Primary repair of nonsteroidal anti-inflammatory drug-associated full thickness gastrointestinal ulcers in 11 dogs.

OBJECTIVE: To report the outcomes of dogs that underwent primary repair of gastroduodenal perforations associated with the administration of nonsteroidal anti-inflammatory drugs (NSAID). A secondary objective was to identify clinicopathological findings that predisposed dogs to postoperative death. STUDY DESIGN: Retrospective study. ANIMALS: Eleven dogs with complete gastric or duodenal perforation related to administration of an NSAID that underwent primary surgical repair. METHODS: Medical records were reviewed for dogs that presented with peritonitis due to a complete gastroduodenal perforation while receiving NSAIDs between November, 2011 and January, 2021. Data collected included patient characteristics, clinical signs, clinicopathological results, surgical details, and postoperative management and outcome. RESULTS: All dogs were large breeds (mean weight 42 kg; range 22-75 kg), with a mean age of 7.35 years. Nine dogs from a total of 11 (82 %) received a concurrent corticosteroid and NSAID, or a higher dose/frequency/length of NSAID administration than recommended by the manufacturer. All gastroduodenal perforations were found in the upper gastrointestinal tract. Eight of 11 (73%) dogs survived to discharge. The median postoperative duration of follow up was 444 days (range 2-1460 days). No association was detected between ulcer size or location and mortality. CONCLUSION: Most dogs who underwent primary repair of complete gastroduodenal ulcers survived. Gastroduodenal perforations were generally due to the administration of higher or longer doses of NSAIDs, or concurrent administration of another NSAID or corticosteroid. CLINICAL SIGNIFICANCE: Primary closure may be associated with a high success rate in dogs with full thickness gastroduodenal ulcers.

Biomechanical Properties of the 1.5 mm Locking Compression Plate: Comparison with the 1.5 and 2.0 mm Straight Plates in Compression and Torsion.

OBJECTIVES: The purpose was to compare the biomechanical properties of a 1.5 mm locking compression plate (1.5 LCP) to the 1.5 mm straight plate (1.5 P), 1.5 mm straight plate stacked (1.5 PSt) and 2.0 mm straight plate (2.0 P) in compression and torsion. We hypothesized that biomechanical properties of the 1.5 LCP would be equivalent to properties of the 1.5 P and would represent an alternative for the treatment of radial fractures in miniature breed dogs in which those plates would be used. MATERIALS AND METHODS: A 1 mm fracture gap model was created with a bone surrogate stabilized with a six-hole plate. Sixteen constructs were built for each of the four plate configurations. Eight constructs from each group were tested in compression to failure and eight constructs were tested in torsion to failure. RESULTS: In compression testing, the 1.5 LCP was stiffer than the 1.5 P, and had similar stiffness than the 1.5 PSt and the 2.0 P. The load at yield of the 1.5 LCP was slightly lower than the 1.5 P. In torsion, the 1.5 LCP and 1.5 P had similar stiffness, but 1.5 LCP was slightly stronger than 1.5 P. The 1.5 PSt and 2.0 P were overall superior to the 1.5 LCP but only marginally so for the 1.5 PSt. CLINICAL RELEVANCE: The 1.5 LCP can be considered biomechanically equivalent to the 1.5 P under the present experimental conditions. The use of the 1.5 LCP can be considered as an option for radial fracture repair in dogs in which a 1.5 P would have otherwise been used. The use of a locking plate to improve overall success rate, in these fractures, remains to be confirmed clinically.

Computed Tomography and Biomechanical Comparison between Trans-Articular Screw Fixation and 2 Polymethylmethacrylate Cemented Constructs for Ventral Atlantoaxial Stabilization.

OBJECTIVES: Canine ventral atlantoaxial stabilization methods have been constantly evolving over the past few decades. Yet, proper experimental data comparing the feasibility and biomechanical properties of currently available surgical options are lacking. The aims of this study were (1) to describe and compare the safety profiles and biomechanical properties of three ventral atlantoaxial stabilization methods; and (2) to test whether recently reported optimal implant definitions constitute reasonable guidelines. METHODS: Three types of atlantoaxial stabilization including trans-articular screw fixation (TSF) and two cemented constructs (MI5 and MI6) were performed in 21 Beagle cadavers. Post-surgical computed tomography (CT) images of the constructs and biomechanical data were then generated and statistically analysed. RESULTS: The CT data revealed that TSF achieved significantly better apposition than cemented constructs. Out of 91 screws positioned, 4.4% were graded as dangerous and 86.8% as optimal. Optimal positioning was most challenging to obtain for mono-cortical screws. Analysis of biomechanical data suggested that all three techniques could likely achieve similar rates of atlantoaxial fusion when submitted to physiological loads but also that cemented constructs were less prone to failure compared with TSF. CLINICAL SIGNIFICANCE: This study provides evidence that all three techniques are technically feasible and biomechanically viable but also that the evaluated surgical guidelines could be improved.

Computed Tomographic Analysis of Ventral Atlantoaxial Optimal Safe Implantation Corridors in 27 Dogs.

Objectives Ventral atlantoaxial stabilization techniques are challenging surgical procedures in dogs. Available surgical guidelines are based upon subjective anatomical landmarks, and limited radiographic and computed tomographic data. The aims of this study were (1) to provide detailed anatomical descriptions of atlantoaxial optimal safe implantation corridors to generate objective recommendations for optimal implant placements and (2) to compare anatomical data obtained in non-affected Toy breed dogs, affected Toy breed dogs suffering from atlantoaxial instability and non-affected Beagle dogs. Methods Anatomical data were collected from a prospectively recruited population of 27 dogs using a previously validated method of optimal safe implantation corridor analysis using computed tomographic images. Results Optimal implant positions and three-dimensional numerical data were generated successfully in all cases. Anatomical landmarks could be used to generate objective definitions of optimal insertion points which were applicable across all three groups. Overall the geometrical distribution of all implant sites was similar in all three groups with a few exceptions. Clinical Significance This study provides extensive anatomical data available to facilitate surgical planning of implant placement for atlantoaxial stabilization. Our data suggest that non-affected Toy breed dogs and non-affected Beagle dogs constitute reasonable research models to study atlantoaxial stabilization constructs.

Cuttable plate fixation for small breed dogs with radius and ulna fractures: Retrospective study of 31 dogs.

This retrospective study evaluated complication rates for radius and ulna fractures in small breed dogs in which 1.5 mm to 2.7 mm cuttable bone plates were used for internal fixation. The medical records of all cases from 2004 to 2011 that were presented to our clinic were reviewed. Inclusion criteria were: dogs with body weight < 9 kg, fracture of the radius and ulna with open reduction, and internal fixation utilizing a cuttable bone plate. Thirty-four fractures in 31 dogs met the inclusion criteria. Of 25 dogs that were available for follow-up, all achieved union, minor complications occurred in 9, and major complications occurred in 8. External coaptation was responsible for complications in 8 cases and the need for coaptation needs to be investigated. Excluding minor complications, 32% of patients required at least 1 additional surgery or additional hospitalization. All but 2 of the dogs returned to full function. The 1.5 mm straight plate was successfully used in all dogs with a body weight of 0.9 to 2.6 kg.

Fixation à l'aide d'une plaque taillable chez les chiens de petites races pour les fractures de radius et de cubitus : étude rétrospective de 31 chiens. Cette étude rétrospective a évalué les taux de complication pour les fractures de radius et de cubitus chez les chiens de petites races pour lesquels des plaques vissées taillables de 1,5 mm à 2,7 mm ont été utilisées pour la fixation interne. Les dossiers médicaux de tous les cas de 2004 à 2011 présentés à notre clinique ont été examinés. Les critères d'inclusion étaient les suivants : chiens avec un poids corporel de < 9 kg, la fracture de radius et de cubitus avec une réduction ouverte et une fixation interne utilisant une plaque vissée taillable. Trente-quatre fractures de 31 chiens ont satisfait aux critères d'inclusion. Parmi les 25 chiens qui étaient disponibles pour le suivi, on a observé une union réussie, des complications mineures se sont produites dans neuf cas et des complications majeures ont eu lieu dans huit cas. La coaptation externe a été responsable des complications dans huit cas et le besoin de coaptation doit être étudié. En excluant les complications mineures, 32 % des patients ont requis au moins une chirurgie additionnelle ou une hospitalisation additionnelle. Tous les chiens sauf deux sont retournés à une fonction complète. La plaque de 1,5 mm a été utilisée avec succès chez tous les chiens ayant un poids corporel de 0,9 à 2,6 kg.(Traduit par Isabelle Vallières).

The magnitude of muscular activation of four canine forelimb muscles in dogs performing two agility-specific tasks.

BACKGROUND: The purpose of this study was to measure the muscular activation in four forelimb muscles while dogs performed agility tasks (i.e., jumping and A-frame) and to provide insight into potential relationships between level of muscular activation and risk of injury. Muscle activation in eight healthy, client-owned agility dogs was measured using ultrasound-guided fine-wire electromyography of four specific forelimb muscles: Biceps Brachii, Supraspinatus, Infraspinatus, and Triceps Brachii - Long Head, while dogs performed a two jump sequence and while dogs ascended and descended an A-frame obstacle at two different competition heights. RESULTS: The peak muscle activations during these agility tasks were between 1.7 and 10.6 fold greater than walking. Jumping required higher levels of muscle activation compared to ascending and descending an A-frame, for all muscles of interest. There was no significant difference in muscle activation between the two A-frame heights. CONCLUSIONS: Compared to walking, all of the muscles were activated at high levels during the agility tasks and our findings indicate that jumping is an especially demanding activity for dogs in agility. This information is broadly relevant to understanding the pathophysiology of forelimb injuries related to canine athletic activity.

Ex vivo torsional properties of a 2.5 mm veterinary interlocking nail system in canine femurs. Comparison with a 2.4 mm limited contact bone plate.

OBJECTIVE: To evaluate the torsional properties of the Targon® Vet Nail System (TVS) in small canine femurs and to compare these properties to those of the 2.4 mm LC-DCP® plates. METHODS: Thirty-six cadaveric femurs were allocated to three groups (n = 12). In all bones, points just distal to the lesser trochanter and just proximal to the fabellae were marked and a midshaft transverse osteotomy was performed. Group 1: bones were fixed with the 2.5 mm TVS with the bolts applied at the pre-identified marks. Group 2: A TVS system with 25% shorter inter-bolt distance was used. Group 3: A 7-hole 2.4 mm LC-DCP® plates were applied. All constructs were tested non-destructively for 10 cycles, followed by an acute torsion to failure. RESULTS: Torque at yield was 0.806 ± 0.183 and 0.805 ± 0.093 Nm for groups 1 and 2 and 1.737 ± 0.461 Nm for group 3. Stiffness was 0.05 ± 0.01, 0.05 ± 0.007, and 0.14 ± 0.015 Nm/° for groups 1 to 3 respectively. Maximal angular displacement under cyclic loading was 16.6° ± 2.5°, 15.6° ± 2.1°, and 7.8° ± 1.06° respectively. There was no significant difference for any of the parameters between groups 1 and 2. Both torque at yield and stiffness were significantly greater between group 3 and groups 1 and 2. CLINICAL SIGNIFICANCE: The TVS had approximately half the torsional strength and approximately 1/3 of the stiffness of the 2.4 mm bone plate. Slippage of the locking mechanism was probably the cause of the early failure. The system should be considered as a low-strength and low-stiffness system when compared to bone plates.

Intra-articular implantation of gentamicin impregnated collagen sponge causes joint inflammation and impaired renal function in dogs.

OBJECTIVE: Gentamicin impregnated collagen sponge (GICS) can be used to treat intra-articular surgical site infections. High local concentrations of gentamicin can be reached for short periods; however the collagen vehicle may persist for much longer periods. We wished to determine the effect of sponge implantation on joint inflammation and renal function. METHODS: Eighteen medium sized mixed breed research dogs of hound type were randomized to two groups; arthroscopic implantation of GICS at gentamicin dose = 6 mg/kg (n = 9) or sham operation (n = 9). Endpoints consisted of joint inflammation measured by synovial fluid cell counts and cytokine concentrations; lameness measured by force plate asymmetry indices; and renal function measured by glomerular filtration rate (GFR) study. The prevalence of lesions associated with aminoglycoside nephrotoxicity was assessed by renal biopsy and transmission electron microscopy. RESULTS: Gentamicin impregnated collagen sponge implantation caused joint inflammation (p <0.01), lameness (p = 0.04), and decreased GFR (p = 0.04). No difference was observed in the prevalence of renal lesions on biopsy between the treatment and control groups (p = 0.49). CLINICAL SIGNIFICANCE: Gentamicin impregnated collagen sponge implantation causes joint inflammation and lameness as well as GFR reductions at the dose assessed. Gentamicin impregnated collagen sponge are not recommended for intra-articular implantation in dogs.

Association between methicillin-resistant Staphylococcus pseudintermedius carriage and the development of surgical site infections following tibial plateau leveling osteotomy in dogs.

OBJECTIVE: To evaluate the association between preoperative carriage of methicillin-resistant Staphylococcus pseudintermedius (MRSP) and the development of surgical site infections (SSIs) following tibial plateau leveling osteotomy (TPLO) in dogs. DESIGN: Prospective multicenter study. ANIMALS: 549 dogs. PROCEDURES: At 7 veterinary hospitals, swab specimens were obtained from the pharynx, nares, rectum, and skin of dogs admitted for TPLO. Specimens were submitted for culture of MRSP. For each dog, information regarding preoperative and postoperative antimicrobial administration, comorbidities, contact with other dogs, and whether the dog developed an SSI was obtained. Univariable and multivariable analyses were performed to identify variables associated with preoperative and postoperative MRSP colonization and the development of an SSI. RESULTS: Of the 549 study dogs, 24 (4.4%) were identified as MRSP carriers before TPLO and 37 (6.7%) developed an SSI after TPLO. Bacteriologic culture was performed on specimens obtained from 32 of the 37 SSIs, and MRSP was isolated from 11 (34%). Carriers of MRSP (OR, 6.72; 95% confidence interval [CI], 2.12 to 21.4) and Bulldogs (OR, 11.1; 95% CI, 2.07 to 59.3) were at risk for development of an SSI after TPLO, whereas postoperative administration of antimicrobials (OR, 0.36; 95% CI, 0.15 to 0.91) appeared to protect against development of an SSI. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that carriage of MRSP were a risk factor for development of an SSI after TPLO and measures to rapidly identify and treat MRSP carriers are warranted. Postoperative administration of antimicrobials protected against development of an SSI after TPLO.

DIAGNOSIS AND SURGICAL TREATMENT OF A COMPLEX ANGULAR HIND LIMB DEFORMITY IN A SERVAL (FELIS SERVAL).

A 2-yr-old neutered male pet serval (Felis serval) was presented for progressive hind limb lameness that started at 6 mo of age. Previous therapy included only nutritional supplementation. Direct and video gait analysis confirmed bilateral hind limb lameness, more severe on the right. Physical examination and radiography revealed a multifocal complex bilateral angular deformity with a significant rotational component. A right tibial corrective osteotomy was followed by internal rotation and stabilization with a 2.7-mm eight-hole locking compression plate and locking screws. Other deformities were not corrected. Clinical improvement was noted immediately and has been maintained over the 16-mo follow-up.

Investigation of incidence and risk factors for surgical glove perforation in small animal surgery.

OBJECTIVE: To identify incidence and risk factors for surgical glove perforation in small animal surgery. STUDY DESIGN: Observational cohort study. SAMPLE POPULATION: Surgical gloves (n = 2132) worn in 363 surgical procedures. METHODS: All gloves worn by operative personnel were assessed for perforation at end-procedure using a water leak test. Putative risk factors were recorded by a surgical team member. Associations between risk factors and perforation were assessed using multivariable multi-level random-effects logistic regression models to control for hierarchical data structure. RESULTS: At least 1 glove perforation occurred in 26.2% of procedures. Identified risk factors for glove perforation included increased surgical duration (surgery >1 hour OR = 1.79, 95% CI = 1.12-2.86), performing orthopedic procedures (OR = 1.88; 95% CI = 1.23-2.88), any procedure using powered instruments (OR = 1.93; 95% CI = 1.21-3.09) or surgical wire (OR = 3.02; 95% CI = 1.50-6.05), use of polyisoprene as a glove material (OR = 1.59, 95% CI = 1.05-2.39), and operative role as primary surgeon (OR = 2.01; 95% CI = 1.35-2.98). The ability of the wearer to detect perforations intraoperatively was poor, with a sensitivity of 30.8%. CONCLUSIONS: There is a high incidence of unrecognized glove perforations in small animal surgery.

Intra-articular pharmacokinetics of a gentamicin impregnated collagen sponge in the canine stifle: an experimental study.

OBJECTIVE: To investigate local and systemic pharmacokinetics of gentamicin after intra-articular implantation of a gentamicin impregnated collagen sponge (GICS) in the inflamed canine joint. STUDY DESIGN: Descriptive repeated measures experimental study. ANIMALS: Dogs (n = 9). METHODS: Stifle joint inflammation was caused by urate injection. Twenty-four hours later a GICS (gentamicin dose, 6 mg/kg) was arthroscopically implanted. Synovial fluid and plasma gentamicin concentrations were measured for 14 days after implantation, and pharmacokinetic parameters modeled using statistical moment analyses. RESULTS: Intra-articular gentamicin concentrations fell to sub-MIC for Staphylococcus sp. (4 µg/mL) by 22.4 hours (95% CI: 18.6-26.2) after sponge implantation. Cmax synovial was 2397 µg/mL (95%CI: 1161-3634 µg/mL) at 1.2 hours (95%CI: 0.5-1.8 hours). Plasma gentamicin concentrations achieved levels of Cmax plasma = 8.0 µg/mL (95%CI: 6.1-10.0 µg/mL) at 1.5 hours (95%CI: 0.8-2.1) after GICS placement and fell below target trough of 2.0 µg/mL by 5.6 hours (95%CI: 4.7-6.5 hours) after GICS placement. CONCLUSIONS: Intra-articular gentamicin concentration after GICS placement at an IV-equivalent dose reached high levels and declined rapidly. The maximum plasma levels attained were ∼1/3 of the recommended sub-toxic target for people after parenteral gentamicin administration.

Imaging diagnosis--temporomandibular joint dysplasia in a Basset Hound.

A 5-month-old intact male Basset Hound presented for evaluation of pain and crepitation during manipulation of the temporomandibular joint, worse on the right side. A computed tomography (CT) scan of the head was performed. The CT images demonstrated the osseous features of temporomandibular joint dysplasia and facilitated a 3D reconstruction, which allowed better visualization of the dysplastic features. The patient responded to conservative management with a tape muzzle with no recurrence reported by the owner 6 months after presentation.

Internet-based survey of the nature and perceived causes of injury to dogs participating in agility training and competition events.

OBJECTIVE: To characterize injuries (on the basis of type and severity of injury and affected region of the body) among dogs participating in agility training and competition events and examine associations between injury characteristics and perceived causes of injury. DESIGN: Internet-based, retrospective, cross-sectional survey. ANIMALS: 3,801 privately owned dogs participating in agility training or trials. PROCEDURES: A retrospective electronic survey was developed to investigate demographic factors for dogs and handlers, frequency of participation in agility training and competition, and perceived causes and characteristics of injuries acquired by dogs during agility-related activities. Respondents were handlers recruited through member lists of large canine agility associations in Canada and the United Kingdom and through promotion on an agility blog site. Associations between cause and anatomic site or type of injury and between injury severity (mild vs severe) and setting (competition vs practice) were investigated. RESULTS: Surveys were received from 1,669 handlers of 3,801 agility dogs internationally. Handler-reported data indicated 1,209 of 3,801 (32%) dogs had ≥ 1 injury; of 1,523 analyzed injuries, the shoulder (349 injuries), back (282), and neck (189) regions and phalanges (202) were predominantly affected. Soft tissue injuries (eg, strain [muscle or tendon injury; 807], sprain [ligament injury; 312], and contusion [200]) were common. Injuries were most commonly incurred during interactions with bar jumps, A-frames, and dog walk obstacles (260, 235, and 177 of 1,602 injuries, respectively). Anatomic site and type of injury were significantly associated with perceived cause of injury. CONCLUSIONS AND CLINICAL RELEVANCE: These findings provided a basis for further experimental studies to identify specific mechanisms of various types of injury in dogs that participate in agility activities.

Survey-based analysis of risk factors for injury among dogs participating in agility training and competition events.

OBJECTIVE: To identify potential risk factors for agility-related injuries among dogs. DESIGN: Internet-based, retrospective, cross-sectional survey. ANIMALS: 3,801 privately owned dogs participating in agility training or trials. PROCEDURES: A retrospective electronic survey was used to investigate potential risk factors for injury among dogs participating in agility-related activities. Respondents were handlers recruited through member lists of large canine agility associations in Canada and the United Kingdom and through promotion on an agility blog site. Variables evaluated included demographic information for handlers and dogs, exposure variables (eg, frequency of agility practice and competition in the past year), and use of preventive measures intended to keep dogs fit for agility (warmup, cooldown, or conditioning exercises; alternative therapeutic treatments [eg, acupuncture, massage, or chiropractic care]; or dietary supplement products). RESULTS: Data were collected from 1,669 handlers of 3,801 agility dogs internationally; 1,209 (32%) dogs incurred ≥ 1 injury. Previous injury (OR, 100.5), ≤ 4 years of agility experience for dogs (OR, 1.5), use of alternative therapeutic treatments (OR, 1.5), and Border Collie breed (OR, 1.7) were associated with increased odds of injury. Handlers having 5 to 10 or > 10 years of experience (OR, 0.8 and 0.6, respectively) and dogs having > 4 years of experience in the sport (OR, 0.6) were associated with decreased odds of injury. CONCLUSIONS AND CLINICAL RELEVANCE: Specific factors were associated with agility-related injuries in dogs. Educational prevention strategies should target at-risk populations in an effort to reduce potential injuries. Future research should focus on the biomechanical factors associated with agility-related injuries.

Comparison of overground and treadmill-based gaits of dogs.

OBJECTIVE: To compare overground and treadmill-based gaits of dogs. ANIMALS: 5 clinically normal adult mixed-breed dogs. PROCEDURES: To obtain dynamic gait data, 30 retroreflective markers were affixed bilaterally to specific regions of the hind limbs and pelvis of each dog. For each dog, 3-D joint motion data (sagittal [flexion and extension], transverse [internal and external rotation], and frontal [abduction and adduction] planes of motion) for the hip, femorotibial, and tarsal joints were acquired during walking and trotting through a calibrated testing space overground or on a treadmill. Comparison of data was performed via generalized indicator function analysis and Fourier analysis. RESULTS: Both overground and treadmill-based gaits produced similar waveforms in all planes of motion. Fourier analysis revealed no difference between overground and treadmill-based gaits in the sagittal plane of motion; however, small differences were detected between overground and treadmill-based gaits in the other 2 planes of motion. Additionally, femorotibial joint motion during walking did not differ among planes of motion. Generalized indicator function analysis was able to detect differences between overground and treadmill-based gait waveforms in all planes of motion for all joints during walking and trotting. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, overground and treadmill-based gaits produced similar waveform shapes. Of the 3 planes of motion evaluated, only sagittal plane kinematic gait data were unaffected by mode of ambulation as determined via Fourier analysis. Sagittal kinematic gait data collected from dogs during overground or treadmill-based ambulation were comparable. However, analysis methods may affect data comparisons.

Clinical findings and prognostic factors for dogs undergoing cholecystectomy for gall bladder mucocele.

OBJECTIVE: To report clinical findings and explore prognostic factors for dogs that had cholecystectomy for gall bladder mucocele. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 43) with gall bladder mucoceles. RESULTS: Diagnosis of gall bladder mucoceles was confirmed by histopathology and 74% were diagnosed based on preoperative abdominal ultrasonography. Intraoperative evidence of gall bladder rupture was noted in 10 dogs (23%), and 16 (37%) had evidence of previous leakage in the abdominal cavity. One dog had positive bacterial growth from the gall bladder content. The most common histopathologic findings in liver biopsies obtained at surgery were cholangiohepatitis, biliary hyperplasia, or cholestasis. Univariate analysis showed evidence of postoperative hypotension (P = .05) to be significantly negatively associated with survival. Significant difference in mean postoperative serum lactate (P = .034) and postoperative packed cell volume (P = .063) between dogs that survived and died was also noted. CONCLUSIONS: Elevations in postoperative serum lactate concentrations and immediate postoperative hypotension in dogs undergoing cholecystectomy for gall bladder mucoceles are associated with poor clinical outcome.

Effects of unfocused extracorporeal shock wave therapy on healing of wounds of the distal portion of the forelimb in horses.

OBJECTIVE: To determine effects of extracorporeal shock wave therapy (ESWT) on healing of wounds in the distal portion of the forelimb in horses. ANIMALS: 6 horses. PROCEDURES: Five 6.25-cm2 superficial wounds were created over both third metacarpi of 6 horses. Forelimbs were randomly assigned to treatment (ESWT and bandage) or control (bandage only) groups. In treated limbs, each wound was treated with 625 shock wave pulses from an unfocused electrohydraulic shock wave generator. In control limbs, each wound received sham treatment. Wound appearance was recorded weekly as inflamed or healthy and scored for the amount of protruding granulation tissue. Standardized digital photographs were used to determine the area of neoepithelialization and absolute wound area. Biopsy was performed on 1 wound on each limb every week for 6 weeks to evaluate epithelialization, fibroplasia, neovascularization, and inflammation. Immunohistochemical staining for A smooth muscle actin was used to label myofibroblasts. RESULTS: Control wounds were 1.9 times as likely to appear inflamed, compared with treated wounds. Control wounds had significantly higher scores for exuberant granulation tissue. Treatment did not affect wound size or area of neoepithelialization. No significant difference was found for any of the histologic or immunohistochemical variables between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment with ESWT did not accelerate healing of equine distal limb wounds, but treated wounds had less exuberant granulation tissue and appeared healthier than controls. Therefore, ESWT may be useful to prevent exuberant granulation tissue formation and chronic inflammation of such wounds, but further studies are necessary before recommending ESWT for clinical application.

Multiple myeloma with central nervous system involvement in a cat.

CASE DESCRIPTION: A 1.5-year-old spayed female domestic shorthair cat was admitted for hind limb locomotor difficulties and signs of pain along the lumbar portion of the vertebral column. At the time of referral, the cat was paraparetic with deficits in the spinal reflexes of the hind limbs. Neuroanatomic localization was at the L6-S2 spinal cord segments, corresponding approximately to the region of the L4-L6 vertebral bodies. CLINICAL FINDINGS: Radiography revealed a mixed osteolytic-proliferative lesion within the body of L5 involving the cranial end plate, as well as punctate radiolucencies in the distal portion of the femur. Magnetic resonance imaging revealed an intramedullary spinal cord lesion along with extensive meningeal and nerve root lesions in the area of the L4-L6 vertebral bodies. Cytologic analysis of a bone marrow aspirate from the right trochanteric fossa revealed a substantial plasma cell infiltrate. Analysis of CSF revealed a high protein concentration and morphologically abnormal plasma cells. Urine, but not serum, protein electrophoresis revealed a sharp gamma-globulin peak consistent with a monoclonal band of Bence-Jones proteins. The diagnosis was multiple myeloma. TREATMENT AND OUTCOME: The cat was treated with melphalan and prednisolone. A rapid clinical response was reported, and by week 3 after diagnosis, the cat's locomotion and behavior had normalized. However, by month 4, multifocal neurologic deficits were evident. The cat was euthanized at 9 months because of tetraparesis and substantial weight loss. CLINICAL RELEVANCE: To our knowledge, this is the first report of myeloma in a cat that had electrophoretically detectable light chain proteinuria but lacked a detectable serum monoclonal gammopathy.