Elvin Kulendra

Retrospective study of Achilles mechanism disruption in 45 dogs.

Forty-five cases of canine Achilles mechanism disruption were reviewed, mostly involving medium-sized dogs, among which dobermanns, labradors and border collies were most commonly represented. Most cases were acute in onset (66.7 per cent), and were usually closed injuries (75.6 per cent). In the majority of cases, the damage involved all tendons (26.7 per cent), all tendons except the superficial digital flexor tendon (22.2 per cent), or the gastrocnemius alone (20 per cent). Damage most commonly occurred at the tendo-osseous junction (60 per cent), with injury occurring less commonly at the musculotendinous junction (20 per cent) or in the body of the tendon (13.3 per cent). A plantigrade posture was not predictive of involvement of specific tendons, but was more likely if the injury involved the musculotendinous junction. The most common method of treatment was a primary tendon repair using polydioxanone suture in a locking-loop pattern, with placement of a temporary calcaneotibial screw and cast. The outcome was not significantly influenced by whether the injury was open or closed, the duration of the injury, the tendons involved, or the method of repair. Complications were recorded in 16 cases (35 per cent), of which 10 were minor and six major. Complications were significantly more likely if the damage involved the body of the tendon. Long-term follow-up was available for 19 dogs; the outcome of surgery was considered to be good to excellent in 18 dogs.

Stabilization of Sacroiliac Luxation in 40 Cats Using Screws Inserted in Lag Fashion

OBJECTIVE To (1) identify prognostic indicators for stability after stabilization of sacroiliac luxation with screws inserted in lag fashion and (2) report dorsoventral dimensions of the sacrum in cats. STUDY DESIGN Multicenter retrospective study. SAMPLE POPULATION Cats (n=40) with sacroiliac luxation. METHODS Case records and radiographs of cats presented at the Queens Veterinary School Hospital Cambridge and the Royal Veterinary College Hatfield for screw fixation of sacroiliac luxation were reviewed. Dorsoventral dimensions of 15 feline cadaveric sacral bodies were measured to identify the appropriate implant size for use in fixation with screws inserted in lag fashion. RESULTS Of 40 cats, 13 had left, 14 right, and 13 bilateral sacroiliac luxations. Of 48 screws analyzed, 42 (87.5%) were placed within the sacral body or exited ventrally and 6 (12.5%) were considered malpositioned. Screw purchase within the sacrum was statistically different between unstable and stable repairs (P=.001). Using confidence intervals for screw length within the sacrum and effect on stability, the lowest screw depth that contained 95% of the screws that did not loosen was approximately 60% of the sacral width. Mean dorsoventral sacral dimension at its narrowest point was 5.9+/-1.14 mm. There was no significant difference in the incidence of implant loosening between those luxations that were 100% reduced and those that were <100% reduced (P=.7837). CONCLUSIONS Screw purchase within the feline sacrum of at least 60% of the sacral width significantly reduces the risk of loosening. CLINICAL RELEVANCE Screw placement to a depth of 60% of the width of the feline sacrum is recommended.

Management of bilateral ureteral trauma using ureteral stents and subsequent subcutaneous ureteral bypass devices in a cat

This report describes a cat that presented with abdominal pain and worsening azotaemia following unknown trauma. Further diagnostic investigations and surgery confirmed bilateral ureteral trauma. The cat was initially managed surgically by bilateral ureteroureterostomy over ureteral stents. The clinical signs and biochemical parameters rapidly resolved, but 2 months later the cat developed signs consistent with sterile cystitis that was unresponsive to medical management. Removal of the ureteral stents resulted in severe azotaemia as a result of stricture formation at the previous ureteral anastomosis site. The ureteral stents were initially replaced with soft stents, but subsequently cut short owing to the persistence of clinical signs of cystitis. Following shortening of the ureteral stents severe azotaemia was again observed. The resulting pelvic dilatation allowed for placement of bilateral subcutaneous ureteral bypass (SUB) systems, which resulted in alleviation of all clinical signs 12 months after SUB placement.

Evaluation of the transarticular external skeletal fixator for the treatment of tarsocrural instability in 32 cats

The medical records of all cats with tarsocrural joint instability that were treated between June 2002 and December 2008 at the Royal Veterinary College were retrospectively reviewed. A total of 32 cats were identified. Information gathered included signalment, type of injury (subluxation or luxation), concurrent fractures, presence of soft tissue wounds, transarticular external skeletal fixation (TESF) type, configuration of TESF (number of pins proximal and distal to the joint), duration of hospitalisation, duration of TESF prior to removal, complications and cost. A significant association was identified between the length of hospitalisation and the presence of wounds. Similarly a significant association was present between wounds and final cost of treatment. Additionally, the authors found that a high number of implant related complications were present when only two pins were used proximal and distal to the tarsocrural joint, but this association was not significant.

Cavitary pulmonary lesion associated with Aspergillus fumigatus infection in a German shepherd dog.

A two-year-old female German shepherd dog was presented with chronic cough and haemoptysis. Thoracic radiographs revealed a thin-walled cavitary lesion within a consolidated left cranial lung lobe. Bronchoalveolar lavage confirmed a concurrent bacterial infection; however, despite antibiotic and anthelmintic therapy the clinical signs failed to resolve. A left cranial lung lobectomy was performed. Histopathology and fungal culture confirmed the presence of Aspergillus fumigatus. The necrotic cavity had features compatible with a bronchial origin, possibly a form of cystic bronchiectasis, arising either as a congenital anomaly or acquired secondary to infection. Surgery provided resolution of clinical signs for just over a year before the dog deteriorated again and was subsequently euthanised. Necropsy was declined by the owners. This case report presents a unique presentation in which the predominant clinical sign was coughing due to pulmonary involvement. Aspergillus fumigatus was isolated from the left cranial lung lobe.

Necrotising fasciitis with sub-periosteal Streptococcus canis infection in two puppies

Necrotising fasciitis is an uncommon and potentially devastating disease which has been infrequently reported in animals. This brief communication describes an unusual presentation of necrotising fasciitis in two immature Bull Terriers. Both animals were admitted with a history of minimal trauma yet rapidly progressive, localising, disproportionate pain. Streptococcus canis was cultured from sub-periosteal fluid-filled pockets surrounding the femur in both cases.

Osteochondritis dissecans-like lesion of the intercondylar fossa of the femur in a dog

An 11-month-old neutered female crossbreed dog was admitted with left pelvic limb lameness. Radiographs and computed tomography identified an osteochondritis dissecans- (OCD) like lesion in the intercondylar fossa of the femur originating from the axial aspect of the medial femoral condyle. Stifle arthrotomy was performed in order to remove the bony fragment. It was concluded that the clinical features and location of this lesion indicate an osteochondritis dessicans-like lesion. Fragment removal was associated with an excellent outcome.

Short and long-term outcome following surgical stabilization of tarsocrural instability in dogs

OBJECTIVES To evaluate the outcome and complications following surgical stabilization of canine tarsocrural luxations. METHODS Medical records of dogs which were surgically treated for tarsocrural joint instability between February 2007 and June 2014 were reviewed. Surgical technique, complications and long-term outcome (via questionnaire and Canine Brief Pain Inventory) were assessed. RESULTS Twenty-four dogs (26 joints) were included. All injuries were traumatic. All joints had associated fractures; malleolar in 21/26 limbs (13/26 medial). Eight joints had internal fracture fixation and transarticular external skeletal fixator, six had external fixator alone, four had prosthetic ligaments with external fixator, and four had prosthetic ligaments with external coaptation. Two joints had pantarsal arthrodesis and two primary ligament repair. Complications occurred in 24/26 limbs giving 45 distinct complications; 16 were minor, 29 major, and 31 complications were external fixator associated. Prosthetic ligaments were significantly associated with major complications (p = 0.017); five out of eight required subsequent removal between 105-1006 days. Cost was significantly associated with major complications (p = 0.017) and soft tissue wounds (p = 0.03). Long-term lameness was seen in nine of 14 dogs. There was no association between pain severity (p = 0.3) and pain interference scores (p = 0.198) when comparing stabilization methods. CLINICAL SIGNIFICANCE Complications are common; however many are external fixator related. Prosthetic ligaments are significantly associated with major complications. Regardless of technique, a degree of ongoing lameness is likely.

Topographic Bone Density of the Radius and Ulna in Greyhounds and Labrador Retrievers With and Without Medial Coronoid Process Disease

OBJECTIVE To quantify, using computed tomography (CT), cross-sectional ulnar bone density (UBD), and regional radial bone density (RRBD) at the level of the medial coronoid process (MCP) in elbows with and without medial coronoid process disease (MCPD) and with and without fragmentation of MCP (FCP). STUDY DESIGN Retrospective clinical case-control and ex vivo study. SAMPLE POPULATION Labrador Retriever elbows (n = 54) and normal cadaveric Greyhound elbows (11) undergoing elbow CT. MATERIALS AND METHODS Labrador Retriever elbows were divided into 2 groups: (1) clinically unaffected and (2) MCPD-affected elbows. This 2nd group was subdivided based on the presence of a displaced FCP. UBD was measured linearly, in Hounsfield units (HU) across the widest part of the ulna incorporating the MCP. The radial head was divided into 6 zones, with mean RRBD (HU) calculated for each group. RESULTS MCPD-affected Labrador Retriever elbows had significantly lower UBD within the MCP with a higher UBD in the cranial ulnar medulla. Lower RRBD was also seen in the radial head adjacent to the MCP in MCPD-affected Labrador Retriever elbows with FCP compared with Labrador Retriever elbows without FCP. Greyhounds had consistently lower RRBD and UBD at the apex of the MCP compared with clinically unaffected Labrador Retriever elbows. CONCLUSIONS Our results suggest a caudolateral load-transfer shift through the ulna in MCPD-affected elbow joints, unloading the MCP. Changes in regional radial head bone density suggest that the radial head is involved in the pathogenesis of MCPD.

Management of peristomal tissue necrosis following prepubic urethrostomy in a cat

This report describes the successful management of peristomal tissue necrosis following prepubic urethrostomy in a cat. The novel technique of temporary urethral ligation was used in combination with temporary tube cystostomy and vacuum assisted closure to allow for wound management prior to performing wound closure by utilization of a flank fold skin flap then definitive prepubic urethrostomy. Eleven month follow-up indicated excellent outcome with the cat having returned to normal behaviour apart from having adapted its posture to urinate.