Localised erythema multiforme-like reaction confined to a region of clipper burn in a dog.

Localised erythema multiforme (LEM) is only reported to occur in humans and not in domestic species. This case report describes the clinical and histopathological features of LEM-like reaction in a dog, confined to a region of clipper burn.

L'érythème polymorphe localisé (LEM) n'est signalé que chez l'homme et non chez les animaux domestiques. Ce cas clinique décrit les caractéristiques cliniques et histopathologiques d'une réaction de type LEM chez un chien, localisé sur une région de brûlure de tondeuse.

El eritema multiforme localizado (LEM) sólo se ha descrito en seres humanos y no en especies domésticas. Este artículo describe un caso de un perro con una lesión confinada a una zona de quemadura por un rasurador cuyas características clínicas e histopatológicas fueron similares a LEM.

O eritema multiforme localizado (EML) é relatado apenas em humanos e não em animais domésticos. Este relato de caso descreve as características clínicas e histopatológicas de uma reação EML-símile em um cão, limitada a uma região de queimadura por lâmina de tosa.

Cytokine and Growth Factor Concentrations in Canine Autologous Conditioned Serum.

OBJECTIVE: To compare cytokine and growth factor concentrations in canine autologous conditioned serum (ACS) to canine plasma. STUDY DESIGN: Experimental in vivo study. ANIMALS: Client-owned, adult dogs (n=22). METHODS: Blood collected from 16 medium to large breed dogs was used to produce ACS (Orthokine(®) vet irap 10 syringes) and citrated plasma (control). Canine-specific ELISA assays were run per manufacturers' instructions for interleukin (IL)-10, IL-4, tumor necrosis factor (TNF)-α, insulin-like growth factor (IGF)-1, fibroblast growth factor (FGF)-2, transforming growth factor (TGF)-ß1, IL-1ß, and interleukin-1 receptor antagonist (IL-1ra). Serum, in addition to plasma and ACS, was collected from an additional 6 dogs for TNF-α, IL-1ß, and IL-1ra analysis (total of 22 dogs). Data were analyzed for differences in each cytokine concentration using pairwise comparisons between ACS, plasma, and serum using Wilcoxon signed-rank tests. Significance was set at P<.05. RESULTS: There was a large variability in growth factor and cytokine concentrations in ACS and plasma for individual dogs. There were no significant differences in IL-10, TNF-α, IGF-1, FGF-2, and TGF-ß1 concentrations between ACS, plasma, and serum. The IL-1ß concentrations in ACS (median, range 46.3 pg/mL, 0-828.8) and IL-4 (0.0 pg/mL, 0-244.1) were significantly higher than plasma (36.6 pg/mL, 0-657.1 and 0.0 pg/mL, 0-0, respectively). The IL-1ra concentration in ACS (median, range 3,458.9 pg/mL, 1,243.1-12,089.0) was significantly higher than plasma (692.3 pg/mL, 422.5-1,475.6). The IL-1ra:IL-1ß ratio in ACS was significantly higher than plasma (39.9 vs. 7.2). CONCLUSION: IL-1ra concentrations in canine ACS were comparable to those published for people and horses and pro-inflammatory cytokines remained low in canine ACS.

Cefazolin concentration in surgically created wounds treated with negative pressure wound therapy compared to surgically created wounds treated with nonadherent wound dressings.

OBJECTIVE: To compare cefazolin concentrations in biopsied tissue samples collected from surgically created wounds treated with negative pressure wound therapy to those collected from surgically created wounds treated with nonadherent dressings. STUDY DESIGN: Prospective, controlled, experimental study. ANIMALS: Adult female spayed Beagles (n = 12). METHODS: Full thickness cutaneous wounds were created on each antebrachium (n = 24). Immediately after surgery, cefazolin (22 mg/kg intravenously [IV]) was administered to each dog and continued every 8 hours during the study. The right wound was randomly assigned to group I or group II whereas the wound on the contralateral antebrachium was assigned to the other group. Group I wounds were treated with negative pressure wound therapy (NPWT) and group II wounds were treated with nonadherent dressings for 3 days. Dressings were changed and tissue biopsies obtained from wound beds at 24 hours intervals for both groups. Cefazolin wound tissue and plasma concentrations were measured by liquid chromatography mass spectrometry (LC-MS/MS). Blood samples for measuring plasma cefazolin concentrations were collected before biopsy sampling. At the time of surgery and at each subsequent bandage change, wound beds were swabbed and submitted for aerobic and anaerobic culture. RESULTS: After initiating cefazolin treatment, wound tissue antibiotic concentrations between treatment groups were not significantly different at any sampling time. Similarly, after initiating cefazolin treatment, plasma cefazolin concentrations were not significantly different at any sampling time for individual dogs. CONCLUSIONS: Using a canine experimental model, NPWT treatment of surgically created wounds does not statistically impact cefazolin tissue concentrations when compared with conventional nonadherent bandage therapy.

Bead size has a greater effect on in vitro elution from antimicrobial-impregnated calcium sulfate beads than drug concentration.

OBJECTIVE: To compare the elution characteristics of amikacin-impregnated calcium sulfate (CaSO4) beads based on different drug concentrations and bead size configurations. SAMPLE: Six groups of amikacin-impregnated CaSO4 beads and one negative control group. PROCEDURES: Amikacin-impregnated CaSO4 beads were formed with either 500 mg (low-concentration) or 1 g (high-concentration) of amikacin per 15 g CaSO4 hemihydrate powder. The number of beads necessary to approximate 150 mg of amikacin for each of the 3 bead sizes (3 mm, 5 mm, and 7 mm) at both low and high concentrations were placed in 6 mL of phosphate-buffered saline. The saline was sampled at 14 time points over 28 days. Amikacin concentrations were determined using liquid chromatography-mass spectrometry. RESULTS: Smaller beads reached higher mean peak concentrations than larger beads (P < .0006). Peak concentrations for the low- and high-concentration groups were 20.5 mg/mL and 27.4 mg/mL, 13.1 mg/mL and 14.0 mg/mL, and 8.85 mg/mL and 6.75 mg/mL for the 3 mm, 5 mm, and 7 mm beads, respectively. Bead size also affected the length of therapeutic duration, lasting 6 days for the 3 mm and 5 mm beads and 9 days for the 7 mm beads. However, this was only statistically evident among the high-concentration beads (P < .044). Antimicrobial concentration within the same bead sizes did not affect elution. CLINICAL RELEVANCE: Amikacin-impregnated CaSO4 beads achieved extreme supratherapeutic eluent concentrations. While additional studies are needed, bead size significantly affected elution with smaller beads reaching higher peak concentrations and 7 mm, high-concentration beads demonstrating a longer therapeutic duration than smaller beads.

Canine spinal nephroblastoma: long-term outcomes associated with treatment of 10 cases (1996-2009).

OBJECTIVE: To report clinical outcome associated with treatment of canine spinal cord nephroblastoma (CSN). STUDY DESIGN: Case series. ANIMALS: Dogs (n=10) with histopathologically confirmed CSN. METHODS: Records of dogs with CSN were reviewed and clinicopathologic, diagnostic imaging, treatment, outcome, and survival data were collected. RESULTS: CSN resulted in clinical signs of chronic, progressive T3-L3 myelopathy in young, large breed dogs, with an overrepresentation of German Shepherd Dogs (n=4). All CSN were located between T9 and L2. Dogs treated with cytoreductive surgery (n=6) or radiotherapy (1) survived longer (median, 374 days; range, 226-560 days) than dogs treated palliatively (3; median, 55 days; range, 38-176 days). Tumors confined to an intradural-extramedullary (ID-EM) location were associated with superior survival (n=6; median, 380 days; range, 176-560 days) than tumors with intramedullary (IM) involvement (n=4; median, 140 days; range, 38-269 days). Treatment resulted in temporary improvement in neurologic function in 9 dogs, including all dogs treated surgically, but local disease progression resulted in death of 8 dogs. CONCLUSIONS: Results of this observational study suggest that surgical cytoreduction and radiotherapy are effective at improving survival in dogs with CSN, and that ID-EM tumors may be associated with a more favorable prognosis than IM neoplasms.

Rectus abdominis muscle flap for repair of prepubic tendon rupture in 8 dogs.

The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002-2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs.

Zurich Cementless Dual Mobility Cup for Canine Total Hip Prosthesis: Implant Characteristics and Surgical Outcome in 105 Cases.

Dislocation after total hip arthroplasty (THA) remains a troublesome complication, and a source of frustration for the owner and the surgeon. The dislocation rate of hip prostheses in dogs is reported to range from 4 to 15%, representing the most common short-term complication. This is especially true in large and giant breed dogs, usually requiring revision surgery. With the increase in the number of THA being performed in veterinary surgery, reducing or preventing complications such as postoperative THA dislocation will be of paramount importance. The Zurich cementless dual mobility (DM) system allows impingement-free range of angulation of 80 to 132 degrees between the ceramic head and the polyether ether ketone (PEEK) cup when combined with the range of the PEEK cup in the outer metal cup. In this article, we review the use of the DM cup in THA in large and giant breed dogs, in terms of its history, biomechanics, outcomes and complications based on 105 cases.

Computed tomographic and cross-sectional anatomic characterization of myofascial compartments and soft tissue spaces in the manus in cadavers of dogs without forelimb disease.

OBJECTIVE: To characterize the computed tomographic (CT) and cross-sectional anatomic features of myofascial compartments and soft tissue spaces in the manus of cadavers of dogs without forelimb disease. ANIMALS: 33 cadavers of adult medium- to large-breed dogs without forelimb disease. PROCEDURES: Forelimbs were removed from the cadavers within 4 hours after euthanasia or within 6 hours after thawing from initial freezing. Specimens were then frozen for variable periods and thawed for approximately 16 hours before use. Each manus of 60 forelimbs underwent CT before and after injection of a radiopaque, blue-staining contrast medium into locations where soft tissue spaces and myofascial compartments were predicted (on the basis of pilot study data [6 forelimbs]). Two veterinary radiologists reviewed CT images and recorded the presence or absence of a discrete space or compartment at each injection site. Each manus was subsequently dissected or sectioned transversely. Locations of blue-staining contrast medium accumulation were compared with locations of contrast enhancement in CT images. Anatomic structures within each soft tissue space or myofascial compartment were described. RESULTS: 13 soft tissue spaces and 5 myofascial compartments were identified in the manus. Three myofascial structures that were examined were determined not to be compartments. CONCLUSIONS AND CLINICAL RELEVANCE: Knowledge of soft tissue spaces and myofascial compartments are used to map the likely spread of disease in the hands and feet of humans. Thus, understanding the locations and extent of similar structures in the canine manus may improve the effectiveness of surgical interventions in dogs with injury or inflammation of this region of the forelimb.

Modeling of the spread of infection in the interdigital spaces of the manus in limbs from clinically normal dogs.

OBJECTIVE: To determine whether the pattern of extension of modeled infection from the interdigital web spaces in dogs is predictable and whether the distribution differs among initial injury sites. SAMPLE POPULATION: Thawed frozen forelimbs from 23 cadavers of previously healthy adult medium- to large-breed dogs. PROCEDURES: The manus of each forelimb was evaluated by use of computed tomography (CT) before and after injection of radiopaque blue-staining contrast medium into the interdigital web spaces. Two veterinary radiologists reviewed the CT images and recorded the extent of contrast medium from each site. Each manus was dissected or sectioned transversely after imaging, and the extent of contrast medium accumulation was recorded and compared with locations of CT contrast enhancement. The Fisher exact test was performed to determine whether the pattern of contrast medium extension differed by injection site. RESULTS: Injections made in the interdigital web spaces of the canine manus led to unique and predictable patterns of extension into the surrounding soft tissues. That pattern of extension primarily involved the soft tissues of the digits. CONCLUSIONS AND CLINICAL RELEVANCE: In humans, knowledge of common extension patterns from infected soft tissue spaces is used to predict the spread of disease within the hand and develop surgical plans that will minimize patient illness. Identification of the common sites of disease spread from the interdigital web spaces in dogs may help improve surgical planning and treatment for infection in the manus.

Titanium-Alloy Anchoring System as a Suitable Method of Extracapsular Repair.

Objective: To characterize the effect of a titanium-alloy anchoring system (TAS) on the motion of the cranial cruciate ligament (CrCL) deficient stifle. To compare the motion with the TAS to that of the CrCL-intact and CrCL-deficient stifle. Study Design: Each canine pelvic limb was mounted in a loading jig under 30% body weight. Motion data was collected using an electromagnetic tracking system at stifle angles of 125°, 135°, and 145° with the CrCL-intact, CrCL-deficient and the TAS applied. Results: Total translation of the CrCL-deficient stifle following the TAS was reduced, but remained greater than the CrCL-intact stifle at angles of 125°, 135°, and 145°. Internal rotation of the TAS groups was greater than the CrCL-intact group at 145°, but not 125° and 135°. Varus motion of the TAS group was decreased compared to the CrCL-deficient group, but increased compared to the CrCL-intact group at angles of 125°, 135°, and 145°. Conclusion: Total translation and internal rotation of the CrCL-deficient stifle following the TAS differed from that of the CrCL-intact stifle. However, the TAS reduced total translation and internal rotation of the tibia relative to the femur in the CrCL-deficient stifle to levels that may yield clinically acceptable results.

Biomechanical Comparison of Three Crural Fascia Repair Techniques for Tibial Tuberosity Advancement Surgery.

OBJECTIVES: The aim of this study was to compare the strength of three described techniques for repair of the medial crural fascia to the strength of the intact fascia of the paired limbs. We hypothesized that intact controls would have higher peak loads at failure than repair groups and that the modified Mason-Allen suture pattern would have the highest peak load at failure of the repair groups. MATERIALS AND METHODS: Canine cadavers (n = 22) were randomly assorted into three groups. Group A: a continuous suture pattern. Group B: five equally spaced simple interrupted cruciate sutures over a simple continuous suture pattern. Group C: an interrupted modified Mason-Allen suture pattern. The mid-portion of the crural fascia was incised in Groups A and C, while Group B used a cranial incision. Contralateral limbs were utilized as paired controls. Tibiae were mounted to a biomaterial testing machine and the medial crural fascia loaded at 10 mm/min. RESULTS: Mean peak load to failure for Group A: 201.0N, Group B: 261.0N, Group C: 306.1N and Intact limbs: 799.5N. Between repair groups, there was no significant difference between peak loads to failure identified. Significant differences were identified between all repairs and intact limbs. All repairs approached a mean of 33.5% (267.8N) of intact medial crural fascia strength. CLINICAL SIGNIFICANCE: All repair techniques met no more than 1/3 intact medial crural fascia strength. Further research is required to continue to evaluate the most clinically appropriate technique to repair the medial tibial crural fascia.

Non-Invasive Blood Perfusion Measurements Using a Combined Temperature and Heat Flux Surface Probe.

Non-invasive blood perfusion measurement systems have been developed and tested in a phantom tissue and an animal model. The probes use a small sensor with a laminated flat thermocouple to measure the heat transfer and temperature response to an arbitrary thermal event (convective or conductive) imposed on the tissue surface. Blood perfusion and thermal contact resistance are estimated by comparing heat flux data with a mathematical model of the tissue. The perfusion probes were evaluated for repeatability and sensitivity using both a phantom tissue test stand and exposed rat liver tests. Perfusion in the phantom tissue tests was varied by controlling the flow of water into the phantom tissue test section, and the perfusion in the exposed liver tests was varied by temporarily occluding blood flow through the portal vein. The phantom tissue tests indicated that the probes can be used to detect small changes in perfusion (0.005 ml/ml/s). The probes qualitatively tracked the changes in the perfusion of the liver model due to occlusion of the portal vein.

Surgical treatment of an elbow hygroma utilizing microvascular free muscle transfer in a newfoundland.

Microvascular free muscle transfer utilizing the rectus abdominis muscle, in combination with a mesh skin graft and transarticular external fixator, were used following the surgical excision of an elbow hygroma in a Newfoundland dog. Postoperatively, the dog did well with minimal complications and has yet to have a recurrence 10 months following surgery. This report describes the utility and successful use of the rectus abdominis free tissue transfer in the surgical correction of a difficult elbow hygroma in the dog.

Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat.

The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.

Effect of a single intra-articular injection of bupivacaine on synovial fluid prostaglandin E2 concentrations in normal canine stifles.

OBJECTIVE: To identify if synovial fluid prostaglandin E2 increases in response to a single intra-articular dose of bupivacaine in the normal canine stifle. RESULTS: There were no significant differences in synovial fluid prostaglandin E2 (PGE2) concentrations between treatment groups or over time within bupivacaine or saline groups. Samples requiring ≥ 3 arthrocentesis attempts had significantly higher PGE2 concentrations compared to samples requiring 1 or 2 attempts. Following correction for number of arthrocentesis attempts, PGE2 concentrations were significantly higher than baseline at 24 and 48 h in the bupivacaine group; however there were no significant differences between the bupivacaine and saline groups. In normal dogs, a single bupivacaine injection did not cause significant synovial inflammation, as measured by PGE2 concentrations, compared to saline controls. Future research should minimize aspiration attempts and include evaluation of the synovial response to bupivacaine in clinical cases with joint disease.

Effect of 9 mm tibial tuberosity advancement on cranial tibial translation in the canine cranial cruciate ligament-deficient stifle.

OBJECTIVE: To assess the effect of 9 mm tibial tuberosity advancement (TTA) on cranial tibial translation (CTT) in a cranial cruciate ligament (CCL)-deficient canine stifle model. STUDY DESIGN: In vitro cadaveric study. ANIMALS: Canine pelvic limbs (n=12). METHODS: Each stifle was placed in a jig at 135 degrees with a simulated quadriceps force and tibial axial force. CTT distance was measured with the CCL intact (iCCL), transected (tCCL), and after performing TTA using a 9 mm cage. RESULTS: Mean CTT for iCCL was 0.42 mm, 1.58 mm after severing the CCL, and 1.06 mm post-TTA. The tCCL CTT measured without any quadriceps force was 2.59 mm. Differences between the intact and tCCL (P<.0001) and tCCL and TTA (P=.0003) were significant. The difference between the tCCL with and without the quadriceps force was not significant (P=.0597). CONCLUSIONS: These data confirm that TTA does reduce CTT in tCCL stifles in this model. The CTT noted was less than that noted clinically. The addition of a simulated quadriceps force to a CCL-deficient stifle before a TTA, by itself, may not significantly lessen CTT. CLINICAL RELEVANCE: Whereas this in vitro model demonstrated that TTA reduced CTT in canine stifles with CCL transected, the model limitations preclude extrapolation to the effect of TTA in a live dog.

The use of vacuum-assisted closure therapy for the treatment of distal extremity wounds in 15 dogs.

OBJECTIVE: To evaluate clinical outcome after vacuum-assisted closure (VAC) therapy in dogs with traumatic wounds located in the distal extremities and report our early experience with VAC. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=15) with traumatic distal extremity wounds. METHODS: Medical records (1999-2003) of dogs with traumatic injuries to the distal extremities managed by VAC were evaluated. Data included signalment, location of wound, time until surgical intervention, wound reconstruction methods, orthopedic procedures, outcome, complications associated with VAC, and length of hospitalization. RESULTS: The mean number of days until reconstruction was 4.6 days (range, 2-7 days). Reconstructive surgery was successful in all cases. Mean hospitalization was 9.7 days (range, 6-16 days). Complications included dermatitis at the wound margin and loss of vacuum causing wound desiccation. CONCLUSION: VAC therapy can be used to achieve adequate management of traumatic distal extremity wounds. VAC provides an effective method of securing skin grafts over the wound bed. CLINICAL RELEVANCE: VAC therapy can be used as an ancillary treatment for distal extremity wounds in dogs before surgical repair as well as a method for securing skin grafts to the wound bed.

Diagnosis and surgical management of vascular ectasia in a dog.

CASE DESCRIPTION: An 8-year-old male Golden Retriever was evaluated because of an 8-week history of intermittent diarrhea with melena and hematochezia that were not responsive to medical treatment and resulted in severe anemia. CLINICAL FINDINGS: Exploratory celiotomy with intestinal and colonic biopsy revealed mild enterocolitis but did not result in diagnosis of the cause of melena and hematochezia. Endoscopy of the upper portion of the gastrointestinal tract and colonoscopy were performed. Multifocal areas of coalescing, tortuous mucosal blood vessels were observed in the cecum and all regions of the colon. A diagnosis of vascular ectasia (VE) was made on the basis of the endoscopic and histologic appearance of the lesions. TREATMENT AND OUTCOME: An ileorectal anastamosis was performed. Melena and hematochezia resolved within 3 days after surgery, and the anemia resolved within 6 weeks after surgery. Surgical resection of the cecum and colon and feeding of a highly digestible diet resulted in long-term (22 months) resolution of clinical signs. CLINICAL RELEVANCE: Initial exploratory celiotomy with intestinal and colonic biopsy failed to reveal the VE lesions responsible for the melena, hematochezia, and anemia. Endoscopic evaluation was necessary for detection of the colonic VE lesions. Surgical resection of the cecum and colon and feeding of a highly digestible diet may result in a favorable outcome in affected dogs.

Use of computed tomographic densitometry to quantify contrast enhancement of compressive soft tissues in the canine lumbosacral vertebral canal.

OBJECTIVES: To evaluate computed tomography (CT) densitometry as a technique for quantifying contrast enhancement of compressive soft tissues in the canine lumbosacral vertebral canal and to determine whether the degree of contrast enhancement can be used to help predict tissue type or histopathologic characteristics. ANIMALS: 29 large breed dogs with lumbosacral stenosis. PROCEDURE: Contrast-enhanced CT of L5-S3 was performed by use of a previously described protocol. At each disk level, CT densities of a water-filled syringe, epaxial muscles, and 4 vertebral canal locations were measured. Mean tissue enhancement was calculated by vertebral canal location, using water-filled syringe enhancement as a correction factor. Corrected CT enhancement was compared with tissue type, degree of tissue inflammation, and degree of tissue activity. RESULTS: Intravenous contrast administration of contrast medium significantly increased CT densities of water-filled syringes and epaxial muscles. Corrected CT enhancement of vertebral canal soft tissues at stenotic sites was greater than at nonstenotic sites. There was no association between enhancement and tissue type for any vertebral canal location. There was no correlation between enhancement and degree of tissue inflammation. There was a correlation between enhancement and tissue activity in the dorsal vertebral canal only. CONCLUSIONS AND CLINICAL RELEVANCE: A water-filled syringe is a useful calibration tool for CT density measurements. The degree of tissue contrast enhancement, measured by CT densitometry, can be helpful for predicting the location of compressive soft tissues in dogs with lumbosacral stenosis. However, it is of limited value for predicting compressive soft-tissue types or histopathologic characteristics.

Lumbosacral and pelvic injuries.

Pelvic fractures are commonly observed in cats after automobile-induced trauma and frequently affect other organ systems. An organized systematic approach should be followed in the evaluation of pelvic fractures. Common pelvic fracture patterns observed in cats include pubic fractures in combination with unilateral ilial fractures, unilateral sacroiliac luxations, bilateral sacroiliac luxations, and contralateral ilial body fractures. Narrowing of the pelvic canal may preclude normal passage of feces and result in megacolon. Timely and precise surgical intervention is necessary so as to impart a favorable prognosis.