Objective—To determine the extent to which a hydroxyapatite coating promotes pin stability in the third metacarpal bone during transfixation casting in horses.
Animals—14 adult horses.
Procedures—7 horses each were assigned to either an uncoated or hydroxyapatite-coated pin group. Three transcortical pins were placed in the third metacarpal bone of each horse and incorporated into a cast for 8 weeks. Insertion and extraction torque were measured, and torque reduction was calculated. Radiography was performed at 0, 4, and 8 weeks. Lameness evaluation was performed at 2, 4, 6, and 8 weeks. Bacteriologic culture of pins and pin holes was performed at pin removal.
Results—All horses used casts without major complication throughout the study. Insertion torque was higher in uncoated pins. There was no effect of group on extraction torque. Hydroxyapatite-coated pins had lower torque reduction. Five of 15 hydroxyapatite-coated pins maintained or increased stability, whereas all uncoated pins loosened. Pin hole radiolucency, lameness grades, and positive bacteriologic culture rates were not different between groups.
Conclusions and Clinical Relevance—Hydroxyapatite coating increased pin stability within the third metacarpal bone of horses during 8 weeks of transfixation casting but did not improve pin performance on clinical assessments. Clinical use of hydroxyapatite-coated transfixation pins may result in greater pin stability; however, further research is necessary to improve the consistency of pin osteointegration and elucidate whether clinical benefits will ultimately result from this approach in horses.
Objective—To compare the bursting strength of a vessel sealant device (VSD) with that of an encircling suture on uterine horns and bodies from dogs.
Sample—Uteri from 24 shelter dogs with unknown reproductive histories.
Procedures—Uterine horns and bodies were allocated to groups to be sealed with suture or a VSD. Uteri were then infused with saline (0.9% NaCl) solution until the seals burst or the uteri reached a maximal pressure of 300 mm Hg. Variables recorded included dog age, uterine body and horn diameter, and maximal pressure.
Results—The median (range) bursting pressure reached in sealed uterine horns was 300 (0 to 300) mm Hg for the VSD group and 300 (200 to 300) mm Hg for the suture group. Within the VSD group, seals of 2 of 3 uterine horns with a diameter ≥ 9 mm burst before intraluminal pressure reached 100 mm Hg, compared with 1 of 21 uterine horns with a diameter < 9 mm. The median bursting pressure for uterine bodies was 237 (0 to 300) mm Hg for the VSD group versus 300 (175 to 300) mm Hg for the suture group. Within the VSD group, seals in uterine bodies with a diameter ≥ 9 mm failed at a significantly lower pressure (125 [0 to 125]) mm Hg than those with a diameter < 9 mm (275 [125 to 300]) mm Hg.
Conclusions and Clinical Relevance—The failure pressure for both sealing techniques was high, which indicated that the VSD may be a safe instrument for sealing the uterine horn in dogs. Given the low mean bursting pressure for seals in uterine bodies with large diameters, the VSD cannot be recommended for sealing uterine bodies ≥ 9 mm in diameter.
Objective—To determine angles of insertion for laminar vertebral fixation of L1 and L2 by use of a locking plate in dogs and to confirm screw placement by use of computed tomography (CT).
Sample—Vertebral specimens harvested from 8 canine cadavers.
Procedures—The point of insertion and minimum and maximum insertion angles for laminar and facet screws for laminar vertebral stabilization were determined by use of CT. A precontoured locking plate was then placed by use of 1 locking screw in the lamina of each lumbar vertebra and 1 nonlocking screw in the facet joint. The position and angle of the screws were examined by use of CT, and penetration into the vertebral canal was recorded.
Results—Mean ± SD insertion angles for L1 and L2 were 18 ± 4° and 21 ± 5° toward the vertebral canal and 11 ± 4.4° and 10 ± 3° in a dorsal direction, respectively. Insertion angles for the facet joint were between 24 ± 4° ventrally and 12 ± 2° dorsally. Insertion of the screw did not penetrate the vertebral canal for 23 of 24 (96%) screws. For 23 of 24 inserted screws, the previously determined angle was maintained and purchase of bone and cortices was satisfactory.
Conclusions and Clinical Relevance—Placement of laminar and facet screws in canine vertebrae was possible and can be performed safely if angles of insertion determined pre-operatively via CT are maintained.
Objective—To compare biomechanical characteristics of vertebral segments after vertebral body plating or laminar stabilization following complete incision of the annulus fibrosus.
Sample—Vertebral segments from T13 through L3 obtained from 18 canine cadavers.
Procedures—A 4-point bending moment was applied in flexion and extension to the intact vertebral segments to determine a baseline range of motion (ROM) and neutral zone (NZ). Vertebral columns were then destabilized by creating a defect in the intervertebral disk via complete incision of the ventral aspect of the annulus fibrosus. The bending moment was applied again after stabilization was accomplished via vertebral body plating or with laminar stabilization (n = 9 vertebral segments/stabilization technique). The ROM and NZ were compared with their baseline values and among treatment groups. Finally, load-to-failure testing was performed in flexion.
Results—Mean relative ROM and NZ for segments treated with laminar stabilization were significantly lower than those for segments treated with vertebral plates.
Conclusions and Clinical Relevance—Analysis of in vitro results suggested that laminar stabilization of vertebral segments provided greater stiffness than did vertebral body plating.
Objective—To evaluate the effects of pilot hole diameter and tapping on insertion torque and axial pullout strength of 4.0-mm cancellous bone screws in a synthetic canine cancellous bone substitute.
Sample—75 synthetic cancellous bone blocks (15 blocks/group).
Procedures—For groups 1 through 5, screw size-pilot hole diameter combinations were 3.5–2.5 mm (cortical screws), 4.0–2.5 mm, 4.0–2.5 mm, 4.0–2.0 mm, and 4.0–2.0 mm, respectively. Holes were tapped in groups 1, 2, and 4 only (tap diameter, 3.5, 4.0, and 4.0 mm, respectively). One 70-mm-long screw was inserted into each block; in a servohydraulic materials testing machine, the screw was extracted (rate, 5 mm/min) until failure. Mean group values of maximum insertion torque, axial pullout strength, yield strength, and stiffness were determined.
Results—Mean maximum insertion torque differed significantly among the 5 groups; the group 5 value was greatest, followed by group 3, 4, 2, and 1 values. Group 3, 4, and 5 axial pullout strengths were similar and significantly greater than the group 2 value; all values were significantly greater than that for group 1. Group 5 and 4 yield strengths were similar and significantly greater than the group 3, 2, and 1 values. Stiffness in group 3 was similar to group 4 and 2 values but significantly greater than the group 5 value; all values were significantly greater than that for group 1.
Conclusions and Clinical Relevance—These synthetic cancellous bone model findings suggested that tapping a 2.0-mm-diameter pilot hole when placing a 4.0-mm screw is the optimal insertion technique.
Objective—To compare the bone temperature and final hole dimensions associated with sequential overdrilling (SO) and single 6.2-mm drill bit (S6.2DB) methods used to create transcortical holes in the third metacarpal bones (MCIIIs) of horse cadavers.
Sample—60 MCIIIs from 30 horse cadavers.
Procedures—In phase 1, hole diameter, tap insertion torque, peak bone temperature, and postdrilling bit temperature for 6.2-mm-diameter holes drilled in the lateral or medial cortical region of 12 MCIIIs via each of three 2-bit SO methods with a single pilot hole (diameter, 3.2, 4.5, or 5.5 mm) and the S6.2DB method were compared. In phase 2, 6.2-mm-diameter transcortical holes were drilled via a 2-bit SO method (selected from phase 1), a 4-bit SO method, or a S6.2DB method at 1 of 3 locations in 48 MCIIIs; peak bone temperature during drilling, drill bit temperature immediately following drilling, and total drilling time were recorded for comparison.
Results—Hole diameter or tap insertion torque did not differ among phase 1 groups. Mean ± SD maximum bone temperature increases at the cis and trans cortices were significantly less for the 4-bit SO method (3.64 ± 2.01°C and 8.58 ± 3.82°C, respectively), compared with the S6.2DB method (12.00 ± 7.07°C and 13.19 ± 7.41°C, respectively). Mean drilling time was significantly longer (142.9 ± 37.8 seconds) for the 4-bit SO method, compared with the S6.2DB method (49.7 ± 24.3 seconds).
Conclusions and Clinical Relevance—Compared with a S6.2DB method, use of a 4-bit SO method to drill transcortical holes in cadaveric equine MCIIIs resulted in smaller bone temperature increases without affecting hole accuracy.
Objective—To determine hyaluronan concentrations in peritoneal fluid from healthy horses and horses with sudden signs of severe abdominal pain and to identify the cellular sources of hyaluronan within the peritoneal cavity.
Animals—7 client-owned horses that were evaluated for sudden signs of severe abdominal pain, 6 healthy teaching horses, and 13 euthanized horses (11 with no abdominal disease and 2 that had undergone abdominal surgery 2 weeks previously for a different study).
Procedures—Abdominal fluid was collected from the client-owned and teaching horses. Hyaluronan concentrations were determined with an ELISA. Equine mesothelial cells were aseptically harvested from euthanized horses immediately after euthanasia, cultured, and processed for western blot immunoassays to detect expression of the following mesothelial cell markers: cytokeratins 8 and 18, vimentin, calretinin, mesothelin, and CD44. A reverse transcriptase–PCR assay was used to detect genetic expression of hyaluronan synthase-2 (HAS-2) from cultured and native equine tissue.
Results—The mean ± SD abdominal hyaluronan concentration in peritoneal fluid from horses with signs of abdominal pain (1,203.3 ± 46.3 ng/mL) was significantly greater than that in healthy horses (228.4 ± 167.3 ng/mL). Harvested cells were maintained, and immunoblotting analyses confirmed expression of the mesothelial markers. Gene expression of HAS-2 from cultured mesothelial cells and fibroblasts was confirmed.
Conclusions and Clinical Relevance—Peritoneal hyaluronan concentration was much higher in horses with severe abdominal pain than in healthy horses. Cultured equine mesothelial cells and fibroblasts can produce hyaluronan through HAS-2. Future investigation should focus on establishing the effect of exogenous hyaluronan administration on mesothelial cell function in horses with abdominal disease.
Objective—To identify hemostatic imbalances indicative of an increased risk of intra-abdominal adhesion formation in foals versus adult horses.
Animals—Horses with colic undergoing exploratory laparotomy or abdominocentesis as part of a clinical examination (n = 16 foals ≤ 6 months of age and 19 adults ≥ 5 years of age) and horses without colic undergoing herniorrhaphy (15 foals) or euthanasia for noninflammatory and nongastrointestinal disease (10 foals and 20 adults).
Procedures—Paired abdominal fluid and blood samples were collected from each horse into buffered sodium citrate and centrifuged immediately after collection. Supernatants were stored at −80°C, then thawed for measurement of fibrinogen concentration, plasminogen activity, antiplasmin activity, and D-dimer concentration. Supernatant analyte concentrations or activities were compared within age group (foals with and without colic vs adults with and without colic) and within disease status (foals and adults without colic vs foals and adults with colic).
Results—All analyte concentrations or activities in abdominal fluid samples were significantly lower in the noncolic groups than in the colic groups, and none differed between foal and adult groups. Several plasma analyte values differed by disease status and age.
Conclusions and Clinical Relevance—The risk of intra-abdominal adhesion formation in the foals in this study did not appear to be attributable to differences in intra-abdominal hemostasis between adult horses and foals. Strategies for initial medical and surgical management of colic in adult horses may be applicable to foals with similar disorders.
Objective—To develop and determine the feasibility of a novel minimally invasive technique for percutaneous catheterization and embolization of the thoracic duct (PCETD) in dogs and to determine thoricic duct TD pressure at rest and during short-term balloon occlusion of the cranial vena cava (CrVC).
Animals—Fifteen 7- to 11-month-old healthy mixed-breed dogs.
Procedures—Efferent intestinal lymphangiography was performed, and the cisterna chyli was punctured with a trochar needle percutaneously under fluoroscopic guidance. When access was successful, a guide wire was directed into the TD through the needle and a vascular access sheath was advanced over the guide wire. Thoracic duct pressure was measured at rest and during acute balloon occlusion of the CrVC. The TD was then embolized cranial to the diaphragm with a combination of microcoils and cyanoacrylate or ethylene vinyl alcohol.
Results—Successful puncture of the cisterna chyli with advancement of a wire into the TD was possible in 9 of 15 dogs, but successful catheterization was possible in only 5 of 9 dogs. Acute balloon occlusion of the CrVC led to a substantial TD pressure increase in 4 of 4 dogs, and embolization of the TD was successful in 4 of 4 dogs.
Conclusions and Clinical Relevance—PCETD can successfully be performed in healthy dogs; however, this minimally invasive technique cannot currently be recommended for routine treatment of chylothorax, in part because of the technically demanding nature of the procedure. An increase in jugular venous pressure led to an increase in TD pressure, potentially predisposing some dogs to developing chylothorax.
Objective—To evaluate histologic reactions to 8 suture materials and cyanoacrylate tissue adhesive (CTA) in the musculature and skin of ball pythons.
Animals—30 hatchling ball pythons.
Procedures—In each snake, ten 1-cm skin incisions were made (day 0). At 8 sites, a suture of 1 of 8 materials was placed in the epaxial musculature, and the incision was closed with the same material. One incision was closed by use of CTA. No suture material was placed in the tenth incision, which was allowed to heal by second intention (negative control). Snakes (n = 5/group) were euthanized for harvest of treatment-site tissues at days 3, 7, 14, 30, 60, and 90. Skin and muscle sections were examined microscopically and assigned a subjective score (0 to 4) for each of the following: overall severity of inflammation, fibrosis, number of macrophages, number of granulocytes, number of perivascular lymphocytes, and degree of suture fragmentation.
Results—Subjective score analysis revealed that CTA did not cause a significant inflammatory response, compared with the negative control. All suture materials caused significantly more inflammation over all time points; for all suture materials, inflammatory response scores were significantly higher than values for the negative control 90 days after implantation. No sutures were completely absorbed by the end of the study period, and several sutures appeared to be in the process of extrusion.
Conclusions and Clinical Relevance—In snakes, CTA can be used to close small superficial incisions or lacerations with minimal inflammatory response, and sutures may undergo extrusion from tissues prior to complete absorption.