Comparison of the different supports used in veterinary medicine for pressure sore prevention.

OBJECTIVES: To compare the pressure-relieving capacity of different supports used in veterinary medicine and to find the more common pressure sore locations in laterally recumbent dogs, so as to recommend protocols for decubitus ulcer prevention. MATERIALS AND METHODS: We compared the support properties of: (1) blankets on the floor, (2) a standard mattress, (3) a veterinary memory foam mattress and (4) a human medicine memory foam mattress. Three cadaver dogs with different body condition scores but similar sizes were positioned on the different supports in lateral recumbency. Pressures were measured in each dog and at each support contact point over a 4-hour period using a TexiSense pressure mat. RESULTS: Regardless of the body condition score and the support used, the skin overlying the scapula-humeral articulation, the greater trochanter and the thirteenth rib were the recurrent risk zones. In these risk zones, pressure-relieving mats led to lower pressures than did the standard mats or the blanket placed on the floor. The contact pressures appeared to depend on body condition score, with maximal pressures observed in thin dogs. CLINICAL SIGNIFICANCE: It is important to use a pressure-relieving mat to reduce the risk of pressure sores, but static pressure-relieving mats are generally insufficient to maintain safe pressures in risk zones (<60 mmHg), particularly in thin patients, and so frequent changes in position are recommended.

Thoracic bite trauma in dogs and cats: a retrospective study of 65 cases.

OBJECTIVES: To report a case series of thoracic bite trauma in dogs and cats and to evaluate risk factors for mortality. METHODS: A retrospective study concerning thoracic bite wounds in dogs and cats was performed. Lesions were categorized by depth of penetration: no wound, superficial, deep or penetrating. Thoracic radiographic reports were reviewed. Lesion management was classified as non-surgical, wound exploration, or explorative thoracotomy. RESULTS: Sixty-five cases were collected. Twenty-two percent of patients with normal respiratory patterns showed thoracic radiographic lesions. Respiratory distress was not correlated with mortality. Twenty-eight patients were presented with superficial wounds and 13 with deep wounds. Eight patients exhibited penetrating wounds. Radiographic lesions were observed in 77% of dogs and 100% of cats. Explorative thoracotomy was performed in 28% of patients, and surgical wound exploration in 17.2%. With the exception of skin wounds, thoracic wall discontinuity was the most frequent lesion. Thoracotomy was associated with increased length of hospitalisation but was not correlated with mortality. The mortality rate was 15.4%. No studied factor correlated with mortality, and the long-term outcomes were excellent. CLINICAL SIGNIFICANCE: A penetrating injury, more than three radiographic lesions, or both together seemed to be indicative of the need for a thoracotomy. In the absence of these criteria, systematic bite wound explorative surgery is recommended, with extension to thoracotomy if thoracic body wall disruption is observed.

Comparison of radiographic measurements of the patellar tendon-tibial plateau angle with anatomical measurements in dogs. Validity of the common tangent and tibial plateau methods.

OBJECTIVE: To evaluate the validity of the common tangent and conventional tibial plateau angle methods for measuring the patellar tendon angle (PTA) in dogs. METHODS: Radiographs of cadaveric stifles (n = 20) placed at 135° in true lateral position were obtained to measure the PTA with both methods. A Kirschner wire was inserted perpendicularly to the patellar tendon at its insertion on the tibia and the stifle was dissected. Two Kirschner wires were then used to identify the anatomical landmarks of the tibial plateau. A digital image was obtained of the proximal tibia in true lateral position. Six blinded observers measured each PTA digitally while the anatomical PTA was determined by an independent blinded observer from the angle between the line representing the tibial plateau and the Kirschner wire representing the perpendicular to the patellar tendon. The agreement between the methods was determined statistically from an intraclass correlation coefficient (ICC). RESULTS: The global ICC for the common tangent method (0.44) and for the conventional method (0.4) indicated that their overall validity is poor. The measurements obtained by common tangentmethod and conventional method were respectively below and above the anatomical measurements. The reproducibility of the PTA measurements based on images of the dissected stifles was very good. CLINICAL SIGNIFICANCE: Both the common tangent and conventional methods show poor concordance with the anatomical measurement of PTA. Further studies are needed to determine if errors in measurements affect the clinical outcome.

Computed tomographic measurements with and without myelography to characterise thoracolumbar extruded disc herniation.

OBJECTIVE: To determine association between computed tomography measurements of spinal cord compression and postoperative outcome. METHODS: A retrospective review of medical records of dogs presenting with intervertebral disease. Data were collected with a minimum of 2 years follow-up period. Computed tomography morphometric indices, particularly the ratio of spinal cord or herniated disc to vertebral canal dimensions, were obtained from survey and myelogram computed tomographic images. The pattern of disc disease was scored as single or continuous (multiple herniated discs), and was compared to postoperative outcome. RESULTS: Fifty-two dogs were included. There was no significant correlation between the degree of spinal cord compression and postoperative outcome. However, postoperative outcome differed significantly between dogs with single or continuous patterns of disc disease (P=0·001). Of those with single patterns, 75% had a postoperative outcome score greater than 75% while 75% of continuous pattern cases had scores lower than 83%. CLINICAL SIGNIFICANCE: Simple observation of the pattern of disc disease as revealed by computed tomography could be used as a prognostic indicator. The outcome tends to be better for single patterns of disc disease, whereas the outcome was poor for most cases with continuous patterns.

Treatment of a nonunion, secondary to gunshot fracture, of the distal radius with circular external fixation and rhBMP-2 in a cat.

OBJECTIVE: To report the successful use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the treatment of an antebrachial non-union, secondary to gunshot fracture, stabilized with circular external fixation in a cat. PROCEDURE: Following a diagnosis of a highly comminuted gunshot fracture of the distal right radius and ulna, the fracture was stabilized with a circular external fixation. A two-ring frame was placed in closed fashion. RESULTS: The skin wound healed uneventfully by second intention in 21 days. Twenty-eight weeks after external fixation, bone healing was absent. 0.8mL of 0.2mg/mL of rhBMP-2 in two collagen sponges was placed in the bone defect. Eight weeks after rhBMP-2 implantation, an early bone healing response was noted on radiographic evaluation. Sixteen weeks after rhBMP-2 implantation, fracture union was achieved. DISCUSSION: To the authors' knowledge, 160 µg is the lowest reported dose of rhBMP-2 that leads to bony union in a cat. However as an individual case study, this report can not be used as evidence that rhBMP-2 at this lower dose is appropriate for use in all cats. Further studies are needed to establish the minimum efficient dose of rhBMP-2 in cats.

Description of the type of chemical restraint used by French veterinarians to perform hip dysplasia screening radiographs. A retrospective study based on 3302 radiographs.

The objective of this study was to investigate the type of chemical restraint used by French practitioners to perform official hip screening radiographs, to determine the proportion of dogs under general anesthesia versus dogs under sedation, and to search for a difference in hip dysplasia (HD) prevalence between the two groups. From September 2005 to August 2008, 3302 conventional ventrodorsal hip extended radiographs sent for official scoring to the same panellist were selected because information related to the type of chemical restraint had been provided. There were 2825 dogs under general anesthesia and 477 were sedated. Chemical restraint used by French veterinarians to perform HD screening radiographs is mainly based on general intra-venous anesthesia with an alpha2 agonist associated with ketamine. A single injection of alpha2 agonist is also mostly used for dogs which are radiographed while under sedation. A very low (1.7%) difference in HD prevalence was noted between the anesthetized and the sedated group. Except for acepromazine, which has been demonstrated to provide insufficient muscle relaxation to show evidence of hip laxity, the protocols seem acceptable as regards the Federation Cynologique Internationale requirements for HD screening.

Risk of simultaneous phenotypic expression of hip and elbow dysplasia in dogs: a study of 1,411 radiographic examinations sent for official scoring.

In order to look for phenotypic correlation between hip (HD) and elbow (ED) dysplasia, we used radiographic scoring obtained from 1,411 dogs of different breeds, which were evaluated for authoritative grading of both conditions. In this population, we found that the risk ratio for an animal to be simultaneously affected by HD and ED is 1.67. For a dog with ED, the risk ratio to be affected by HD increases as the ED grade increases. Similarly, for a dog affected by HD, the risk ratio to be affected by ED increases as the HD grade increases. In a dog affected by HD or ED, the clinician should look for the second condition in the same animal. Due to the low, yet positive correlation, selection against one trait will not affect the other trait sufficiently. Therefore selection has to be conducted at reduction of HD as well as reduction of ED.

Diagnostic value of ultrasonography to assess stifle lesions in dogs after cranial cruciate ligament rupture: 13 cases.

The objective of this study was to evaluate the accuracy of ultrasonographic diagnosis of lesions in the canine stifle associated with cranial cruciate ligament rupture. Thirteen dogs that had a diagnosis of cranial cruciate ligament rupture were included in this prospective clinical study. Two ultrasonographers who were unaware of specific historical and clinical data performed the sonography with a high frequency (8-16 MHz) linear transducer. Surgical treatment of the affected stifle was performed within two days of ultrasonography by a surgeon who was unaware of the ultrasonographic findings. The lesions observed during ultrasonography and arthrotomy were compared at the completion of the study. Visualisation of the superficial tendons (quadriceps and long digital extensor) and ligaments (patellar ligament, collateral ligaments) of the stifle using ultrasonography was excellent. However, the detection of deep stifle ligaments (cranial cruciate ligament and caudal cruciate ligament) was extremely difficult to perform using ultrasonography. For cranial cruciate ligament rupture, the sensitivity for ultrasonographic diagnosis was 15.4%. For meniscal lesions, the sensitivity, specificity, positive and negative predictive values for ultrasonographic diagnosis were 82%, 93%, 90% and 88% respectively. High frequency ultrasonography is a non-invasive method for accurately and efficiently detecting superficial ligaments, tendons and meniscal lesions associated with cranial cruciate ligament rupture in the stifle of non-sedated dogs.

Two cases of surgically treated feline patellar fractures.

A transverse patellar fracture in a six-month-old cat was successfully treated by figure-of-eight dorsal wiring of the patella. A longitudinal patellar fracture with luxation of a large medial fragment in a 2.5-year-old cat was treated by lateral marginal patellectomy with a positive outcome. While adding material to the few veterinary reports in that species, in this brief communication, the authors discuss the aetiology, diagnosis, and the treatment of the presented cases with regards to findings in previously published feline cases.

Prevalence of hip dysplasia according to official radiographic screening, among 31 breeds of dogs in France.

In order to determine the prevalence of hip dysplasia (HD) from radiographs that were submitted for authorative grading, and its changes over the time in 31 breeds of dogs in France, a 14 year-retrospective study was conducted. Significant differences were observed between breeds, with HD prevalence ranging from 59.7% (Cane Corso) to 3.9% (Siberian Husky). When comparing the 1993-1999 with the 2000-2006 period in 15 breeds, a significant decrease in HD prevalence was detected in Berger Picard, Bernese Mountain dog, Briard, Gordon Setter, White Swiss Sheepdog and Rottweiler. Modifications observed in the other breeds were not statistically significant.

Canine hip dysplasia radiographic screening. Prevalence of rotation of the pelvis along its length axis in 7,012 conventional hip extended radiographs.

The prevalence of rotation of the pelvis along its length axis was noted, as was the number of rotations towards the right or left hand side of the dog, on 7,012 conventional hip extended radiographs, which were sent for official screening. 29.8% of the radiographs showed a rotation the pelvis. The rotation was statistically more frequent towards the left hand side of the dog. The number of rejected radiographs for too important pelvis rotation was only 5.2%. The consequences of the pelvis rotation on the Norberg-Olsson angle, on the dorsal femoral head coverage, and in the aspect of cranial acetabular edge have to be taken into account when scoring the dog for hip dysplasia.

Determination of the depth of excision using a dermatome (Aesculap) to export all hair follicle bulbs from a donor site in the dog.

The aim of the study was to determine the depth of excision using a dermatome to excise all hair follicle bulbs from the donor site. Partial-thickness skin samples of different depth, ranging from 0.4 to 1 mm, were excised using a dermatome (Aesculap) from the dorsal aspect of the trunk of the dog. Biopsies, using a 6-mm biopsy punch, were performed in the centre of each donor site and excised sample. They were processed routinely for histological examination and the aspect of the hair follicles was observed. Split-thickness skin grafts of >or=0.7 mm deep performed with a dermatome contain the entire hair follicle.

Bilateral parieto-occipital dermoid sinuses in a Rottweiler.

Bilateral dermoid sinuses were identified on the parieto-occipital region of a Rottweiler. Diagnosis was confirmed by histological examination after successful complete surgical resection. The dermoid sinuses were independent with separate tracts. This unusual parasagittal location can be explained by craniofacial development: dermoid sinuses on the head could occur along the lines of embryological fusion and not only in the sagittal plane. A hypothesis of an origin at the level of the suture between the parietal and interparietal bones is possible in this case.

Perirenal expanding haematoma in a cat.

A four-year-old, entire male domestic cat was referred for assessment of a large abdominal mass of three-weeks duration. Diagnostic imaging suggested the presence of either splenic neoplasia, an abdominal abscess or haematoma. A coeliotomy was performed and an enlarged, irregular mass, including the left kidney and adrenal gland, was identified. The mass was removed, requiring a left adrenalo-uretero-nephrectomy. The aorta was accidentally punctured during the procedure, resulting in paraplegia. Given a poor prognosis, the owners decided to have the cat euthanased. Histological examination of the mass was characteristic of a chronic expanding haematoma.

Influence of anaesthesia on canine hip dysplasia score.

Hip dysplasia (HD) scores, based on the five grades, as defined by the Fédération Cynologique Internationale, were compared between anaesthetized (group 1, n = 3839) and non-sedated non-anaesthetized dogs (group 2, n = 1517). Each dog was radiographed in the standard ventro-dorsal hip joint extended position. Each radiograph was evaluated by the same reader blinded regarding the dog's status of anaesthesia. Results showed that there was a significant difference in hip dysplasia prevalence between group 1 (22%) compared with group 2 (9%) (P < 0.005). This difference was the result of a lower rate of hip-joint laxity assessment and the measurement of Norberg-Olsson angle <105 degrees in group 2 compared with group 1. The acetabular and femoral morphologies were not significantly different between the groups. The data confirm that the scoring of dogs for HD on standard radiographs with the hip joints extended is influenced by anaesthesia.