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  • Author or Editor: Alan J. Lipowitz x
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Abstract

Objective—To measure and compare tibial plateau angles (TPA) of dogs with cranial cruciate ligament (CrCL) injuries and dogs without CrCL injuries.

Design—Prospective study.

Animals—87 dogs.

Procedure—Stifle joints were measured from lateral radiographic views to determine TPA in 3 groups: group-1 dogs had CrCL injuries, group-1a dogs, a subgroup of group 1, had 1 unaffected stifle joint, and group-2 dogs had no CrCL injuries. Age, sex, breed, body weight, limb injured, and TPA were recorded for each dog.

Results—56 stifle joints were measured in group-1 dogs; mean TPA was 23.76°, and mean age and weight were 5.7 years and 37.91 kg (83.4 lb), respectively. Fourteen stifle joints were measured in group-1a dogs; mean TPA was 24.71°, and mean age and weight were 5.6 years and 38.06 kg (83.8 lb), respectively. Sixty stifle joints were measured in group-2 dogs; mean TPA was 18.10°, and mean age and weight of these dogs were 4.83 years and 35.85 kg (79 lb), respectively. The most common breeds included Labrador Retriever, Golden Retriever, and Rottweiler. The TPA of dogs in group 1 and group 1a were significantly greater than the TPA of dogs in group 2.

Conclusions and Clinical Relevance—Dogs with CrCL injuries have a significantly greater TPA than dogs without CrCL injury. With further investigation, a normal TPA can be determined. In the future, TPA measurements may be used to screen dogs suspected of being susceptible to CrCL injury. (J Am Vet Med Assoc 2001;218:363–366)

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in Journal of the American Veterinary Medical Association

Abstract

Objectives—To determine the earliest age that canine tibial plateau angles (TPAs) can be reliably measured and determine whether TPAs change during long bone growth.

Animals—10 Labrador Retrievers and 20 Labrador Retriever-hound crossbreeds.

Procedure—Stifle joints were radiographed every 2 months from 8 weeks of age to radiographic closure of the tibial physes. Four examiners radiographically evaluated TPA, physeal closure status (ie, complete or incomplete) of the proximal and distal tibial physis, and whether anatomic TPA measurement landmarks were sufficiently visible (LSV) or insufficiently visible (LIV) for accurate measuring. Linear regression analysis was performed to detect change in TPAs over time. Mean ages with 95% confidence intervals (CIs) were determined for dogs with radiographs classified as LIV and LSV.

Results—TPAs did not change from 90 days of age to physeal closure. Mean age for dogs with radiographs classified as LIV was 70.2 days (95% CI, 68.12 to 72.28 days), with no dog with LIV radiographs over 81 days of age. Mean age for dogs with radiographs classified as LSV was 85.5 days (CI, 76.73 to 94.27 days).

Conclusions and Clinical Relevance—TPAs in Labrador Retrievers and Labrador Retriever-hound crossbreeds can be measured accurately after 90 days of age, and earlier attempts to measure result in falsely low TPA measurements. Measuring TPAs in growing dogs may allow earlier detection of premature physeal closures. As more is learned about the role of the TPA in cranial cruciate ligament injury, early treatment may be possible for growing dogs with cruciate ligament injuries and excessive tibial slope. (Am J Vet Res 2004;65:513–518)

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in American Journal of Veterinary Research

Abstract

Objective—To identify factors associated with leakage following intestinal anastomosis in dogs and cats.

Design—Retrospective study.

Animals—90 dogs and 25 cats.

Procedure—Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded.

Results—Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration ≤ 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs.

Conclusions and Clinical Relevance—Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration ≤ 2.5 g/dL. (J Am Vet Med Assoc 2003; 223:73–77)

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in Journal of the American Veterinary Medical Association

Objective

To determine whether preoperative radiographic evidence of degenerative joint disease (DJD), hip joint laxity, or age at surgery is associated with long-standing DJD or hip function in dogs with hip dysplasia (HD) that had a triple pelvic osteotomy (TRO).

Design

Prospective study.

Animals

34 dogs with HD.

Procedure

Dogs that had TPO performed during an 8-year period were chosen for long-term follow-up evaluation that included physical examinations, pelvic radiographs, and owner questionnaires. Data on radiographic evidence of DJD, Norberg angle, and percentage of femoral head coverage were retrieved from preoperative records and determined from follow-up radiographs.

Results

Approximately 40% of dogs had progression of DJD. Eighty-seven percent of dogs received excellent or good physical examination scores, and 76% received excellent or good at-home activity scores. Preoperative and long-standing DJD were not associated. The risk of DJD was increased with increased age at surgery, narrower preoperative Norberg angle, and lower percentage of femoral head coverage, but these variables were not associated with clinical hip function.

Clinical Implications

TPO for treatment of HD in dogs may slow, rather than stop, radiographic progression of DJD; however, clinical outcome is acceptable for most dogs. Preoperative evidence of DJD may not be a limiting criterion in selecting dogs as suitable TPO candidates. Dogs with extensive hip joint laxity before surgery may be predisposed to developing DJD; thus, the risk-to-benefit ratio for TPO versus salvage procedures should be considered. Younger dogs may develop less severe DJD after TPO; surgery should be considered at the first sign of hip joint laxity and pain. (J Am Vet Med Assoc 1998;213:80-85)

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in Journal of the American Veterinary Medical Association

Objective

To determine long-term results of various treatments for traumatic coxofemoral joint dislocation in dogs.

Design

Retrospective case series.

Animals

64 dogs that underwent closed reduction and bandage stabilization, extracapsular suture stabilization, transacetabular pinning, toggle pinning, DeVita pinning, or femoral head and neck excision.

Procedure

Follow-up evaluations included owner evaluation (64 dogs), physical evaluation (23), and radiography (19). Follow-up time ranged from 8 to 156 months.

Results

Owner evaluation scores after closed reduction were significantly better than scores after DeVita pinning, extracapsular suture stabilization, and femoral head and neck excision. On physical examination, 6 of 23 dogs were lame on the side of the previous dislocation. Signs of pain and crepitation were evident during palpation of 12 and 8 of 25 joints, respectively. Thirteen of 21 joints had radiographic evidence of degenerative joint disease. There was a greater progression of degenerative joint disease in previously dislocated joints than in unaffected joints. There were not any significant differences between treatments in regard to results of physical and radiographic evaluation. Time between trauma and treatment and existence of concomitant injuries did not influence follow-up results, but there was a significant association between body weight and radiographic evaluation score.

Clinical Implications

Concomitant injuries do not appear to justify a worse prognosis in dogs with traumatic coxofemoral joint dislocation, nor does a delay in treatment of > 3 days. Gait abnormalities and degenerative joint disease might develop in the long term. Proper body weight should be maintained regardless of treatment. (J Am Vet Med Assoc 1997; 210:59–64)

Free access
in Journal of the American Veterinary Medical Association

Summary

Medical records of 23 dogs with unilateral and 3 dogs with bilateral chronic bicipital tenosynovitis were reviewed. Mean age of affected dogs was 4.6 years (SD, 2.0 years), and mean body weight was 32.6 kg (SD, 14.5 kg). Neither a breed nor a gender predilection was detected. All dogs had a history of intermittent or progressive weight-bearing lameness that became worse after exercise. Mean duration of lameness prior to medical or surgical treatment was 6.5 months (range, 0.25 to 24 months), in all dogs, signs of pain were evident during palpation of the biceps tendon within the intertubercular groove. Radiography revealed sclerosis or osteophytosis of the intertubercular groove in all 29 shoulder joints. Mild degenerative joint disease was evident rudiographicully in 17. Arthrography was performed in 12 joints, and in 11 there were irregularities of or filling defects along the biceps tendon. Arthrocentesis was performed on 17 joints; 14 synovial fluid samples had cytologic abnormalities consistent with degenerative joint disease.

Medical treatment, consisting of injection of methylprcdnisolone acetate into the biceps tendon and its synovial sheath, was attempted in 21 of the 29 affected shoulder joints. Surgery, which consisted of tenodesis of the biceps tendon, was attempted in 14 joints; S of these had not been treated medically; the remaining 6 had poor results following medical treatment.

Gross and histologic findings consistent with chrome bicipital tenosynovitis were observed in all 14 joints in which surgery was performed. Seventeen of the medically treated shoulders were available for clinical evaluation, and results were excellent or good in 7. Twelve of the surgically treated shoulders were available for clinical re-evaluation, and results were excellent or good in all 12 (mean duration of follow-up, 5.7 months; range, 2 to 13 months). Owners of all dogs were contacted by telephone. Owners reported that results were excellent or good in 1.0 of the 21 medically treated shoulder joints, and in ail 14 of the, surgically treated shoulder joints (mean duration of follow-up, 30.1 months; range, 4 to 82 months).

Complications developed in 3 of the 4 dogs in which an osteotomy of the greater tubercle had been performed (implant migration, 2 dogs; delayed union, 1 dog). A seroma developed in 1 of the 10 dogs in which tenodesis was performed by laterally transposing the biceps tendon through a hole in the greater tubercle. Complications related to medical treatment were not detected.

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify surgical and postoperative complications of tibial plateau leveling osteotomy (TPLO) in dogs with rupture of the cranial cruciate ligament (CCL) and compare their incidence with those reported in the literature for other commonly performed CCL stabilization procedures.

Design—Retrospective study.

Animals—346 dogs undergoing 397 TPLO procedures.

Procedure—Medical records of dogs undergoing 563 consecutive TPLO procedures were reviewed. Complications were recorded and assigned to groups on the basis of the period during which the complication was observed.

Results—397 TPLOs met the criteria for inclusion in the study. Complications (n = 136) were recorded in 113 of the 397 (28%) procedures. Multiple complications developed in 10 dogs. In 19 dogs, a second surgery was performed to manage complications. Development of a complication after surgery was not associated with age or body weight of the dog, tibial plateau angle prior to stifle joint surgery, or experience of the surgeon. Factors significantly associated with complications were breed and performance of an arthrotomy concomitantly with TPLO.

Conclusions and Clinical Relevance—TPLO was associated with development of numerous complications, some of which required surgical correction. Most complications resolved with nonsurgical treatment. Several complications were unique to the TPLO procedure because of the surgical technique and implants required. Although TPLO was associated with a greater number of complications than other CCL stabilization methods, the incidence of major complications was similar. (J Am Vet Med Assoc 2003;222:184–193)

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in Journal of the American Veterinary Medical Association

Summary

Modular, porous-coated, titanium segmental endoprostheses were implanted bilaterally in the femoral diaphysis of 7 adult mixed-breed dogs. Autogenous bone graft in particle form was placed around the implant and bone. In 1 limb, homologous fibrin adhesive was mixed with the graft in situ before soft tissue closure. The contralateral limb was grafted in identical manner, but without fibrin adhesive, and served as a control. Radiography was performed immediately after surgery and 1, 2, 3, 4, 6, 8, 10, and 12 weeks later to assess callus area and bone remodeling. At 12 weeks, dogs were euthanatized and bone/implant fixation strength was tested under torsion and compared with values for 6 in vitro controls. Histomorphometric and microradiographic analyses of transverse sections of the distal portion of the implanted femurs were performed. Radiographic callus area was significantly (P < 0.05) smaller in the femurs grafted with fibrin adhesive, compared with the contralateral control. New bone formation (21.4 ± 1.8% vs 19.2 ± 2.4%), unlabeled bone (64.8 ± 3.0% vs 67.9 ± 4.2%), porosity (13.9 ± 0.7% vs 12.9 ± 0.8%), and bone ingrowth into the porous coating (10.3 ± 0.9% vs 10.0 ± 1.2%) were not significantly different between fibrin- and nonfibrin-grafted implants, respectively. There were no significant differences in torsional strength of implant fixation between the fibrin- and nonfibrin-grafted femurs or between the in vivo implanted femurs and the in vitro controls. These data indicate that fibrin adhesive may have been advantageous in maintaining apposition of bone graft adjacent to the endoprosthesis, but it probably did not have an enhancing effect on extracortical bone bridging or ingrowth over a porous-coated segmental bone replacement endoprosthesis.

Free access
in American Journal of Veterinary Research