Influence of radiographic examination findings on recommendations made during routine clinical re-evaluation of dogs with uncomplicated tibial plateau leveling osteotomy.

OBJECTIVE: To determine the influence of follow-up radiographic examination on recommendations made during routine clinical re-evaluation of dogs that had undergone uncomplicated tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Retrospective multi-institutional case series. ANIMALS: Client-owned dogs (N = 1010) that underwent uncomplicated TPLO. METHODS: Records from 11 institutions were searched for dogs that had been treated with unilateral TPLO and had no history of postoperative complications before their routine follow-up examination. The frequency of change in further clinical recommendations resulting from client- or clinician-voiced concerns or radiographic abnormalities was investigated. RESULTS: Follow-up evaluation was performed at a median of 6 (range, 4-15) weeks after TPLO. Radiographic examination findings contributed to a change in recommendations in 4.15% (38/915) of dogs presented without client concerns and without abnormalities at orthopedic examination. Abnormal radiographic findings alone influenced the management of 3.76% (38/1010) of dogs. An association was detected between clinical features and radiological findings leading to a change in recommendations (P < .0001). Administration of analgesia at the time of follow-up was associated with radiographic abnormalities (P = .017) and change in postoperative plans (P = .0007). CONCLUSION: Radiographic examination findings at follow-up did not influence the management of most dogs with uncomplicated TPLO. CLINICAL SIGNIFICANCE: Radiographic examination findings are unlikely to influence the treatment of dogs that seem to be recovering uneventfully from an uncomplicated TPLO without concerns from clients, analgesia, or abnormal findings on thorough orthopedic examination by a surgical specialist, at the time of the planned clinical re-evaluation.

Clinical comparison of the hybrid dynamic compression plate and the castless plate for pancarpal arthrodesis in 219 dogs.

OBJECTIVE: To describe and compare a large population of dogs that had pancarpal arthrodesis (PCA) using either a hybrid dynamic compression plate (HDCP) or a CastLess Plate (CLP). STUDY DESIGN: Multicenter, retrospective, cohort study. ANIMALS: Dogs (n = 240; 261 PCA). METHODS: Medical records (2000-2012) from 12 UK orthopedic centers were reviewed for dogs that had PCA to document signalment, diagnosis, arthrodesis method, and complication rates. Follow-up data were used to compare outcome (lameness evaluation and radiographic healing) after use of HDCP and CLP plates. RESULTS: PCA was performed with HDCP in 125 cases, CLP in 105, and by other techniques in 31. Carpal hyperextension injury was the most common diagnosis in HDCP and CLP groups. Surgical site infection (18.3%) was the most common postoperative complication. There was no difference in intra- (11% HDCP, 21% CLP) or postoperative (34% HDCP, 41% CLP) complication rates. Use of external coaptation did not affect postoperative complication rates or outcome. External coaptation related complications occurred in 32% HDCP and 18% CLP (P = .02). At median follow-up, most dogs were classified as having no or mild lameness (73% HDCP, 83% CLP) and there was radiographic healing in 40% HDCP and 46% CLP (P = .8) cases. CONCLUSIONS: CLP and HDCP may both be used successfully to achieve pancarpal arthrodesis. Adjunctive external coaptation does not appear to have a measurable clinical benefit but is associated with morbidity.

Comparison between shoulder computed tomography and clinical findings in 89 dogs presented for thoracic limb lameness.

Computed tomography (CT) is an established technique for detecting shoulder lesions in dogs, however the clinical significance of shoulder CT lesions often remains uncertain. The purposes of this retrospective study were to describe the prevalence of CT lesions in both shoulder joints for 89 dogs presenting with thoracic limb lameness and to compare CT lesions with clinical characteristics. For all included dogs, results of a full orthopedic examination, other diagnostic tests, and signalment data were available in medical records. Multilevel, multivariable logistic regression was used to test clinical significance of the most prevalent CT lesions and determine factors associated with their presence. Computed tomographic lesions were detected in one or both shoulder joints for 51/89 dogs (57.3%). Mineralization of one or more surrounding peri-articular soft-tissue structures was identified in 31.5% of dogs, with supraspinatus muscle/tendon mineralization being the most frequently identified (24.7%). The prevalence of humeral head osteochondrosis was 9 and 21.3% of dogs had shoulder osteoarthritis. Border collies (odds ratio [OR] 9.3; 95% CI 1.39-62.1, P = 0.02) and dogs with shoulder pain (OR 4.3; 95% CI 1.08-17.1, P = 0.04) had increased risk of osteochondrosis lesions. Border collies (OR 8.4; 95% CI 1.27-55.6; P = 0.03) and older animals (OR 1.04; 95% CI 1.02-1.1, P < 0.001) had increased risk of osteoarthritis lesions. Female entire dogs had an increased risk of supraspinatus mineralization lesions (OR 6.8; 95% CI 1.55-29.5, P = 0.01). Findings indicated that shoulder CT lesions are common in dogs with thoracic limb lameness, and that some CT lesions are not associated with shoulder pain.