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Case Description—A 3-year-old spayed female Labrador Retriever was evaluated for progressive lameness of the left forelimb 21 months after being shot in the elbow with a lead bullet.

Clinical Findings—Physical examination findings were consistent with moderate osteoarthritis of the left elbow joint. Orthogonal radiographic views of the elbow revealed multiple metallic fragments in and around the joint space as well as signs of osteoarthritis.

Treatment and Outcome—The elbow joint was evaluated arthroscopically. A lead-based bullet fragment was seen in the lateral synovial compartment and removed in multiple pieces. Excess fibrin and synovium were removed, and microfractures were created in exposed subchondral bone to stimulate neovascularization and fibrocartilage formation. In a follow-up telephone conversation 4 months after surgery, the owner reported a marked improvement in the lameness.

Clinical Relevance—Removal of lead intra-articular foreign bodies may be indicated even if the material is not believed to mechanically interfere with joint motion.

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in Journal of the American Veterinary Medical Association


Objective—To compare the efficacy of meloxicam administered perioperatively with transdermal administration of fentanyl via a patch placed preoperatively in dogs undergoing orthopedic surgery.

Design—Prospective study.

Animals—16 dogs.

Procedure—Unilateral or bilateral osteotomy of the tibia and fibula was surgically performed, and a uniplanar external distraction device was placed in each limb. Postoperative pain and lameness were assessed 24, 48, and 72 hours after administration of the first of 3 doses of meloxicam (0.2 mg/kg [0.09 mg/lb], IV, given preoperatively, followed by 0.1 mg/kg [0.045 mg/lb], IV, after 24 hours, and 0.1 mg/kg, PO, after 48 hours) or preoperative placement of a transdermal fentanyl patch (50 μg/h) left in place for 72 hours.

Results—No significant differences in total pain scores were detected between groups. Mean ± SD lameness scores assessed at 24 and 72 hours were lower in dogs in the meloxicam group than dogs in the fentanyl group. Lameness scores decreased with time in a similar manner in both treatment groups.

Conclusions and Clinical Relevance—Perioperative administration of meloxicam or preoperative placement of a transdermal fentanyl patch provided effective and similar postoperative analgesia in dogs undergoing orthopedic surgery. However, because of its anti-inflammatory effects, treatment with meloxicam reduced the degree of lameness and resulted in rapid functional recovery of the limb. (J Am Vet Med Assoc 2005;227:1768–1774)

Full access
in Journal of the American Veterinary Medical Association