Toby Gemmill

Prevalence of radiographic signs of degenerative joint disease in a hospital population of cats.

The prevalence of radiographic signs of degenerative joint disease (including appendicular osteoarthritis) among a hospital population of 218 cats was 33·9 per cent (74 cats), and the prevalence of signs of appendicular joint osteoarthritis was 16·5 per cent (36 cats). Half of the cases of appendicular joint osteoarthritis had no apparent radiographic or historical cause, and clinical signs of lameness were recorded in only six of them, all of which had an apparent radiographic cause. The 74 cats with radiographic signs of degenerative joint disease were on average significantly older than the 144 cats in which there were no radiographic signs of the disease.

Retrospective evaluation of the long-term outcome of non-surgical management of 74 dogs with clinical hip dysplasia

The long-term outcome for dogs treated non-surgically for clinical signs of canine hip dysplasia were evaluated retrospectively; 74 dogs were evaluated by a postal questionnaire sent to their owners, and 24 of these were also evaluated by a veterinary clinical examination. A total of 11 outcome variables were evaluated. Depending on the variable assessed, between 31 (41·9 per cent) and 49 (66·2 per cent) of the dogs remained clinically affected according to their owners assessment, and between 17 (70·8 per cent) and 23 (95·8 per cent) of the 24 dogs had abnormalities attributed to hip osteoarthritis according to the veterinary assessment. Orthopaedic abnormalities other than hip dysplasia affected 17 of the 24 dogs. Long-term medications had been prescribed for the treatment of clinical signs associated with hip dysplasia in 41 of the 74 dogs.

Comparison of Complication Rates and Clinical Outcome Between Tibial Plateau Leveling Osteotomy and a Modified Cranial Closing Wedge Osteotomy for Treatment of Cranial Cruciate Ligament Disease in Dogs

OBJECTIVE To report complication rates and clinical outcomes after tibial plateau leveling osteotomy (TPLO) and a modified cranial closing wedge osteotomy (mCCWO) for treatment of cranial cruciate ligament disease in dogs. STUDY DESIGN Prospective cohort study. ANIMALS Dogs weighing 20-60 kg with unilateral cranial cruciate ligament disease treated by either TPLO (n = 97) or mCCWO (n = 74). METHODS Clinical and radiographic assessments including lameness score, morphometric measurements and tibial plateau angle (TPA) were made before surgery and 8 weeks after either TPLO or mCCWO. Long-term outcome assessment by owner questionnaire or interview was undertaken at ≥6 months postoperatively. RESULTS Significant differences in lameness scores between groups were not identified at short- or long-term follow-up. Major complication and reoperation rates did not differ significantly between groups (TPLO 7.2% and 6.1%; mCCWO 9.5% and 5.4%). Median postoperative TPA did not differ significantly between groups (TPLO group 5.5°; mCCWO group 6.5°). At >6 months owner assessed lameness, disability, quality of life and satisfaction were not different between groups and were good in 90-97% of dogs. CONCLUSIONS In dogs weighing 20-60 kg, TPLO and mCCWO are associated with similar complication rates and clinical outcomes when performed by surgeons experienced with the surgical techniques.

Hybrid Cemented/Cementless Total Hip Replacement in Dogs: Seventy‐Eight Consecutive Joint Replacements

OBJECTIVE To evaluate the use of hybrid total hip replacement (THR), using a cementless acetabular component and a cemented femoral component. STUDY DESIGN Prospective case series. SAMPLE POPULATION Client-owned dogs (n = 71). MATERIALS AND METHODS Consecutive clinical cases that had hybrid THR were studied. Radiographic features, pain scores, and lameness scores were recorded pre- and postoperatively. Longer term outcome was assessed by owner questionnaire. RESULTS Hybrid THRs (n = 78) were performed in 71 dogs. Four cases (5%) had major postoperative complications; 3 were resolved after revision surgery, and 1 owner requested an explantation. No other major complications were identified on follow-up radiographs (67 THR) at 12 weeks. On clinical follow up (77 THR) at 4 weeks, lameness had improved in 68, was unchanged in 8, and was worse in 1. Pain had decreased in 72, was unchanged in 4, and was worse in 1. At 12 weeks (69 THR) compared with preoperative status, lameness had improved in 67 and was unchanged in 2. Pain had improved in 68 and was unchanged in 1. Longer term follow-up (mean, 16 months) was available for all hips. No further complications were reported. Owner satisfaction was good for 76 THRs and reasonable for 2. CONCLUSIONS Hybrid THR can be performed successfully with a low complication rate and represents an alternative to either entirely cemented or cementless implantation.

Evaluation of a joint distractor to facilitate arthroscopy of the canine stifle.

OBJECTIVES To assess a novel technique for arthroscopic evaluation of the canine stifle avoiding the need for fat pad debridement. STUDY DESIGN Prospective study. SAMPLE POPULATION Cadaveric canine stifles (n=10); Client-owned dogs (15). METHODS In cadaveric stifles, the femoropatellar space was assessed before placement of a joint distractor and examination of the femorotibial joint. Time to complete evaluation of the femoropatellar space, to observe the cruciate ligaments, and to completion of examination of the femorotibial joint were recorded. Distractor-assisted arthroscopy was then performed in 15 consecutive clinical cases. Clinical information, time to complete joint evaluation, and ability to perform any additional arthroscopic surgery were recorded. RESULTS Observation and palpation of intra-articular structures were possible in all cadaveric stifles. Mean time to evaluate the femoropatellar space was 3.2 minutes (range, 2-4 minutes); to observe the cruciate ligaments, 5.8 minutes (range, 3-8 minutes); and to completion of joint inspection, 9.1 minutes (range 6-13 minutes). In the clinical cases, observation of intra-articular structures was also possible in all stifles. Mean time to complete joint inspection was 21 minutes (range, 10-40 minutes). Partial meniscectomy was performed successfully in 5 stifles. CONCLUSIONS Use of a joint distractor allowed arthroscopic observation of all relevant structures. Partial meniscectomy was readily performed. CLINICAL RELEVANCE Use of a joint distractor may simplify arthroscopic assessment of the canine stifle and avoid potential morbidity associated with fat pad debridement.

Presumptive exercise-associated peracute thoracolumbar disc extrusion in 48 dogs.

Forty-eight dogs were diagnosed with presumptive exercise-associated peracute thoracolumbar disc extrusion. The median age was seven years (range two to 11 years), and median bodyweight was 23 kg (range 10 to 41 kg). The duration of signs before presentation ranged from 0.5 to four days. Twenty-nine dogs were non-ambulatory, of which 17 were incontinent and two had lost pain perception. Pelvic limbs were hyporeflexic or areflexic in 11 dogs. Intervertebral disc narrowing was evident on radiographs in 44 dogs. Myelography demonstrated a small, extradural space-occupying lesion dorsal to an intervertebral disc between T11-12 and L3-4 with adjacent spinal cord swelling. Forty-six dogs were treated non-surgically, one was euthanased and one was managed by hemilaminectomy (and subsequently euthanased). Follow-up information was available for 46 dogs 1.5 to 55 months after injury (median 22 months) showing that pelvic limb function had improved in all cases and all non-ambulatory dogs had regained the ability to walk. Six dogs remained faecally incontinent, and one dog remained urinarily and faecally incontinent.

Budd-Chiari-like syndrome caused by a congenital hiatal hernia in a shar-pei dog

CONGENITAL diaphragmatic hernias have been well documented in shar-pei dogs (Callan and others 1993). The presenting signs are usually regurgitation, vomiting and hypersalivation. Ascites has not been reported in congenital or acquired diaphragmatic hernias. This short communication describes a congenital hiatal hernia in a shar-pei dog that presented with ascites caused by a mechanical obstruction of the caudal vena cava (Budd–Chiari-like syndrome [BCLS]) (Van der Linde-Sipman and Stokhof 1974). A six-month-old male shar-pei dog was referred with a two-week history of regurgitation, abdominal enlargement and lethargy. There was no history of trauma. Physical examination revealed marked fluid distension of the abdomen, pitting oedema of the pelvic limbs (Fig 1), enlarged prescapular lymph nodes and a slight pyrexia (39·0°C). The initial diagnostic evaluation included serum biochemistry, haematology, urinalysis and analysis of abdominal fluid following paracentesis. Serum biochemistry demonstrated panhypoproteinaemia (albumin 20 g/l, reference range 29 to 36 g/l, globulin 19 g/l, reference range 28 to 42 g/l) and hypocalcaemia that was probably due to the hypoalbuminaemia. Mild hyperglycaemia and leucocytosis (monocytosis and neutrophilia), which were attributed to stress, were also identified. The urinalysis was unremarkable. The abdominal fluid was found to have a protein content of 28 g/l and a cell count of 0·375 x 109/l consisting of non-degenerate neutrophils, occasional eosinophils and a few macrophages. The enlarged lymph nodes were attributed to vascular congestion and were not investigated. A radiograph of the thorax demonstrated a large, soft tissue opacity containing some gas shadows in the caudo dorsal right thorax. An area of alveolar infiltrate partially obscured the cardiac silhouette. Loss of abdominal serosal detail secondary to a peritoneal effusion was evident (Fig 2). Abdominal ultrasonography confirmed the presence of moderately echogenic free fluid within the abdomen. The diaphragm appeared indistinct at the mid-ventral level. One liver lobe was identiVeterinary Record (2006) 159, 322-323

Precision of a novel computed tomographic method for quantification of femoral varus in dogs and an assessment of the effect of femoral malpositioning.

OBJECTIVE To assess the precision of a novel protocol for determination of femoral varus angle (FVA) using computed tomography (CT) in dogs, and to quantify the effect of femoral rotational and sagittal plane malpositioning on measured FVA. STUDY DESIGN Cross-sectional study. SAMPLE POPULATION Femora (n = 66) from dogs that had pelvic limb CT examination for patellar instability (26) or other reasons (10). METHODS Three observers measured FVA of each of 66 femora on three separate occasions. Standardized orientation of a volume rendered image was achieved by superimposition of the caudal and distal aspects of the femoral condyles on a lateral projection, definition of a sagittal plane axis, and finally rotation through 90° to yield a cranial projection. Intra- and inter-observer variability were estimated using the intra-class correlation coefficient. The effect of variation in rotational and sagittal plane orientation on measured FVA was subsequently quantified using 6 femora with FVAs between -0.4° and 19°. RESULTS Intra-class correlation coefficients for the 3 observers, indicating intra-observer variation, were 0.982, 0.937, and 0.974. The intra-class correlation coefficient of the means of the results from each observer, indicating inter-observer variation, was 0.976. Consistent linear variations in measured FVA occurred as a result of rotational malpositioning in all 6 tested femora, and as a result of sagittal plane malpositioning in femora with FVAs ≥ 7.9°. CONCLUSIONS The reported protocol for the measurement of FVA in dogs is repeatable and reproducible. Small variations in femoral orientation, as might be expected with conventional radiography, lead to clinically significant alterations in measured FVA.

Treatment of fractures of the tibial and/or fibular malleoli in 30 cats.

Five cats were treated for a fracture of the medial malleolus, 10 for a fracture of the lateral malleolus and 15 for fractures of both malleoli. Open reduction and internal fixation with Kirschner wires (K-wires) with or without a tension band wire was applied to 26 of the fractures. Unilateral-uniplanar or bilateral-uniplanar transarticular external skeletal fixators were applied to provide coaptation in 19 cases and appeared to be well tolerated. In 24 cases fracture healing was assessed radiographically between four and eight weeks after treatment. In seven cases fracture healing was good, in 12 cases it was reasonable, in four cases it was poor and in one case with two fractures healing was poor in one and reasonable in the other. The 12 fractures treated by open reduction and internal fixation with K-wires and a tension band wire all showed evidence of good or reasonable healing. The nine fractures treated by open reduction and internal fixation with K-wires without a tension band wire showed evidence of good or reasonable healing in six cases and poor healing in three cases. Complications occurred in nine of the cats and included persistent talocrural instability, soft tissue necrosis, implant migration and external fixator pin breakage. Twenty-one of the cats were followed up by telephone questionnaire for between 5·5 and 84 months; the owner satisfaction was excellent in 17 cases, good in two cases, moderate in one case and poor in one case.

Compensatory humeral overgrowth associated with antebrachial shortening in six dogs

ers 1987) growth plates has been shown to result in compensatory overgrowth of the adjacent long bone. This short communication describes the radiographic identification and relevance of compensatory humeral overgrowth in six dogs with antebrachial shortening treated by bone lengthening. Case records and radiographs were retrieved for six dogs which were presented with antebrachial growth deformities to Glasgow University Veterinary School between 1997 and 2002. Dogs were included if they had a marked unilateral antebrachial shortening (> 10 mm or >10 per cent reduction in antebrachial length). The signalment, radiographic diagnosis and treatment of each case are summarised in Table 1. The lengths of the long bones in both normal and affected legs were estimated from radiographs (Figs 1, 2, Table 2). The dogs were all presented when they were between three and six months of age (mean 4-3 months); all were presented with a relatively shortened radius (mean shortening 24-5 mm [ 18-2 per cent]) compared with the contralateral limb. Five dogs had rotational or angular deformities. Antebrachial limb-lengthening procedures were performed on all the dogs. The mean length deficit of the affected radius at the end of distraction and consolidation was 9-2 mm (5.9 per cent). The humeral length was measured at presentation in three dogs, in which a mean increase in humeral length of 5.0 mm (3.8 per cent) of the affected limb was identified relative to the contralateral limb. This overgrowth was not sufficient to