Bernadette Van Ryssen

Accuracy of pressure plate kinetic asymmetry indices and their correlation with visual gait assessment scores in lame and nonlame dogs

OBJECTIVE To determine the accuracy of pressure plate kinetic asymmetry indices (ASIs) for diagnosis of unilateral hind limb lameness in dogs and their correlation with visual gait assessment (VGA) scores. ANIMALS 9 healthy dogs and 16 dogs with previously diagnosed unilateral rupture of the cranial cruciate ligament and concurrent unilateral hind limb lameness. PROCEDURES Dogs were walked over a pressure plate to determine paw contact area (PCA), peak vertical pressure (PVP), peak vertical force (PVF), and vertical impulse (VI) of both hind limbs. An ASI was calculated for each gait variable. Simultaneously, gait was assessed visually and scored by use of a numeric rating scale (0 to 10). The ASI of each variable was tested for its usefulness in discrimination between lame and nonlame dogs and for correlation with VGA scores. RESULTS Sensitivity and specificity of ASIs to discriminate between lame and nonlame dogs were excellent for PVF, VI, and PCA; these values were substantially lower for ASI of PVP. Cutoff values to discriminate between lame and nonlame dogs were determined by use of ASIs for PVF, VI, and PCA; however, this could not be done for ASI of PVP. Correlations between ASIs of PVF, VI, and PCA and VGA scores were higher than correlation between the ASIs of PVP and VGA scores. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ASIs of PVF and VI determined via analysis of pressure plate measurements were reliable indicators of clinical lameness in dogs, but the ASI of PVP was not. The ASI of PCA is an interesting new variable for assessment of limb loading symmetry.

Diagnostic and Surgical Arthroscopy in Osteochondrosis Lesions

In the dog, as in man and the horse, arthroscopy has an important role in treatment of joint disease. In the shoulder, elbow, and stifle joints, surgical arthroscopy can and should replace the classical surgical methods of treating osteochondrosis lesions. In elbow and tarsocrural joint disorders, the diagnostic potentials of arthroscopy are evident. With the established techniques, not only can the lesions be diagnosed with accuracy, but they can also be treated within the same procedure, making arthroscopy the treatment of choice to deal with osteochondrosis lesions. Without a doubt, arthroscopy will play an important role in the understanding of the etiopathology of different joint diseases, especially within the elbow joint, where so many questions remain unresolved. The advantages of arthroscopy in the diagnosis and treatment of osteochondrosis have also encouraged other veterinary surgeons to adopt the technique. In the developmental stage of arthroscopy in the dog, a frequently expressed comment was that arthrotomy was as valuable and as easy (or easier) to perform as arthroscopy. Now that the advantages of arthroscopy have been demonstrated, the skepticism has changed into enthusiasm. The same evolution is noted with arthroscopy in both man and the horse.

Canine mesenchymal stem cells: state of the art, perspectives as therapy for dogs and as a model for man

Interest in mesenchymal stem cells (MSCs) both for regenerative and reparative therapies in dogs is emerging, as the current treatment options for several conditions often do not result either in the desired clinical outcome or in the patients’ return to normal function. In addition, canine MSCs have been evaluated in some experimental and preclinical studies on efficacy and safety testing of novel treatments for humans, since the dog is considered to be a superior model for humans than rodents. Although these MSCs can be derived from several sources, clinical use has favoured bone marrow and adipose tissue because of their relative ease of stem cell recovery and the minimal donor-site morbidity. Before any type of stem cell can be applied clinically, its unequivocal characterization by a set of specific functional or phenotypic markers is crucial. However, no uniform characterization criteria are available for canine MSCs so far. Moreover, although multi-lineage potential of canine MSCs has been demonstrated in a limited number of studies, research on the differentiation potential of MSCs towards tenocytes is still lacking in canine medicine. In contrast, this latter subject has been explored already in human as well as in equine medicine, demonstrating the need for a specific ‘niche’, i.e. factors with a positive influence on the MSC differentiation. Since most of these factors are still unknown regarding canine MSC, critical basic knowledge is urgently required to motivate and correctly translate the potential therapeutic applications of these stem cells in both dog and man.

Computed tomography findings in 32 joints affected with severe elbow incongruity and fragmented medial coronoid process.

OBJECTIVE To describe the computed tomography (CT) findings in dogs with severe elbow incongruity combined with a fragmented medial coronoid process (FCP) and compare these with normal joints and congruent joints affected by FCP. STUDY DESIGN Clinical study. ANIMALS Client-owned dogs with elbow lameness (n = 40) and purpose bred dogs (n = 5; controls). METHODS The CT features of 32 severely incongruent joints with concomitant FCP were compared with those of 32 congruent elbow joints affected with FCP and 10 normal joints. RESULTS In severely incongruent elbow joints, a radioulnar step and widened joint spaces were visible on each CT plane. Additional features typically seen in severely incongruent elbows were a cyst at the radioulnar transition and fragmentation of the axial border of the medial coronoid incisure. None of these features appeared in normal or in congruent FCP joints. CONCLUSION On CT, several features associated with severe elbow incongruity and concomitant FCP were detected, which were not found in normal joints or congruent joints affected by FCP.Objective To describe the computed tomography (CT) findings in dogs with severe elbow incongruity combined with a fragmented medial coronoid process (FCP) and compare these with normal joints and congruent joints affected by FCP. Study Design Clinical study. Animals Client-owned dogs with elbow lameness (n = 40) and purpose bred dogs (n = 5; controls). Methods The CT features of 32 severely incongruent joints with concomitant FCP were compared with those of 32 congruent elbow joints affected with FCP and 10 normal joints. Results In severely incongruent elbow joints, a radioulnar step and widened joint spaces were visible on each CT plane. Additional features typically seen in severely incongruent elbows were a cyst at the radioulnar transition and fragmentation of the axial border of the medial coronoid incisure. None of these features appeared in normal or in congruent FCP joints. Conclusion On CT, several features associated with severe elbow incongruity and concomitant FCP were detected, which were not found in normal joints or congruent joints affected by FCP.

Worldwide screening for canine hip dysplasia: where are we now?

OBJECTIVE To critically review the different screening systems used for canine hip dysplasia (CHD) and their impact on the prevalence of the disease. STUDY DESIGN Critical literature review. METHODS Literature search through PubMed (November 1959-October 2011) and the Orthopedic Foundation for Animals (OFA), Fédération Cynologique Internationale (FCI), British Veterinary Association/Kennel Club (BVA/KC), and Pennsylvania Hip Improvement Program (PennHIP) websites. RESULTS The OFA, FCI, and BVA/KC screening methods, which use the hip-extended radiographic projection, have had relatively minor success on CHD prevalence. These screening approaches are prone to conflicting data regarding interobserver agreement. The PennHIP and Dorsolateral Subluxation (DLS) systems, both distraction methods, have not reported on prevalence but seem to be important heritable traits in genomic screening of dysplastic dogs. CONCLUSION A shift towards genome screening yields a promising future combating CHD, although further investigation towards fine-mapping in the search for genes, responsible for CHD, is necessary.Objective To critically review the different screening systems used for canine hip dysplasia (CHD) and their impact on the prevalence of the disease. Study design Critical literature review. Methods Literature search through PubMed (November 1959–October 2011) and the Orthopedic Foundation for Animals (OFA), Federation Cynologique Internationale (FCI), British Veterinary Association/Kennel Club (BVA/KC), and Pennsylvania Hip Improvement Program (PennHIP) websites. Results The OFA, FCI, and BVA/KC screening methods, which use the hip-extended radiographic projection, have had relatively minor success on CHD prevalence. These screening approaches are prone to conflicting data regarding interobserver agreement. The PennHIP and Dorsolateral Subluxation (DLS) systems, both distraction methods, have not reported on prevalence but seem to be important heritable traits in genomic screening of dysplastic dogs. Conclusion A shift towards genome screening yields a promising future combating CHD, although further investigation towards fine-mapping in the search for genes, responsible for CHD, is necessary.

Arthroscopic findings in 32 joints affected by severe elbow incongruity with concomitant fragmented medial coronoid process.

Objective To report arthroscopic findings in dogs with severe elbow incongruity combined with fragmented medial coronoid process (FCP) and compare these findings in normal joints and congruent joints affected by FCP. Study design Clinical study. Animals Dogs with elbow lameness (n = 40) and purpose bred dogs (5; controls). Materials and Methods Arthroscopic features of 32 severely incongruent joints with concomitant FCP were compared with 32 congruent elbow joints affected with FCP and 10 normal joints. A radioulnar step of ≥3 mm on radiographs and computed tomography (CT) scans was the selection criterion for a severely incongruent joint. Intraarticular structures were visually assessed at various sites within the joint. Regions of interest were: the radioulnar transition, humeroradial and humeroulnar joint space, trochlear notch, primary and secondary lesions of the medial coronoid process, and radial head. Results Incongruent joints had a radioulnar step and changes at the cartilage in the center of the trochlear notch, an irregular radioulnar transition, and an abnormal surface of the radial head. Coronoid pathology was present in every pathologic joint. Conclusion Arthroscopy allowed detection of several features that were signs or consequences of severe elbow incongruity or accompanying inflammation. After a prominent radioulnar step, cartilage changes involving the radial head and trochlear notch were most frequently seen.OBJECTIVE To report arthroscopic findings in dogs with severe elbow incongruity combined with fragmented medial coronoid process (FCP) and compare these findings in normal joints and congruent joints affected by FCP. STUDY DESIGN Clinical study. ANIMALS Dogs with elbow lameness (n = 40) and purpose bred dogs (5; controls). MATERIALS AND METHODS Arthroscopic features of 32 severely incongruent joints with concomitant FCP were compared with 32 congruent elbow joints affected with FCP and 10 normal joints. A radioulnar step of ≥ 3 mm on radiographs and computed tomography (CT) scans was the selection criterion for a severely incongruent joint. Intraarticular structures were visually assessed at various sites within the joint. Regions of interest were: the radioulnar transition, humeroradial and humeroulnar joint space, trochlear notch, primary and secondary lesions of the medial coronoid process, and radial head. RESULTS Incongruent joints had a radioulnar step and changes at the cartilage in the center of the trochlear notch, an irregular radioulnar transition, and an abnormal surface of the radial head. Coronoid pathology was present in every pathologic joint. CONCLUSION Arthroscopy allowed detection of several features that were signs or consequences of severe elbow incongruity or accompanying inflammation. After a prominent radioulnar step, cartilage changes involving the radial head and trochlear notch were most frequently seen.

SENSITIVITY AND SPECIFICITY OF RADIOGRAPHY FOR DETECTION OF ELBOW INCONGRUITY IN CLINICAL PATIENTS

Elbow incongruity is an important factor regarding the treatment and prognosis of elbow dysplasia. Our purpose was to determine the sensitivity and specificity for radiographic detection of elbow incongruity in clinical patients, to establish inter- and intraobserver variation for different parameters, and to evaluate the possibility of radiographic grading of incongruity. Standard radiographic projections were acquired from 29 incongruent and nine congruent elbows of dogs of various ages and breeds. Computed tomography (CT) was used to diagnose and grade the incongruity. All radiographs were evaluated by four observers for detection and grading of elbow incongruity. Sensitivity, specificity, inter- and intraobserver variability were calculated. The mean sensitivity for detection of incongruity was very good (88.8%) with a mean specificity of 91.7%. Correct grading of incongruity was difficult. The radioulnar step and the widening of the humeroulnar and humeroradial joint space were seen most frequently. Intraobserver and interobserver variability were fair to excellent (Kappa = 0.372-0.809), depending on the investigated parameters. Radiography is valuable to screen for elbow incongruity. In over 91% of the patients, a clear distinction could be made between a congruent and an incongruent joint grading was not possible.

RADIOGRAPHIC FEATURES OF PRIMARY AND CONCOMITANT FLEXOR ENTHESOPATHY IN THE CANINE ELBOW

Primary flexor enthesopathy is a recently recognized elbow disorder and should be considered in the differential diagnosis of elbow lameness. For treatment planning purposes, it is important to make a distinction between primary and concomitant forms of the disease. The purpose of this prospective study was to compare radiographic findings for dogs with primary flexor enthesopathy (n = 17), concomitant flexor enthesopathy (n = 24), elbow dysplasia (n = 13), and normal dogs (n = 7). All dogs underwent a complete radiographic examination and each radiographic image was evaluated for the presence or absence of following characteristics: irregular medial humeral epicondyle, spur and calcified body. Additionally, the presence or absence of other elbow disorders (medial coronoid process disease, osteochondritis dissecans, ununited anconeal process, incongruity, subtrochlear sclerosis, and osteoarthritis) was recorded. Radiographic characteristics of flexor enthesopathy were found in 86% of painful joints in the primary flexor enthesopathy group and in 100% of painful joints in the concomitant flexor enthesopathy group. Radiographic characteristics of flexor enthesopathy were not found in sound elbow and elbow dysplasia groups. Frequencies and details of individual radiographic characteristics did not differ between primary and concomitant flexor enthesopathy groups. Findings support the use of radiography as a first screening method for detection of flexor enthesopathy, but not as a technique for distinguishing primary vs. concomitant forms.

Computed tomography of canine elbow joints affected by primary and concomitant flexor enthesopathy.

Flexor enthesopathy is an important differential diagnosis for elbow lameness in dogs. The disorder can be a primary cause of elbow lameness or concomitant with other elbow pathology. Since treatment differs for primary and concomitant forms of flexor enthesopathy, a noninvasive method for distinguishing between them is needed. In the current prospective study, computed tomographic (CT) examination was performed before and after IV injection of contrast in 17 dogs with primary flexor enthesopathy, 24 dogs with concomitant flexor enthesopathy, 13 dogs with elbow dysplasia, and seven normal dogs. Dogs were assigned to groups based on results of clinical examination and at least three other imaging modalities. Computed tomographic lesions consistent with flexor enthesopathy were found in all clinically affected joints with primary flexor enthesopathy and in 29 of the 30 clinically affected joints with concomitant flexor enthesopathy. Those lesions were not found in sound elbows or joints affected by elbow dysplasia. Flexor lesions detected in dogs with primary flexor enthesopathy were not significantly different from those detected in dogs with the concomitant form. Findings indicated that CT can be applied to detect flexor enthesopathy, but a distinction between the primary and concomitant forms was not always possible. Authors recommend the use of multiple diagnostic techniques for treatment planning in affected dogs.

The Prevalence of Nine Genetic Disorders in a Dog Population from Belgium, the Netherlands and Germany

The objective of this study was to screen a dog population from Belgium, the Netherlands and Germany for the presence of mutant alleles associated with hip dysplasia (HD), degenerative myelopathy (DM), exercise-induced collapse (EIC), neuronal ceroid lipofuscinosis 4A (NCL), centronuclear myopathy (HMLR), mucopolysaccharidosis VII (MPS VII), myotonia congenita (MG), gangliosidosis (GM1) and muscular dystrophy (Duchenne type) (GRMD). Blood samples (K3EDTA) were collected for genotyping with Kompetitive Allele Specific PCR (n = 476). Allele and genotype frequencies were calculated in those breeds with at least 12 samples (n = 8). Hardy-Weinberg equilibrium was tested. Genetic variation was identified for 4 out of 9 disorders: mutant alleles were found in 49, 15, 3 and 2 breeds for HD, DM, EIC and NCL respectively. Additionally, mutant alleles were identified in crossbreeds for both HD and EIC. For HD, DM, EIC and NCL mutant alleles were newly discovered in 43, 13, 2 and 1 breed(s), respectively. In 9, 2 and 1 breed(s) for DM, EIC and NCL respectively, the mutant allele was detected, but the respective disorder has not been reported in those breeds. For 5 disorders (HMLR, MPS VII, MG, GM1, GRMD), the mutant allele could not be identified in our population. For the other 4 disorders (HD, DM, EIC, NCL), prevalence of associated mutant alleles seems strongly breed dependent. Surprisingly, mutant alleles were found in many breeds where the disorder has not been reported to date.