OBJECTIVE:To describe the technique and outcome of a rostral labial pivot flap variant in dogs. ANIMALS:Four dogs with rostral lip/paranasal defect underwent rostral labial pivot flap. STUDY DESIGN:Short case series. METHODS:Rostral lip and paranasal defects with concurrent nasal mucosal involvement resulting from tumor resection were reconstructed using the rostral labial pivot flap and its variants, including incorporation of a mucosal island flap ± nasal rotation flap for modification of lip heights. Medical records were reviewed for all dogs that underwent tumor resection followed by reconstruction with a rostral labial pivot flap technique and its modifications. RESULTS:The rostral labial pivot flap and its variants provided acceptable outcomes in four dogs for reconstruction of rostral lip and paranasal defects. Incorporation of a mucosal island flap was effective for nasal mucosal reconstruction, and use of a nasal rotation flap to reduce tension and address lip height discrepancy resulted in acceptable outcomes. Two dogs experienced minor complications, including an oronasal fistula and mild narial stenosis, neither of which was associated with clinical signs. All dogs were considered to have normal function and quality of life at follow-up. CONCLUSION:The rostral labial pivot flap can be a reasonable and adaptable option for reconstruction of rostral lip and paranasal defects in dogs. Acceptable cosmetic and functional outcomes with low morbidity were observed in this series; however, additional cases are needed to better define success rates and complications.
OBJECTIVE:To describe vaginourethroplasty-based resection and reconstruction of distal urethral leiomyosarcoma in a female dog and report long-term outcomes. STUDY DESIGN:Case report. ANIMALS:One 10-year-old spayed female mixed-breed dog. METHODS:Retrograde urethrovaginography identified a distal urethral filling defect. Two days later, contrast-enhanced computed tomography under general anesthesia demonstrated a 17 × 17 × 24 mm distal urethral mass without distant metastasis; blind biopsy performed immediately afterward was nondiagnostic. Because stranguria progressed, surgery was performed 20 days after presentation in two sequential phases during a single general anesthetic. The proximal urethra was anastomosed end-to-end to the vaginal stump through a ventral approach. Bladder neck cystopexy was added, and the distal urethra, mass, and adjacent vaginal mucosa were removed en bloc through a perineal approach, followed by vaginal reconstruction and vulvoplasty. RESULTS:The mass was initially diagnosed as undifferentiated sarcoma and later classified as leiomyosarcoma after immunohistochemical reevaluation. The mitotic count was 12 per 10 high-power fields, and the distal margin was minimal. Voluntary urine storage and voiding were maintained; mild urinary incontinence was managed medically. Approximately 13 months after surgery, a right inguinal lymph node lesion morphologically compatible with metastasis from the prior urethral mesenchymal malignancy was excised. At 49 months after presentation, no local recurrence or new distant metastasis attributable to the urethral lesion had been detected. CONCLUSION:In this dog with distal urethral leiomyosarcoma, the combined ventral and perineal approach was associated with preserved urinary function; no local recurrence was detected through 49 months after presentation.
OBJECTIVE:To evaluate clinical and radiographic outcomes in cats with congenital pectus excavatum (PE) treated with external coaptation and to identify associations between clinical presentation, defect severity, and postoperative complications. STUDY DESIGN:Retrospective clinical study. SAMPLE POPULATION:A total of 25 cats. METHODS:Medical records from 2010 to 2024 from a small animal referral hospital were retrospectively evaluated for cats undergoing sternal splinting for PE. RESULTS:A total of 25 cats met inclusion criteria. All cats were younger than 20 weeks of age. Most cats (19/25) presented with tachypnea or exercise intolerance, and 25/25 had a palpable defect on examination. The survival rate was 24/25. Significant improvement in conformation was observed postoperatively, with frontosagittal index decreasing from a mean of 5.44-2.09 (p < .001) and vertebral index increasing from 4.45-8.47 (p < .001). Clinical signs resolved in all cases by recheck. Complications included pneumothorax, suture breakage, dermatitis, persistent defect, and death. No association was found between preoperative severity and breed, pneumothorax, or suture breakage. Splint duration was for a median of 28 days (range: 21-43 days) and was significantly inversely associated with dermatitis severity (p = .036). CONCLUSION:Congenital PE in this population of cats 20 weeks of age or younger was corrected with external coaptation, resolving clinical signs and improving thoracic conformation with minimal complications. CLINICAL SIGNIFICANCE:External coaptation is an effective correction method for PE in young cats, resulting in resolution of clinical signs. While the survival rate in this study was excellent, owners should be counseled on potential complications.
OBJECTIVE:To describe the application of a cell saver device (CSD) to manage blood loss in dogs and cats. STUDY DESIGN:Retrospective study. ANIMALS:A total of 102 client-owned dogs and one cat. METHODS:Medical records were reviewed for all animals in which autotransfusion using blood generated by the CSD was used. Data retrieved included signalment, surgical details, blood test results, degree of blood loss, blood collection method, transfusion volume, timing of administration, additional blood products used, variations in packed cell volume (PCV), and incidence of transfusion reactions. Short-term complications and overall outcome were assessed by telephone follow-up. RESULTS:There were 103 autotransfusions performed, during emergency (n = 40) and elective (n = 63) procedures. The mean transfusion volume was 14 mL/kg. For every 1 mL of blood transfused per kilogram of bodyweight, PCV increased by approximately 0.6%. Allogeneic blood products (ABPs) were used in addition to autologous blood in 14% of cases. The transfusion reaction rate associated with autotransfusion was 1%. CONCLUSION:The use of a CSD appeared safe and versatile for management of blood loss in dogs. The inclusion of only a single feline case highlights the need for further studies evaluating the safety and efficacy of this technique in cats. CLINICAL SIGNIFICANCE:Autotransfusion using a CSD is applicable in a wide range of emergency and elective surgeries, presenting an alternative to ABPs.
OBJECTIVE:To determine whether reduced intra-articular (IA) injection volumes provide complete synovial surface coverage while minimizing leakage following canine elbow arthroscopy. STUDY DESIGN:Randomized cadaveric study. ANIMALS:Forty elbow joints from 20 canine cadavers weighing >15 kg. METHODS:Standard medial elbow arthroscopy was performed with portals placed under arthroscopic guidance. The egress portal was created along the caudal margin of the medial epicondylar ridge, directed toward the anconeal process. A third, craniomedial instrument portal was created approximately 1 cm cranial to the camera portal. Following arthroscopy, India ink-volume-matched to whole, half, or quarter of a 0.5 mg/kg ropivacaine dose (0.75% concentration)-was injected via the egress portal. Each joint underwent 10 passive flexion-extension cycles before dissection. A masked investigator (ES) qualitatively assessed synovial surface coverage (100%, 75%-99%, 50%-74%, 25%-49%, 0%-24%) and leakage severity (mild, moderate, severe). Portal placement attempts, cadaver age, and bodyweight were recorded. RESULTS:Mean cadaver age was 9.3 years (range: 1-16 years), and mean weight was 29.9 kg (range: 17.9-43.6 kg). Complete (100%) synovial surface coverage was observed in all 40 elbows, including those receiving quarter-dose injections. Leakage occurred in every dose group, with a similar distribution of mild, moderate, and severe categories. Portal placement was successful on the first attempt in 32 elbows (80%) and the second attempt in eight elbows (20%). CONCLUSION:Reduced IA injection volumes achieved complete synovial surface coverage but did not reduce leakage severity. CLINICAL SIGNIFICANCE:Reduced intra-articular injection volumes were sufficient to achieve complete synovial surface coverage in this model, suggesting potential flexibility in clinical dosing strategies. Nonetheless, extravasation occurred at all tested volumes, reinforcing that some leakage should be expected in practice.
OBJECTIVE:To explore the frequency and severity of abnormalities in perioperative point-of-care bloodwork in dogs and cats undergoing cranial surgery for tumor resection with particular emphasis on dyskalemia development. STUDY DESIGN:Retrospective observational study. ANIMALS:A total of 61 dogs and 14 cats undergoing cranial surgery for tumor resection between 2009 and 2023. METHODS:Medical records and point-of-care blood variables of dogs and cats undergoing surgical tumor resection were reviewed. Electrolyte, acid-base, creatinine, glucose, and lactate concentrations were recorded preoperatively, intraoperatively, and immediately postoperatively and compared to reference intervals. Medications and IV fluids administered were recorded. RESULTS:Intraoperative mannitol was administered to 24/61 (39%) dogs and 5/14 (36%) cats, and hypertonic saline to 1/61 dog. Two of 75 (3%) animals experienced mild intraoperative hyperkalemia (<5.9 mmol/L), none experienced moderate or severe hyperkalemia. Intraoperative hypokalemia was present in 6/75 (8%) animals. Mean (±SD) preoperative potassium concentration ([K+]; mmol/L) was 3.75 (±0.45), increasing to 3.91 (±0.46) intraoperatively, and decreasing postoperatively to 3.74 (±0.46). Intraoperative [K+] was significantly higher than postoperative (p < .001). Intraoperative bicarbonate, sodium, and ionized calcium concentrations were lower than preoperative concentrations but returned to baseline postoperatively and largely remained within institutional reference intervals. CONCLUSION:Intraoperative alterations in [K+], bicarbonate, sodium, and ionized calcium concentrations occurred during cranial surgery in dogs and cats, but were generally mild and transient. Clinically relevant hyperkalemia was not observed in this cohort. CLINICAL SIGNIFICANCE:Clinically significant hyperkalemia may be uncommon in veterinary cranial surgery, but routine perioperative point-of-care bloodwork remains advised to monitor electrolyte and acid-base status.
OBJECTIVE:To determine short- and long-term outcomes of core decompression combined with autologous bone marrow aspirate concentrate (BMAC) in treating moderate-to-severe refractory distal sesamoid bone (DSB) trabecular pathology in horses. STUDY DESIGN:Retrospective observational study. ANIMALS:A total of 21 client-owned Warmblood horses with DSB pathology unresponsive to conservative management. METHODS:Preoperative diagnosis included lameness localization by diagnostic analgesia and magnetic resonance imaging (MRI) confirmation of DSB trabecular pathology. Horses underwent arthroscopic core decompression via the palmar recess of the distal interphalangeal joint followed by intraosseous BMAC injection. Outcomes were assessed clinically and by follow-up radiography and MRI. RESULTS:No major intraoperative or postoperative complications occurred in any of the 21 operated horses. Nine horses met inclusion criteria for long-term follow-up, which included clinical, radiographic, and MRI assessments at 6 months and up to 18 months postoperatively. At 6 months, six of nine horses (67%) were sound and returned to training. MRI follow-up demonstrated reduced short tau inversion recovery (STIR) hyperintensity and increased T1-weighted signal within the DSB trabecular bone, consistent with a reduction in active trabecular bone pathology. Three horses remained lame with unchanged MRI findings. At 18 months, six horses remained sound, and three returned to their previous or intended performance levels. Radiographic remodeling of cyst-like lesions was evident in three cases. CONCLUSION:Core decompression augmented with BMAC was well tolerated with no unexpected complications in this cohort. This approach allowed horses with advanced DSB trabecular pathology refractory to conservative therapy return to function. CLINICAL IMPACT:This combined surgical-orthobiologic approach may offer a viable therapeutic option for horses with advanced refractory navicular bone pathology.
OBJECTIVE:To describe the surgical technique, perioperative course, and outcome of laparoscopic typhlectomy (LT) in a dog with an isolated cecal mass. STUDY DESIGN:Case report. ANIMALS:A 12-year-old male Labrador retriever. METHODS:A dog presented with a 3 week history of gastrointestinal signs and weight loss. Advanced imaging identified a 1.7 cm cecal mass without evidence of lymphadenopathy or metastasis. A four-portal laparoscopic approach was used. The ileocecal fold was dissected using ultrasonic and monopolar energy devices, and the cecum was resected with a 60 mm endoscopic linear stapler fitted with a 2.5 mm cartridge. The specimen was retrieved in a laparoscopic bag. Total surgical time was 66 min. RESULTS:Laparoscopic typhlectomy was completed and the dog recovered without intraoperative complications, resumed voluntary feeding within 6 h, and was discharged after 36 h. Histopathology confirmed a gastrointestinal stromal tumor with tumor-free margins. No recurrence or gastrointestinal complications were observed during 6 months of clinical and ultrasonographic follow up. Survival time was 365 days; euthanasia was performed because of an unrelated neurological condition. CONCLUSION:Although typhlectomy is an established procedure, this report shows the feasibility of a totally laparoscopic approach for selected cecal lesions in dogs. Laparoscopic typhlectomy may provide a minimally invasive alternative to open typhlectomy in selected patients.
Jejunocecostomy (JC), or jejunocecal anastomosis, is arguably the most controversial surgical procedure in equine small intestinal surgery. It is also the only option for resection and anastomosis for a third of small intestinal strangulating lesions in horses. Critics of the procedure identify its low survival and high complication rates as reasons to avoid its use. This review is intended to highlight findings of recent research and clinical studies that validate use of the JC, and to provide some insights into technical aspects of the procedure that might improve its survival rates. Jejunocecostomy is more complicated than most anastomoses used in the equine small intestine, and a review of its complexities could help to improve outcomes with this anastomosis. The negative attitude towards its use is not supported by recent research and clinical studies. If the ileum has incurred ischemic changes that necessitate its being bypassed, JC is a valid treatment if owner- and disease-related issues support the cost of resection and anastomosis. Concerns about poor outcomes with JC can lead to an inappropriate anastomosis or euthanasia whenever this anastomosis is indicated. The different methods used for JC might influence its success rate, but all methods applied with recognition of potential pitfalls can have favorable outcomes.
OBJECTIVE:To describe procedural details of a unilateral or bilateral temporary or permanent ligation of the common carotid artery (CCA) at the level of the medial retropharyngeal lymph node (MRLN), with or without concurrent lymphadenectomy in dogs. STUDY DESIGN:Computed tomographic (CT) and cadaveric study. ANIMALS:Medium breed (15-35 kg) client-owned dogs undergoing CT evaluation (n = 10) and cadaver dogs (n = 12). METHODS:A total of 10 dog contrast-enhanced CT scans were evaluated for spatial assessment of the carotid artery, regional lymphocenters, and adjacent anatomy. A total of 12 dog cadavers were randomized to undergo two of four surgical procedures for carotid artery ligation at the level of the MRLN: lateral or ventral approach, with or without lymphadenectomy. Feasibility, consistency of anatomical landmarks, and completeness of carotid isolation were assessed. RESULTS:CT evaluation consistently identified the CCA dorsomedial to the MRLN and the MRLN medial to the caudodorsal mandibular salivary gland. Both approaches provided reliable access to the CCA and cervical lymph nodes. CCA ligation was successfully performed bilaterally in all cadavers, with and without lymphadenectomy. No gross evidence of vascular trauma was observed. CONCLUSION:The described approach may be used to minimize intraoperative bleeding in dogs undergoing maxillofacial surgery and may take advantage of planned unilateral or bilateral lymphadenectomy, minimal additional dissection, and elective permanent ligation. CLINICAL SIGNIFICANCE:CCA ligation at the level of the MRLN may provide an adaptable surgical approach to the CCA and cervical lymph nodes in dogs. Further evaluation of this approach in clinical dogs undergoing maxillofacial procedures is warranted to determine potential intraoperative procedural complications.
OBJECTIVE:Despite known occupational radiation risks, data on exposure during digital radiography (DR) or fluoroscopy-guided equine fracture repair are lacking. This study quantified radiation doses to a model surgeon's hand, lenses, thyroid, and gonads, and assessed protective effects of radiation-reducing surgical gloves and attenuating ointment. STUDY DESIGN:Comparative, controlled, simulation-based study. ANIMAL/SAMPLE POPULATION:Anthropomorphic model. METHODS:Distal limb fracture fixation was simulated using a model with dosimeters at the region of the lenses, thyroid, gonads, drill-holding hand, and under a lead apron (fetal dose). Radiation was measured over 10 DR or 10 single-image fluoroscopy exposures, then repeated using radiation-reducing surgical gloves or ointment. RESULTS:All radiation doses were below occupational limits. Dosimeters placed at the level of the gonads (outside the gown) received the highest mean dose (DR: 6.87 ± 0.40 μSv; fluoroscopy: 0.98 ± 0.28 μSv), followed by thyroid (outside the gown) (DR: 2.60 ± 0.52 μSv; fluoroscopy: 0.48 ± 0.08 μSv), hand (DR: 2.02 ± 0.54 μSv; fluoroscopy: 0.32 ± 0.06 μSv) and lenses (DR: 1.25 ± 0.28 μSv; fluoroscopy: 0.23 ± 0.07 μSv). The lowest exposure was measured underneath the gown (fetal dose) (DR: 0.01 ± 0.01 μSv; fluoroscopy: 0.01 ± 0.01 μSv). DR exposure exceeded fluoroscopy at all sites (p < .001). Radiation-reducing surgical gloves significantly lowered hand dose (p < .001), whereas ointment had no effect (p = .54). Off-beam hand exposure from 10 images was approximately one-millionth of the annual dose limit. CONCLUSION:Image-guided equine distal limb fracture fixation results in minimal hand radiation exposure, relative to other regions of the body, with DR producing higher doses than single-image fluoroscopy. Radiation-reducing surgical gloves significantly lower hand exposure during DR procedures. CLINICAL SIGNIFICANCE:Radiation-reducing surgical gloves offer additional protection and are recommended during image-guided surgery. Whenever feasible, pulsed fluoroscopy should be preferred over DR.
OBJECTIVE:To investigate the effects of muscle activation on internal tibial rotation and cranio-caudal translation (CCT) in intact and cranial cruciate ligament (CCL) deficient stifles. STUDY DESIGN:Ex vivo biomechanical study. ANIMALS:Eight cadaveric, nonpaired canine stifles. METHODS:Stifles were tested intact and after arthroscopic CCL transection. Quadriceps, biceps femoris, and gastrocnemius forces were simulated with pneumatic actuators in single or cocontraction muscle activation (0%-100% bodyweight [BW]). The tibia was mounted to a linear-torsional tester; the femur to a six-degrees-of freedom fixture. Internal tibial rotation (5 Nm torque) and CCT (30% BW cranial and caudal translation) were recorded via motion tracking system. RESULTS:Without muscle activation, CCL transection increased internal tibial rotation (34.8 ± 11.8° CCL-deficient vs. 27.9 ± 10.8° intact; p = .041). Across 0%-100% BW activation, internal rotation decreased in both conditions, to 4.3 ± 2.3° (intact; p < .0001 vs. 0% BW) and 2.8 ± 1.3° (CCL-deficient; p = .001 vs. 0% BW) at 100% BW. At 100% BW, biceps femoris reduced internal rotation more than quadriceps and gastrocnemius in both CCL conditions. Muscle activation reduced CCT in CCL-deficient stifles; however, at 100% BW, CCT was 19.1 mm in CCL-deficient versus 2.8 mm in intact (+582%; p < .0001). CONCLUSION:Periarticular muscle activation mitigates axial plane rotational laxity but does not prevent CCT. CLINICAL SIGNIFICANCE:Targeted muscle strengthening may help manage rotational laxity; however, surgical stabilization remains necessary to address CCT after CCL rupture. Internal tibial rotation may require additional surgical stabilization in selected cases.
OBJECTIVE:To report outcomes and complications of proximal tibial detorsional osteotomy (PTDO) in dogs with patellar luxation (PL). STUDY DESIGN:Multicenter retrospective observational case series. ANIMALS:A total of 53 stifles in 50 client-owned dogs. METHODS:Medical records (2013-2023) were reviewed. Preoperative tibial torsion was assessed by computed tomography (CT; tibial torsion angle [TTA]) or by standardized caudocranial radiographs (tibial tuberosity alignment). Concurrent procedures and implants were recorded. Postoperative radiographs were evaluated for patellar position, tibial alignment, bone healing, and implant position. Final limb function was categorized as full, acceptable, or unacceptable based on lameness, patellar tracking, complications, and radiographic outcomes. RESULTS:Medial PL was present in 52/53 (98%) cases. Preoperative medial displacement of the tibial tuberosity was diagnosed in 52/53 (98%) limbs. Mean preoperative TTA was 8.8° ± 4.7 (external torsion). Normal patellar tracking was restored in 51/53 (96%) cases. Final limb function was full in 38/53 (72%) and acceptable in 13/53 (24%) cases. Mean radiographic follow-up was 3.0 ± 0.9 months (short-term). Mean time to radiographic union was 2.7 ± 0.5 months. Overall complications occurred in 18/53 (33%: 11% major; 22% minor); most major events were implant-related and managed successfully with revision. CONCLUSION:PTDO effectively corrected abnormal tibial torsion, resulting in restoration of zormal patellar tracking in 96% of stifles. A 11% major complication rate was observed. CLINICAL RELEVANCE:PTDO is a reliable surgical technique to treat abnormal tibial torsion in dogs with PL.
OBJECTIVE:To describe the surgical techniques and evaluate outcomes of laparoscopic hepatectomy using en bloc hilar pedicle control (EHPC) in dogs with hepatic masses. STUDY DESIGN:Prospective study. ANIMALS:A total of 10 client-owned dogs. METHODS:Dogs with hepatic masses not involving the hilar pedicle (portal vein, hepatic artery, and bile duct), hepatic veins at the hilus, and caudal vena cava (CVC) underwent laparoscopic hepatectomy using EHPC. Data on signalment, blood tests, imaging, intraoperative findings, histopathology, and clinical outcomes were collected. RESULTS:Masses were located in the right lateral, right medial, left medial, and left lateral lobes, or the caudate process of the caudate lobe. All dogs completed laparoscopic hepatectomy without conversion to laparotomy. Median operation time was 165 min (range: 90-230 min). Histopathology revealed hepatocellular carcinoma (n = 9) and adenoma (n = 1) and nodular hyperplasia (n = 2). Median hospital stay was 3 days (range: 2-4 days). One dog developed tension pneumothorax from an iatrogenic diaphragmatic injury, and three were diagnosed with bradycardia and hypotension following the Pringle maneuver. Disseminated hepatocellular carcinoma lesions were detected on the greater omentum in one dog 724 days post-surgery. All dogs were discharged. CONCLUSION:Laparoscopic hepatectomy using EHPC was safely performed in dogs with liver masses, with favorable short- and long-term outcomes. CLINICAL RELEVANCE:Laparoscopic hepatectomy using EHPC is a viable option for dogs with liver masses, provided there is no involvement of the hilar pedicle, hepatic veins at the hilus, and CVC.
OBJECTIVE:To determine the prevalence of ununited plantar eminence (UPE) of the first phalanx (P1) in North American Standardbreds and evaluate its association with early racing performance. STUDY DESIGN:Retrospective cohort study with matched sibling controls. SAMPLE POPULATION:Imaging records from 1897 yearling Standardbred horses. METHODS:Screening images were reviewed for the presence of UPE and other orthopedic abnormalities. Sex, age, sire, gait, and racing performance data were obtained from the United States Trotting Association. Affected horses were compared with unaffected siblings using non-parametric tests for performance outcomes. Within affected horses, regression analyses were used to assess the influence of sex, gait, and concurrent developmental orthopedic disease (DOD) lesions on performance. RESULTS:UPE was identified in 74 of 1898 horses (3.9%). Most affected horses (67.6%) had concurrent DOD lesions, most commonly plantar osteochondral fragments. At two years of age, there were no differences in performance outcomes between groups. As 3-year-olds, affected horses were less likely to start, and had fewer starts and lower earnings than unaffected siblings. CONCLUSION:UPE of P1 was an uncommon finding frequently associated with other DOD lesions. While 2-year-old racing performance was similar between groups, affected horses showed reduced performance during the three-year-old season. CLINICAL SIGNIFICANCE:UPE could have meaningful implications for long-term athleticism in Standardbred racehorses, given the reduced racing performance at 3 years of age in the affected study cohort. However, as UPE is frequently found in combination with other DOD lesions, the clinical relevance of UPE as an isolated lesion is not clear.
OBJECTIVE:To describe a novel dorsal occipito-cervical fixation technique utilizing a patient-specific implant to stabilize complex craniocervical junction anomalies (CCJAs) in a small-breed dog. STUDY DESIGN:Case report. ANIMAL:A 7-month-old male Pomeranian dog. METHODS:The dog presented with ambulatory tetraparesis and cervical pain. Advanced imaging revealed fusion of the C2-C4 vertebrae, occipital condyle hypoplasia, and atlas ventral arch hypoplasia, resulting in atlanto-occipital dislocation and atlantoaxial instability. A patient-specific dorsal occipito-cervical implant and implant-specific drill guide were designed from computed tomography (CT)-based three-dimensional models to incorporate predefined geometric constraints and planned screw trajectories, enabling controlled intraoperative realignment and dorsal stabilization. RESULTS:Postoperative CT confirmed satisfactory alignment with no evidence of implant migration. Neurologic function improved gradually, with ambulation achieved by two months, and stability was maintained through 33 months of follow-up. CONCLUSION:This case demonstrated the feasibility of patient-specific dorsal occipito-cervical fixation in a small-breed dog with complex CCJAs.
OBJECTIVE:To evaluate the applicability and clinical effectiveness of a modified clamp-rod internal fixation (M-CRIF) system compared with conventional locking plate osteosynthesis in the treatment of feline corpus ilium fractures. STUDY DESIGN:Prospective, controlled clinical study. ANIMALS:Thirty-six client-owned cats with corpus ilium fractures. METHODS:Cats were randomly assigned to two groups: Group I (M-CRIF, n = 18) and Group II (locking plate, n = 18). All fractures were stabilized with a lateral approach. Radiographic healing, sacral index (SI), and complications were assessed at postoperative days 21, 45, 60, and 120. Long-term outcomes were assessed using owner questionnaires addressing mobility and defecation. RESULTS:Fracture union was achieved in all cats. Healing scores increased over time in both groups (p < .05). At day 45, Group I showed higher healing scores than Group II (p = .002). Sacral index narrowing was lower in Group I (p = .005). Implant-related complications occurred in 22.2% (4/18) of cats in the plate group, including screw loosening and one revision surgery, whereas no screw loosening was observed in the M-CRIF group. Preoperative neurological deficits were present in 22.2% of cats, decreasing to 5.5% postoperatively. Owner questionnaires indicated satisfactory mobility, although some discrepancies with clinical and radiographic findings were observed. CONCLUSION:The M-CRIF system provided greater stability, fewer complications, and better preservation of the pelvic canal than locking plates. CLINICAL SIGNIFICANCE:This study is the first clinical evaluation of the M-CRIF system in feline ilial fractures and demonstrates favorable outcomes, supporting its use as a reliable alternative to conventional plating.
OBJECTIVE:To evaluate the feasibility, accuracy, and safety of percutaneous pedicle screw fixation (PPSF) in the canine lumbosacral junction using three-dimensional (3D)-printed patient-specific drill guides (PSGs). STUDY DESIGN:Cadaveric study and clinical case report. SAMPLE POPULATION:A total of 13 Beagle cadavers and one 5-year-old German Shepherd. METHODS:In each cadaver, one side underwent 3D-PSG-assisted PPSF by a novice surgeon and freehand PPSF on the contralateral side by an experienced surgeon. Outcomes included operative time (min), fluoroscopic counts, incision length (mm), vertebral canal breach (grade 0-2; grade 2 defined as relevant), and angular deviation (degrees). The clinical case underwent unilateral biportal endoscopy laminectomy and discectomy followed by 3D-PSG-assisted PPSF. RESULTS:Operative times were comparable (PSG: 22.65 ± 2.71 min; freehand: 24.82 ± 5.00 min; p = .139). Fluoroscopic acquisitions were fewer with 3D-PSG (median 5 [5-8]) than freehand (9 [7-14]; p = .003). At L7, canal breach occurred in 1/13 (PSG) and 6/13 (freehand; p = .073); relevant were 1/1 and 4/6, respectively. At S1, breach rates did not differ: 3/13 (PSG) and 2/13 (freehand; p = 1.000); relevant were 1/3 and 1/2, respectively. Angle deviations at L7 were smaller in the 3D-PSG (sagittal 2.58° and 5.82°, p = .018; transverse 6.4° and 12.8°, p = .036). No significant differences at S1. In the clinical case, minor breaches occurred at L7 left (medial) and S1 right (cranial). The dog exhibited normal gait at 3 months. CONCLUSION:3D-PSG-assisted PPSF at the canine lumbosacral junction was feasible, with improved screw placement accuracy at L7 and reduced fluoroscopic exposure. CLINICAL SIGNIFICANCE:3D-PSGs may standardize screw trajectory control across surgeon experience levels.
OBJECTIVE:To define the stabilizing role of feline carpal ligaments through selective transection and radiographic assessment of joint angulation under standardized loading. STUDY DESIGN:Experimental ex vivo cadaveric study. SAMPLE POPULATION:Sixty carpal joints from 30 adult cats without orthopedic disease. METHODS:Carpi were mounted in a custom radiolucent clamping device and subjected to standardized 20 N varus, valgus, and extension loads. Measurement tolerances were 3.5° for varus, 6.4° for valgus, and 6° for extension. Individual ligaments or ligament complexes were sequentially transected, and stability changes were quantified radiographically using dorsopalmar and mediolateral projections. RESULTS:Transection of the medial collateral ligament produced only minor valgus increase below tolerance thresholds. Palmar radiocarpal ligament desmotomy caused valgus and hyperextension instability with consistent radiocarpal subluxation. Additional flexor retinaculum transection increased extension by up to 27.9° and resulted in antebrachiocarpal luxation. Lateral collateral ligament transection produced marked varus instability (+16.8°) with ulnocarpal subluxation, and the ulnopalmar and accessory ulnar ligaments acted as secondary stabilizers. Distal palmar carpometacarpal ligament transection caused hyperextension (+12.3°) with mediocarpal and carpometacarpal subluxation. Isolated flexor myotomy or tenotomy did not produce measurable instability unless fascial structures were disrupted. CONCLUSION:Feline carpal stability depends on coordinated ligamentous and fascial interactions rather than a single dominant stabilizer. This reproducible multiplanar testing model provides a biomechanical basis to improve diagnosis and treatment of feline carpal injuries, which are often extrapolated from canine data. CLINICAL RELEVANCE:These data highlight that isolated ligament repair may not adequately restore carpal stability in cats. Clinicians should consider the integrated role of ligamentous and fascial structures when diagnosing and managing carpal injuries.
