David R. Mason

Measurement of humeroradial and humeroulnar transarticular joint forces in the canine elbow joint after humeral wedge and humeral slide osteotomies.

OBJECTIVE To determine the effect of humeral wedge and humeral slide osteotomies on force distribution between the articular surfaces of the humerus and the radius and ulna in normal canine thoracic limbs. STUDY DESIGN In vitro mechanical testing. SAMPLE POPULATION Cadaveric canine right thoracic limbs (n=12). METHODS Transarticular elbow force maps were measured using a tactile array pressure sensor in elbow joints of axially aligned limbs under 200 N axial load before and after humeral wedge and humeral slide osteotomies. RESULTS Loading induced 2 distinct areas of high forces that corresponded with the proximal articular surfaces of the radius and ulna. Mean force on the proximal articular surface of the ulna was reduced by 25% and 28% after 4 and 8 mm sliding osteotomies, respectively. Statistically significant differences were not observed for the wedge osteotomies. CONCLUSION Humeral slide osteotomy significantly decreases force on the proximal articular surface of the ulna. CLINICAL RELEVANCE The proximal articular surface of the ulna contributes significantly to load transfer through the canine elbow joint. Abnormalities that significantly increase this force might contribute to canine elbow dysplasia, specifically fragmentation of the medial coronoid process and osteochondritis dissecans of the medial aspect of the humeral condyle. Under the conditions studied, the overall reduction in mean joint surface force across the proximal articular surface of the ulna after humeral slide osteotomy indicates that this technique merits further investigation for potential use in medial compartmental osteoarthritis of the canine elbow joint.

Severity of patellar luxation and frequency of concomitant cranial cruciate ligament rupture in dogs: 162 cases (2004-2007)

OBJECTIVE To evaluate severity of medial patellar luxation (MPL) and frequency of concomitant cranial cruciate ligament rupture (CCLR) in dogs. DESIGN Retrospective case series. ANIMALS 162 dogs (266 stifle joints). PROCEDURES Medical records of 162 small-breed dogs with MPL were reviewed. Signalment, body weight, luxation grade, bilateral or unilateral MPL, CCLR, and difference in luxation grades between stifle joints were evaluated. Association between severity of MPL and CCLR was investigated. RESULTS 58 dogs had unilateral MPL, and 104 dogs had bilateral MPL. Dogs ranged from 8.4 months to 16.7 years of age (mean, 5.7 years), and mean body weight was 5.45 kg (12 lb). Forty-one percent of all dogs had concomitant CCLR. Mean age for dogs with MPL alone was 3.0 years, which differed significantly from mean age of dogs with MPL and concomitant CCLR (7.8 years). Dogs with grade IV MPL were significantly more likely to have concomitant CCLR than were dogs with any other grade of MPL. In dogs with bilateral MPL and unilateral CCLR, there was a significantly higher grade of luxation in the stifle joint with CCLR. CONCLUSIONS AND CLINICAL RELEVANCE Small-breed dogs with MPL and concomitant CCLR were older than were dogs with only MPL. Dogs with grade IV MPL were more likely to have CCLR than were dogs with other grades of MPL. Most dogs with concomitant CCLR had a higher MPL grade in the affected stifle joint than in the intact joint. These findings should be beneficial in client education and clinical diagnosis.

Fracture Repair Using a Polyaxial Locking Plate System (PAX)

OBJECTIVES To report outcomes and complications of dog and cat fractures treated with the polyaxial locking plate system (PAX). STUDY DESIGN Case series. ANIMALS Dogs (n = 60) and 2 cats. METHODS Medical records (December 2009-March 2011) of dogs and cats with fractures treated with the PAX system were reviewed. Cases with adequate follow-up to document a functional union, had surgery performed by an author, had no prior treatment of the fracture(s), and with complete operative records were included. Signalment, body weight, bone(s) fractured, area of bone fractured, fracture classification, concurrent orthopedic injuries, complications, time to functional union, if minimally invasive plate osteosynthesis (MIPO) techniques were used, plate size, number of plates, bone graft use, and ancillary methods of fixation were recorded. Additionally, fracture segment: plate length, screw, number of plate holes, number of empty screw holes overlying/adjacent to the fractures, number of cortices engaged above/below the fracture was evaluated. Variables were evaluated statistically for effect on complications and functional union. RESULTS Sixty-two animals were included. Mean time to functional union was 7.1 weeks. Complications occurred in 12 animals (19%) and plate failure occurred in 3 (5%). Statistically significant factors that affected time to functional union were the presence of multiple injuries and age. Those associated with complications were double plates and number of cortices engaged above and below fractures. CONCLUSIONS The PAX system allows for multidirectional screw insertion with an overall complication rate and time to functional union similar to other fracture repair implant systems.

An analysis of the quality of canine cranial cruciate ligament disease information available on the Internet.

Objective: To assess the quality of information available on the Internet pertaining to canine cranial cruciate ligament (CCL) disease. Study Design: Survey Study. Methods: Three search phrases were entered separately into 5 search engines and the 1st page of websites from each search was analyzed. Unique websites were evaluated by 3 Diplomates of the American College of Veterinary Surgeons using standardized scales for content and information value score (IVS). Websites were further categorized by veterinary or non-veterinary authorship. The readability of each website was scored using a proven literacy scale (Flesch–Kinkaid system). Results: Fifty-four unique websites were evaluated. Websites located using anatomically correct veterinary terminology had significantly (P<.05) higher ratings for content and IVS compared with those found using lay terminology. Websites authored by veterinarians also had significantly (P<.05) higher IVS compared with those authored by non-veterinarians. Websites found using anatomically correct veterinary terminology, and those authored by veterinarians, had significantly (P<.05) lower readability scores, requiring a higher literacy level for comprehension. Conclusions: Information available on the Internet with respect to canine CCL disease is of highly variable quality. Use of anatomically correct veterinary terminology when conducting an Internet search detects sites with higher quality information; however, a higher literacy level is required to understand the material. Similarly, websites authored by veterinarians are more likely to present higher quality information, but require a more advanced literacy level for comprehension. Clinical Relevance: CCL disease information on the Internet is of variable quality and can be misleading.OBJECTIVE To assess the quality of information available on the Internet pertaining to canine cranial cruciate ligament (CCL) disease. STUDY DESIGN Survey Study. METHODS Three search phrases were entered separately into 5 search engines and the 1st page of websites from each search was analyzed. Unique websites were evaluated by 3 Diplomates of the American College of Veterinary Surgeons using standardized scales for content and information value score (IVS). Websites were further categorized by veterinary or non-veterinary authorship. The readability of each website was scored using a proven literacy scale (Flesch-Kinkaid system). RESULTS Fifty-four unique websites were evaluated. Websites located using anatomically correct veterinary terminology had significantly (P<.05) higher ratings for content and IVS compared with those found using lay terminology. Websites authored by veterinarians also had significantly (P<.05) higher IVS compared with those authored by non-veterinarians. Websites found using anatomically correct veterinary terminology, and those authored by veterinarians, had significantly (P<.05) lower readability scores, requiring a higher literacy level for comprehension. CONCLUSIONS Information available on the Internet with respect to canine CCL disease is of highly variable quality. Use of anatomically correct veterinary terminology when conducting an Internet search detects sites with higher quality information; however, a higher literacy level is required to understand the material. Similarly, websites authored by veterinarians are more likely to present higher quality information, but require a more advanced literacy level for comprehension. CLINICAL RELEVANCE CCL disease information on the Internet is of variable quality and can be misleading.

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

OBJECTIVE To compare the incidence of intra-abdominal complications in dogs following resection and functional end-to-end stapled anastomosis (FEESA) versus anastomosis with an end-to-end sutured technique for treatment of enteric lesions. DESIGN Multicenter, retrospective descriptive cohort study. ANIMALS 180 dogs. PROCEDURES Medical records of dogs undergoing intestinal resection and anastomosis at 3 nonaffiliated private practice specialty centers were retrospectively reviewed. Preoperative clinical variables, indication for surgery, surgical technique (sutured end-to-end anastomosis vs FEESA), and evidence of postoperative anastomosis site leakage (dehiscence) were recorded. Variables of interest were analyzed for associations with dehiscence. RESULTS Dehiscence rates of sutured and stapled anastomoses were 12 of 93 (13%) and 4 of 87 (5%), respectively; odds of postoperative dehiscence were significantly lower for dogs with FEESAs than for dogs with sutured anastomoses (OR, 0.28; 95% confidence interval, 0.09 to 0.94). Among dogs that underwent surgery for treatment of intestinal dehiscence after surgery at another facility, subsequent dehiscence developed in 3 of 5 with sutured anastomoses and 0 of 11 with stapled anastomoses. Dehiscence rates varied significantly among clinics. No other variable was associated with risk of dehiscence. Eleven of 16 dogs with dehiscence were euthanized without additional surgery. Impaction at the anastomosis site was identified months or years after surgery in 3 dogs (4 anastomosis sites) that had FEESAs. CONCLUSIONS AND CLINICAL RELEVANCE Odds for dehiscence were significantly greater for sutured end-to-end anastomoses than FEESAs, and dogs undergoing surgery for previous dehiscence were significantly more likely to experience a subsequent dehiscence with a sutured anastomosis. However, variability of procedure types and dehiscence rates among clinics suggested further research is needed to confirm these findings. Obstruction at the anastomosis site was identified as a potential long-term complication of FEESA.