Effect of doxycycline on contralateral canine cranial cruciate ligament rupture. A prospective randomized clinical trial in 69 dogs.

OBJECTIVE: To evaluate whether doxycycline administered to dogs with unilateral cranial cruciate ligament rupture (Uni-CCLR) would decrease the risk of contralateral-CCLR (Co-CCLR). To evaluate predictors for Co-CCLR survival. To evaluate if a predisposition of Labrador Retrievers to Co-CCLR exists when compared to other breeds. METHODS: In this prospective randomized controlled clinical trial, 69 client-owned dogs with Uni-CCLR were randomly assigned to a doxycycline (group-D: 7.5 mg/kg PO BID x 6 weeks) or non-doxycycline (group-ND: negative control). Medical and imaging data, time from Uni- to Co-CCLR and to follow-up were recorded. Statistics included chi-squared test, logistic regression, Kaplan-Meier survival analysis, log rank test, survival curves, and frailty model (p <0.05). RESULTS: This study included 32 dogs in group-D, and 37 dogs in group-ND. Median follow-up was 54.5 and 61 months, respectively. Contralateral CCLR occurred in 53.1% and 48.6% at medians of 20 and 11 months, respectively. Doxycycline did not significantly decrease the risk of Co-CCLR (p = 0.83). This risk was decreased by 14.2% with each year of age but increased with each increasing kilogram of body weight and each increasing degree of tibial plateau angle by 5.4% and 9.7%, respectively. Labrador Retrievers were not significantly predisposed (p = 0.37). CLINICAL SIGNIFICANCE: At the dose regimen investigated doxycycline does not decrease the risk for Co-CCLR.

Accuracy of three pre- and intra-operative measurement techniques for osteotomy positioning in the tibial plateau levelling procedure.

OBJECTIVES: To prospectively compare the accuracy of three preoperative measurement techniques in tibial plateau levelling osteotomy (TPLO) planning. METHODS: Fifty-nine dogs were randomly assigned to one of three measurement techniques; A, B or C. Surgeons measured the intended osteotomy location on preoperative radiographs according to the assigned technique. Measurements were used intra-operatively during osteotomy placement. Postoperative measurements were made by a single blinded observer and compared to preoperative measurements. RESULTS: Fifty-one dogs were included for final statistical analysis. The mean absolute differences between pre- and postoperative measurements was 1.72 mm ± 0.958, 1.79 mm ± 1.010, and 3.56 mm ± 1.839, for techniques A, B and C, respectively. No significant differences were identified for patient age, gender, limb or surgeon. Techniques A and B were not significantly different (p = 0.8799). Techniques A and B were significantly more accurate than C (p = 0.0001 and p = 0.0003, respectively). Weight was significantly different among the groups (p = 0.047) but the statistical results did not change when an adjustment was made for bodyweight (p = 0.4971, p <0.001 and p = 0.0007, respectively). CLINICAL SIGNIFICANCE: Preoperative measuring for planning a TPLO osteotomy is recommended. Techniques A and B in the current study were clinically practical and significantly more accurate compared to technique C.

Handling of the tibial muscle envelope in tibial plateau levelling osteotomy - to elevate or not? A clinical study of 40 dogs.

OBJECTIVE: To compare the outcome of the tibial plateau levelling osteotomy (TPLO) procedure, using a 6-hole 3.5 mm locking TPLO plate and performed with the muscle elevation technique (ET) and placement of sponges, to the TPLO without performing these steps (non-elevation-technique [NET]). MATERIAL AND METHODS: Medical records and radiographs of dogs with ET (n = 21) or NET (n = 19) were retrospectively reviewed. Signalment, TPLO procedure side, meniscal treatment, surgery time, haemorrhage, pre- and postoperative tibial plateau angle, assistant, amount of rehabilitation, bone healing (cortical, osteotomy, combined healing scores), complications, limb function, recovery time and follow-up were recorded and analysed using multivariate analysis. A value of p <0.05 was considered significant. RESULTS: Surgery time was significantly shorter with the NET (68.5 min ± 3.4) than with the ET (87.8 min ± 3.4) (p <0.01). No significant differences were detected for all other evaluated factors. Soft tissue trauma was minimal and none of the dogs suffered severe haemorrhage. The bone healing scores with the NET and the ET were not significantly different (p = 0.1, p = 0.2, p = 0.1). Complications were rare, minor and not significantly different between groups (p = 0.73). CLINICAL RELEVANCE: The results of this in vivo study indicate that NET is a feasible technique that can be considered for the clinical setting.

Minimally displaced tibial tuberosity avulsion fracture in nine skeletally immature large breed dogs.

OBJECTIVE: The objective of this study was to describe the clinical and radiographic features, as well as the treatment and outcome of minimally displaced tibial-tuberosity-avulsion-fractures (MDTTAF). MATERIALS AND METHODS: Signalment, history, diagnostics, therapy, and outcome were recorded. Follow-up was documented as re-examination, radiographic assessment or telephone conversation. RESULTS: Nine large breed dogs that were presented with lameness originating from the proximal tibia were included. All showed signs of pain when pressure was applied to the tibial tuberosity. There was no stifle instability or intra-articular disease. The main feature on mediolateral radiographs was a widened tibial-tuberosity-physis with reactive new bone and loss of edge definition of the epiphyseal and metaphyseal margins. Non-surgical treatment was chosen in eight dogs, and surgery in one dog. Radiographic follow-up showed progressive closure of the tibial-tuberosity-physis and healing. Clinical signs resolved at a median of 28 days (range: 14-120). DISCUSSION: Minimally displaced tibial-tuberosity-avulsion-fractures should be a differential diagnosis in skeletally immature large breed dogs older than nine months of age with signs of subtle pelvic-limb lameness, and signs of proximal tibial pain, but no evidence of stifle joint disease. Thorough clinical examination and critical review of bilateral radiographs are important to diagnose MDTTAF. The outcome in these cases suggests that the prognosis for MDTTAF is excellent. Age and size of the affected dogs in this study differ from an earlier publication that illustrated more severely displaced tibial tuberosity avulsion fractures, occurring mainly in terriers around five months of age.

Deformity secondary to bilateral incomplete ossification of the humeral condyle in a German Shorthaired Pointer dog. A case report with ten-year follow-up.

A five-month-old male, German Shorthaired Pointer dog was presented for severe, bilateral, thoracic-limb-lameness, with elbow swelling, pain, and crepitus. Radiography and computed tomography confirmed bilateral incomplete ossification of the humeral condyles (IOHC), with a non-displaced incomplete fracture of the left medial epicondylar crest and condylar deformity, characterised by enlargement of the trochleas with extension of the disto-medial aspect of the bone below the normal elbow joint level, and a deformed proximo-medial aspect of the ulna and radius. Transcondylar lag screws were placed bilaterally in an attempt to prevent fracture. Microscopic examination of biopsies, harvested from both humeral condyles, was supportive of IOHC. Six years after surgery, radiographs showed severe osteoarthritis and it appeared that fusion of the humeral condyles had not occurred. The dog followed an active life style until 10 years after surgery when the elbows showed almost no observable range-of-motion. However, discomfort was evident only after heavy exercise. Incomplete ossification of the humeral condyles may be associated with osteoarthritis, risk for non-union, implant failure, or secondary condylar fracture. This dog maintained good limb function despite these concerns, and despite bilateral humeral condylar deformity as well as development of severe osteoarthritis. This is the first report of a German Shorthaired Pointer dog with IOHC and the first histological description supportive of this condition in a five-month-old dog.

Does Osgood-Schlatter disease exist in the dog?

Osgood-Schlatter disease (OSD) is a condition affecting human adolescents in which there is partial separation of bone fragments from the tibial tuberosity at the site of insertion of the patellar ligament to the tibial tuberosity. Tensile trauma seems to be the most likely aetiology. Clinical signs in people consist of swelling and pain at the proximal part of the tibial tuberosity and around the distal end of patellar ligament. Radiographs frequently show small ossicles at the patellar ligament insertion. Conservative treatment is usually curative. The term OSD has also been used for the canine patient. However, radiographs of these patients typically show an enlarged radiolucent line at the apophyseal plate of the tibial tuberosity. This finding is consistent with a mild avulsion fracture of the canine tibial tuberosity. Based on the radiographic differences between the two species, it seems more appropriate to use the term OSD only for people. The purpose of this paper is to review the literature on OSD in people and the reports of injuries to the proximal tibial tuberosity in dogs. In addition, a new classification system for tibial tuberosity avulsion injuries in the immature dog is proposed, with an algorithm for management of this injury.

Mandibular and sublingual sialocoeles in the dog: a retrospective evaluation of 41 cases, using the ventral approach for treatment.

AIMS: To review results of the ventral approach for mandibular and sublingual sialoadenectomy for the treatment of sialocoeles associated with the mandibular and sublingual salivary glands in the dog, and to determine rates of recurrence and complication following this procedure. METHODS: Thirty-nine dogs with 41 sialocoeles that underwent surgical intervention were retrospectively evaluated with respect to signalment, aetiology, location of sialocoeles, duration of clinical signs, treatment prior to referral, post-operative use of antibiotics and drains, complications, and recurrence. RESULTS: The mean age at the time of surgery was 5.1 (SD 3.8) years, and duration of clinical signs 6.6 (SD 10.6) months. Long-term follow-up was available for 31 dogs; the minimum was 8 months and mean 47.7 (SD 25.8) months post-surgery. There was no recurrence of sialocoeles following the ventral approach for mandibular and sublingual sialoadenectomy. Postoperatively, 6/35 (17%) cases developed a seroma at the surgical site. No breed or sex predisposition was determined. The cause of the sialocoele was unknown in 36/41 (88%) cases. CONCLUSIONS AND CLINICAL RELEVANCE: Excellent clinical results were achieved with a low rate of complications using the ventral approach for mandibular and sublingual sialoadenectomy. The ventral approach is recommended to minimise the risk of recurrence of sialocoeles.