A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases.

OBJECTIVE: (1) To determine whether Oxley's modified cranial closing wedge osteotomy (CCWO) results in a tibial plateau angle (TPA) of 5° in silico, (2) compare in silico to clinical postoperative TPA and (3) determine the impact of ostectomy distalization in silico. STUDY DESIGN: Cross-sectional retrospective radiographic in silico study. SAMPLE POPULATION: A total of 100 stifle radiographs; 90 dogs (small ≤25 kg = 84; large >25 kg = 16). METHODS: Tibial plateau angles were measured preoperatively (TPAPre ), after in silico planning (TPAPlan ), and postoperatively (TPAPost ). Virtual ostectomies were evaluated for plate fit. Postoperative ostectomy position was measured. Virtual ostectomies were performed 5/7.5/10/15 mm from the patellar tendon insertion in 10 dogs from each preoperative TPA category (≤20°/21-25°/ 26-30°/31-35°/>35°). Comparisons for TPAPre , TPAPost , and TPAPlan were made between small and large dogs, and the outcome to the target 5° between TPA categories and ostectomy positions. RESULTS: Mean ± SD TPAPre was 28.6 ± 6.2° and higher in small than large dogs. Mean TPAPlan was 7.6 ± 2.7°. Plate fit was appropriate in all. In silico, TPAs were greater than 5° except for cases with TPAPre > 35°. Median TPAPost was 5.5° (-4-21) and was higher in small (7°) than large (4.5°) dogs. Postoperative ostectomy position was more distal than Oxley's guidelines. When distalized >7.5 mm in silico, the magnitude of under-correction increased. CONCLUSIONS: Oxley's modified CCWO did not result in TPA of 5° in most cases. Ostectomy distalization exacerbated under-correction. CLINICAL IMPACT: Current guidelines should be modified to achieve 5° TPA postoperatively.

A case series of 37 surgically managed, paraplegic, deep pain negative French bulldogs, with thoracolumbar intervertebral disc extrusion, from two English referral centres.

Background: Thoracolumbar intervertebral disc extrusions (TL-IVDEs) are a common spinal disorder in dogs, especially within chondrodystrophic breeds. Loss of deep pain perception is a well-documented negative prognostic indicator in dogs with TL-IVDE. The objectives of this study were to report the rate of return of deep pain perception and independent ambulation in surgically treated, paraplegic, deep pain perception negative French bulldogs with TL-IVDEs. Methods: A retrospective case series of deep pain perception negative dogs with TL-IVDE presenting to two referral centres between 2015 and 2020 was conducted. Medical and MRI records were reviewed, including the following quantitative MRI changes: lesion length, extent of spinal cord swelling and severity of spinal cord compression. Results: Thirty-seven French bulldogs met the inclusion criteria, with 14 of 37 (38%) regaining deep pain perception by the time of discharge (median hospitalisation 10.0 days [interquartile range 7.0-15.5 days]) with two dogs independently ambulatory (6%). Ten of the 37 dogs were euthanased during hospitalisation. Significantly fewer dogs (3/16, 19%) with L4-S3 lesions regained deep pain perception compared to 11 of 21 (52%) of dogs with T3-L3 lesions (p = 0.048). Quantitative MRI changes were not associated with the return of deep pain perception. After discharge, with a median 1-month follow-up period, an additional three dogs regained deep pain perception and five dogs became independently ambulatory (17/37 [46%] and 7/37 [19%], respectively). Conclusions and clinical importance: This study adds support to the contention that the recovery of French bulldogs with TL-IVDE from surgery is poor compared with other breeds; further prospective, breed-controlled studies are indicated.

Risk factors associated with short-term mortality and recurrence of status epilepticus in dogs.

BACKGROUND: Status epilepticus (SE) is an emergency associated with serious consequences for both patient and owner. Data regarding risk factors for short-term mortality or recurrence in dogs with SE is limited. OBJECTIVE: Identify risk factors associated with short-term mortality (euthanasia or spontaneous death) and recurrence of SE in dogs. ANIMALS: One hundred twenty-four client-owned dogs that sustained an episode of SE. METHODS: Retrospective multicenter study using data collected from medical records of dogs presented in SE to the contributing institutions. Multivariable logistic regression analysis was performed using a manual backwards stepwise approach to identify risk factors associated with short-term mortality and recurrence of SE after discharge. RESULTS: Short-term mortality for affected dogs was 29.8%. Factors significantly associated with short-term mortality included increased patient age, shorter duration of hospitalization, development of SE before arrival, and SE caused by a potentially fatal etiology. Status epilepticus recurred in 27% of dogs that survived to discharge. Factors significantly associated with recurrence of SE included prior history of pharmacoresistant epilepsy and predominance of a focal seizure phenotype. CONCLUSIONS AND CLINICAL IMPORTANCE: Our results may be used to inform clinicians and dog owners regarding risk factors for both short-term mortality and recurrence in dogs with SE.

Research priorities for idiopathic epilepsy in dogs: Viewpoints of owners, general practice veterinarians, and neurology specialists.

BACKGROUND: Epilepsy is the most common chronic neurological disease in dogs that adversely affects the quality of life (QoL) of affected dogs and their owners. Research on epilepsy in dogs is expanding internationally, but where best to focus limited research time, funds, and expertise to achieve better outcomes for affected dogs and their owners has not been studied. OBJECTIVE: To explore idiopathic epilepsy (IE) research priorities of owners of dogs with IE, general practice veterinarians, and veterinary neurologists. METHODS: An international online survey was conducted in 2016 and repeated in 2020. Participants rated the absolute importance and relative rank of 18 areas of IE research, which were compared between groups and time points. RESULTS: Valid responses were received from 414 respondents in 2016 and 414 respondents in 2020. The development of new anti-seizure drugs (ASD) and improving the existing ASD management were considered the most important research priorities. Areas of research with increasing priority between 2016 and 2020 included non-ASD management, with the greatest potential seen in behavioral and dietary-based interventions. Disagreements in priorities were identified between groups; owners prioritized issues that impacted their and their dog's QoL, for example, adverse effects and comorbidities, whereas general practitioner vets and neurologists prioritized clinical issues and longer-term strategies to manage or prevent IE, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Ensuring that voices of owners are heard in the planning of future research should be a broader goal of veterinary medicine, to target research efforts toward areas most likely to improve the QoL of the dog-owner dyad.