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- Author or Editor: Sharon C. Kerwin x
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Abstract
Objective—To develop a visual analogue scale (VAS) questionnaire that is repeatable and valid for use in assessing pain and lameness in dogs.
Sample Population—48 client-owned dogs with mild to moderate lameness.
Procedure—The dogs were from 3 studies conducted during a 3-year period. Of the 48 dogs, 19 were used in repeatability assessment, 48 were used in principal component analysis, and 44 were used in model selection procedures and validity testing. A test-retest measure of repeatability was conducted on dogs with a change of < 10% in vertical peak force. A force platform was used as the criterion-referenced standard for detecting lameness. Principal component analysis was used to describe dimensionality of the data. Repeatable questions were used as explanatory variables in multiple regression models to predict force plate measurements. Peak vertical, craniocaudal, and associated impulses were the forces used to quantify lameness. The regression models were used to test the criterion validity of the questionnaire.
Results—19 of 39 questions were found to be repeatable on the basis of a Spearman rank-correlation cut point of > 0.6. Model selection procedures resulted in 3 overlapping subsets of questions that were considered valid representations of the forces measured (vertical peak, vertical impulse, and propulsion peak). Each reduced model fit the data as well as the full model.
Conclusions and Clinical Relevance—The VAS questionnaire was repeatable and valid for use in assessing the degree of mild to moderate lameness in dogs. (Am J Vet Res 2004;65:1634–1643)
Abstract
Objective—To measure 15F2t isoprostane concentrations in the urine of dogs undergoing ovariohysterectomy (OHE) and dogs undergoing surgery because of intervertebral disk disease (IVDD) and to assess relationships between urinary concentrations of 15F2t isoprostanes and neurologic score in dogs with IVDD.
Animals—11 dogs undergoing OHE and 32 dogs with IVDD undergoing hemilaminectomy.
Procedures—Paired urine samples were obtained at induction of anesthesia and approximately 1 hour after OHE (controls) and were collected from dogs with IVDD at induction of anesthesia (28 samples) and approximately 1 hour after hemilaminectomy (31 samples); 26 paired urine samples were obtained from dogs with IVDD. Urinary isoprostane concentrations were measured by use of a commercial ELISA, and results were adjusted on the basis of urinary creatinine concentrations. Differences in the mean isoprostane-to-creatinine ratio were analyzed. Neurologic score was determined in dogs with IVDD by use of the modified Frankel scoring system.
Results—Urinary isoprostane-to-creatinine ratios were significantly higher in dogs with IVDD than in control dogs before and after surgery. There was no significant difference between values before and after surgery for either group. There was a significant correlation of neurologic score and urinary isoprostane-to-creatinine ratio because dogs that had higher neurologic scores (ie, less severely affected) generally had higher isoprostane-to-creatinine ratios.
Conclusions and Clinical Relevance—Urinary isoprostane-to-creatinine ratios were higher in dogs with IVDD before and after surgery. Analysis of these data suggests that dogs with IVDD are in a state of oxidative stress and that preemptive treatment with antioxidants warrants further investigation.
Abstract
Objective—To determine whether hyperbaric oxygen treatment (HBOT) would affect incorporation of an autogenous cancellous bone graft in diaphyseal ulnar defects in cats.
Animals—12 mature cats.
Procedure—Bilateral nonunion diaphyseal ulnar defects were created in each cat. An autogenous cancellous bone graft was implanted in 1 ulnar defect in each cat, with the contralateral ulnar defect serving as a nongrafted specimen. Six cats were treated by use of hyperbaric oxygen at 2 atmospheres absolute for 90 minutes once daily for 14 days, and 6 cats were not treated (control group). Bone labeling was performed, using fluorochrome markers. Cats were euthanatized 5 weeks after implanting, and barium sulfate was infused to evaluate vascularization of grafts. Ulnas were evaluated by use of radiography, microangiography, histologic examination, and histomorphometric examination.
Results—Radiographic scores did not differ between treatment groups. Microangiographic appearance of grafted defects was similar between groups, with all having adequate vascularization. Differences were not observed between treated and nontreated groups in the overall histologic appearance of decalcified samples of tissue in grafted defects. Mean distance between fluorescent labels was significantly greater in cats given HBOT than in nontreated cats. Median percentage of bone formation in grafted defects was significantly greater in cats given HBOT.
Conclusions—Hyperbaric oxygen treatment increased the distance between fluorescent labels and percentage of bone formation when incorporating autogenous cancellous bone grafts in induced nonunion diaphyseal ulnar defects in cats, but HBOT did not affect revascularization, radiographic appearance, or qualitative histologic appearance of the grafts. (Am J Vet Res 2000;61:691–698)
Abstract
Objective—To determine the effect of femur positioning on radiographic assessment of completeness of excision after femoral head and neck excision (FHNE) in medium to large breed dogs.
Sample Population—10 femurs from canine cadavers (body weight > 20 kg).
Procedure—Complete FHNE was performed on 5 canine femurs. Excision consisting of inadequate removal of the medial distal aspect of the femoral neck was performed on the remaining 5 femurs. Each femur was positioned with predetermined amounts of internal and external rotation about the long axis and radiographed. Investigators evaluated a set of 8 radiographic views of each femur. Sensitivity (SE), specificity (SP), positive predictive value, negative predictive value, and completeness of excision assessment accuracy were estimated for each of the femur positions.
Results—Craniocaudal radiographic views of the femur positioned with external rotation of 15°, 30°, and 45° as a group had the highest SE, SP, and completeness of excision assessment accuracy relative to other radiographic views. The SE, SP, and accuracy of assessment were higher when the degree of external rotation was increased from 15° to 30° or 45°.
Conclusions and Clinical Relevance—Craniocaudal radiographic views of the femur positioned in external rotation (15°, 30°, and 45°) improved the ability to detect adequacy of excision relative to standard craniocaudal and lateromedial radiographic views. Evaluation of craniocaudal radiographic views of the femur positioned in external rotation may increase the ability to assess FHNE adequacy in medium- to large- breed dogs.
Abstract
Objective—To determine the microchemical and surface composition of tibial plateau leveling osteotomy (TPLO) plates before and after explantation.
Sample Population—7 TPLO plates surgically removed from host dogs 6 to 54 months after implantation; 2 raw unpolished-and-unpassivated 316L TPLO plates; and 2 heat-treated, polished-and-passivated, and cleaned 316L TPLO plates.
Procedures—Samples were removed by use of standard techniques to ensure the plate surface was not damaged. Sample pieces were dissolved and analyzed by inductively coupled plasma–mass spectrometry (ICP-MS) to determine bulk elemental composition. Other sample pieces were investigated by use of scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and x-ray photoelectron spectroscopy (XPS) for determination of sample morphology, near-surface elemental composition, and surface elemental composition, respectively. To investigate the possibility of corrosion in situ, some samples were chemically corroded and analyzed.
Results—ICP-MS confirmed that elemental composition of samples was consistent with 316L stainless steel. The SEM and EDS analyses revealed trace amounts of polishing materials and a nonuniform carbonaceous biofilm on < 1% of the surface area of samples removed from the host dogs. The XPS analysis indicated an increase in the chromium-to-iron ratio on passivated surfaces, with no difference between passivated samples before implantation and after explantation.
Conclusions and Clinical Relevance—Composition of the TPLO plates was consistent with 316L stainless steel. No chemical or topographic changes were detected in TPLO plates that had been implanted in dogs for up to 54 months. A small amount of biofilm was evident on the surface of 2 plates.
Abstract
Objective—To determine complications and neurologic outcomes associated with dexamethasone administration to dogs with surgically treated thoracolumbar intervertebral disk herniation, compared with dogs not receiving dexamethasone.
Design—Retrospective case series.
Animals—161 dogs with surgically confirmed thoracolumbar disk herniation.
Procedures—Medical records from 2 hospitals were used to identify dogs that had received dexamethasone < 48 hours prior to admission (dexamethasone group dogs), dogs that received glucocorticoids other than dexamethasone < 48 hours prior to admission (other-glucocorticoid group dogs), and dogs that received no glucocorticoids (nontreatment group dogs). Signalment, neurologic injury grade, laboratory data, and complications were extracted from medical records.
Results—Dexamethasone group dogs were 3.4 times as likely to have a complication, compared with other-glucocorticoid or nontreatment group dogs. Dexamethasone group dogs were 11.4 times as likely to have a urinary tract infection and 3.5 times as likely to have diarrhea, compared with other-glucocorticoid or nontreatment group dogs. No differences in neurologic function at discharge or recheck evaluation were detected among groups.
Conclusions and Clinical Relevance—Results indicated that treatment with dexamethasone before surgery is associated with more adverse effects, compared with treatment with glucocorticoids other than dexamethasone or no treatment with glucocorticoids, in dogs with thoracolumbar intervertebral disk herniation. In this study population, no difference in outcome was found among groups. These findings suggest that the value of dexamethasone administration before surgery in dogs with thoracolumbar disk herniation should be reconsidered.
Abstract
OBJECTIVE To describe outcomes for dogs after treatment of craniodorsal hip luxation with closed reduction and Ehmer sling placement and investigate potential risk factors for sling-associated tissue injury or reluxation of the affected hip at or near the time of sling removal.
DESIGN Retrospective multicenter cohort study.
ANIMALS 92 dogs.
PROCEDURES Case information was solicited from 10 veterinary medical facilities through electronic communications. Data on patient demographic information, cause of injury, presence of concurrent injuries, details of Ehmer sling placement and management, and outcome at sling removal were collected. Data were analyzed for associations with outcomes.
RESULTS 40 of 92 (43.5%) dogs had reluxation of the affected hip joint at or near the time of sling removal. Odds of reluxation occurring for dogs that had the initial injury attributed to trauma were 5 times those for dogs without known trauma (OR, 5.0; 95% confidence interval, 1.3 to 18.7). Forty-six (50%) dogs had soft tissue injuries secondary to sling use; 17 of these dogs had injuries classified as severe, including 1 dog that required limb amputation. Odds of severe sling injury for dogs that had poor owner compliance with home care instructions noted in the record, those that had the sling placed by an intern rather than a board-certified surgeon or resident, and those that were noted to have a soiled or wet bandage on ≥ 1 occasion were 12.5, 4.0, and 5.7 times those for dogs without these findings, respectively.
CONCLUSIONS AND CLINICAL RELEVANCE Placement of an Ehmer sling following closed reduction of a craniodorsal hip luxation had a low success rate and high complication rate.
Abstract
Objective—To determine whether body weight, body condition score, or various body dimensions were associated with acute thoracolumbar intervertebral disk extrusion or protrusion and whether any of these factors were associated with severity of clinical signs in Dachshunds.
Design—Cross-sectional clinical study.
Animals—75 Dachshunds with (n = 39) or without (36) acute thoracolumbar intervertebral disk extrusion or protrusion.
Procedures—Signalment, various body measurements, body weight, body condition score, and spinal cord injury grade were recorded at the time of initial examination.
Results—Mean T1-S1 distance and median tuber calcaneus–to–patellar tendon (TC-PT) distance were significantly shorter in affected than in unaffected dogs. A 1-cm decrease in T1-S1 distance was associated with a 2.1-times greater odds of being affected, and a 1-cm decrease in TC-PT distance was associated with an 11.1-times greater odds of being affected. Results of multivariable logistic regression also indicated that affected dogs were taller at the withers and had a larger pelvic circumference than unaffected dogs, after adjusting for other body measurements. Results of ordinal logistic regression indicated that longer T1-S1 distance, taller height at the withers, and smaller pelvic circumference were associated with more severe spinal cord injury.
Conclusions and Clinical Relevance—Results suggest that certain body dimensions may be associated with acute thoracolumbar intervertebral disk extrusion or protrusion in Dachshunds and, in affected dogs, with severity of neurologic dysfunction.
Abstract
Objective—To examine associations between CSF biomarkers, initial neurologic dysfunction, and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH).
Design—Prospective clinical study.
Animals—54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs.
Procedures—For each dog, variables, including CSF myelin basic protein (MBP), lactate, calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase (CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbar IVDH, initial neurologic function was characterized by use of a modified Frankel score (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deep nociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up was assessed.
Results—Among dogs with thoracolumbar IVDH, those with CSF CK activity ≤ 38 U/L had a 35-fold increase in the odds of long-term ambulation, compared with the odds in dogs with CSF CK activity > 38 U/L, adjusting for neurologic functioning at the evaluation. The CSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activity were not predictive of long-term ambulatory outcome. Data analysis revealed that long-term functional recovery was > 98% for affected dogs, regardless of their initial MFS, when CSF CK activity was ≤ 38 U/L and MBP concentration was ≤ 3 ng/mL.
Conclusions and Clinical Relevance—In dogs with acute thoracolumbar IVDH, CSF CK activity and MBP concentration appeared to be prognostic indicators and, along with initial MFS, can be used to predict long-term ambulatory outcome.
Abstract
Objective—To describe clinical signs and results of treatment in cats with patellar luxation.
Design—Retrospective case series.
Animals—42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints.
Procedures—Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent.
Results—34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats.
Conclusions and Clinical Relevance—Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.