Center of rotation of angulation-based leveling osteotomy for stifle stabilization in skeletally immature dogs.

OBJECTIVE: To describe short-term outcomes of center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) in skeletally immature dogs with cranial cruciate ligament (CrCL) injury. STUDY DESIGN: Retrospective case series. ANIMALS: Fifteen skeletally immature dogs (16 stifles). METHODS: Medical records of dogs with CrCL injury and radiographically documented open proximal tibial physis and tibial tuberosity apophysis managed with CBLO were reviewed. Clinical assessment, radiographic assessment, and complications were reviewed. RESULTS: Fifteen dogs (16 stifles) with radiographically documented open proximal tibial physis and tibial tuberosity apophysis and CrCL injury underwent a CBLO. Mean tibial plateau angle (TPA) was 26° preoperatively, 9° postoperatively, and 9° at final recheck. One dog developed 10° recurvatum of the proximal tibia secondary to inadvertent over rotation of the tibial plateau (TPA 3°) to protect primary repair of an insertional CrCL avulsion. Correction of the recurvatum was declined as the dog had full limb function. Two dogs developed a valgus deformity secondary to a plate screw engaging the distolateral aspect of the proximal tibial physis. Owners of these dogs reported normal function but requested surgical revision to prevent long-term problems secondary to abnormal weight bearing. Both dogs regained full function following recovery from revision surgery. At a mean time of 23 months following surgery, all dogs continued to have full function as per phone conversation with owners. CONCLUSION: With proper preoperative planning, CBLO is an option for skeletally immature dogs with CrCL injury.

Center of rotation of angulation-based leveling osteotomy combined with a coplanar cranial closing wedge ostectomy to manage cranial cruciate ligament insufficiency in dogs with excessive tibial plateau angle.

OBJECTIVE: To describe outcomes of dogs with excessive tibial plateau angle (eTPA) and cranial cruciate ligament (CrCL) disease treated with center of rotation of angulation-based leveling osteotomy (CBLO) and cranial closing wedge ostectomy (CCWO). STUDY DESIGN: Retrospective study. ANIMALS: Twenty-one dogs. METHODS: Medical records of dogs with CrCL disease and eTPA (>34°) treated with CBLO/CCWO were reviewed. Signalment, body weight, intra-articular structure appearance, TPA (preoperatively, postoperatively, and at osteotomy healing), postoperative function, and complications were recorded. RESULTS: Twenty-one dogs (28 stifles) with CrCL disease/eTPA underwent CBLO/CCWO. Twenty stifles had complete CrCL tears and eight tears were partial. Mean age and weight of dogs were 4 years (range, 1-9) and 27 kg (range, 4-65), respectively. Medial menisci were normal in 20 stifles, torn in 5, and degenerative in 3. All lateral menisci were normal. The caudal cruciate ligament was normal in 26 stifles and partially torn in 2. Mean TPA was 43° preoperatively, 10° postoperatively, and 10° at final recheck. Grade 4 healing occurred in all osteotomies by 8 weeks postoperatively. Complications included one pin migration, breakage of two proximal screws (1 case), one late-onset caudolateral band CrCL tear, two late-onset meniscal tears, and one surgical site infection. Eighteen dogs returned to full function, and three dogs achieved acceptable function, at a mean of 27 months. CONCLUSION: Center of rotation of angulation-based leveling osteotomy/CCWO resulted in grade 4 osteotomy healing by 8 weeks, minimal complications, and acceptable to full return to function. CLINICAL SIGNIFICANCE: Center of rotation of angulation-based leveling osteotomy/CCWO should be considered to treat canine CrCL disease/eTPA.

Articular cartilage lesions associated with complete lateral meniscal tears in the dog.

OBJECTIVE: To describe articular cartilage (AC) lesions associated with complete lateral meniscal tears in dogs. STUDY DESIGN: Observational series. ANIMALS: Seventeen dogs with arthroscopic evidence of a complete lateral meniscal tear and associated AC lesions. METHODS: Medical records of dogs with arthroscopic evidence of complete lateral meniscal tear and associated AC lesions between March 2006 and December 2017 were examined for arthroscopic findings. RESULTS: The cranial cruciate ligament (CrCL) was intact in 11 of 17 dogs, partially ruptured but competent in 4 of 17 dogs, and completely ruptured in 2 of 17 dogs. All dogs had grossly normal caudal cruciate ligament, medial meniscus, and AC of the medial compartment. In each dog, a complete radial tear of the caudal body of the lateral meniscus was associated with degenerative osteoarthritis (OA) of the lateral compartment of the stifle. The Outerbridge score of the lateral tibial condyle and lateral femoral condyle was 5 of 5 in 15 dogs, 3 of 5 in 1 dog, and 4 of 5 in 1 dog. CONCLUSION: Dogs with complete tears of the lateral meniscus developed degenerative OA of the lateral compartment of the stifle leading to AC loss and clinical dysfunction. CLINICAL SIGNIFICANCE: Complete lateral meniscal tears may occur as isolated injuries in dogs with a functional CrCL.

Comparison of Outcome After Use of Extra-Luminal Rings and Intra-Luminal Stents for Treatment of Tracheal Collapse in Dogs.

OBJECTIVE: To report short- and long-term complications and outcomes of dogs treated for tracheal collapse secondary to chondromalacia with extra-luminal rings (ELR) or intra-luminal stents (ILS). STUDY DESIGN: Retrospective cohort. SAMPLE POPULATION: Dogs with naturally occurring tracheal collapse (n = 103). METHODS: Medical records (2002-2012) of dogs diagnosed with tracheal collapse that had treatment with ELR (n = 73) or ILS (30) were reviewed. Demographic information, procedural information, complications, survival time, and subjective outcomes were recorded. Follow-up periods were defined as <730 days (short-term) and >730 days (long-term). RESULTS: Ninety-two percent of dogs undergoing ELR and 100% of dogs undergoing ILS survived to hospital discharge. ELR dogs were significantly younger (P = .009) and significantly fewer had main-stem bronchial collapse (P < .001). After accounting for effects of age and presence of main-stem bronchial collapse, there was no significant difference in median survival time between groups. Dogs with main-stem bronchial collapse (regardless of treatment type) had a shorter survival time than dogs without main-stem bronchial collapse. Major complications occurred in ELR (42%) and ILS dogs (43%). CONCLUSIONS: Both ELR and ILS are associated with high complication rates. Younger dogs and dogs without main-stem bronchial collapse had a longer survival time, regardless of treatment.

Facilitation of soft tissue surgery: surgical staplers and vessel sealing devices.

Recent advances and acceptance of various medical devices have clearly helped in the efficiency, simplicity, and effectiveness of veterinary surgery. The goals of surgery include efficient methods and minimal surgical times, delicate tissue handling techniques, confidence with tissue reconstruction, and minimizing contamination, leakage and complications. Mechanical means of suturing, cutting, and hemostasis assist with accomplishing these goals. Most recently, stapling instrumentation and vascular sealing devices have become common instruments on all levels of surgery because of their ease of use and increase in surgical efficiency.

Arthroscopic documentation of elbow cartilage pathology in dogs with clinical lameness without changes on standard radiographic projections.

OBJECTIVE: To document cartilage damage associated with elbow lameness in dogs without radiographic signs. STUDY DESIGN: Case series. ANIMALS: Dogs (n=16). METHODS: Medical records (November 2004-January 2006) of dogs with undiagnosed forelimb lameness localized to the elbow but without radiographic signs that had lesions identified by either computed tomography (CT) or nuclear scintigraphy and confirmed by arthroscopy were included. Signalment, duration of clinical signs before admission, surgical diagnosis, and treatment were recorded. RESULTS: Sixteen dogs (10 left, 6 right elbows) were identified. Median age was 30.1 months and median duration of clinical signs before admission was 15.6 months. CT or scintigraphy were strongly suggestive of elbow pathology before confirmation by arthroscopy. Medial coronoid pathology was identified in every abnormal elbow and osteochondrosis dissecans in 2 elbows. CONCLUSIONS: Elbow pathology not associated with radiographic changes can be identified by CT and scintigraphy. Coronoid pathology is the most likely diagnosis. CLINICAL RELEVANCE: Absence of radiographic signs in elbows with clinical signs of lameness should be evaluated with advanced imaging techniques (CT, scintigraphy) and arthroscopy to identify the cause of lameness.

Balancing veterinary students' and house officers' learning experiences in veterinary teaching hospitals.

Veterinary students at two large veterinary referral teaching hospitals were surveyed on their perceptions of competition with interns and residents for learning experiences during clinical instruction. Their responses led to an additional survey of a cohort of clinical educators on how this competition might be managed, what impedes effective management, and how progress toward an improved clinical learning environment might be measured. This article describes the results of the survey and discusses the nature of the competition and factors affecting the competitive learning environment. The results of this study should be expanded to include a larger cohort of veterinary students and an assessment of house officers' and faculty members' perceptions.

Effects of femur position on radiographic assessment of completeness of femoral head and neck excision in medium- to large-breed dogs.

OBJECTIVE: To determine the effect of femur positioning on radiographic assessment of completeness of excision after femoral head and neck excision (FHNE) in medium to large breed dogs. SAMPLE POPULATION: 10 femurs from canine cadavers (body weight > 20 kg). PROCEDURE: Complete FHNE was performed on 5 canine femurs. Excision consisting of inadequate removal of the medial distal aspect of the femoral neck was performed on the remaining 5 femurs. Each femur was positioned with predetermined amounts of internal and external rotation about the long axis and radiographed. Investigators evaluated a set of 8 radiographic views of each femur. Sensitivity (SE), specificity (SP), positive predictive value, negative predictive value, and completeness of excision assessment accuracy were estimated for each of the femur positions. RESULTS: Craniocaudal radiographic views of the femur positioned with external rotation of 15 degrees, 30 degrees, and 45 degrees as a group had the highest SE, SP, and completeness of excision assessment accuracy relative to other radiographic views. The SE, SP, and accuracy of assessment were higher when the degree of external rotation was increased from 15 degrees to 30 degrees or 45 degrees. CONCLUSIONS AND CLINICAL RELEVANCE: Craniocaudal radiographic views of the femur positioned in external rotation (15 degrees, 30 degrees, and 45 degrees) improved the ability to detect adequacy of excision relative to standard craniocaudal and lateromedial radiographic views. Evaluation of craniocaudal radiographic views of the femur positioned in external rotation may increase the ability to assess FHNE adequacy in medium- to large-breed dogs.

The effect of experimental gastric dilatation-volvulus on adenosine triphosphate content and conductance of the canine gastric and jejunal mucosa.

The objective of this study was to determine if experimental gastric dilatation volvulus (GDV) would decrease adenosine triphosphate (ATP) concentration and increase membrane conductance of the canine gastric and jejunal mucosa. Male dogs (n = 15) weighing between 20 and 30 kg were used. Dogs were randomly assigned to 1 of 3 equal groups: Group 1 was control, group 2 was GDV, and group 3 was ischemia. All dogs were anesthetized for 210 min. Group 1 had no manipulation. Group 2 had GDV experimentally induced for 120 min followed by decompression, derotation, and reperfusion for 90 min. Group 3 had GDV experimentally induced for 210 min. Gastric (fundus and pylorus) and jejunal tissue was taken at 0, 120, and 210 min from all of the dogs. Tissue was analyzed for ATP concentration, mucosal conductance, and microscopic changes. The ATP concentration in the fundus did not change significantly from baseline in group 2, but decreased significantly below baseline at 210 min in group 3. The ATP concentration in the jejunum decreased significantly below baseline in groups 2 and 3 at 120 min, remaining significantly decreased in group 3 but returning to baseline at 210 min in group 2. Mucosal conductance of the fundus did not change significantly in any dog. Mucosal conductance of the jejunum increased at 120 min in groups 2 and 3, and became significantly increased above baseline at 210 min. The jejunal mucosa showed more profound cellular changes than the gastric mucosa. The jejunum showed substantial decreases in ATP concentration with an increase in mucosal conductance, suggesting cell membrane dysfunction. Dogs sustaining a GDV are likely to have a change in the activity of mucosal cells in the jejunum, which may be important in the pathophysiology of GDV.