed by magnetic resonance imaging (MRI). METHODS: After FMD, titanium screws were placed around the perimeter of the foramen magnum defect and a skull plate fashioned from titanium mesh and polymethylmethacrylate was attached to the back of the skull, using the titanium screws as anchor posts. Follow-up was obtained by direct examination by the authors, telephone interviews with owners and referring veterinarians, and a questionnaire sent to owners of surviving dogs designed to assign objective measures of response to surgical intervention. Surgical success was defined as improvement in >or=1 aspects of clinical dysfunction (e.g. scratching, pain) postoperatively. Owner-assigned pre- and postoperative quality-of-life (QOL) scores (1-5) for surviving dogs were compared using a Wilcoxon's signed rank test for paired data (P

Medical infrared imaging and orthostatic analysis to determine lameness in the pelvic limbs of dogs.

Subtle lameness makes it difficult to ascertain which is the affected limb. A study was conducted to investigate a change in the thermal pattern and temperature of the thermal image of the paw print in a lame pelvic limb compared to a non-lame pelvic limb of dogs confirmed by orthostatic analysis. Fourteen client owned dogs with a unilateral pelvic limb lameness and 14 healthy employee dogs were examined and the pelvic limbs radiographed. Thermal images of the paw print were taken after each dog was kept in a static position on a foam mat for 30 seconds. Average temperatures and thermographic patterns were analyzed. Analysis was performed in a static position. The asymmetry index for each stance variable and optimal cutoff point for the peak vertical force and thermal image temperatures were calculated. Image pattern analysis revealed 88% success in differentiating the lame group, and 100% in identifying the same thermal pattern in the healthy group. The mean of the peak vertical force revealed a 10.0% difference between the left and right pelvic limb in healthy dogs and a 72.4% between the lame and non-lame limb in the lame dog group. Asymmetry index analysis revealed 5% in the healthy group and 36.2% in the lame group. The optimal cutoff point for the peak vertical force to determine lameness was 41.77% (AUC = 0.93) and for MII 0.943% (AUC = 0.72). The results of this study highlight the change in the thermal pattern of the paw print in the lame pelvic limb compared to a non-lame pelvic limb in the lame group and the healthy group. Medical infrared imaging of the paw prints can be utilized to screen for the lame limb in dogs.

Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002).

OBJECTIVE: To describe clinical signs and results of treatment in cats with patellar luxation. DESIGN: Retrospective case series. ANIMALS: 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. PROCEDURES: Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. RESULTS: 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.

Chiari-like Malformation.

Chiari-like malformation is a condition of the craniocervical junction in which there is a mismatch of the structures of the caudal cranial fossa causing the cerebellum to herniate into the foramen magnum. This herniation can lead to fluid buildup in the spinal cord, also known as syringomyelia. Pain is the most common clinical sign followed by scratching. Other neurologic signs noted are facial nerve deficits, seizures, vestibular syndrome, ataxia, menace deficit, proprioceptive deficits, head tremor, temporal muscle atrophy, and multifocal central nervous system signs. MRI is the diagnostic of choice, but computed tomography can also be used.