Feline osteochondromatosis in a 12-year-old feline leukaemia virus-negative cat.

Feline osteochondromatosis is a spontaneous osteocartilaginous exostosis associated with feline leukaemia virus (FeLV) infection or due to a frameshift variant in the exostosin glycosyltransferase 1 (EXT1) gene. Osteochondromatosis was diagnosed in an indoor-only, 12-year-old, neutered female, Russian Blue cat. Radiographs revealed bilateral calcified proliferations in the elbow, costochondral and sternochondral joints, which distorted the normal skeletal structure. Grossly, the proliferated joints presented with consistent, rounded masses, causing complete ankylosis. The main histopathological finding was an osteocartilaginous proliferation composed of multiple irregular islands of well-differentiated hyaline cartilage surrounded and delimited by osteoid tissue. Immunohistochemistry of the osteochondromas, bone marrow and mediastinal lymph nodes, using a primary anti-FeLV gp70 antibody, and FeLV proviral DNA real-time polymerase chain reaction on bone marrow were negative. Sequencing of exon 6 of the EXT1 gene was performed and nucleotide BLAST analysis demonstrated the absence of a frameshift variant. This study reports the only case of spontaneous feline osteochondromatosis in an animal more than 10 years old.

Combined Gap and Interpositional Arthroplasty Utilizing Three-Dimensional Printed Model in a Dog with Temporomandibular Joint Ankylosis and Pseudoankylosis.

Objective: To report the surgical treatment of a canine with both ankylosis and pseudoankylosis of temporomandibular joint (TMJ). Methods: The patient presented for inability to open his mouth. Facial asymmetry with normal dental occlusion was appreciated and computed tomography (CT) was performed. CT was used to diagnose ankylsosis and pseudoankylosis of left TMJ secondary to chronic maxillofacial trauma. A gap arthroplasty followed by interpositional arthroplasty using temporalis muscle fascia was performed to remove the site of fusion and prevent re-ankylosis between remaining cut boney surfaces. A three-dimensional (3D) printed skull for surgical planning and intraoperative spatial localization was employed. Results: Following preoperative and intraoperative evaluation of the 3D printed skull, the surgery was performed successfully without major complications. The patient's TMJ range of motion was markedly improved and remains improved as noted by inter-incisal distance measurements, ability to pant, and ease of chewing. Conclusion: A combined Gap and interpositional arthroplasty was assisted with the use of a 3D printed skull and immediately resulted in improved TMJ range of motion and patient quality of life. Three-month postoperative CT revealed stable ostectomies with no complications, with the exception of left-sided disuse masticatory muscle atrophy. Long-term follow-up is warranted. Clinical Significance: Three-dimensional printed skull models may be utilized preoperatively and intraoperatively to determine individual variants and landmarks, especially in cases where anatomical structures are difficult to recognize. Gap arthroplasty with interpositional myofascial transposition is an option for a patient with both anklyosis and pseudoankylosis of the TMJ.

Modified retrograde intubation through the cricothyroid membrane in a cat with temporomandibular joint ankylosis.

A 6-month-old, 2.9-kg, male, Korean short hair cat was referred for inadequate mouth opening (4 mm), and condylectomy was scheduled for ankylosis of the left temporomandibular joint. Retrograde intubation via the cricothyroid membrane was planned since direct visualisation of the larynx was not possible. In dorsal recumbency, the cricothyroid membrane was punctured with an 18-gauge needle, and a J-tip guidewire, inserted via the needle, was advanced and identified at the mouth. A 6-Fr truncated feeding tube was inserted from the mouth to the cricothyroid membrane along the guidewire. The guidewire was removed, and the tip of the feeding tube was advanced as an anterograde guide to the inner trachea. Subsequently, an endotracheal tube was inserted along the feeding tube. Capnography was used to confirm correct intubation. Condylectomy was performed on the left temporomandibular joint, and the patient recovered from anaesthesia uneventfully. Retrograde intubation is less invasive than tracheostomy or cricothyroidotomy, and the cricothyroid membrane has been suggested as a suitable site for guidewire insertion in humans and dogs. However, when resistance is encountered during the advancement of endotracheal tube using the traditional technique without the anterograde guide, it may be difficult to distinguish where the resistance occurred leading to damage or oesophageal displacement in cats with relatively fragile airway. This report suggests that retrograde intubation via the cricothyroid membrane can be performed in cats with limited visualisation of the larynx, and an anterograde guide following the retrograde wire could reduce the potential damage or oesophageal displacement.

Comparison of unilateral rostral, middle and caudal segmental mandibulectomies as an alternative treatment for unilateral temporomandibular joint ankylosis in cats: an ex vivo study.

OBJECTIVES: Temporomandibular joint ankylosis (TMJA) is the partial or complete inability to open the mouth due to intra- or extra-articular fibrous, bony or fibro-osseous tissue proliferation. Surgical procedures such as gap arthroplasty, condylectomy or wide extra-articular osteotomy have been recommended to treat this condition; these techniques are challenging, time-consuming and have been occasionally associated with postoperative recurrence, severe periarticular neurovascular iatrogenic trauma and death. Segmental mandibulectomy had previously been recommended as an alternative option for unilateral TMJA, but the location of mandibulectomy and extent of bone removal from the mandible region have not been mentioned in the literature. This study aimed to validate the area of the mandibular body (rostral, middle or caudal) and amount of bony tissue that should be osteotomized during a segmental mandibulectomy for treatment of unilateral TMJA in cats. METHODS: In this block study, 30 cadaver heads of domestic shorthair cats were randomly divided into three groups of 10 specimens each based on the mandibular region that would undergo segmental mandibulectomy (rostral, middle and caudal). The size of the removed mandibular segment and pre- and postoperative vertical range of mandibular motion were compared for statistical purposes. RESULTS: A significant statistical difference was observed between the pre- and postoperative vertical range of mandibular motion between the rostral, middle and caudal segmental mandibulectomies (P <0.001). The mean postoperative recovered range of mandibular motion for the rostral, middle and caudal segmental mandibulectomies was 50.4%, 81.9% and 90.4%, respectively. CONCLUSIONS AND RELEVANCE: The caudal segmental mandibulectomy showed the highest postoperative vertical range of mandibular motion. The removal of a minimum of 1.2 cm of the caudal mandibular body was required to achieve nearly full recovery of presurgical mouth opening in the specimens of this study. The caudal segmental mandibulectomy may eliminate the risk of iatrogenic periarticular neurovascular damage inherent to more invasive surgeries performed at the temporomandibular joint area. When performed unilaterally, the caudal segmental mandibulectomy is a viable surgical alternative that may show a similar outcome to other surgical techniques.

Long-term radiographic and histological follow-up after resection of the distal interphalangeal joint using a plantar approach in German Holstein cows.

Resection of the distal interphalangeal joint (DIJ) is a claw-preserving method for treatment of septic arthritis. This study presents the radiographic and histological findings of the surgically-treated area after resection of the DIJ using a plantar approach in seven German Holstein cows. Histological postmortem evaluation 439 to 710 days after surgery showed that there was extensive proliferation of connective tissue rich in collagen fibres in the space left after resection in three cows; this was classified as fibrous ankylosis. In the remaining four cows, histological evaluation 1010 to 1756 days after surgery showed extensive new bone formation in the joint cavity consistent with osseous ankylosis. Radiographs of the resected DIJ region obtained at the time of histological examination revealed no osseous ankylosis in two cows, partial ankylosis in one cow and complete osseous ankylosis in four cows. Formation of complete osseous ankylosis after resection of the DIJ did take longer than 1-2 years in three of our specimens indicating a longer time span compared to earlier studies.

Intra- and Extra-articular Features of Temporomandibular Joint Ankylosis in the Cat (Felis catus).

Temporomandibular joint (TMJ) ankylosis is an uncommon clinical entity in human and veterinary medicine. However, the condition is severely debilitating and is life-limiting if not treated. This study sought to characterize the intra- and extra-articular features of naturally occurring TMJ ankylosis in cats. TMJs from client-owned cats (n = 5) that underwent bilateral TMJ gap arthroplasty were examined and compared with TMJs from healthy, age-matched feline cadavers (n = 2) by cone-beam computed tomography (CBCT), micro-computed tomography (µCT) and histologically. Features of bilateral intra- and extra-articular ankylosis compounded by degenerative joint lesions were identified radiographically and histologically in all affected cats. Features of TMJ 'true' ankylosis included variable intracapsular fibro-osseous bridging, degeneration of the disc and the articular surfaces, narrowing of the joint space and flattening of the condylar process of the mandible. Extra-articular features of TMJ ankylosis included periarticular bone formation and fibro-osseous bridging between the mandible, zygomatic arch and coronoid process. In addition, subchondral bone loss or sclerosis, irregular and altered joint contours and irregularly increased density of the medullary bone characterized the degenerative changes of the osseous components of the TMJ. Complex radiological and histological features of both ankylosis and pseudoankylosis were identified that clinically manifested in complete inability to open the mouth.

Retrograde intubation in a dog with severe temporomandibular joint ankylosis: case report.

BACKGROUND: Orotracheal intubation in dogs is a common and easily-performed procedure that provides a patent airway during anaesthesia. In dogs with temporomandibular joint ankylosis or pseudo-ankylosis, airway management can be a challenging procedure since these dogs have a limited ability to open their mouth. Methods to provide safe, uneventful intubation in such patients may include minimally invasive techniques such as retrograde intubation using a guide wire and fibre-optic-aided laryngoscopy. CASE PRESENTATION: We report a case of a 16-month-old, intact female Bull Terrier weighing 17 kg, admitted to the hospital for surgical treatment of bilateral ankylosis of the temporomandibular joint. Intubation was achieved, without direct observation of the larynx, by retrograde intubation using a vascular access catheter and a vascular wire guide through cricothyroid membrane. Bilateral condylectomy was performed and the dog recovered uneventfully. CONCLUSIONS: In conclusion, retrograde intubation was relatively simple to perform with the guide wire technique and no specific training or equipment were necessary.

The First Record of Incidences of Ankylosis in Seven Triplefin Fishes (Pisces: Tripterygiidae) from New Zealand.

Different cases of vertebral ankylosis were examined in seven tripterygiid species obtained from waters around New Zealand. The skeletal deformities observed are located in the caudal region of the vertebral column. Those occurred in Forsterygion nigripenne, Matanui bathytaton and in one specimen of Ruanoho whero were severe cases. The mechanism of the formation of vertebral ankylosis and the causes behind such anomaly were discussed. Further studies are needed to relate specific pollutants with the observed types of deformities. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 301:39-45, 2018. © 2017 Wiley Periodicals, Inc.

Ankylosis and pseudoankylosis of the temporomandibular joint in 10 dogs (1993-2015).

OBJECTIVE: To describe the clinical features and results of treatment of true ankylosis and pseudoankylosis of the temporomandibular joint in dogs. METHODS: This study was a retrospective case series. Ten client-owned dogs that were presented for inability to open the mouth or a severely decreased range of motion of the temporomandibular joint were included. Information on the surgical procedures performed and the perioperative complications were documented. Three-dimensional printing of the skull was performed in four dogs. RESULTS: Two dogs were diagnosed with temporomandibular joint ankylosis and seven dogs with pseudoankylosis. One dog had evidence of combined temporomandibular joint ankylosis and pseudoankylosis. Of the seven dogs with pseudoankylosis, six had an osseous fusion involving the zygomatic arch and mandible. Surgical treatment was performed in nine dogs and a revision surgery was needed in one dog. Follow-up ranged from five months to eight years (mean: 48.6 months). Eight out of nine dogs that were treated surgically regained the ability to open their mouth, but six dogs never regained a fully normal temporomandibular joint range of motion. CLINICAL SIGNIFICANCE: Temporomandibular joint ankylosis and pseudoankylosis are uncommon in the dog. Surgical treatment for temporomandibular joint ankylosis or pseudoankylosis in dogs is a successful option and carries a prognosis dependent on patient-specific abnormalities. Computed tomography complemented with three-dimensional printing is valuable for understanding the extent of abnormalities and for preoperative planning.

False ankylosis of the temporomandibular joint in a cat. Correction by partial zygomatic arch resection.

OBJECTIVE: To describe the use of two-dimensional computer-assisted tomography (CT) with three-dimensional (3D) reconstruction in the diagnosis and planning of surgical treatment of a case of false ankylosis of the temporomandibular joint. CASE REPORT: A young European Shorthaired cat was presented with the complaint of inability to eat and open its jaws. A CT scan with 3D reconstruction allowed visualization of the lesion which was causing extra-articular ankylosis of the temporomandibular joint. Surgery was performed to resect an osseous lesion of the zygomatic arch, thus freeing the temporomandibular joint. Postoperative physical therapy was initiated immediately following surgery, and then carried out by the owner with a one year follow-up. Clinical examination of the cat was performed during regular office visits (at 1 month and 3 months following surgery), which allowed objective assessment of postoperative recuperation. At the end of a year, the owners reported that the cat had maintained sufficient jaw opening without any signs consistent with chronic pain. CONCLUSION: Computed tomography scan with 3D reconstruction allowed planning of the surgical correction of extra-articular ankylosis of the temporomandibular joint, and in this case condylectomy was avoided, since temporomandibular joint range-of-motion was maintained.

Bilateral extracapsular soft-tissue ossification affecting range of TMJ motion in an Airedale terrier.

A 3 mo old female Airedale terrier presented with decreased range of motion of the temporomandibular joint (TMJ), which was first recognized at weaning. Computed tomography (CT) revealed abnormal, bilateral ossification of the soft tissues extending from the region of the tympanic bullae to the medial aspect of the angular process of each mandible. Those ossified structures most closely approximated the location of the lateral pterygoid muscles. The ossified structures were present at presentation and initially manifested as complete ossification on the right side. The condition progressed to complete bilateral ossification by 3 yr of age. The mandibular condyles associated with the temporomandibular joints were malformed. The patient had severe mandibular distoclusion with deviation of the mandible to the left. The left mandibular cheek teeth were positioned in a caudal cross bite. A single treatment of manual stretching and breakdown of the ossified muscle of mastication by placement of tongue depressors within the oral cavity resulted in no increase in TMJ range of motion as measured by the incisal opening. This is the first reported case of spontaneous false ankylosis of the TMJ in an Airedale terrier.

Retrospective evaluation of facilitated pastern ankylosis using intra-articular ethanol injections: 34 cases (2006-2012).

REASONS FOR PERFORMING STUDY: While surgical arthrodesis is the treatment of choice for osteoarthritis of the proximal interphalangeal joint, some clients are unable to pursue surgery due to costs. A more economical technique was sought using intra-articular ethyl alcohol injections to facilitate ankylosis. OBJECTIVES: To describe the technique and outcome of intra-articular ethyl alcohol injections for facilitated ankylosis of proximal interphalangeal joints with osteoarthritis. METHODS: As a retrospective case series, the medical records (2006-2012) of clinical cases diagnosed with proximal interphalangeal joint osteoarthritis treated with intra-articular ethyl alcohol injections were reviewed. Cases with follow-up of at least 6 months were included. Technique and outcome were determined. Evaluation of outcome was assessed using return to previous performance or intended use and owner satisfaction as the indicators of success. Soundness and level of work are also reported. RESULTS: Thirty-four horses were included in the study. At the time of follow-up, 17 horses (50%) were sound, while 13 horses (38%) were improved but not sound. One horse's lameness was unchanged, and 3 horses were lost to follow-up. The median time until horses became sound or returned to work was 8 months. Six horses had complications, 4 of which were mild and transient. CONCLUSIONS AND POTENTIAL RELEVANCE: The use of intra-articular ethyl alcohol in the proximal interphalangeal joint in horses affected by osteoarthritis appears to be a viable method for facilitated ankylosis if surgical management is not an option.

Temporomandibular joint injuries and ankylosis in the cat.

OBJECTIVE: To evaluate cause, location, treatment, and the clinical outcome of traumatic temporomandibular joint (TMJ) lesions and TMJ ankylosis in cats. METHODS: Cats with TMJ injuries were included in this study. Lesions were classified as luxations, fractures of the condylar process, and intra-articular temporal bone fractures. Signalment, cause and type of injuries, treatment methods, clinical outcome, complications and joint ankylosis were assessed and evaluated statistically. RESULTS: Temporomandibular joint lesions were observed in 82 of 161 cats with maxillofacial injuries. One hundred forty-nine TMJ lesions were determined in 112 joints. Falling was the most common cause and fractures of the condylar process were the most common types of injuries. Isolated TMJ injuries and caudal TMJ luxations were mainly caused by falling. Condylectomy was used in ankylosis, chronic luxation, reluxation and in two cases with multiple TMJ lesions. Ankylosis was observed in 10.97% of cases and was generally observed in fracture combinations of condylar process and mandibular fossa (χ² = 8.52; p <0.05). No significant relationship between age and development of ankylosis (χ² = 3.995; p >0.05) was found. CONCLUSION: In contrast to previous studies, traumatic TMJ lesions were observed in a considerable amount of cats with maxillofacial injuries, and fractures of the condylar process were the most common type. Lesions caused by falling were mostly simple, whereas vehicular trauma caused more complicated lesions. Ankylosis did not appear as a rare condition. Any cat with TMJ injury is susceptible to the development of ankylosis.

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (dish) resulting in adjacent segment disease.

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (DISH) are usually incidental findings and in most dogs are either asymptomatic or associated with mild clinical signs. Severe spondylosis deformans and DISH can result in complete bony fusion of consecutive vertebral segments. One of the recognised complications following vertebral fusion in human patients is the development of adjacent segment disease, which is defined as degenerative changes, most commonly degenerative intervertebral disc disease, in the mobile vertebral segment neighboring a region of complete vertebral fusion. A similar syndrome following cervical fusion in dogs has been termed the domino effect. The purpose of this retrospective study was to investigate the hypothesis that vertebral fusion occurring secondary to spondylosis deformans or DISH in dogs would protect fused intervertebral disc spaces from undergoing degeneration, but result in adjacent segment disease at neighbouring unfused intervertebral disc spaces. Eight dogs with clinical signs of thoracolumbar myelopathy, magnetic resonance imaging of the thoracolumbar vertebral column, and spondylosis deformans or DISH producing fusion of > or = 2 consecutive intervertebral disc spaces were evaluated. Vertebral fusion of > or = 2 consecutive intervertebral disc spaces was correlated (P = 0.0017) with adjacent segment disease at the neighbouring unfused intervertebral disc space. Vertebral fusion appeared to protect fused intervertebral disc spaces from undergoing degeneration (P < 0.0001). Adjacent segment disease should be considered in dogs with severe spondylosis deformans or DISH occurring in conjunction with a thoracolumbar myelopathy.

Alcohol-facilitated ankylosis of the distal intertarsal and tarsometatarsal joints in horses with osteoarthritis.

OBJECTIVE: To assess the safety and efficacy of alcohol-facilitated ankylosis of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses with osteoarthritis (bone spavin). DESIGN: Prospective clinical trial. ANIMALS: 21 horses with DIT or TMT joint-associated hind limb lameness and 5 nonlame horses. PROCEDURES: 11 horses (group 1) underwent lameness, force-plate, and radiographic examinations; following intra-articular analgesia, lameness and force-plate examinations were repeated. Nonlame horses were used for force-plate data acquisition only. Following localization of lameness to the DIT and TMT joints, contrast arthrographic evaluation was performed; when communication with the tibiotarsal joint was not evident or suspected, 70% ethyl alcohol (3 mL) was injected. Group 1 horses underwent lameness, force-plate, and radiographic examinations every 3 months for 1 year. Ten other horses (group 2) underwent lameness and radiographic examinations followed by joint injection with alcohol; follow-up information was obtained from owners or via clinical examination. RESULTS: Significant postinjection reduction in lameness (after 3 days to 3 months) was evident for all treated horses. Twelve months after injection, 10 of 11 group 1 horses were not lame; lameness grade was 0.5 in 1 horse. Follow-up information was available for 9 of 10 group 2 horses; 7 were not lame, and 2 remained mildly lame (1 had a concurrent problem in the injected limb, and the other had DIT joint collapse that precluded needle entry). CONCLUSIONS AND CLINICAL RELEVANCE: Intra-articular alcohol injection in horses with bone spavin resulted in a rapid (usually within 3 months) reduction in lameness and joint space collapse.

Temporomandibular joint ankylosis in cats and dogs. A report of 10 cases.

Temporomandibular joint (TMJ) ankylosis is characterized by difficulty or inability to open the mouth. The ankylosis may be articular ('true') or extra-articular ('false'). Clinical signs, radiographic studies, treatment and follow-up are presented in a retrospective study involving five cats and five dogs. The findings were compared with TMJ ankylosis in humans. CT imaging with three-dimensional reconstruction proved to be of great value in determining the extent of the abnormalities and helped with preoperative planning. Articular TMJ ankylosis occurred in six animals and extra-articular TMJ ankylosis was found in the other four cases. In three cats and in three dogs, the TMJ ankylosis was trauma related; the remaining patients were diagnosed with a tumour. Resection of ankylosing tissue in false ankylosis or gap arthroplasty in true ankylosis was successful in all of the trauma induced cases. In the two cats, with tumour related ankylosis, the ankylosis was caused by an osteoma and resection had a good prognosis, whereas the two dogs had to be euthanatized.

Ankylosis of tarsometatarsal luxations using external fixation.

This report evaluates the suitability of using an external fixator as the sole means of correcting tarsometatarsal luxations. Four dogs were included in this report. Each dog weighed more than 20 kg and had sustained a tarsometatarsal luxation with plantar, medial or lateral instability. The luxations were immobilised with an external fixator for between 12 and 17 weeks. The surgery did not involve soft tissue dissection, debridement of articular cartilage or a cancellous bone graft and no external coaptation was used postoperatively. The result of this treatment was to ankylose the tarsometatarsal luxation and allow the dogs to return to normal function.

Centrodistal joint lameness in dogs.

Lameness attributable to pathology of the centrodistal joint was investigated in five racing greyhounds, five Border collies and two other dogs. Diagnosis was made by the induction of pain from rotationally stressing the medial aspect of the tarsus, and by the exclusion of tarsal fractures and instabilities. Radiographic changes included plantar ligament entheslopathy and centrodistal joint osteophytosis. In many of the cases, the lameness was poorly responsive to rest and non-steroidal anti-inflammatory drugs. One dog was managed conservatively and became sound. In 10 of 11 cases, surgical promotion of centrodistal ankylosis was associated with a return to soundness.

Facilitated ankylosis of the distal interphalangeal joint in a foal.

A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiographically 7 weeks following surgery. Evaluation of the horse 30 months following surgery revealed complete fusion of the middle and distal phalanges, and the distal sesamoid bone. The horse is pasture sound and is used as a breeding stallion. This report describes the surgical approach and case management employed to achieve facilitated ankylosis as a treatment for unresolved septic arthritis of the distal interphalangeal joint. This is the first report of successful facilitated ankylosis of the distal interphalangeal joint in a foal.