Comparison of two computerized methods to evaluate the elbow dysplasia in Rhodesian Ridgeback and Beagle dogs

Deckblatt-Impressum Inhaltsverzeichnis Abbildungsverzeichnis Tabellenverzeichnis Abkürzungen Einleitung Literatur Material und Methoden Ergebnisse Diskussion Zusammenfassung Summary Literaturverzeichnis Danksagung SelbständigkeitserklärungDie Ellbogengelenkdysplasie (ED) ist in zunehmendem Maße in den Blickpunkt tierzüchterischer Bemühungen gerückt. International anerkannt zur Bewertung von Ellbogengelenken bei ED gefährdeten Hunden ist das Bewertungssystem der IEWG, welches aber nur auf Ausmaß und Grad sekundärer arthrotischer Veränderungen beruht. Mit den Methoden nach Mues (2001) und Viehmann (1998) sollten primäre Veränderungen der Ellbogengelenke ermittelt werden. Beide Verfahren wollen eine größere Objektivität als die bisher gängigen Methoden haben. Bei der Messung nach Mues wurde eine Methodik auf der Basis von Winkelmessungen entwickelt, bei der die äußereren Gelenkstrukturen und die Gelenkgröße computergestützt erfasst und fünf Parameter, die das Gelenk charakterisieren, gemessen werden. Bei der Messmethode nach Viehmann werden absolute Werte ermittelt, indem Gelenkanteile und Flächen gemessen werden. Es werden acht Parameter bestimmt, die die Gelenkgröße, Stufen im Gelenk und die ulnare Gelenkfläche vermessen. Auch bei der Methode nach Viehmann werden Knochenpunkte computergestützt gesetzt. Es wurden seitliche Röntgenaufnahmen der Ellbogengelenke von 204 Rhodesian Ridgebacks und 20 Beagles vergleichend im Verfahren nach Mues und Viehmann evaluiert. Der Rhodesian Ridgeback wurde gewählt, weil er als große Rasse, im Gegensatz zu ED gefährdeten Rassen, wie z. B. Berner Sennenhund, Deutscher Schäferhund oder Rottweiler, als so gut wie ED-frei gilt und so als Referenz für große Rassen bezeichnet werden kann. Der Beagle ist eine mittelgroßen Rasse, die nicht als Risikogruppe einer Ellbogengelenksdysplasie gilt. Alle 408 Ellbogengelenke der Rhodesian Ridgebacks waren bereits nach den Richtlinien der IEWG beurteilt und 95,6% waren ED frei befundet. Die Gelenke der Beagles waren ED frei. Die zu untersuchenden Gruppen waren nicht altersgleich, da in der Beaglegruppe mehr ältere Tiere vertreten waren. Mit den Verfahren nach Mues und Viehmann sollten primäre Gelenkveränderungen objektiv im Hinblick auf eine ED ermittelt werden. Mues errechnet daraus das Risiko der ED-Vererblichkeit. Viehmann bestimmt geometrische Faktoren, die die Kongruenz (ED negativ) und Inkongruenz (ED positiv) beschreiben. Beide Verfahren beanspruchen eine größtmögliche Objektivität mit folgendem Ergebnis: Bei der Messung nach Mues zeigte sich ein signifikanter Unterschied zwischen Rhodesian Ridgeback und Beagle bei zwei der fünf gemessenen Parameter. Eine Korrelation mit dem ED Grad konnte beim Rhodesian Ridgeback für zwei der fünf Parameter (40%) nachgewiesen werden. Eine angemessene Wiederholbarkeit und daraus resultiernde Reproduzierbarkeit wurde bei einem Parameter ermittelt (20%). Bei der Messung nach Viehmann schlägt sich ein Rasseunterschied in zwei die Gelenkgröße und in einem, die Stufe im Gelenk beschreibenden Parameter nieder. Der ED Grad lässt sich signifikant durch sieben von acht Parametern (87%) unterscheiden. Allerdings konnte eine Wiederholbarkeit mit einer angemessenen Korrelation der Mittelwerte zum ED Grad nur für zwei dieser sieben Parameter (25%) nachgewiesen werden. In der Gesamtheit der statistischen Auswertungen beider Messmethoden bleiben zur Bewertung des Ellbogengelenks beim Rhodesian Ridgeback zwei sinnvolle, die Gelenkgröße beschreibende, Parameter übrig. Diese zwei Größen zeigen sowohl eine signifikante Korrelation zum ED-Grad des Gelenks, als auch eine ausreichende Wiederholbarkeit und dadurch Zuverlässigkeit innerhalb eines Gelenks. Die beiden Messmethoden sind in Anbetracht des Aufwands (Digitalisieren des Bildmaterials, Benutzung spezieller Computersysteme) zur individuellen Beurteilung eines Ellbogengelenks im Hinblick auf eine Ellbogengelenksdysplasie wohl nur eingeschränkt in der Routine einsetzbar.The elbow joint dysplasia (ED) has gained greater importance in the endeavours of Breeders. The internationally recognized measuring method for ED endangered dogs is the scoring system of the IEWG, which is only based upon dimension and degree of the secondary arthrotic changes. With the methods of Mues (2001) and Viehmann (1998), primary changes of the elbow joint could be obtained. Both methods claim to have a greater objectivity than the current methods that are commonly used. For measurement with Mues a method is used based upon angle measurement, where the outer joint structures and the size of the joint are compiled by a computer and evaluated based upon five parameters that characterize the joint. With the measuring methods from Viehmann, absolute values are obtained by measuring the parts and areas of the joint. Eight parameters are defined that measure the joint size, steps in the joint, and the surface ulnare joint. With Viehmann skeletal reference points can be set with computer support. Lateral radiographs of the elbow joints of 204 Rhodesian Ridgebacks and 20 Beagles were evaluated and compared in the methods of Mues and Viehmann. The Rhodesian Ridgeback was selected because it is a large breed that in contrast to ED endangered breeds like the Bernese Mountain Dog, German Shepherd, or Rottweiler, is considered to be almost free of ED, and can therefore be seen as a reference point for large breeds. The Beagle is a dog breed of medium size that is not considered to be ED endangered. All 408 elbow joints of the Rhodesian Ridgebacks were already judged according to the parameters of the IEWG and 95.6% were found to be free of ED. The joints of the Beagles were free of ED. The study groups were not of the same age, as the Beagle group was represented by more older animals. With the procedures of Mues and Viehmann, primary joint changes could be objectively obtained with regard to a elbow joint dysplasia. Mues calculates the hereditary risk of ED from this information. Viehmann defines geometric factors that describe the congruence (ED negative) and non-congruence (ED positive). Both methods demand the largest possible objectivity, with the following results: the measurements according to Mues show a significant difference between Rhodesian Ridgebacks and Beagles in two of the five measured parameters. With the Rhodesian Ridgebacks a correlation with the degree of ED was proved for two of the five parameters (40%). An acceptable repeatability and resulting reproducibility was detected in one parameter (20%). According to the measurements of Viehmann, the difference of breed is reflected by two parameters that describe the size of the joint and by one parameter that describes the step in the joint. The degree of ED is significantly differentiated by seven out of eight parameters (87%). However, a repeatability with suitable correlation to the mean degree of ED could only be proven for two out of these seven parameters (25%). In the totality of the statistical evaluation of both measuring methods, only two useful joint size describing parameters remain for the evaluation of the elbow joint of the Rhodesian Ridgeback. These two values show both a significant correlation to the degree of ED of the joint, and enough repeatability, and therefore reliability within a joint. Both measuring methods for individual evaluation of an elbow joint in regard to an elbow joint dysplasia are, considering their expenditures (digitalization of the visual material, use of special computer systems), limited in everyday implementation

Assessment of Hydroxyethyl Starch (6% HES 130/0.4) Kidney Storage in Critically Ill Dogs: A Post-mortem Prospective Study.

Objective: Intravenous hydroxyethyl starch (HES) solutions are potentially nephrotoxic due to rapid renal tissue uptake, subsequent osmotic nephrosis, and long-lasting intracellular storage. This study aimed to investigate the severity of intracellular storage of HES in renal tissue samples from critically ill dogs receiving 6% HES 130/0.4. Materials and Methods: Fresh, post-mortem (<2 h after death) renal tissue samples were analyzed through histology, immunohistochemistry (HES 130/0.4-specific antibodies), and electron microscopy for the severity of renal tubular vacuolization (VAC), intravacuolar HES accumulation (ACC), and ultra-structure impairment. Moreover, we investigated the relationship between VAC or ACC grade and HES dose (mL/kg), duration of HES administration (h), and pre-HES plasma creatinine concentrations. Results: Histology revealed that 2/20 dogs (10%) had no, 11/20 dogs (55%) had mild, 5/20 dogs (25%) had moderate, and 2/20 dogs (10%) had severe VAC. Immunohistochemistry revealed that 5/20 dogs (25%) had no, 6/20 dogs (30%) had mild, 7/20 dogs (35%) had moderate, and 2/20 dogs (10%) had severe ACC. Both changes were predominantly found in the distal tubular epithelium of mild and moderate cases, and all tubular segments were affected in severe cases. Seven of 20 dogs (35%) had osmotic nephrosis (ON). On electron microscopy, large granules with an electron-dense content were repeatedly detected in individual cells, mainly in the distal tubules. No correlation was found between cumulative HES dose or duration of HES administration and VAC grade, ACC grade, or presence/absence of ON. Conclusion: A high percentage of dogs had renal tubular HES storage and one-third of dogs showed HES-induced ON. Short-term HES administration caused VAC and ACC, regardless of the dose or duration of administration. In contrast to previous studies, HES 130/0.4 deposits were mainly located in the renal distal tubule

Kinetics of Plasma Cytokines, Angiopoietin-2, and C-Reactive Protein in Dogs With Gastric Dilatation Volvulus.

Background: The degree of systemic inflammation, reperfusion injury and endothelial activation are potentially important determinants of clinical outcomes in dogs with gastric dilatation volvulus (GDV). Objective: To evaluate plasma concentrations and kinetics of inflammatory markers in dogs with GDV over a time frame of 48 h, and to compare to healthy dogs. Design and Setting: Prospective, observational cohort study in client-owned dogs with GDV. Materials and Methods: Fifteen dogs with GDV and 9 healthy control dogs were enrolled. Plasma concentrations of interleukin (IL)-6, IL-7, IL-8, IL-10, IL-15, IL-18, interferon gamma (IFN-γ), keratinocyte chemotactic-like, monocyte chemotactic protein (MCP)-1, Angiopoietin (Ang)-2, and C-reactive protein (CRP) were measured at admission (prior any therapeutic intervention, (T0), immediately after surgery (T1), 24 ± 4 h (T24), and 48 ± 4 h (T48) post-surgery. Cytokines were measured using multiplex magnetic bead assay. Plasma Ang-2 was measured with a commercial human ELISA test kit validated for dogs. Results: Dogs with GDV had significantly higher plasma concentrations of IFN-γ and IL-10 compared to healthy control dogs at all time points. Concentrations of IL-6 were significantly higher at T1 and T24, concentrations of MCP-1 at T24, and concentrations of CRP at T24 and T48. A significant increase between T0 and T1 was found for IL-6, IL-10, and CRP, between T1 and T24 for IL-8, IFN-γ, MCP-1, and CRP, and between T24 and T48 for IL-15, Ang-2, and CRP. A significant decrease between T0 and T1 was found for IL-7, IL-8, IL-15, IL-18, and Ang-2; between T1 and T24 for IL-6 and KC-like; and between T24 and T48 for IL-6. Conclusion: In GDV dogs, a mild pro-inflammatory reaction was present at admission, which peaked immediately after and up to 24 h post-surgery, mainly represented by IL-6, IFN-γ, MCP-1, and CRP, and which decreased at T48. In addition, the anti-inflammatory IL-10 was increased in GDV dogs at all time points

Evaluation of the Effect of Storage Time on ROTEM S® Parameters in Healthy and Ill Dogs.

Viscoelastic testing as a bedside test to assess global haemostasis has gained popularity in the past decade, with rotational thromboelastometry (ROTEM) and thromboelastography (TEG) being the two commonly used devices. TEG studies suggest analysis 30 min after blood sampling. However, the reproducibility of results over time for ROTEM analysis using lyophilized samples in dogs has not been established. In this study, we investigated the influence of time on viscoelastic testing, using 33 healthy staff-/client-owned dogs for blood sampling and repeated measurements of ROTEM tracings at three different time points after blood collection. Additionally, a group of 21 hospitalized patients with suspected coagulation disorders were included to investigate whether stability over time was comparable between healthy and ill dogs. We demonstrated a significant difference of ROTEM tracings over time, with a tendency towards hypocoagulability over time. These changes do have a clinical relevance as they exceed reference intervals and could therefore lead to erroneous conclusions about a patient's coagulation status. Therefore, time-specific reference intervals are proposed and presented in this publication

Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs

Rotational Thromboelastometry (ROTEM) allows for the global assessment of hemostasis in whole blood samples. Preanalytical and analytical factors may influence test results, and data about the reliability and reproducibility of lyophilized ROTEM tests are scarce. Therefore, the objective of this study was to evaluate the influence of blood collection site on ROTEM S parameters and to assess intrarater and in-between device variability. A total of thirty, healthy, staff-owned dogs were included. Blood collection and ROTEM analysis were performed by trained staff according to a standardized protocol. Extrinsically activated (tissue factor; Ex-TEM S), with the addition of cytochalasin for platelet inhibition (Fib-TEM S), and intrinsically activated (In-TEM) analyses were performed. Analysis of our data showed significant variability for various Ex-TEM S and Fib-TEM S parameters from different collection sites and intrarater and in-between device measurements. We conclude that serial monitoring with ROTEM should be performed on the same device, with blood always taken from the same collection site using a standardized blood sampling technique. While In-TEM S, apart from maximum lysis, showed very stable and reliable results, we suggest interpreting especially clotting and clot formation parameters from Ex-TEM S and Fib-TEM S tests with caution and using duplicate measurements to detect outliers and to prevent initiation of incorrect therapies

Evaluation of the Effect of Storage Time on ROTEM S® Parameters in Healthy and Ill Dogs

Viscoelastic testing as a bedside test to assess global haemostasis has gained popularity in the past decade, with rotational thromboelastometry (ROTEM) and thromboelastography (TEG) being the two commonly used devices. TEG studies suggest analysis 30 min after blood sampling. However, the reproducibility of results over time for ROTEM analysis using lyophilized samples in dogs has not been established. In this study, we investigated the influence of time on viscoelastic testing, using 33 healthy staff-/client-owned dogs for blood sampling and repeated measurements of ROTEM tracings at three different time points after blood collection. Additionally, a group of 21 hospitalized patients with suspected coagulation disorders were included to investigate whether stability over time was comparable between healthy and ill dogs. We demonstrated a significant difference of ROTEM tracings over time, with a tendency towards hypocoagulability over time. These changes do have a clinical relevance as they exceed reference intervals and could therefore lead to erroneous conclusions about a patient’s coagulation status. Therefore, time-specific reference intervals are proposed and presented in this publication

Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs.

Rotational Thromboelastometry (ROTEM) allows for the global assessment of hemostasis in whole blood samples. Preanalytical and analytical factors may influence test results, and data about the reliability and reproducibility of lyophilized ROTEM tests are scarce. Therefore, the objective of this study was to evaluate the influence of blood collection site on ROTEM S parameters and to assess intrarater and in-between device variability. A total of thirty, healthy, staff-owned dogs were included. Blood collection and ROTEM analysis were performed by trained staff according to a standardized protocol. Extrinsically activated (tissue factor; Ex-TEM S), with the addition of cytochalasin for platelet inhibition (Fib-TEM S), and intrinsically activated (In-TEM) analyses were performed. Analysis of our data showed significant variability for various Ex-TEM S and Fib-TEM S parameters from different collection sites and intrarater and in-between device measurements. We conclude that serial monitoring with ROTEM should be performed on the same device, with blood always taken from the same collection site using a standardized blood sampling technique. While In-TEM S, apart from maximum lysis, showed very stable and reliable results, we suggest interpreting especially clotting and clot formation parameters from Ex-TEM S and Fib-TEM S tests with caution and using duplicate measurements to detect outliers and to prevent initiation of incorrect therapies

Plasma procalcitonin kinetics in healthy dogs and dogs undergoing tibial plateau leveling osteotomy.

BACKGROUND Procalcitonin (PCT) is a well-established biomarker for bacterial infection in human patients. OBJECTIVES We aimed to analyze the kinetics of plasma PCT (pPCT) in healthy dogs and dogs with canine cranial cruciate ligament (CCL) rupture undergoing tibial plateau leveling osteotomy (TPLO). METHODS This prospective, longitudinal study included 15 healthy dogs and 25 dogs undergoing TPLO. Hematology, pPCT, and C-reactive protein (CRP) were assessed on 3 consecutive days in healthy dogs and 1 day preoperatively and days 1, 2, 10, and 56 postoperatively. Inter- and intraindividual variability of pPCT were assessed in healthy dogs. Median pPCT concentrations of dogs with CCL rupture preoperatively were compared with healthy controls, and median pPCT concentrations, as well as percentage change post anesthesia, arthroscopy, and TPLO, were compared with baseline. For the correlation analysis, the Spearman rank correlation test was used. RESULTS Inter- and intraindividual variabilities of pPCT in healthy dogs were 36% and 15%, respectively. Median baseline pPCT concentrations were not significantly different between healthy dogs (118.9 pg/mL; IQR: 75.3-157.3 pg/mL) and dogs undergoing TPLO (95.9 pg/mL; IQR: 63.8-117.0 pg/mL). Plasma PCT concentrations were significantly lower immediately post- than preoperatively (P < 0.001). CRP, WBC, and neutrophil concentrations increased significantly on post-OP day 2 and had normalized by day 10. CONCLUSIONS These results indicate that CCL rupture, as well as anesthesia, arthroscopy, and TPLO combined, are not associated with increased pPCT concentrations in dogs with uncomplicated recovery. Considering the high intraindividual variability, individual serial measurements rather than a population-based reference interval should be considered