Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning.

OBJECTIVE: To report the outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning (FGNMP). STUDY DESIGN: Retrospective case series. ANIMALS: A total of 15 client owned dogs and two cats with 57 metabone fractures. METHODS: Description of FGNMP and reporting of the following data: signalment, pre- and postoperative radiographs, intramedullary pin diameter used, anesthesia, surgery and coaptation times, duration to normal weightbearing and bone union, postoperative care and complications. RESULTS: Median surgery time was 54 min (range: 26-99), median duration of coaptation was 14 days (range: 1-5 weeks), median time to normal weightbearing was 16 days (range: 2-45) and median time to bone union was 6 weeks (range: 4-12). All cases had at least 12 months of post-surgical follow-up with a median follow-up of 18 months (range: 12-70). No major complications occurred. Mild radiographic changes associated with subchondral bone sclerosis were noted on follow-up radiographs in 13/57 fractures. All cases returned to normal gait and full (15) or acceptable (2) function. CONCLUSION: In this study, FGNMP was an effective and safe technique for metabone fracture repair, requiring only short-term external coaptation in most patients. Time to bone union and return to normal function compared favorably to previously reported techniques. CLINICAL RELEVANCE: Fluoroscopically guided normograde metabone pinning provides an alternative technique for treatment of metabone fractures.

Comparison of classic and needle arthroscopy to diagnose canine medial shoulder instability: 31 cases.

This retrospective study compared surgery time, anesthesia time, and costs recorded with classic arthroscopy or needle arthroscopy when diagnosing canine medial shoulder instability. Signalment, examination findings, diagnostics, anesthesia time, surgery time, treatment, invoices, and complications were reported. All cases (classic arthroscopy, 14 cases; needle arthroscopy, 17 cases) were diagnosed with medial shoulder instability. Anesthesia times, surgery times, and invoices were statistically compared for classic and needle arthroscopy (P < 0.05). No significant differences were reported for surgery time (P = 0.13) but existed for anesthesia time (35 minutes shorter with needle arthroscopy; P < 0.0001) and invoice (38% lower with needle arthroscopy; P < 0.0001). No complications were recorded by the time of last direct follow-up, which was at a mean of 12.4 weeks after surgery. Needle arthroscopy offers an alternative, safe technique to reliably diagnose canine medial shoulder instability. Shorter anesthesia times and lower costs to the client may be advantages of needle over classic arthroscopy.

Comparaison de l'arthroscopie classique à l'arthroscopie l'aiguille pour diagnostiquer l'instabilité médiale de l'épaule chez le chien : 31 cas. Cette étude rétrospective a comparé le temps de chirurgie et d'anesthésie ainsi que les coûts engendrés entre une arthroscopie classique et une arthroscopie à l'aiguille lors du diagnostic de l'instabilité médiale de l'épaule chez le chien. Sont rapportés dans cette étude, les commémoratifs, les résultats de l'examen clinique, les diagnostics, le temps d'anesthésie, le temps de chirurgie, le traitement, les coûts et les complications. Le temps d'anesthésie et de chirurgie ainsi que leur coût ont été comparés pour les deux techniques arthroscopie classique et arthroscopie à l'aiguille (P < 0,05) pour tous les cas diagnostiqués avec une instabilité médiale de l'épaule (classique = 14; aiguille = 17). Aucune différence significative n'a été mise en évidence pour la durée de la chirurgie (P = 0,13) à contrario de la durée de l'anesthésie, plus courte (35 min de moins avec la technique à l'aiguille; P < 0,0001) et moins coûteuse (38 % plus économique avec la technique à l'aiguille; P < 0,0001). Aucune complication n'a été enregistrée lors de la dernière consultation de contrôle post-opératoire qui avait lieu en moyenne 12,4 semaines après la chirurgie. Pour diagnostiquer une instabilité médiale de l'épaule, la technique à l'aiguille offre une alternative sûre, avec comme avantages, des durées d'anesthésie plus courtes et des coûts inférieurs pour le client, par rapport à la technique classique.(Traduit par les auteurs).

Tibial Apophyseal Percutaneous Pinning in Skeletally Immature Dogs: 25 Cases (2016-2019).

OBJECTIVE: The aim of this study was to report the clinical experience with fluoroscopically guided tibial apophyseal percutaneous pinning (TAPP) for tibial tuberosity avulsion fractures (TTAF). STUDY DESIGN: This is a retrospective case series. MATERIALS AND METHODS: Medical records of skeletally immature dogs (n = 25) were reviewed. The association of pin design [smooth (SP); negatively threaded (NTP)], pin insertion angles, TTAF-type, age and breed with various outcome variables was statistically evaluated. Long-term follow-up was assessed via direct examination, radiographs, questionnaires and videos. RESULTS: Mean age, weight and surgery times were 6.2 months, 9.6 kg and 21 minutes respectively. No major complications occurred among the 19 SP and 6 NTP; no pin broke. Seromas and patellar desmitis rates were higher with SP (11/19; 16/19) versus NTP (0/6; 2/6) (p = 0.02; 0.03). The median horizontal pin cross angles for cases without and with desmitis were 40 and 26 degrees respectively (p = 0.047). Explantation was needed in 5/19 SP and 0/6 NTP cases. The mean tibial plateau angle (TPA) changed significantly between initial (25.6 degrees) and follow-up (18.8 degrees) radiographs (p = 0.0002). Long-term outcome, obtained at a mean of 19.9 months, was excellent in all cases. CONCLUSION: Tibial apophyseal percutaneous pinning can be considered to treat TTAF. Divergent pin placement and using NTP might reduce complications. Tibial plateau angle should be monitored until skeletal maturity has been reached. Long-term outcome post TAPP can be expected to be excellent.

Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds).

OBJECTIVE To determine which method (lateral fabellotibial suture [LFS], tibial plateau leveling osteotomy [TPLO], tibial tuberosity advancement [TTA], or tightrope-like braided multifilament suture secured with metallic buttons [TR]) Veterinary Orthopedic Society (VOS) members preferred for treating cranial cruciate ligament rupture (CCLR) in dogs weighing > 15 kg (33 lb), identify factors associated with this preference, and assess concerns related to surgical implant material used. DESIGN Cross-sectional study. SAMPLE 187 VOS members. PROCEDURES All registered VOS members received an online survey from June to July 2016. Responses were compiled and evaluated for associations with method preferences and perceived complications. RESULTS Overall response rate was 38.4% (221/575). Respondents had graduated from veterinary school a mean of 23 years prior to survey completion, and collectively they performed approximately 30,000 CCLR surgeries annually. The most commonly preferred method was TPLO (147 [78.6%]), followed by TTA (26 [13.9%]), the LFS procedure (11 [5.9%]), and the TR procedure (3 [1.6%]). The preference for TPLO was independent of board certification or college of training (American, European, or other College of Veterinary Surgeons). Non-board-certified surgeons, including general practitioners, also favored TPLO. The most common perceptions were that titanium implants (used for TTA) were associated with the lowest incidence of major complications, whereas braided multifilament suture (used for the TR procedure) was associated with the highest incidence of major complications. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that TPLO was preferred for treating CCLR in dogs weighing > 15 kg and that the TR procedure was perceived as having the highest complication rate. With results of this survey in mind, use of the TR procedure should be considered cautiously when treating CCLR.

Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases.

OBJECTIVES: To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures. METHODS: Clinical data of 14 dogs and three cats were included. The "spiking" technique was described. RESULTS: Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures. Surgery times ranged from eight to 54 minutes. The "spiking" technique was successfully applied in six tibial tuberosity avulsion fracture cases. Return to function was at a mean (± standard deviation) of 1.9 (± 1.6) weeks. Long-term (>12 months; n = 17) follow-up was available at a mean of 40.6 (± 13.4) months. Major complications consisted of skin irritation from a pin (distal tibia / fibula physeal fracture case; 8 weeks post-PTPFR), and a bilateral grade II medial patella luxation (tibial tuberosity avulsion fracture case; 1.5 years post-PTPFR). One case developed a mild tibial tuberosity avulsion fracture re-avulsion. All conditions in these three cases were not of clinical concern at follow-up and final outcome was graded as good in these and excellent in the other 14 cases. CLINICAL SIGNIFICANCE: Percutaneous tibial physeal fracture repair can be considered as a technique to treat tibial physeal fractures. The "spiking" technique was successfully applied in six dogs. A larger, prospective case series is indicated to provide additional clinical information.

Radiographic quantitative assessment of caudal proximal tibial angulation in 100 dogs with cranial cruciate ligament rupture.

OBJECTIVE: To evaluate inter- and intraobserver variability in the measurement of distal tibial axis/proximal tibial axis angle (DPA) from lateral radiographs of canine tibia in dogs with cranial cruciate ligament rupture (CCLR). STUDY DESIGN: Retrospective clinical study. ANIMALS: Dogs (n=100) with cranial cruciate ligament rupture. METHODS: Medical records of dogs diagnosed with CCLR were reviewed. In addition to signalment and TPA measurements, measured DPA (mDPA) was calculated for each lateral view of the tibia in each animal, twice, by 3 blinded observers. Subjective scoring of DPA (sDPA) was also recorded, twice, by 3 additional blinded observers from lateral views of the proximal half of the tibia in each dog. Inter- and intraobserver variability was measured by intraclass correlation coefficient (ICC) for each measurement. Correlation between mDPA and sDPA was also determined. RESULTS: Median tibial plateau angle (TPA) of the subject population was 27.9° (range 18.8-41.3°; IQR: 25.5-30.75°). Mean ± SD mDPA was 6.50 ± 2.81° (confidence intervals [CI]: 5.94-7.06°; range 0-13.33°). There was no correlation between age and weight of dogs and the mDPA (P=.58 and .12). There was a moderate correlation between mDPA and TPA (r(2)=0.49, P<.0001). There was a moderate correlation between sDPA and mDPA (r(2)=0.27, P<.0001). Good inter- and intraobserver agreement was found in the measurement of mDPA. CONCLUSION: mDPA is a reproducible measurement of caudal angulation of proximal tibia. Furthermore, mDPA of dogs with cranial cruciate ligament disease in this report are in concordance with previous reports.

Craniomandibular osteopathy with a unique neurological manifestation in a young Akita.

This report describes a 4 mo old intact male Akita that presented for evaluation of a life-long history of facial swelling and failure to thrive. Physical examination revealed an enlarged cranium with prominent bony swellings on the maxillary bone, excessive laxity and crepitus involving multiple joints, and proprioceptive deficits. Radiographs demonstrated multiple osseous abnormalities including endosteal thickening of the femurs and ilium. Necropsy revealed gross compression of the cerebellum and brainstem. Physical exam findings, radiographic abnormalities, and histopathology of multiple bony lesions were all consistent with craniomandibular osteopathy. In this unique case of craniomandibular osteopathy, the dog was affected with severe bony proliferations leading to generalized hyperostotic lesions and brainstem compression resulting in neurologic deficits.

Complications associated with use of subcutaneous vascular access ports in cats and dogs undergoing fractionated radiotherapy: 172 cases (1996-2007).

OBJECTIVE: To describe complications associated with use of a subcutaneous vascular access port (SVAP) in cats and dogs treated with fractionated radiotherapy and to determine predisposing factors for developing these complications. DESIGN: Retrospective case series. ANIMALS: 46 cats and 126 dogs. PROCEDURES: The medical records of cats and dogs undergoing radiation therapy that received placement of an SVAP between March 1996 and August 2007 were reviewed. Data were recorded and analyzed to determine factors for development of complications associated with the use of an SVAP during treatment with fractionated radiotherapy. RESULTS: 18 and 36 major and minor complications were identified, respectively. Sex and the lack of administration of propofol during anesthesia induction were significantly associated with development of major complications. Female cats and dogs were 5.00 times as likely as male cats and dogs to develop major complications associated with SVAP usage. Animals in which propofol was not administered were 19.15 times as likely as animals administered propofol to develop major complications. Placement of SVAP catheters in a femoral vein was 17.20 times as likely as placement in the jugular vein to result in minor complications. CONCLUSIONS AND CLINICAL RELEVANCE: Factors associated with the development of complications included sex, propofol administration, and vein in which an SVAP catheter was inserted. The use of an SVAP may be a useful alternative to repeated catheterizations in cats and dogs.

Effects of renal autograft ischemia and reperfusion associated with renal transplantation on arterial blood pressure variables in clinically normal cats.

OBJECTIVE: To evaluate the effect of renal autograft ischemia and reperfusion associated with renal transplantation on pulse rate and pressure and arterial blood pressure variables in clinically normal cats. ANIMALS: 10 cats. PROCEDURES: A radiotelemetric implant was placed in each cat to measure hemodynamic variables; baseline data were recorded before surgery. Standard heterotopic renal implantation and contralateral nephrectomy were performed (day 0). Autografts were stored in cold sucrose phosphate solution for 30 minutes (n = 5) or 3 hours (5); cats were anephric during this period. Hemodynamic variables were recorded every 5 minutes for up to 16 days after surgery; mean daily values were calculated. RESULTS: Data from 6 cats were available for analysis. Two cats developed ureteral obstructions and became azotemic at 111 and 197 hours after kidney reperfusion. Mean serum creatinine and BUN concentrations were greater than baseline values on days 1 and 2. Although changes from baseline hemodynamic values were detected in some cats, arterial blood pressure measurements did not change significantly from baseline at any time point. Compared with baseline data, mean pulse rate was increased on days 1 and 2 and days 6 through 12; mean pulse pressure was increased on days 1 and 2. CONCLUSIONS AND CLINICAL RELEVANCE: In clinically normal cats, hypertension was not induced by clinically relevant periods of ischemia-reperfusion injury of renal autografts and was not an inherent consequence of the transplantation process. Causes of marked posttransplantation hypertension in cats with chronic kidney disease require further investigation.