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CASE DESCRIPTION A 9-month-old 4.6-kg (10.1-lb) spayed female Shih Tzu was examined for a 4-week history of left forelimb lameness.
CLINICAL FINDINGS Moderate left forelimb lameness was present when weight bearing, accompanied by buckling of the left carpal joint and moderate signs of pain with hyperextension of the elbow joint. A 32° angular deformity of the left radius in a 45° craniomedial oblique plane (equivalent to 23° valgus and 23° procurvatum) and a 55° external torsional deformity were measured on 3-D reconstructed CT images. Humeroulnar incongruity of the left elbow joint was also evident. Single oblique osteotomy (SOO) and dynamic proximal ulnar osteotomy were recommended.
TREATMENT AND OUTCOME Creation of a 3-D printed bone model from reconstructed CT images aided surgical planning. The SOO was located 45° medial to the sagittal plane of the left radius at the level of the center of rotation of angulation. The SOO was oriented 32° distolaterally from the transverse plane of the radius and traversed the left ulna. The bones were rotated along the osteotomy into grossly proper alignment and stabilized with a plate and bone screws. Dynamic proximal ulnar osteotomy was then performed. Six months after surgery, radiographs showed remodeling at the SOO site and the lameness had resolved. The owners expressed satisfaction with the outcome.
CLINICAL RELEVANCE In dogs with angular and torsional long bone deformities, SOO may be a viable alternative to wedge osteotomies. The SOO simultaneously addressed angular and torsional deformities without bone loss and provided rigid internal fixation.
To determine whether a single dose of trazodone administered to dogs before a veterinary visit reduced their behavioral and physiologic signs of stress and owners’ stress during veterinary visits.
20 dogs and their owners.
In this randomized double-blinded placebo-controlled crossover clinical trial, dogs with a history of anxiety during veterinary visits were scheduled for 2 veterinary visits 1 week apart and randomly assigned to receive a single oral dose of either trazodone (9 to 12 mg/kg) or a placebo 90 minutes before transport to the veterinary clinic for alternate visits between September 21 and November 3, 2019. For each visit, we collected and assessed owner-completed surveys of dog stress score (DSS) and owner stress score; various investigator-reported scores, including from video-recorded behavior analyses; and patient-related physiologic data.
Dogs treated with trazodone versus placebo had lower mean DSSs, assessed by owners for physical examination and assessed by video analysis for time spent in the examination room; lower mean SD of normal-to-normal intervals, root mean square of successive heartbeat interval difference, and respiratory rate; and higher mean heart rate. No meaningful differences were observed in other behavioral or physiologic outcomes, including serum cortisol concentrations.
A single dose of trazodone before transport reduced signs of stress during veterinary visits for dogs in the present study and may be useful as an anti-anxiety medication for similarly affected dogs, potentially resulting in higher-quality clinical examinations and improved patient welfare.