Evaluation of the usage of incisional liposomal bupivacaine as a local anaesthetic for dogs undergoing limb amputation.

BACKGROUND: Bupivacaine lioposomal suspension has recently emerged in the veterinary field for local analgesia. OBJECTIVE: To describe the extra-label administration of bupivacaine liposomal suspension at the incision site of dogs undergoing limb amputation and characterize any complications. STUDY DESIGN: Nonblinded retrospective study. ANIMALS: Client-owned dogs undergoing limb amputation from 2016 to 2020. METHODS: Medical records of dogs undergoing limb amputation with concurrent use of long-acting liposomal bupivacaine suspension were reviewed for incisional complications, adverse effects, hospitalization length, and time to alimentation. Data were compared to a control group (CG) of dogs who underwent a limb amputation procedure without concurrent use of liposomal bupivacaine suspension. RESULTS: Forty-six dogs were included in the liposomal bupivacaine group (LBG) and 44 cases in the CG. The CG had 15 incidences of incisional complications (34%) compared to 6 within the LBG (13%). Four dogs required revisional surgery in the CG (9%) whereas none of the dogs required revisional surgery in the LBG. Time from surgery to discharge was statistically higher in the CG compared to the LBG (p = 0.025). First time to alimentation was statistically higher in the CG (p value = 0.0002). The total number of rechecks needed postoperatively revealed the CG having a statistically significant increase in recheck evaluations (p = 0.001). CONCLUSIONS: Extra-label administration of liposomal bupivacaine suspension was well-tolerated in dogs undergoing limb amputation. Liposomal bupivacaine usage did not increase incisional complication rates and its use allowed for a quicker time to discharge. CLINICAL SIGNIFICANCE: Surgeons should consider inclusion of extra-label administration of liposomal bupivacaine in analgesic regimens for dogs undergoing limb amputation.

Stifle joint osteoarthritis in small-breed and medium-breed dogs is more severe after cranial cruciate ligament injury than medial patellar luxation.

This retrospective observational study aimed to characterize the severity and distribution of OA in the stifle joints of small and medium dogs with CCL injury and/or MPL. Radiographs of the stifle joints from 218 dogs from 10 small and medium breeds were included; 127 joints had CCL injury, 76 joints had MPL, and 73 joints had CCL injury and MPL. OA was graded at 33 sites within the joint. The mean ± SD OA score was 20.3 ± 9.9. For all joints, OA was more severe in heavier than lighter dogs (P = 0.003). Joints with MPL (14.9 ± 8.2) had lower OA scores than joints with CCL injury (22.2 ± 10.0, P = 0.003) or CCL injury and MPL (22.6 ± 9.4, P < 0.001). OA scores were higher in joints with MPL for older dogs (r = 0.408, P < 0.001) but did not change with age in joints with CCL injury. The pattern of OA did not differ among joints with CCL injury or MPL. The retrospective nature of the study limited findings to associations but did not allow conclusions regarding factors causing OA or enhancing its progression. We concluded that, in small- and medium-breed dogs, the patterns of stifle OA joint after CCL injury and MPL are similar. Radiographic OA after CCL injury is more severe than MPL. An increase in age leads to an increase in OA at the time of presentation at a referral hospital in stifle joints with MPL and without CCL injury.