Animals—58 dogs with lameness secondary to osteoarthritis.
Procedures—Dogs enrolled in the placebo arm of an FDA-approved study were evaluated to determine the relationship between subjective (caregiver responses) and objective (force platform gait analysis) patient outcome measures.
Results—A caregiver placebo effect for owners evaluating their dog's lameness occurred 39.7% of the time. A caregiver placebo effect occurred 44.8% of the time when veterinarians examined dogs for lameness at a walk, 44.8% of the time when veterinarians examined dogs for lameness at a trot, and 43.1% of the time when veterinarians evaluated dogs for signs of pain on palpation of the joint. This effect was significantly enhanced with time. Mean ground reaction forces (GRFs) remained unchanged for dogs during treatment with the placebo. Individually, of 58 dogs, 5 had GRFs that worsened by ≥ 5% over 42 days, 7 had GRFs that improved by ≥ 5% over 42 days, and 46 had GRFs that remained unchanged.
Conclusions and Clinical Relevance—A caregiver placebo effect was common in the evaluation of patient response to treatment for osteoarthritis by both pet owners and veterinarians. Force platform gait analysis was an unbiased outcome measure for dogs with lameness from osteoarthritis. A caregiver placebo effect should be considered when interpreting owner and veterinary reports of patient response to treatment.
Objective—To determine the effects of early postoperative
rehabilitation on limb function in dogs after
surgery for ruptured cranial cruciate ligament (RCCL).
Design—Prospective clinical study.
Animals—51 client-owned dogs.
Procedure—Dogs weighing between 20 and 40 kg
(44 to 88 lb) that had RCCL and medial meniscal injury
were studied. After removal of the RCCL and complete
medial meniscectomy, the stifle joint was stabilized
by use of a lateral retinacular stabilization technique.
Twenty-five dogs were included in a postoperative
rehabilitation group, and 26 dogs were included
in an exercise-restricted group. Limb function (peak
vertical force [PVF] and vertical impulse [VI]) was
determined before surgery and 6 months after
surgery, using force platform gait analysis.
Results—Prior to surgery, mean PVF and VI in affected
limbs were similar between groups. Six months
after surgery, PVF and VI were significantly increased
in dogs of both groups. However, PVF and VI in dogs
in the rehabilitation group were significantly greater
than those of dogs in the exercise-restricted group.
At this time, differences in limb function (as measured
by PVF and VI) between the repaired and normal
limbs were not evident in dogs in the rehabilitation
group. Conversely, limb function in the repaired
limb of dogs in the exercise-restricted group was still
significantly less than that of the normal limb.
Conclusion and Clinical Relevance—Dogs that
have surgery for RCCL and a torn medial meniscus
benefit from postoperative rehabilitation; rehabilitation
should be considered part of the postoperative
management of these patients. (J Am Vet Med Assoc
Objective—To determine hip, stifle, and tarsal joint
ranges of motion (ROM) and angular velocities during
swimming and walking in healthy dogs and dogs with
surgically corrected cranial cruciate ligament (CCL)
Design—Prospective clinical study.
Animals—13 healthy dogs and 7 dogs with CCL rupture.
Procedure—Dogs with CCL rupture were enrolled in
a postoperative aquatic rehabilitation program and
evaluated 21 to 35 days after surgery. Dogs were
filmed while swimming in a pool and while walking at
a fast (1.3 m/s) or slow (0.9 m/s) pace on a treadmill.
Maximal angles of extension and flexion, ROM, and
angular velocities were calculated.
Results—In healthy dogs, swimming resulted in a
significantly greater ROM in the hip joint than did
walking, but in dogs with CCL rupture, ROM of the
hip joint did not vary with swimming versus walking.
For dogs in both groups, swimming resulted in significantly
greater ROM of the stifle and tarsal joints than
did walking, primarily because of greater joint flexion.
Stifle joint ROM was significantly lower in dogs with
CCL rupture than in healthy dogs, regardless of
whether dogs were swimming or walking.
Conclusions and Clinical Relevance—Results suggested
that following surgical management of a ruptured CCL
in dogs, swimming resulted in greater ROM of the stifle
and tarsal joints than did walking. This suggests that if
ROM is a factor in the rate or extent of return to function
in these dogs, then aquatic rehabilitation would likely
result in a better overall outcome than walking alone.
(J Am Vet Med Assoc 2003;222:739–743)
Objective—To determine short- and long-term rates of successful outcomes of surgical and nonsurgical treatments for overweight dogs with cranial cruciate ligament rupture (CCLR).
Design—Prospective, randomized, clinical trial.
Animals—40 client-owned overweight dogs with unilateral CCLR.
Procedures—Dogs were randomly assigned to nonsurgical (physical therapy, weight loss, and NSAID administration) or surgical (tibial plateau leveling osteotomy) treatment groups; dogs in both groups received the same nonsurgical treatments. Dogs were evaluated immediately before and 6, 12, 24, and 52 weeks after initiation of treatments via owner questionnaires, gait analysis, and dual-energy x-ray absorptiometry. A successful outcome was defined as an affected limb net ground reaction force > 85% of the value for healthy dogs and a ≥ 10% improvement in values of questionnaire variables.
Results—Owner questionnaire responses indicated dogs in both groups improved during the study, but dogs in the surgical treatment group seemed to have greater improvement. Body fat percentages for dogs in both treatment groups significantly decreased during the study. Surgical treatment group dogs had significantly higher peak vertical force for affected limbs versus nonsurgical treatment group dogs at the 24- and 52-week evaluation times. Surgical treatment group dogs had a higher probability of a successful outcome (67.7%, 92.6%, and 75.0% for 12-, 24-, and 52-week evaluations, respectively) versus nonsurgical treatment group dogs (47.1%, 33.3%, and 63.6% for 12-, 24-, and 52-week evaluations, respectively).
Conclusions and Clinical Relevance—Overweight dogs with CCLR treated via surgical and nonsurgical methods had better outcomes than dogs treated via nonsurgical methods alone. However, almost two-thirds of the dogs in the nonsurgical treatment group had a successful outcome at the 52-week evaluation time.
Objective—To document peak vertical force (PVF)
and vertical impulse (VI) in the pads of Greyhounds
and Labrador Retrievers.
Animals—8 Greyhounds and 8 Labrador Retrievers.
Procedure—Velocity and acceleration were restricted
to ranges of 0.9 to 1.1 m/s and –0.1 to 0.1 m/s2,
respectively. The PVF and VI measurements were collected
from digital pad (DP)-2, -3, -4, and -5 and the
metacarpal pad (McP) or metatarsal pad (MtP) of each
limb in each dog.
Results—We found no significant differences
between the left and right forelimbs or hind limbs for
any pad in either breed. Vertical forces in the forelimb
were always greater than those in the hind limb. The
PVF in the forelimbs of Greyhounds was greatest in
DP-3, -4, and -5 and DP-3, DP-4, and the MtP in the
hind limbs. The VI in Greyhound forelimbs was greatest
in DP-3, -4, and -5 but greatest in DP-4 in the hind
limbs. The PVF in the forelimbs of Labrador Retrievers
was greatest in the McP, whereas in the hind limbs it
was greatest in DP-4. The VI in Labrador Retriever
forelimbs was greatest in DP-3, DP-4, and the McP
but greatest in DP-3 and -4 in the hind limbs.
Significant differences were detected in load distribution
between the breeds.
Conclusions and Clinical Relevance—This study
confirms that DP-3 and DP-4 are major weight-bearing
pads in dogs. However, loads were fairly evenly distributed,
and DP-5 and the McP or MtP bear a substantial
amount of load in both breeds. (Am J Vet Res 2004;65:1497–1501)
Objective—To determine the effect of exogenous
growth hormone or somatostatin on chemotherapeutic
efficacy in athymic (nude) rats with osteosarcoma.
Animals—66 female athymic rats.
Procedure—Osteosarcoma was induced at an intratibial
site. Rats were randomly allotted to 6 treatment
groups. Rats were treated with saline (0.9% NaCl)
solution alone, platinum, diammine [1,1-cyclobutane
dicaboxylato (2-)-0,0']-(SP-4-2) (CBDCA; ie, carboplatin)
plus saline solution, somatostatin alone,
somatostatin plus CBDCA, growth hormone alone, or
growth hormone plus CBDCA. Variables measured
included estimated WBC count and percentage of
neutrophils, plasma concentration of insulin-like
growth factor I (IGF-I), body weight, tumor volume,
weight of primary tumor, survival time, and distant
metastasis at time of death.
Results—Tumors formed at the injection sites in all rats.
Treatment with growth hormone increased, and treatment
with somatostatin decreased, plasma IGF-I concentration.
Treatment with growth hormone or somatostatin
altered CBDCA efficacy, as determined by evaluation
of mean and median survival times. Metastatic pulmonary
disease developed in 63 of 64 rats.
Conclusions and Clinical Relevance—The technique
used here reliably induced local osteosarcomas and
metastatic pulmonary disease. Treatment with growth
hormone and CBDCA or somatostatin may improve
chemotherapeutic efficacy without increasing toxic
Implications for Human Medicine—Results reported
here may be useful in the study of osteosarcoma
in humans. (Am J Vet Res 2000;61:646–650)
Objective—To compare tibial plateau angle (TPA)
between Greyhounds without damage to the cranial
cruciate ligaments and Labrador Retrievers with and
without damage to the cranial cruciate ligaments.
Animals—87 client-owned dogs and 15 research
Procedure—Standing position, horizontal-beam radiography
was performed on Greyhounds and unaffected
Labrador Retrievers to determine standing
TPA. Lateral radiography of the stifle joint was performed
on all dogs to determine traditional TPA. Age
and body weight were recorded for unaffected and
affected Labrador Retrievers.
Results—Greyhounds had mean standing TPA of
1.56° and mean traditional TPA of 22.50°. Unaffected
Labrador Retrievers had mean standing TPA of 3.52°
and traditional TPA of 27.97°. Affected Labrador
Retrievers had mean traditional TPA of 25.55°. No significant
difference was found in mean standing TPA
between Greyhounds and unaffected Labrador
Retrievers. Standing TPAs in Greyhounds and unaffected
Labrador Retrievers were not significantly different
from a plane drawn parallel to the ground.
Significant differences in traditional TPAs were
detected among all 3 groups.
Conclusions and Clinical Relevance—Greyhounds
had mean traditional TPA of 22.50°; similar angles
should be considered normal for dogs. Although
affected Labrador Retrievers had mean traditional
TPA that was significantly greater than that of
Greyhounds, the steepest TPA was found in unaffected
Labrador Retrievers. Because Greyhounds
and unaffected Labrador Retrievers had similar
standing TPAs, we conclude that although TPA may
be associated with damage to the cruciate ligaments,
many dogs with a steep TPA do not develop
cruciate ligament disease. (J Am Vet Med Assoc 2002;221:1426–1429)
OBJECTIVE To test ex vivo mechanical properties of 4 allograft fixation techniques for cranial cruciate ligament (CCL) replacement.
SAMPLE 30 stifle joints from canine cadavers.
PROCEDURES CCL-deficient stifle joints repaired by 1 of 4 techniques (n = 6/group) and CCL-intact stifle joints (control group; 6) were mechanically tested. Three repair techniques involved a patella-patella ligament segment (PPL) allograft: a tibial and femoral interference screw (PPL-2S), a femoral interference screw and the patella seated in a tapering bone tunnel in the tibia (PPL-1S), or addition of a suture and a bone anchor to the PPL-1S (PPL-SL). The fourth technique involved a deep digital flexor tendon (DDFT) allograft secured with transverse femoral fixation and stabilized with a tibial interference screw and 2 spiked washers on the tibia (DDFT-TF). The tibia was axially loaded at a joint angle of 135°. Loads to induce 3, 5, and 10 mm of femoral-tibia translation; stiffness; and load at ultimate failure with the corresponding displacement were calculated. Group means were compared with a multivariate ANOVA.
RESULTS Mean ± SD load for the intact (control) CCL was 520.0 ± 51.3 N and did not differ significantly from the load needed to induce 3 mm of femoral-tibial translation for fixation techniques PPL-SL (422.4 ± 46.3 N) and DDFT-TF (654.2 ± 117.7 N). Results for the DDFT-TF were similar to those of the intact CCL for all outcome measures.
CONCLUSIONS AND CLINICAL RELEVANCE The DDFT-TF yielded mechanical properties similar to those of intact CCLs and may be a viable technique to test in vivo.
Objective—To evaluate short-term postoperative forelimb function after scalpel and laser onychectomy in cats.
Design—Randomized, prospective study.
Animals—20 healthy adult cats.
Procedures—Cats were randomly assigned to the laser (n = 10) or scalpel (10) onychectomy group. Unilateral left forelimb onychectomy was performed. In the scalpel group, a tourniquet was used during surgery and a bandage was applied after surgery. Pressure platform gait analysis was performed prior to and 1, 2, 3, and 12 days after onychectomy. Peak vertical force (PVF), vertical impulse, and the ratio of the PVF of the left forelimb to the sum of the remaining limbs (PVF ratio) were used as outcome measures.
Results—The laser onychectomy group had significantly higher ground reaction forces on days 1 and 2 and significantly higher PVF ratio on day 12, compared with the scalpel group. Similarly, significant differences were found in change in ground reaction forces on days 1 and 2 and the PVF ratio on day 12, compared with day −1. No cats required rescue analgesia during the course of the study. One cat in the laser group had signs of depression and was reluctant to walk on day 2 after surgery, had physical examination findings consistent with cardiac insufficiency, and was euthanized.
Conclusions and Clinical Relevance—Cats had improved limb function immediately after unilateral laser onychectomy, compared with onychectomy with a scalpel, tourniquet, and bandage. This improved limb function may result from decreased pain during the 48 hours following unilateral laser onychectomy.
Objective—To evaluate the analgesic effects of topical
administration of bupivacaine, IM administration
of butorphanol, and transdermal administration of fentanyl
in cats undergoing onychectomy.
Animals—27 healthy adult cats.
Procedure—Cats were randomly assigned to 1 of 3
treatment groups, and unilateral (left forefoot) onychectomy
was performed. Gait analysis was performed
before and 1, 2, 3, and 12 days after surgery.
All forces were expressed as a percentage of the
cat's body weight.
Results—On day 2, peak vertical force (PVF) was significantly
decreased in cats treated with bupivacaine, compared
with cats treated with butorphanol or fentanyl. The
ratio of left forelimb PVF to PVF of the other 3 limbs was
significantly lower on day 2 in cats treated with bupivacaine
than in cats treated with fentanyl. No significant
differences in vertical impulse (VI) were found between
groups on any day. Values for PVF, VI, and the PVF ratio
increased progressively following surgery. However, for
all 3 groups, values were still significantly decreased,
compared with baseline values, 12 days after surgery.
Conclusions and Clinical Relevance—Results suggest
that limb function following onychectomy is significantly
better in cats treated with fentanyl transdermally
or butorphanol IM than in cats treated with
bupivacaine topically. Regardless of the analgesic regimen,
limb function was still significantly reduced 12
days after surgery, suggesting that long-term analgesic
treatment should be considered for cats undergoing
onychectomy. Irrigation of the surgical incisions
with bupivacaine prior to wound closure cannot be
recommended as the sole method for providing postoperative
analgesia in cats undergoing onychectomy.
(J Am Vet Med Assoc 2005;227:89–93)