Laura E. Peycke

Meniscal injury following initial cranial cruciate ligament stabilization surgery in 26 dogs (29 stifles)

OBJECTIVE To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. METHODS The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. RESULTS Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. CLINICAL SIGNIFICANCE Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.

Arthroscopic documentation of elbow cartilage pathology in dogs with clinical lameness without changes on standard radiographic projections.

OBJECTIVE To document cartilage damage associated with elbow lameness in dogs without radiographic signs. STUDY DESIGN Case series. ANIMALS Dogs (n=16). METHODS Medical records (November 2004-January 2006) of dogs with undiagnosed forelimb lameness localized to the elbow but without radiographic signs that had lesions identified by either computed tomography (CT) or nuclear scintigraphy and confirmed by arthroscopy were included. Signalment, duration of clinical signs before admission, surgical diagnosis, and treatment were recorded. RESULTS Sixteen dogs (10 left, 6 right elbows) were identified. Median age was 30.1 months and median duration of clinical signs before admission was 15.6 months. CT or scintigraphy were strongly suggestive of elbow pathology before confirmation by arthroscopy. Medial coronoid pathology was identified in every abnormal elbow and osteochondrosis dissecans in 2 elbows. CONCLUSIONS Elbow pathology not associated with radiographic changes can be identified by CT and scintigraphy. Coronoid pathology is the most likely diagnosis. CLINICAL RELEVANCE Absence of radiographic signs in elbows with clinical signs of lameness should be evaluated with advanced imaging techniques (CT, scintigraphy) and arthroscopy to identify the cause of lameness.

Facilitation of Soft Tissue Surgery: Surgical Staplers and Vessel Sealing Devices

Recent advances and acceptance of various medical devices have clearly helped in the efficiency, simplicity, and effectiveness of veterinary surgery. The goals of surgery include efficient methods and minimal surgical times, delicate tissue handling techniques, confidence with tissue reconstruction, and minimizing contamination, leakage and complications. Mechanical means of suturing, cutting, and hemostasis assist with accomplishing these goals. Most recently, stapling instrumentation and vascular sealing devices have become common instruments on all levels of surgery because of their ease of use and increase in surgical efficiency.

Comparison of Outcome After Use of Extra-Luminal Rings and Intra-Luminal Stents for Treatment of Tracheal Collapse in Dogs.

Objective To report short- and long-term complications and outcomes of dogs treated for tracheal collapse secondary to chondromalacia with extra-luminal rings (ELR) or intra-luminal stents (ILS). Study Design Retrospective cohort. Sample Population Dogs with naturally occurring tracheal collapse (n = 103). Methods Medical records (2002–2012) of dogs diagnosed with tracheal collapse that had treatment with ELR (n = 73) or ILS (30) were reviewed. Demographic information, procedural information, complications, survival time, and subjective outcomes were recorded. Follow-up periods were defined as 730 days (long-term). Results Ninety-two percent of dogs undergoing ELR and 100% of dogs undergoing ILS survived to hospital discharge. ELR dogs were significantly younger (P = .009) and significantly fewer had main-stem bronchial collapse (P < .001). After accounting for effects of age and presence of main-stem bronchial collapse, there was no significant difference in median survival time between groups. Dogs with main-stem bronchial collapse (regardless of treatment type) had a shorter survival time than dogs without main-stem bronchial collapse. Major complications occurred in ELR (42%) and ILS dogs (43%). Conclusions Both ELR and ILS are associated with high complication rates. Younger dogs and dogs without main-stem bronchial collapse had a longer survival time, regardless of treatment.OBJECTIVE To report short- and long-term complications and outcomes of dogs treated for tracheal collapse secondary to chondromalacia with extra-luminal rings (ELR) or intra-luminal stents (ILS). STUDY DESIGN Retrospective cohort. SAMPLE POPULATION Dogs with naturally occurring tracheal collapse (n = 103). METHODS Medical records (2002-2012) of dogs diagnosed with tracheal collapse that had treatment with ELR (n = 73) or ILS (30) were reviewed. Demographic information, procedural information, complications, survival time, and subjective outcomes were recorded. Follow-up periods were defined as <730 days (short-term) and >730 days (long-term). RESULTS Ninety-two percent of dogs undergoing ELR and 100% of dogs undergoing ILS survived to hospital discharge. ELR dogs were significantly younger (P = .009) and significantly fewer had main-stem bronchial collapse (P < .001). After accounting for effects of age and presence of main-stem bronchial collapse, there was no significant difference in median survival time between groups. Dogs with main-stem bronchial collapse (regardless of treatment type) had a shorter survival time than dogs without main-stem bronchial collapse. Major complications occurred in ELR (42%) and ILS dogs (43%). CONCLUSIONS Both ELR and ILS are associated with high complication rates. Younger dogs and dogs without main-stem bronchial collapse had a longer survival time, regardless of treatment.

Articular cartilage lesions associated with complete lateral meniscal tears in the dog

OBJECTIVE To describe articular cartilage (AC) lesions associated with complete lateral meniscal tears in dogs. STUDY DESIGN Observational series. ANIMALS Seventeen dogs with arthroscopic evidence of a complete lateral meniscal tear and associated AC lesions. METHODS Medical records of dogs with arthroscopic evidence of complete lateral meniscal tear and associated AC lesions between March 2006 and December 2017 were examined for arthroscopic findings. RESULTS The cranial cruciate ligament (CrCL) was intact in 11 of 17 dogs, partially ruptured but competent in 4 of 17 dogs, and completely ruptured in 2 of 17 dogs. All dogs had grossly normal caudal cruciate ligament, medial meniscus, and AC of the medial compartment. In each dog, a complete radial tear of the caudal body of the lateral meniscus was associated with degenerative osteoarthritis (OA) of the lateral compartment of the stifle. The Outerbridge score of the lateral tibial condyle and lateral femoral condyle was 5 of 5 in 15 dogs, 3 of 5 in 1 dog, and 4 of 5 in 1 dog. CONCLUSION Dogs with complete tears of the lateral meniscus developed degenerative OA of the lateral compartment of the stifle leading to AC loss and clinical dysfunction. CLINICAL SIGNIFICANCE Complete lateral meniscal tears may occur as isolated injuries in dogs with a functional CrCL.

Effects of femur position on radiographic assessment of completeness of femoral head and neck excision in medium to large breed dogs

OBJECTIVE To determine the effect of femur positioning on radiographic assessment of completeness of excision after femoral head and neck excision (FHNE) in medium to large breed dogs. SAMPLE POPULATION 10 femurs from canine cadavers (body weight > 20 kg). PROCEDURE Complete FHNE was performed on 5 canine femurs. Excision consisting of inadequate removal of the medial distal aspect of the femoral neck was performed on the remaining 5 femurs. Each femur was positioned with predetermined amounts of internal and external rotation about the long axis and radiographed. Investigators evaluated a set of 8 radiographic views of each femur. Sensitivity (SE), specificity (SP), positive predictive value, negative predictive value, and completeness of excision assessment accuracy were estimated for each of the femur positions. RESULTS Craniocaudal radiographic views of the femur positioned with external rotation of 15 degrees, 30 degrees, and 45 degrees as a group had the highest SE, SP, and completeness of excision assessment accuracy relative to other radiographic views. The SE, SP, and accuracy of assessment were higher when the degree of external rotation was increased from 15 degrees to 30 degrees or 45 degrees. CONCLUSIONS AND CLINICAL RELEVANCE Craniocaudal radiographic views of the femur positioned in external rotation (15 degrees, 30 degrees, and 45 degrees) improved the ability to detect adequacy of excision relative to standard craniocaudal and lateromedial radiographic views. Evaluation of craniocaudal radiographic views of the femur positioned in external rotation may increase the ability to assess FHNE adequacy in medium- to large-breed dogs.