Short-term outcomes of dogs and cats undergoing lung lobectomy using either a self-ligating loop or a thoracoabdominal stapler.

OBJECTIVE: To assess clinical outcomes of lung lobectomies in dogs and cats using either self-ligating loops (SLLs) or thoracoabdominal (TA) staplers, aiming to inform sample size calculations for future superiority trials. STUDY DESIGN: Retrospective study. ANIMALS: A total of 72 dogs and 15 cats. METHODS: Records from January 2003 to October 2023 at a single institution were reviewed. Cases with lung lobectomy performed via TA stapler or SLL with a minimum 14-day postoperative follow-up were included. Pre-, intra-, and postoperative data were collected, with outcomes of interest including the frequency of intra- and postoperative complications. Outcome comparisons between techniques were performed to inform sample size calculations. RESULTS: A total of 101 lung lobectomies were performed. The TA stapler was used in 83 (82.2%) and the SLL in 18 (17.8%) lung lobectomies. Intraoperative complications were identified in 14/101 lung lobectomies (13.9%), including intraoperative hemorrhage in 12/101 lobectomies (11.8%) and air leakage in 2/101 lobectomies (1.9%). Postoperative complications were identified in 12/87 cases (13.8%), including 4 (4.6%) catastrophic complications and 5 (5.8%) major complications. All intra- and postoperative complications occurred in cases having undergone stapled lung lobectomy; however, no differences were identified between surgical technique and either intraoperative (p = .069) or postoperative complications (p = .112). A sample size of 103 lobectomies per technique group would be required for appropriate evaluation. CONCLUSION: Lung lobectomy using either surgical technique provided a good short-term outcome in this population. CLINICAL SIGNIFICANCE: Self-ligating loop lung lobectomy provided a comparable alternative to stapled lung lobectomy. Further studies are needed to assess technique superiority.

Dome trochleoplasty for correction of patella alta and patella luxation in dogs > 20 kg.

OBJECTIVE: To describe the dome trochleoplasty procedure and report the short-term outcomes and complications associated with a novel technique to correct patellar luxation and patella alta. ANIMALS: 13 dogs (16 stifle joints) diagnosed with medial patellar luxation with concurrent patella alta in dogs > 20 kg. CLINICAL PRESENTATION: Medical records of dogs weighing > 20 kg that underwent a dome trochleoplasty for correction of a medial luxating patella were prospectively evaluated. The procedure described involves an osteotomy of the femoral trochlea, which is then translated and/or rotated to correct patellar luxation. Clinical results were assessed using subjective lameness scoring, radiographic evaluation, and the Canine Brief Pain Inventory (CBPI) tool. RESULTS: 16 stifle joints were included in this study. The overall complication rate was 50%. Major complications occurred in 43.8% of stifle joints due to pin migration and recurrent luxation of the patella. One dog experienced a catastrophic complication 4 months postoperatively. Uncomplicated osteotomy healing was present in 94% of dogs. The median initial lameness score was 2 (mean, 1.81; range, 0 to 4) and at the final recheck was 0 (mean, 0.31; range, 0 to 2). The CBPI scores were available for 50% of stifle joints. The median initial CBPI score was 45.5 (mean, 48.8; range, 32 to 74) and at the final recheck was 17.5 (mean, 20.5; range, 0 to 43). CLINICAL RELEVANCE: The dome trochleoplasty procedure offers an alternative technique for surgical correction of patellar luxation secondary to patella alta in large-breed dogs, but due to its higher complication and reluxation rates, it should be used cautiously and probably in combination with other corrective procedures, such as tibial tuberosity transposition, soft tissue imbrication, and/or soft tissue release rather than as a stand-alone procedure.

Effect of Stem Positioning on Biomechanical Performance of a Novel Cementless Short-Stem Canine Total Hip Implant.

OBJECTIVE: The aim of this study was to evaluate the effect of stem positioning on the biomechanical performance of a novel, collared, short-stem total hip implant under compression and torsion ex vivo. STUDY DESIGN: Six canine cadaveric femurs were implanted with a collared short-stem femoral implant. Canal flare index (CFI), stem angle, absolute and relative cut heights and relative size were measured radiographically and used as independent variables. Biomechanical performance of the construct was evaluated using physiologic loading (loading) and supraphysiologic loading (failure) protocols. RESULTS: During loading protocols, compressive stiffness was influenced by absolute cut height (p = 0.018). During failure protocols, peak torque was influenced by CFI (p = 0.004) and craniocaudal relative size (p = 0.005). Peak load and torsional stiffness were not impacted by any of the radiographic variables (p > 0.05). Three of six femurs developed longitudinal fractures originating at the medial calcar at the time of failure. CONCLUSION: The biomechanical performance of the collared short-stem implant was positively impacted by preserving more of the femoral neck, having a higher CFI and using a smaller implant size relative to the femoral neck isthmus.

Radiographic and Biomechanical Assessment of Three Implant Designs for Canine Cementless Total Hip Replacement.

OBJECTIVE: The aim of this study was to evaluate the relationship between radiographic fit/fill measurements and biomechanical performance of three canine cementless total hip implant designs using an in vitro biomechanical testing protocol that replicates compression and torsion. STUDY DESIGN: Eighteen (six/group) canine cadaveric femurs were implanted with one of three cementless total hip implant designs: (1) collarless, (2) collared or (3) lateral bolt stems. Femoral length, canal flare index (CFI), canal fill, stem fit, stem level and stem angle were measured as independent variables. Biomechanical performance was tested using physiological, non-destructive gait loading (loading protocols) and destructive testing (failure protocols). RESULTS: During loading protocols, compressive stiffness was influenced by stem level (p < 0.05) and torsional stiffness was influenced by stem level and CFI for collarless stems (p < 0.05). During failure protocols, peak load was influenced by mediolateral (ML) stem angle (p < 0.05) and CFI (p < 0.01) for collarless stems and CFI for lateral bolt stems (p < 0.05). Peak torque was influenced by ML stem angle, craniocaudal stem angle and CFI for collarless stems (p < 0.05) and average ML fill for collared stems (p < 0.05). CONCLUSION: Biomechanical performance of collarless stems in cementless hip arthroplasty is more impacted by radiographic fit/fill than lateral bolt and collared stems. As a result, collarless stems may be more dependent on preoperative fit and intraoperative precision.

Uterine perforation secondary to metritis and placenta percreta in a postpartum bitch.

A 3-year-old intact female Labradoodle bitch was referred due to fever and lethargy 4 days postpartum. The dog was reported to have had prolonged labor that required assistance and fetal membranes were retained. Physical examination and diagnostics led to a suspicion of metritis and uterine perforation. Ovariohysterectomy was performed. Gross and histopathology findings revealed multifocal uterine perforation, necrosuppurative metritis, and placenta percreta. Post-operative antibiotic therapy and supportive care resulted in an uneventful clinical recovery. This is the first reported case of placenta percreta in a bitch. It is presumed that this pathology was paramount in the patient's development of metritis and subsequent uterine rupture. Key clinical message: Placenta percreta may lead to more severe clinical consequences of metritis, including uterine rupture.

Perforation utérine secondaire à une métrite et un placenta percreta chez une chienne en période post-partum. Une femelle Labradoodle intacte âgée de 3 ans fut référée pour cause de fièvre et léthargie 4 jours post-partum. Il fut rapporté que la chienne avait eu un travail long qui demanda de l'assistance et qu'il y avait eu rétention des membranes foetales. L'examen physique et le diagnostic mena à un doute de métrite et de perforation utérine. Une ovario-hystérectomie fut réalisée. Les trouvailles de pathologie macroscopique et d'histopathologie révélèrent des perforations utérines multifocales, une métrite nécro-suppurative et un placenta percreta. Une antibiothérapie post-opératoire et des soins de support ont résulté en une guérison clinique sans conséquence. Ceci représente le premier cas rapporté de placenta percreta chez une chienne. Il est présumé que chez cette chienne cette pathologie était vitale dans le développement de la métrite et de la rupture utérine subséquente.Message clinique clé :Un placenta percreta peut mener à des conséquences cliniques plus sévères de métrite, incluant la rupture utérine.(Traduit par Dr Serge Messier).

Effect of the Proximal Abducting Ulnar Osteotomy on Intra-Articular Pressure Distribution and Contact Mechanics of Congruent and Incongruent Canine Elbows Ex Vivo.

OBJECTIVE: To determine the effects of the Proximal Abducting Ulnar Osteotomy (PAUL) on contact pressures of congruent and incongruent (short radius) canine elbows. STUDY DESIGN: Ex vivo biomechanical study. SAMPLE POPULATION: Unpaired normal cadaveric canine forelimbs (n=16). METHODS: A servohydraulic testing frame and thin-film sensors were utilized to measure intra-articular contact area (CA), mean contact pressure (mCP), and peak contact pressure (pCP) for medial and lateral elbow compartments. Percent contribution of the medial compartment relative to the whole (%Med) was also examined. Baseline data were collected in 9 congruent elbows and 7 incongruent elbows where the radius was shortened. Both sets of elbows were tested following ulnar osteotomy and sequential placement of 2 and 3 mm PAUL plates and paw repositioning (to account for any medial to lateral shift of transarticular forces). Paired t-tests compared sequential procedural steps. P<.05 was significant. RESULTS: For congruent elbows, the 2 mm PAUL plate decreased CA in both compartments compared to baseline; lateral pCP increased with subsequent paw repositioning. Induction of radio-ulnar incongruity decreased CA and increased mCP medially, decreased pCP laterally, and increased %MedCA and %MedmCP compared to baseline. Both PAUL plates decreased mCP and pCP medially, with no effect laterally. Paw repositioning had no effect. CONCLUSION: The PAUL procedure had no effect on medial compartment pressure in the congruent elbow. It may ameliorate increased medial compartment pressure in the incongruent elbow. This change does not result from a medial to lateral compartmental shift and deserves further investigation.