Dimitri Leperlier

Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat

Spinal epidural empyema (SEE) represents a severe pyogenic infection of the epidural space. Clinical signs of the disease are non-specific – increased body temperature, intense neck pain, neurological signs of a transverse myelopathy – and can lead to severe and permanent neurological deficits. This report describes the diagnosis and successful surgical treatment of cervical SEE secondary to grass awn migration in a cat. Although it is uncommon, this disease should be suspected in cats with progressive myelopathy. Early diagnosis and emergency surgery combined with antibiotic therapy are required to allow a complete recovery.

The influence of Bone Morphogenic Protein-2 on the consolidation phase in a distraction osteogenesis model

We asked whether locally applied recombinant-Bone Morphogenic Protein-2 (rh-BMP-2) with an absorbable Type I collagen sponge (ACS) carrier could enhance the consolidation phase in a callotasis model. We performed unilateral transverse osteotomy of the tibia in 21 immature male rabbits. After a latency period of 7 days, a 3-weeks distraction was begun at a rate of 0.5mm/12h. At the end of the distraction period (Day 28) animals were randomly divided into three groups and underwent a second surgical procedure: 6 rabbits in Group I (Control group; the callus was exposed and nothing was added), 6 rabbits in Group II (ACS group; receiving the absorbable collagen sponge soaked with saline) and 9 rabbits in Group III (rh-BMP-2/ACS group; receiving the ACS soaked with 100μg/kg of rh-BMP-2, Inductos(®), Medtronic). Starting at Day 28 we assessed quantitative and qualitative radiographic parameters as well as densitometric parameters every two weeks (Days 28, 42, 56, 70 and 84). Animals were sacrificed after 8 weeks of consolidation (Day 84). Qualitative radiographic evaluation revealed hypertrophic calluses in the Group III animals. The rh-BMP-2/ACS also influenced the development of the cortex of the calluses as shown by the modified radiographic patterns in Group III when compared to Groups I and II. Densitometric analysis revealed the bone mineral content (BMC) was significantly higher in the rh-BMP-2/ACS treated animals (Group III).

AGE-RELATED THORACIC RADIOGRAPHIC CHANGES IN GOLDEN AND LABRADOR RETRIEVER MUSCULAR DYSTROPHY

Golden retriever and Labrador retriever muscular dystrophy are inherited progressive degenerative myopathies that are used as models of Duchenne muscular dystrophy in man. Thoracic lesions were reported to be the most consistent radiographic finding in golden retriever dogs in a study where radiographs were performed at a single-time point. Muscular dystrophy worsens clinically over time and longitudinal studies in dogs are lacking. Thus our goal was to describe the thoracic abnormalities of golden retriever and Labrador retriever dogs, to determine the timing of first expression and their evolution with time. To this purpose, we retrospectively reviewed 390 monthly radiographic studies of 38 golden retrievers and six Labrador retrievers with muscular dystrophy. The same thoracic lesions were found in both golden and Labrador retrievers. They included, in decreasing frequency, flattened and/or scalloped diaphragmatic shape (43/44), pulmonary hyperinflation (34/44), hiatal hernia (34/44), cranial pectus excavatum (23/44), bronchopneumonia (22/44), and megaesophagus (14/44). The last three lesions were not reported in a previous radiographic study in golden retriever dogs. In all but two dogs the thoracic changes were detected between 4 and 10 months and were persistent or worsened over time. Clinically, muscular dystrophy should be included in the differential diagnosis of dogs with a combination of these thoracic radiographic findings.

Minimally invasive video-assisted cervical ventral slot in dogs. A cadaveric study and report of 10 clinical cases.

OBJECTIVES To investigate the feasibility of a minimally invasive video-assisted (MIVA) cervical ventral slot (VS) in dogs without the use of fluoroscopy, and to report our initial clinical experiences in dogs. METHODS Two surgical approaches to an intervertebral disk space (IVDS) were performed in eight intact canine cadavers to determine the feasibility of MIVA-VS using the Destandau Endospine™ Devicea (DED) without fluoroscopic guidance. In a subsequent clinical study, 10 client-owned dogs admitted for a Hansen type 1 disk extrusion underwent a MIVA-VS. Recorded data in both studies included: incision lengths, correct targeting of the IVDS, technical problems encountered during the procedure, and potential damage to major anatomical structures. In the 10 clinical cases, duration of the procedure and clinical outcome at five and 12 days, and after a minimum of three months were also recorded. RESULTS Correct exposure of the targeted IVDS was achieved in all cases. There was no major iatrogenic damage. Mean skin incision length was 39 mm and mean surgery time was 52 minutes. The technique provided increased illumination and magnification of the surgical field. Recovery was uneventful in all cases. CLINICAL RELEVANCE The present study provided evidence that MIVA-VS using the DED was feasible and a relatively fast and safe procedure for the treatment of cervical disk herniation. Advantages of the technique seemed to include shorter incisions, less dissection and improved visibility.

Fungal rhinosinusitis caused by Scedosporium apiospermum in a cat

A 3-year-old neutered male Bengal cat with a history of chronic mucopurulent bilateral nasal discharge and sneezing was diagnosed with severe fungal rhinosinusitis. A diagnosis was obtained after computer tomography imaging, histopathological examination and fungal culture. The mold Scedosporium apiospermum was identified as the aetiological agent. To our knowledge, this case is the first description of a rhinitis or sinusitis caused by this agent in a cat. Aggressive surgical debridement combined with topical and systemic antifungal therapy was performed. Unfortunately, the treatment resulted only in a partial remission of signs.

Surgical repair of thoraco-lumbar vertebral fracture-luxations in eight cats using screws and polymethylmethacrylate fixation

OBJECTIVE To report our clinical experience in the surgical treatment of feline thoraco-lumbar vertebral fracture-luxations using optimal safe implantation corridors as previously described in vitro. STUDY DESIGN Retrospective clinical study. MATERIALS AND METHODS Medical records and radiographs of cats with vertebral fracture-luxations stabilized by screws and polymethylmethacrylate (PMMA) using optimal safe implantation corridors between 2009 and 2011 were reviewed. For each patient the data included: signalment, cause of vertebral fracture-luxations, presence of concurrent injuries, pre- and postoperative neurological grade, surgical treatment, imaging findings, and clinical outcome with short-term (2 weeks) and long-term (12 months) follow-up. RESULTS Eight cats with vertebral fracture-luxations involving the lumbar (L)(n = 5), the thoracic (T) spinal segments (n = 2), or the thoraco-lumbar junction (n = 1) were included in the study. Screws and PMMA were used bilaterally in five cats and unilaterally in three cats. No surgical intra-operative complications using the defined corridors were recorded. Implant failure followed by spontaneous recovery was recorded in one case. Two cats died in the postoperative period (≤ 4 days). The short-term and long-term clinical outcome was excellent in four out of eight cats and satisfactory in two out of eight cats. CONCLUSION AND CLINICAL RELEVANCE This pilot study demonstrates the clinical applicability of optimal safe implantation corridors for stabilization of feline thoraco-lumbar vertebral fracture-luxations with screws and PMMA. This technique can be used with limited risks of iatrogenic injuries for stabilization of vertebral fracture-luxation localized between T11-L4.

Stabilization of Olecranon Fractures by Tension Band Wiring or Plate Osteosynthesis: A Retrospective Study of 41 Cases

OBJECTIVES  This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique. METHODS  Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed. RESULTS  Forty-one olecranon fractures were included. Fractures were articular, comminuted and open in 90, 31 and 27% of cases, respectively. Tension band wiring and plate osteosynthesis were performed in 22 and 19 fractures, respectively. Complications occurred more commonly after tension band wiring (74%) compared with plate osteosynthesis (27%) (p = 0.002) and these were probably related to it being used in comminuted fractures (p = 0.01) or to errors in technique. Minor complications included Kirschner wires migration (n = 5), pain (n = 3), osteomyelitis (n = 3), skin breakdown (n = 3) and seroma (n = 1). Implant failure requiring further fixation (n = 4) was observed only in the tension band wiring group. Other major complications included skin wound debridement and closure (n = 1) and chronic lameness requiring implant removal (n = 7). Long-term functional outcomes were excellent regardless of the technique used. CLINICAL SIGNIFICANCE  Plate osteosynthesis should be performed for olecranon fracture repair if technically feasible.

Reproducibility, Accuracy and Effect of Autoclave Sterilization on a Thermoplastic Three-Dimensional Model Printed by a Desktop Fused Deposition Modelling Three-Dimensional Printer

OBJECTIVES  The main purpose of this study was to determine the reproducibility and accuracy of a three-dimensional (3D) bone model printed on a desktop 3D-printer based on fused deposition modelling (FDM) technology with polylactic acid (PLA) and the effect of autoclave sterilization on the printed models. METHODS  Computed tomographic images of the tibia were obtained from 10 feline cadavers, used to create a bone surface-rendering file and sent to the 3D printing software. Right and left tibias were each printed five times with the FDM desktop 3D printer using PLA plastic material. Plastic models and cadaveric bones were measured with a profile projector device at six predetermined landmarks. Plastic bones were then sterilized using an autoclave before being re-measured applying the same method. Analyses of printed model size reliability were conducted using intra-class correlation coefficients (ICC) and Bland-Altman plots. RESULTS  The ICC always showed an almost perfect agreement when comparing 3D-printed models issued from the same cadaveric bone. The ICC showed moderate agreement for one measurement and strong/perfect agreement for others when comparing a cadaveric bone with the corresponding 3D model. Concerning the comparison of the same 3D-printed model, before and after sterilization, ICC showed either strong or perfect agreement. CLINICAL SIGNIFICANCE  Rapid-prototyping with our FDM desktop 3D-printer using PLA was an accurate, a reproducible and a sterilization-compliant way to obtain 3D plastic models.

Effectiveness of a bipolar vessel sealant device for ovariohysterectomy in cats with pyometra

Objectives The objective was to describe the use of a bipolar vessel sealant device for complete ovariohysterectomy in cats (ie, removal of both the ovarian pedicle and the uterine body and vessels) and to report on the feasibility of ovariohysterectomy in cats with pyometra. Methods Cats with confirmed pyometra and whose owners agreed to the surgical procedure were prospectively included in the study. Ovaries were visualised and the vessel sealant device was used to coagulate and cut the suspensory ligament, the ovarian pedicle and the broad ligament up to the level of the uterine body. Once the uterine body was measured, it was grasped, coagulated and transected just proximal to the cervix using the vessel sealant device when its diameter was <0.9 cm. Immediate postoperative and short-term follow-up were evaluated by clinical examination. Results Thirteen cases were initially included between November 2015 and February 2017. Three cases were subsequently excluded because of a uterine body diameter >0.9 cm. Of the 10 cats finally included, all were intact females, with a median age of 2.7 years (range 0.9–9 years). Median weight was 3.7 kg (range 2.6–6.7 kg). The median surgery time was 10.9 mins (range 9.8–15.2 mins). Median uterus diameter was 0.51 cm (range 0.45–0.64 cm) and median skin incision was 4.1 cm (range 3.6–5.1 cm). No complications during the procedures occurred in any patient. All cases were discharged from the hospital 1 day after surgery, without any abnormality. No complications were noted during the postoperative period. Conclusions and relevance The findings suggest that the bipolar vessel sealant device used in this study is safe in performing ovariohysterectomy for pyometra in cats, when the uterine body is <0.9 cm in diameter, without short-term complications.