Valproic acid effect on neural tube defects is not prevented by concomitant folic acid supplementation: Early chick embryo model pilot study.

BACKGROUND: Neural tube defect is one of the most prevalent congenital malformations and it involves a variety of malformations ranging from anencephaly to spina bifida. Folic acid supplementation during pregnancy is known to reduce risk of neural tube defects. Antiepileptic drugs have been associated with neural tube defects, one of which is valproic acid. Protective effect of folic acid on congenital malformations in patients using valproic acid or other antiepileptic medicines during pregnancy has not clearly been delineated uniformly in previous clinical series. In this experimental animal study of early chick embryo model, we would like to determine if there is any dose-response relationship between VA and NTDs and if there is any protective effect of FA on this relationship in early chick embryo period. METHODS: One hundred twenty-two fertile leghorn type chicken eggs were used in this study. Six groups, each of which composed of 20 fertilized eggs, were categorized as: group A-control, group B- folic acid, group C-low-dose valproic acid, group D-high-dose valproic acid, group E-low-dose valproic acid + folic acid, group F-high-dose valproic acid + folic acid. Eggs were hatched for 24 h and injected with destined solutions and hatched till 72th hour. RESULTS: No neural tube defect was observed in group A and B. High dose valproic acid led to significantly higher number of embryos with neural tube defects compared to low-dose valproic acid (p = 0.018). This significant difference was also present between low-dose and high dose valproic acid combined with folic acid (p = 0.031). When effect of folic acid was evaluated no significant difference observed between groups. CONCLUSIONS: Even though number of embryos with neural tube defects decreased with concomitant folic acid administration, this difference could not reach a statistical level. More experimental animal and large-scaled prospective clinical studies are in need to detect folic acid mechanism in inhibiting antiepileptic drugs, if any present.

Surgical correction of a bilateral congenital tarsal hyperextension deformity in a cat.

CASE DESCRIPTION: An approximately three-month-old, 0.45 kg female Domestic Shorthaired kitten with stiff hyperextended hindlimbs distal to the talo-central joint is reported. Attempts at repositioning of the joints by flexion failed while increased manipulative forces caused signs of pain and vocalization. Orthogonal radiographic views revealed a significant malarticulation of the tarsus. Goniometric measurments revealed a 145° extensor and 95° internal torsional deformity. TREATMENT AND OUTCOME: Pantarsal arthrodesis with a transarticular external fixation system was performed for both limbs in two separate stages. Pre-assembled frames were composed of two 40 mm diameter half rings (on the medial side) and two 40 mm diameter full rings connected with two pre-contoured (125° flexion) rods from proximal to distal. Following transection of the superficial and deep digital flexor tendons, cartilage was removed from the articular surfaces, autologous cancellous bone graft was inserted, and joints were fixed in 125° flexion with pre-contured external frames. The cat commenced weight-bearing bilaterally immediately postoperatively. Frames were removed 32 and 27 days after application. Two months after frame removal, joint fusion was confirmed and full weight-bearing at the walk and run was achieved. CLINICAL RELEVANCE: To our knowledge, this is the first report of surgical correction of a bilateral congenital tarsal hyperextension deformity by pantarsal arthrodesis using a transarticular external fixation system.

Correction of severe congenital flexural carpal deformities with semicircular external skeletal fixation system in calves.

OBJECTIVE: To present a novel technique for the treatment of severe congenital flexural forelimb deformities in calves. METHODS: Thirteen calves of different breeds and sex with severe congenital flexural forelimb deformities were enrolled in the study. A semicircular external skeletal fixation system composed of 6-hole, 45° carbon-fiber arches, 6 mm threaded rods, half-pin fixation bolts, 6 mm hexagonal nuts, and negative profile end-threaded half-pins were used for pancarpal arthrodesis. Complications, time to first use of the limb, fixator removal time, preoperative and postoperative sagittal plane angles of the fused joints, and functional outcomes were evaluated clinically and radiographically. Final assessments were determined according to functional and cosmetic outcomes. RESULTS: All of the surgically treated carpal joints obtained fusion. Seven of the calves started to use the limb immediately after recovering from anesthesia. In the other six calves, the time ranged from one to two days. Time to fixator removal ranged from 25 to 36 days (mean 30 days). Final outcome was excellent in 11 cases, and good in two cases. CLINICAL SIGNIFICANCE: The technique was found to be a useful method for the treatment of severe congenital flexural forelimb deformities in calves. The cost of the operation is negligible compared to the economic value of beef cattle.

Treatment of unilateral congenital flexural and torsional limb deformities with circular external skeletal fixation system in two calves.

CASE DESCRIPTION: Two calves with unilateral congenital flexural and torsional limb deformities below the hock joint of the left hindlimb were presented to Veterinary Teaching Hospital of the Ondokuz Mayis University. According to clinical, goniometric and radiological examinations, flexural (130°-40°) and torsional (90°-180°) deformities were diagnosed. Except for the limb deformities, both animals were otherwise completely healthy. TREATMENT AND OUTCOME: In case 1, hock joint arthrodesis was performed using a circular external skeletal fixation system with four full rings 160 mm in diameter. In case 2, the deformity was corrected by fixation after transverse osteotomy at the level of the proximal metatarsals with four full rings 150 mm in diameter, and arthrodesis of the fetlock joint with three full rings 100 mm in diameter. According to clinical examinations and follow-up telephone interviews performed 15 and 24 weeks after discharge, functional use with slight lameness in case 1 and full functional use in case 2 had been achieved. CLINICAL RELEVANCE: None of the previously reported cases of flexural deformity had radiographic signs similar to those of the calves in our report, and the deformities were not as severe as those reported here. To our knowledge, this is the first report of treatment of unilateral congenital flexural and torsional deformities in calves with a circular external skeletal fixation system.

Stabilisation with dorsal and ventral fixation of a traumatic cervical instability in a dog.

This case study reports the outcome of dorsal and ventral stabilisation of a traumatic cervical instability in a dog. A 2-year-old, male Pointer was admitted following a motor vehicle accident. Clinical examination revealed non-ambulatory tetraparesis, severe neck pain and upper motor neuron changes in all limbs. Deep pain response was present. Subluxation of C2/3 and fractures of the dorsal spinous process and lamina of C2 were observed on radiographs. Ventral stabilisation was performed with screws and bone cement (polymethylmethacrylate). For dorsal fixation of the fractures, screws and cerclage wire were used. The dog stood up independently after 1 month, was able to walk 1.5 months postoperatively and had recovered completely at 1 year following surgery. We conclude that combined stabilisation techniques are effective for this type of cervical fracture in which the dorsal, middle and ventral structures of the vertebra are severely disrupted.

The Efficacy of Platelet-rich Plasma Gel and Topical Estradiol Alone or in Combination on Healing of Full-thickness Wounds.

 This randomized study was designed to establish the efficacy of platelet-rich plasma (PRP) gel and topical estradiol alone, or in combination, on healing of full-thickness wounds created on the trunk of rabbits. Fifteen New Zealand white female rabbits and 60 wounds were studied. Four 2.25-cm² full-thickness wounds were created using a template and treatments including a sterile saline solution that were assigned randomly to the wounds. Wounds were bandaged, dressed intermittently, and assessed by wound measurements and a collection of samples at 7, 14, and 21 days to evaluate healing. Variables of interest were hydroxyproline concentration and scored gross and microscopic morphologic characteristics reflective of wound healing. PRP gel + estradiol-treated wounds completely healed faster than wounds given other treatments. Granulation tissue growth to the skin level was faster (P < 0.05) in the PRP gel + estradiol group than the other groups. Only the PRP gel + estradiol group had a significantly lower collagen level than the sterile saline solutions on day 7 (P < 0.05). The PRP gel + estradiol group and estradiol group led to an increase in angiogenesis on day 14 (P < 0.05). Complete epithelization was observed only in the PRP gel + estradiol group compared with the other groups on day 7. PRP gel + estradiol-treatment enhanced healing in full-thickness wounds by reducing the contraction rate with a trend toward accelerating both epithelial migration and the angiogenic response.

Ventricular ependymoma in a German Shepherd dog.

Using magnetic resonance imaging (MRI) together with clinical, pathomorphological and immunohistological methods, a ependymoma is described in a 9-year-old German Shepherd dog, which presented with behavioural and oculocephalic responses and generalised ataxia. The ependymoma, 9 x 6 x 5mm in size, was localised intra-axially in the right interventricular foramen and hydrocephalus was observed by MRI. Microscopically, the tumour was composed of pseudorosettes, and immunohistochemical examination revealed vimentin and glial fibrillary acidic protein immunoreactivity in the neoplastic cells.

Ventral fixation in atlantoaxial instability with axial fracture in a dog.

This study reports the diagnosis and the surgical management of atlanto-axial instability with an oblique axial fracture in a dog. The fracture was diagnosed by radiography and Computed Tomography (CT). In the CT views, the appearance of the distortion of the atlantoaxial articular surface was interpreted as instability. The stabilization was achieved with the cancellous screws. Following the surgery, the neurological status improved and the dog no longer had marked neurological deficits.

Retrobulbar rhabdomyosarcoma in a budgerigar (Melopsittacus undulatus).

This report describes a retrobulbar rhabdomyosarcoma in a 7-year-old male budgerigar (Melopsittacus undulatus). The bird was presented with orbital distension and exophthalmia of the left eye and died during surgery. Necropsy revealed a tan to grey retrobulbar mass compressing all components of the left eye with obscured vision. In histopathological examination, the mass was composed of sheets of spindle-shaped cells with pleomorphic nuclei, numerous bizarre mitotic figures and mononucleated or multinucleated giant cells and also typically strap cells. Neoplastic cells had no cross-striations in sections stained by phosphotungstic acid haematoxylin. The tumour cells did not invade surrounding tissues, including the retina, and there was no metastasis to other organs. Immunohistochemically, tumour cells were positive for desmin, vimentin and alpha-smooth muscle actin, but were negative for S-100 protein and pancytokeratin.

Management of spinal trauma in 69 cats.

This study sought to evaluate a series of clinical and radiological findings on spinal trauma in cats and the outcome that emerged from conservative or surgical treatment using 2 types of spinal stapling: stabilization using a Steinmann pin and coated polypropylene. Case records were reviewed for their diagnostic approaches on the basis of physical and neurological conditions, and concurrent disorders in addition to spinal trauma. Radiological examinations of the vertebral column were carried out using survey radiography, myelography and epidurography. All cases were classified according to etiopathogenesis of the disease. Surgical treatment consisted of decompression (laminectomy, hemilaminectomy and durotomy), or decompression with stabilization which was performed by one of two methods. The first one was the employment of translaminar stapling at the base of a spinous process and the other involved spinal stapling at the spinous process. The spinal lesions were identified as cervical (n = 2), thoracic (n = 35), lumbar (n = 22), sacral and caudal (n = 10). While 19 out of 30 conservatively managed cases recovered, the rest had persistent residual paresis and ataxia. Complete recovery was seen in 4 cats that underwent hemilaminectomy and 3 subjected to laminectomy. Partial recovery was observed in 5 cases involving laminectomy; however, there was no improvement observed in another 2 cases. Each animal was followed for at least a 3-month period to evaluate the clinical assessment of the results following treatment. The results of conservative and operative management of spinal trauma indicated that the type and degree of spinal cord degradation strongly influenced any prognosis. The results emerging from decompressive procedures seemed satisfactory for those cases where instability was not an issue. Both stabilization techniques were not ideal in terms of their methodological versatility or regarding weaknesses of bone structure observed in intra- and postoperative periods. However, translaminar stapling at the base of a spinous process was deemed to be the superior technique.