RESUMEN
OBJECTIVES: The aim of this study was to define landmarks of the intermetatarsal channel of the dorsal pedal artery and to assess whether damage to the dorsal pedal artery during metatarsal screw placement in dogs undergoing pan- and partial-tarsal arthrodesis (PanTA/ParTA) could be a mechanism in the development of plantar necrosis. STUDY DESIGN: This study was divided in to two parts: (1) ex-vivo anatomical study: 19 canine cadavers, (2) retrospective clinical study: 39 dogs. Cadaveric dissection documented the mean intermetatarsal channel position. Metatarsal screw position was evaluated on postoperative radiographs of dogs after PanTA or ParTA. Screw position, arthrodesis type and surgical approach were assessed for their impact on complications, including plantar necrosis. RESULTS: The mean proximal and distal extent of the intermetatarsal channel lies between 4.3% ± 1.9 and 22.8% ± 2.9 the length of metatarsal III (MTIII) respectively. The intermetatarsal channel lies within the most proximal 25% of MTIII in 95% of cases. At least one screw risked damaging the mean intermetatarsal channel position in 92% of dogs; 8% of these dogs went on to develop plantar necrosis. The mean screw position did not differ between ParTA cases with or without plantar necrosis (p > 0.05). CONCLUSION: Violation of the intermetatarsal channel is possible during metatarsal screw placement. Care should be taken when placing screws in the proximal 25% of the metatarsals, specifically avoiding exiting dorsally between MTII and MTIII and across the distal region of the intermetatarsal channel, where the perforating metatarsal artery passes interosseously, as damage may contribute to the aetiology of plantar necrosis.
Asunto(s)
Enfermedades de los Perros , Huesos Metatarsianos , Perros , Animales , Estudios Retrospectivos , Huesos Metatarsianos/cirugía , Metatarso , Factores de Riesgo , Artrodesis/efectos adversos , Artrodesis/veterinaria , Cadáver , Enfermedades de los Perros/etiología , Enfermedades de los Perros/cirugíaRESUMEN
OBJECTIVES: The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome. METHODS: The medical records from seven veterinary hospitals of cats treated for traumatic stifle injury were reviewed. Long-term follow-up data were collected from referring veterinarians and using the Feline Musculoskeletal Pain Index, collected from owners. RESULTS: Seventy-two cats were included in the study. The most common combination of ligament injury involved both cruciate ligaments and the lateral collateral ligament (25.4%). Medial meniscal injury was more common (66.2%) than lateral meniscal injury (59.4%). A temporary transarticular pin was used intraoperatively to aid reduction in 23/73 (31.5%) surgeries. Postoperative immobilisation was applied in 41/72 (56.9%) cats with a mean duration of 4.8 weeks. Short-term complications occurred in 40/64 (62.5%) cats. Long-term complications occurred in seven (17.5%) cats. Overall outcome was excellent in 25/61 (41%) cats, good in 13/61 (21.3%) cats, fair in 11/61 (18%) cats and poor in 12/61 (19.7%) cats. Mean length of follow-up was 29.6 months (range 0.5-204). A significantly poorer outcome was observed in cats with medial meniscal injury and those undergoing revision surgery. Use of a transarticular pin when left in situ for postoperative immobilisation was associated with a poorer outcome (P = 0.043) and a higher risk of complications (P = 0.018). Postoperative immobilisation was not related to outcome. CONCLUSIONS AND RELEVANCE: Traumatic stifle injury in cats can lead to rupture of multiple ligaments causing significant instability of the joint. Surgical treatment is associated with a high rate of short-term complications, although long-term outcome may still be good to excellent in the majority of cats (62.3%). In cats where follow-up was available, postoperative immobilisation had no positive effect on outcome and may not be required. Leaving a transarticular pin for postoperative immobilisation is not recommended as it was significantly associated with a poorer outcome and a higher complication rate.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Enfermedades de los Gatos , Luxaciones Articulares , Animales , Lesiones del Ligamento Cruzado Anterior/cirugía , Lesiones del Ligamento Cruzado Anterior/veterinaria , Enfermedades de los Gatos/cirugía , Gatos , Luxaciones Articulares/veterinaria , Estudios Retrospectivos , Rotura/veterinaria , Rodilla de Cuadrúpedos/lesiones , Rodilla de Cuadrúpedos/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: The aim of this study was to establish breed-standard mechanical tibial joint reference angles in the frontal plane in Dachshunds. STUDY DESIGN: Craniocaudal (n = 38) and mediolateral (n = 32) radiographs of normal tibiae from Dachshunds were retrospectively reviewed. The mechanical medial proximal, mechanical medial distal, mechanical caudal proximal and mechanical cranial distal tibial angles were measured on three occasions by two separate observers using previously established methodology. Interclass correlation coefficient was used to assess the reliability of radiographic measurements. RESULTS: The mean and standard deviation for mechanical medial proximal, mechanical medial distal, mechanical caudal proximal and mechanical cranial distal were 93.1 degrees ± 4.2, 97.5 degrees ± 3.9, 75.3 degrees ± 3.7 and 85.0 degrees ± 5.3 respectively. Intra-observer reliability was good to excellent for all measures, while inter-observer reliability was moderate to excellent in the frontal plane and poor to good in the sagittal plane. Dachshund-specific joint reference angles were similar to a range of previously reported non-chondrodystrophic breeds in the frontal plane but differed to most in the sagittal plane. CONCLUSION: Dachshund tibial joint reference angles are reported which can be used in surgical planning for correction of bilateral pes varus.
Asunto(s)
Enfermedades de los Perros , Tibia , Animales , Cadáver , Perros , Radiografía , Reproducibilidad de los Resultados , Estudios Retrospectivos , Tibia/diagnóstico por imagen , Tibia/cirugíaRESUMEN
OBJECTIVES: The aim of this study was to assess outcomes in cats diagnosed with uroabdomen at a single referral centre. METHODS: Fifty-three cats diagnosed with uroabdomen at a veterinary teaching hospital were identified between June 2003 and September 2016. Data collected included signalment, presenting signs, aetiology, location of rupture, presence of concurrent injury, outcome of urine culture, presence of uroliths and packed cell volume (PCV)/creatinine/potassium levels at presentation. Cats managed medically and surgically were included, and the use of urinary catheters, cystotomy tubes and abdominal drains were recorded. It was determined if patients survived to discharge or if they were euthanased or died. RESULTS: Seventy-four percent (n = 39) of cats survived to discharge. Elevations in creatinine (P = 0.03) were shown to be significantly correlated with survival to discharge. Sex, age, location of rupture, presence of uroliths, outcome of urine culture, presence of concurrent injury, potassium at presentation and PCV at presentation were not associated with survival to discharge. There was no difference in survival between cats that were medically or surgically managed. CONCLUSIONS AND RELEVANCE: Cats that develop uroabdomen have a good chance of survival. Electrolyte and biochemistry values should be assessed at the time of presentation, in addition to the presence of concurrent injury.
Asunto(s)
Enfermedades de los Gatos , Alta del Paciente , Animales , Gatos , Hospitales Veterinarios , Hospitales de Enseñanza , Estudios Retrospectivos , Rotura/veterinariaRESUMEN
Signalment, clinical features, fixation techniques, complications, and outcome for dogs presenting with distal diaphyseal and supracondylar femoral fractures were retrospectively reviewed. A total of 45 dogs with unilateral femoral fractures were included. Supracondylar femoral plates were the most popular method of fixation. However, various fixation techniques resulted in favorable outcomes in most dogs with 19/45 cases achieving full function and 22/45 achieving acceptable function. Degree of fracture comminution did not appear to affect complication rate or be a surrogate for worse clinical outcome.
Résultats de stabilisation chirurgicale de fractures fémorales diaphysaires distales et supracondylaires chez le chien. Une étude rétrospective portant sur le signalement, la présentation clinique, les techniques de réduction de fracture, les complications et les résultats de chiens atteints de fractures fémorales supracondyliennes et diaphysaires distales a été réalisée. Quarante-cinq chiens présentant une fracture fémorale unilatérale ont été inclus au total. Les plaques fémorales supracondyliennes représentaient la méthode d'ostéosynthèse la plus courante. Diverses techniques de fixation ont abouti à des résultats favorables dans la majorité des cas, avec 19/45 cas récupérant une fonction complète et 22/45 une fonction considérée acceptable. Le degré de comminution de la fracture n'apparaissait pas comme étant un facteur de risque de complication ou étant associé à des résultats défavorables.(Traduit par Emilie Fauchon et Emilie Hanot).
Asunto(s)
Enfermedades de los Perros , Fracturas del Fémur , Animales , Placas Óseas/veterinaria , Enfermedades de los Perros/cirugía , Perros , Fracturas del Fémur/cirugía , Fracturas del Fémur/veterinaria , Fijación Interna de Fracturas/veterinaria , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: The aim of this study was to report the outcome and complications of surgical stabilization following fracture of the supraglenoid tubercle in dogs. MATERIALS AND METHODS: Data from three referral centres (Queen Mother Hospital for Animals, Michigan State University and Veterinary Referral Hospital Hallam) were reviewed retrospectively for cases of supraglenoid tubercle fracture (n = 12). RESULTS: Overall success rate was 9/12. Major complication rate was 2/12 and minor complication rate was 9/12. All fractures that had major complications were comminuted. Methods of stabilization included pin and tension band wire (n = 5), lag screw (n = 2), plate fixation (n = 2), fragment removal (n = 2) and conservative management (n = 1). CLINICAL SIGNIFICANCE: Good outcomes can be achieved following fractures of the supraglenoid tubercle, although cases with comminution have a higher complication rate. Further research into the optimal method of fixation and postoperative management is required.
Asunto(s)
Perros/lesiones , Perros/cirugía , Fijación Interna de Fracturas/veterinaria , Fracturas Óseas/veterinaria , Escápula/lesiones , Animales , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/métodos , Masculino , Complicaciones Posoperatorias/veterinaria , Estudios Retrospectivos , Escápula/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVES: The aim of this study was to describe the use of locking compression plates (LCP) in Y-T humeral condyle fractures and to evaluate their clinical outcome. METHODS: This study involved a retrospective review, including clinical, radiographical and canine brief pain inventory outcome evaluation. RESULTS: Eighteen consecutive dogs met the inclusion criteria, and 15/18 were considered to have humeral intracondylar fissure. Twelve of 18 dogs had simple fractures, and the remaining six had comminuted fractures. Postoperative radiographs revealed accurate intracondylar reconstruction (articular step defect [ASD] < 1 mm) in 17/18 of patients. Short-term outcome was considered fully functional in 9/13 and acceptable in 3/13 patients. Complications were diagnosed in 2/13; infection in one with resolution after antibiotic treatment, and one case of implant failure. Nine of 18 owners provided postoperative questionnaire responses (median 25; range: 14-52 months) and 8/9 clients perceived the treatment to have resulted in an excellent overall outcome. CLINICAL SIGNIFICANCE: Repair of Y-T humeral fractures with LCP allowed for hybrid fixation and monocortical screw placement in distal fracture fragments. There was no significant ASD at the intracondylar fracture line in most cases. ASD using combined medial and lateral approaches depends upon the accuracy of supracondylar reduction, particularly on the side that is reduced and stabilized first, and the use of locking screws may have been influential in minimizing primary loss of reduction, potentially maintaining the initial fragment reduction.
Asunto(s)
Placas Óseas/veterinaria , Perros/lesiones , Fracturas del Húmero/veterinaria , Animales , Placas Óseas/efectos adversos , Perros/cirugía , Femenino , Fracturas del Húmero/diagnóstico por imagen , Fracturas del Húmero/cirugía , Masculino , Radiografía/veterinaria , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To characterize a population of cats with pelvic trauma and evaluate factors influencing transfusion requirement and outcome. DESIGN: Retrospective case series (2009-2014). SETTING: University teaching hospital. ANIMALS: One hundred twelve client-owned cats with pelvic trauma. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twenty-one (18.8%) cats received a transfusion. Most cats required only 1 fresh whole blood transfusion (85.8%). Packed cell volume at admission was significantly lower in cats that required transfusion but was not associated with hospitalization time or survival to discharge. Increasing Animal Trauma Triage (ATT) score at admission was significantly associated with transfusion requirement (P = 0.0001) and nonsurvival to discharge (P = 0.03). Number of pelvic fractures was not associated with transfusion requirement but cats with sacroiliac luxations and pubic fractures were more likely to require a transfusion (P = 0.0015 and P = 0.0026, respectively). However, fracture type was not associated with survival to discharge. Most cats (86%) required a surgical procedure and half of transfusions were administered preoperatively. No surgical comorbidities were associated with transfusion requirement or survival. Transfusion requirement was associated with longer length of hospitalization but not survival to discharge. CONCLUSIONS: Transfusion requirement in this population of cats with pelvic fractures was fairly high. Transfusion requirement was associated with lower packed cell volume, higher ATT score at admission, longer length of hospitalization, and certain types of pelvic fractures. Transfusion requirement was not associated with surgical comorbidities, surgical intervention, or survival to discharge. Lower ATT score at admission was associated with survival to discharge.
Asunto(s)
Transfusión Sanguínea/veterinaria , Gatos/lesiones , Huesos Pélvicos/lesiones , Pelvis/lesiones , Animales , Femenino , Fracturas Óseas/complicaciones , Fracturas Óseas/veterinaria , Masculino , Huesos Pélvicos/patología , Pelvis/patología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVES: The aim of this study was to report the complication of lateral radial head subluxation following proximal ulnar osteotomy (PUOO) or proximal ulnar ostectomy (PUOE) in eight dogs. MATERIALS AND METHODS: Case records and diagnostic imaging of dogs developing lateral radial head subluxation following PUOO (n = 7) or PUOE (n = 2) were retrospectively reviewed. Information pertaining to clinical history, signalment, presenting condition, lameness grade, diagnostic imaging and initial surgery details, postoperative complications and their management were retrieved. Outcomes were established from subsequent clinical histories or telephone interviews with referring veterinarians. Comparison was made to a single-centre cohort without lateral radial head subluxation following PUOO or PUOE. RESULTS: Eight dogs (median age: 9.5 months [range: 6 months-6 years], median weight 7.7 kg [range: 5-28 kg]) were included. Six dogs had a PUOO performed; five dogs had unilateral surgery and one had bilateral surgery. Two dogs had unilateral PUOE surgery. Median time to diagnosis of lateral radial head subluxation following surgery was 6.5 weeks (range: 2-20 weeks). Five of the eight dogs had surgical revision of lateral radial head subluxation. Resolution of lateral radial head subluxation was achieved in four dogs, with three achieving acceptable to good mobility. One dog had poor postoperative mobility. A fifth dog remained lame after revision surgery failure. Three dogs did not have revision surgery; two underwent limb amputation and one dog remained lame as revision surgery was declined. CLINICAL SIGNIFICANCE: Lateral radial head subluxation is a potentially severe postoperative complication following PUOO or PUOE.
Asunto(s)
Perros/cirugía , Luxaciones Articulares/veterinaria , Osteotomía/veterinaria , Complicaciones Posoperatorias/veterinaria , Cúbito/cirugía , Animales , Miembro Anterior , Luxaciones Articulares/etiología , Osteotomía/efectos adversos , Cúbito/diagnóstico por imagenRESUMEN
OBJECTIVE: To describe traumatic injuries involving the central tarsal bone (Tc) in nonracing dogs. STUDY DESIGN: Retrospective multicenter study. ANIMALS: Thirty-two client-owned dogs. METHODS: Medical records from January 2010 to December 2016 were searched for dogs with Tc injury. Fracture classification, concurrent tarsal fractures, treatment, and perioperative management were tested for association with postoperative complications and short-term outcome. Outcome measures consisted of the latest lameness score reported in the record. RESULTS: The most common injuries consisted of type V fractures (22) and luxation of the Tc (8). Other injuries included 1 case each of type III and type IV fractures. Twenty-two concurrent fractures involved other tarsal bones. Complications were diagnosed in 18 (62.1%) dogs, consisting of 13 minor, 4 major, and 1 catastrophic complication. Lameness at final follow-up (median 7 weeks) in 28 dogs was scored as 0 of 5 in 14 (50.0%) dogs, 1 of 5 in 7 (25.0%) dogs, 2 of 5 in 4 (14.3%) dogs, 4 of 5 in 1 (3.5%) dogs, and 5 of 5 in 2 (7.1%) dogs. Major complications were associated with the presence of multiple tarsal fractures (risk ratio [RR] 3.94, 95% CI 0.80-19.37, P = .13), specifically when the calcaneus was involved (RR 5.78, 95% CI 1.53-21.88, P = .05). CONCLUSION: The most common diagnosis in this population of nonracing dogs consisted of type V Tc fractures. Fractures affecting other tarsal bones were common and were associated with a higher risk of major complications, especially those affecting the calcaneus. CLINICAL SIGNIFICANCE: Short-term outcomes seem favorable in nonracing dogs with isolated Tc fractures, but dogs with concomitant tarsal fractures are predisposed to major complications.
Asunto(s)
Enfermedades de los Perros/cirugía , Perros/lesiones , Fracturas Óseas/veterinaria , Huesos Tarsianos/lesiones , Tarso Animal/lesiones , Animales , Femenino , Fracturas Óseas/cirugía , Masculino , Complicaciones Posoperatorias , Pronóstico , Estudios Retrospectivos , Huesos Tarsianos/cirugía , Tarso Animal/cirugía , Resultado del TratamientoRESUMEN
A 4 mo old German shepherd dog was presented following an acute onset lameness and swelling of the thoracic limb. Clinical signs, surgical findings, and culture results were consistent with a diagnosis of necrotizing fasciitis. Initial management consisted of extensive surgical debridement, wound lavage, and bandaging. Surgical closure was achieved with an axillary fold flap and distant direct single-pedicle thoracoabdominal flap. Three mo later, following deterioration of the lameness that was associated with carpal valgus, carpal subluxation, and tendinopathy of the distal radial insertion of the biceps brachii tendon, a closing wedge pancarpal arthrodesis and tenotomy of the biceps brachii tendon was performed. We hypothesize that extensive soft tissue trauma and subsequent fibrosis and tendon contracture following soft tissue reconstruction contributed to the complications seen. To the authors' knowledge, this is the first report of carpal valgus deformity and biceps brachii tendinopathy following a distant direct skin flap and axillary skin fold flap.
Asunto(s)
Carpo Animal/patología , Enfermedades de los Perros/cirugía , Fascitis Necrotizante/veterinaria , Colgajos Quirúrgicos/veterinaria , Tendinopatía/veterinaria , Animales , Carpo Animal/cirugía , Perros , Fascitis Necrotizante/cirugía , Femenino , Colgajos Quirúrgicos/efectos adversos , Tendinopatía/cirugíaRESUMEN
OBJECTIVES: To describe the use, quality of life, compliance, complications, and outcome of animals fitted with stump socket prostheses. METHODS: Medical records of dogs fitted with a stump socket prosthesis were reviewed. Functional outcome, quality of life and complications were retrospectively assessed from an owner questionnaire. RESULTS: Thirteen stump socket prostheses (12 dogs) were fitted for a variety of reasons including trauma, congenital abnormalities, and neoplasia. Eight dogs had a good outcome overall and four a poor outcome. Quality of life (QOL) remained good or excellent in 10/12 dogs. Nine complications were seen in 7/12 dogs, most were manageable; surgical wound complications (n = 2) and pressures sores (n = 4) were the most frequently encountered. One dog suffered multiple complications. Thoracic and pelvic limb stump socket prostheses had a similar complication rate, however all animals with a poor outcome had a thoracic limb stump socket prosthesis; two were small breed dogs (under 10 kg) and two had bilateral thoracic limb abnormalities. CLINICAL SIGNIFICANCE: Stump socket prostheses are feasible and versatile in animals. In correctly selected cases, good to excellent outcomes are possible. However, complications are frequent but often manageable. Further investigations are required into the risk factors for poor outcomes and prospective studies are required to assess changes in biomechanics, function, and QOL before and after fitting of a stump socket prosthesis. Until further evidence is available, careful consideration should be given before fitting bilateral thoracic limb stump socket prostheses or thoracic limb stump socket prostheses to small breed dogs.
Asunto(s)
Muñones de Amputación/veterinaria , Perros , Diseño de Prótesis , Calidad de Vida , Muñones de Amputación/cirugía , Animales , Miembros Artificiales , Miembro Posterior , Estudios Prospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To report the long-term radiographic and clinical outcome of the BioMedtrix TATE elbow arthroplasty system in dogs. Assessment was via radiographs, a surgeon-based questionnaire, and owner assessment of outcome using the Liverpool osteoarthritis in dogs (LOAD) and canine brief pain inventory (CBPI) questionnaires. STUDY DESIGN: Retrospective multicenter, case series. ANIMALS: Client-owned dogs undergoing TATE elbow arthroplasty. METHODS: Questionnaires were distributed to surgeons in the United Kingdom performing TATE elbow arthroplasty and to the owners of the dogs operated on. Owners completed the LOAD and CBPI questionnaires. All completed questionnaires from surgeons and owners, and radiographs of the dogs were collated and analyzed. RESULTS: Surgeon questionnaires and radiographs were obtained for 33 elbows from 32 dogs, with owner questionnaires obtained for 19 dogs. Perioperative, short-term, and mid-term complication rates were 60%, 15%, and 15%, respectively. Radiographic assessment of component alignment showed 62% of cartridges were valgus or varus malaligned and 56% of cartridges were either translated medially or laterally relative to the long axis of the ulnar. There was no significant association between component alignment and final clinical outcome. Surgeon assessment reported 24% of dogs to have full, 52% acceptable, and 24% unacceptable outcome. Owner assessment showed significant decreases in pain severity and pain interference from preoperative to final status but no change in mobility scores. CONCLUSIONS: A high complication rate and variability in component placement was recorded with TATE athroplasty. However, component malalignment did not negatively impact clinical outcome. Final clinical outcome was favorable for most cases with significant reductions in pain severity and interference scores despite no changes in mobility scores.
Asunto(s)
Artroplastia/veterinaria , Enfermedades de los Perros/cirugía , Prótesis de Codo/veterinaria , Osteoartritis/veterinaria , Animales , Perros , Femenino , Miembro Anterior/cirugía , Masculino , Osteoartritis/cirugía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVES: To evaluate the outcome and complications following surgical stabilization of canine tarsocrural luxations. METHODS: Medical records of dogs which were surgically treated for tarsocrural joint instability between February 2007 and June 2014 were reviewed. Surgical technique, complications and long-term outcome (via questionnaire and Canine Brief Pain Inventory) were assessed. RESULTS: Twenty-four dogs (26 joints) were included. All injuries were traumatic. All joints had associated fractures; malleolar in 21/26 limbs (13/26 medial). Eight joints had internal fracture fixation and transarticular external skeletal fixator, six had external fixator alone, four had prosthetic ligaments with external fixator, and four had prosthetic ligaments with external coaptation. Two joints had pantarsal arthrodesis and two primary ligament repair. Complications occurred in 24/26 limbs giving 45 distinct complications; 16 were minor, 29 major, and 31 complications were external fixator associated. Prosthetic ligaments were significantly associated with major complications (p = 0.017); five out of eight required subsequent removal between 105-1006 days. Cost was significantly associated with major complications (p = 0.017) and soft tissue wounds (p = 0.03). Long-term lameness was seen in nine of 14 dogs. There was no association between pain severity (p = 0.3) and pain interference scores (p = 0.198) when comparing stabilization methods. CLINICAL SIGNIFICANCE: Complications are common; however many are external fixator related. Prosthetic ligaments are significantly associated with major complications. Regardless of technique, a degree of ongoing lameness is likely.
Asunto(s)
Perros/lesiones , Perros/cirugía , Fijación de Fractura/veterinaria , Inestabilidad de la Articulación/veterinaria , Animales , Calcáneo , Femenino , Peroné , Fijación de Fractura/efectos adversos , Fijación de Fractura/métodos , Fijación Interna de Fracturas/efectos adversos , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas/veterinaria , Inestabilidad de la Articulación/cirugía , Masculino , Evaluación de Procesos y Resultados en Atención de Salud , Estudios Retrospectivos , Encuestas y Cuestionarios , Astrágalo , TibiaRESUMEN
OBJECTIVE: To quantify, using computed tomography (CT), cross-sectional ulnar bone density (UBD), and regional radial bone density (RRBD) at the level of the medial coronoid process (MCP) in elbows with and without medial coronoid process disease (MCPD) and with and without fragmentation of MCP (FCP). STUDY DESIGN: Retrospective clinical case-control and ex vivo study. SAMPLE POPULATION: Labrador Retriever elbows (n = 54) and normal cadaveric Greyhound elbows (11) undergoing elbow CT. MATERIALS AND METHODS: Labrador Retriever elbows were divided into 2 groups: (1) clinically unaffected and (2) MCPD-affected elbows. This 2nd group was subdivided based on the presence of a displaced FCP. UBD was measured linearly, in Hounsfield units (HU) across the widest part of the ulna incorporating the MCP. The radial head was divided into 6 zones, with mean RRBD (HU) calculated for each group. RESULTS: MCPD-affected Labrador Retriever elbows had significantly lower UBD within the MCP with a higher UBD in the cranial ulnar medulla. Lower RRBD was also seen in the radial head adjacent to the MCP in MCPD-affected Labrador Retriever elbows with FCP compared with Labrador Retriever elbows without FCP. Greyhounds had consistently lower RRBD and UBD at the apex of the MCP compared with clinically unaffected Labrador Retriever elbows. CONCLUSIONS: Our results suggest a caudolateral load-transfer shift through the ulna in MCPD-affected elbow joints, unloading the MCP. Changes in regional radial head bone density suggest that the radial head is involved in the pathogenesis of MCPD.
Asunto(s)
Enfermedades de los Perros/diagnóstico por imagen , Artropatías/veterinaria , Animales , Fenómenos Biomecánicos , Densidad Ósea , Cadáver , Estudios de Casos y Controles , Estudios Transversales , Perros , Femenino , Miembro Anterior/diagnóstico por imagen , Artropatías/diagnóstico por imagen , Masculino , Linaje , Radio (Anatomía)/diagnóstico por imagen , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/veterinaria , Cúbito/diagnóstico por imagenRESUMEN
This report describes a cat that presented with abdominal pain and worsening azotaemia following unknown trauma. Further diagnostic investigations and surgery confirmed bilateral ureteral trauma. The cat was initially managed surgically by bilateral ureteroureterostomy over ureteral stents. The clinical signs and biochemical parameters rapidly resolved, but 2 months later the cat developed signs consistent with sterile cystitis that was unresponsive to medical management. Removal of the ureteral stents resulted in severe azotaemia as a result of stricture formation at the previous ureteral anastomosis site. The ureteral stents were initially replaced with soft stents, but subsequently cut short owing to the persistence of clinical signs of cystitis. Following shortening of the ureteral stents severe azotaemia was again observed. The resulting pelvic dilatation allowed for placement of bilateral subcutaneous ureteral bypass (SUB) systems, which resulted in alleviation of all clinical signs 12 months after SUB placement.