OBJECTIVE:To compare the analgesic effects of oral administration of cimicoxib and tramadol over a 30 day period following Tibial Plateau Leveling Osteotomy and partial menisectomy in dogs. DESIGN:Randomized, double blinded, prospective clinical trial. ANIMALS:42 adult client-owned dogs with unilateral cranial cruciate ligament disease and partial meniscal tears. METHODS:Dogs were allocated into 2 treatment groups (cimicoxib or tramadol). Weight bearing while standing, thigh circumference, flexion and extension range of motions, wound classification, adverse effects, Visual Analogue Scale (VAS), Glasgow Composite Measure Pain Scale (CMPS-SF) and Helsinki Chronic Pain Index (HCPI) questionnaire and limb function by means of pressure platform gait analysis were recorded before surgery and at several time points after surgery for 30 days. Outcome measures were compared at each time point among groups. RESULTS:A significant improvement in two objective measures of gait of the cimicoxib group: the vertical impulse on day 1 and day 20 and the peak vertical force on day 20 were significantly improved when compared to the tramadol group. However, no difference was seen for the VI or PVF of dogs on the other days compared. In addiction there was no difference in the weight bearing while standing, thigh circumference, wound classification, adverse effects, VAS, CMPS-SF and HCPI. We did not observe a difference in the number of adverse effects measured in this study with the exception of hock edaema. CONCLUSIONS AND CLINICAL RELEVANCE:A significant difference was not found in long-term postoperative analgesia provided by cimicoxib or tramadol in dogs undergoing TPLO when subjective parameters (with the exception of knee joint range of motion) were evaluated, but use of the force plate analysis revealed a significant difference between groups at T20 for both PVF and VI. The use of cimicoxib improved the limb function and ROM and reduced the occurrence of hock edema, in the first 20 days after surgery, without any additional side effects, compared to tramadol. Thus, the use of cimicoxib should be preferred to tramadol alone in clinical cases similar to the ones included in this study.
A 3-year-old, male Labrador retriever dog was presented with clinical signs of progressive exercise intolerance, bilateral elbow extension, rigidity of the forelimbs, hindlimb flexion and kyphosis. Microscopical examination of muscle tissue showed marked variability in myofibre size, replacement of muscle with mature adipose tissue and degeneration/regeneration of muscle fibres, consistent with muscular dystrophy. Immunohistochemical examination for dystrophin showed markedly reduced labelling with monoclonal antibodies specific for the rod domain and the carboxy-terminal of dystrophin, while expression of β-sarcoglycan, γ-sarcoglycan and β-dystroglycan was normal. Immunoblotting revealed a truncated dystrophin protein of approximately 135 kDa. These findings supported a diagnosis of congenital canine muscular dystrophy resembling Becker muscular dystrophy in man.
Objective: To evaluate the outcome of treatment of antebrachial and crural septic nonunion fractures in dogs using circular external skeletal fixation (CESF), and to document the type and frequency of complications associated with this technique.Methods: The medical records of all dogs with infected antebrachial and crural nonunion fractures treated using the methods of Ilizarov at the Department of Animal Pathology of the University of Turin between 2006 and 2011 were retrospectively reviewed. Only dogs in which radiographic and clinical assessment were available at the time of CESF removal were included in the study.Results: Twenty-three dogs met the inclusion criteria. Twenty nonunion fractures treated with CESF healed and three did not. The latter three cases underwent amputation of the affected limb. In the 20 dogs that achieved bone union, six had minor complications and five had major complications. The midterm outcome was judged to be excellent (n = 11), good (n = 6), fair (n = 2), or poor (n = 4).Conclusions: The results of this study support the use of CESF for the management of antebrachial and crural septic nonunion fractures in dogs. Union was achieved in the majority of dogs and the complication rate was acceptable, considering the severity of the nonunion fractures that were managed in this fashion.
Summary The tibial plateau levelling osteotomy (TPLO) is one of the most common surgical procedures used to treat cranial cruciate ligament disease in dogs. Complications occurring during or after TPLO can range in severity from swelling and bruising to fracture and osteomyelitis. Ten to 34% of TPLO surgical procedures are reported to experience a complication and approximately two to four percent require revision surgery to address a complication. Although the risk factors for many complications have not been fully assessed, the best available evidence suggests that complications of TPLO can be reduced with increased surgeon experience, careful surgical planning, and accurate execution of the surgical procedure. Identification of known or suspected risk factors and intraoperative technical errors allow subsequent action to be taken that is aimed at decreasing postoperative morbidity. There is a need for prospective studies with consistent data reporting in order to fully reveal the incidence risk factors for complications associated with TPLO.
Objectives: To compare fracture healing in diaphyseal tibial fractures stabilized using either minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF).Methods: Dogs in each group were matched for type of fracture, age and body weight. Stage of healing was measured blindly every four weeks postoperatively until complete healing. Outcome variables including fracture length, plate length, plate bridging ratio, plate working length, healing grading, and fracture reduction were compared between groups using the Mann-Whitney test. Significant difference was set at p<0.05.Results: Based on the definition of clinical union, at 30 days five out of eight dogs managed with MIPO had healed, while two of the eight of dogs managed with ORIF had healed. We did not find any significant differences in the other outcome measures. No complications were reported in the MIPO group whereas one major complication was reported in the ORIF group.Clinical significance: All dogs treated by MIPO healed rapidly without any complications, nevertheless the difference in radiographic healing between the two groups was not significant.
Summary Objectives: To quantify the effect of antebrachial torsion on the miscalculation of radial valgus measured radiographically and to assess a radiographic positioning method used to mitigate torsion-associated artifactual miscalculation of concurrent frontal plane angulation. Methods: A canine cadaveric forelimb was used to model different combinations of valgus and external torsion. Valgus was induced in the limb in increments of five degrees, radiographic images were taken at each increment, and the observed radiographic valgus was measured. Various angles of torsion were then induced and the process was repeated for a range of torsional angles at 15° increments. For the second objective, the study was repeated with the forelimb rotationally re-positioned to mirror the degree of the induced torsion of the deformity at each valgus and torsion iteration. Results: Both zero degrees and 15° torsional iterations possessed mean artifactual valgus (AV) values between zero and five degrees for every valgus increment. With torsion of 30° and higher, mean AV values varied widely and did not fall within the zero to five degree accepted range. Rotationally re-positioning the limb in an attempt to alleviate the AV discrepancies resulted in the 30° torsional group having acceptable AV values for valgus values between zero and 20°. Clinical significance: Increasing antebrachial torsion interferes with accurate radiographic measurement of frontal plane deformities. Radiographically repositioning the limb allows the accurate calculation of more valgus and torsion combinations, but still results in miscalculations of more complex deformities.
SummaryObjective: To evaluate the effectiveness of circular external skeletal fixation (CESF) in treating fractures of the distal radius and ulna in toy breed dogs, and to document the type and frequency of complications associated with this technique.Methods: The medical records of small breed dogs with fractures of the distal radius and ulna admitted to the University of Turin and to the Clinica Ferretti between 2002 and 2009 were retrospectively reviewed. The criteria for inclusion of cases in the study were: body weight of 5 kg or less, transverse or short oblique fracture of the distal third of the radius and ulna, no previous repair attempts, and treatment with CESF as the sole method of fixation.Results: Twenty fractures in 16 dogs satisfied the criteria for inclusion into this study. No signs of infection or failure of fixation were detected in any case. Mean frontal plane alignment was 4.7° ± 2.7° and mean sagittal plane alignment was 12.7° ± 7.2°. Postoperative complications occurred in one patient. All fractures achieved union. Mean time until radiographic evidence of a bridging callus and subsequent implant removal was 71 days (range: 30–120).Conclusions: The results of this study support the use of CESF for treatment of fractures of the distal radius and ulna in toy breed dogs as an alternative to other methods of fracture fixation. However, this technique requires a series of follow-up examinations to evaluate the stability of the apparatus, the soundness of the wires and to determine the appropriate time for implant removal.
Femoral interference screw divergence is a potential pitfall associated with ACL reconstruction through transtibial tunnel technique, as angles greater than 15 jeopardize graft fixation. Our mathematical model theorizes the proper degrees of knee flexion during femoral screw insertion and the correct screwdriver position to obtain a minimal divergence of the screw in the femoral tunnel. The cadaveric study confirms our method
Osteochondritis dissecans of the shoulder joint was treated by arthroscopy in 126 dogs. Twenty-four dogs had bilateral surgery, making a total of 150 joints treated. The OCD flaps were removed in small pieces through the cannula or in a single piece through a stab incision. The lameness resolved completely within seven-60 days following arthroscopy in 137 out of 150 affected limbs. Within a subset of 47 dogs with unilateral OCD, it was found that lesions located on the caudo-medial region of the humeral head had a better functional outcome than those lesions located in the caudo-central region of the humeral head.