Surgical treatment of a proximal diaphyseal tibial deformity associated with partial caudal and cranial cruciate ligament deficiency and patella baja

Caudal cruciate ligament injury can be a complication following tibial plateau leveling osteotomy (TPLO) (Slocum und Slocum, 1993) especially if the post-operative Tibial Plateau Angle (TPA) is less than 5 degree. We describe a case of negative TPA associated with partial cranial and caudal ligament rupture treated with a center of rotation of angulation (CORA) based cranial tibial opening wedge osteotomy and tibial tuberosity transposition. A 13 kg, mixed breed dog was presented for right pelvic limb lameness. Radiographically a bilateral patella baja and a malformed tibia tuberosity along with a bilateral TPA of -8 degree were detected. Arthroscopically a partial rupture of the cranial and caudal cruciate ligaments were found. A cranial tibial opening wedge osteotomy of 23 degree and a fibular ostectomy were performed. The osteotomy was fixed with a 8 holes ALPS 9 (KYON, Switzerland) and a 3-holes 2.0mm UniLock plate (Synthes, Switzerland). Then a proximal tibial tuberosity transposition of 10mm was performed and fixed with a pin and tension band construct. The postoperative TPA was 15 degree. The radiographic controls at 6, 10 weeks, 6 months and 1 year after surgery revealed an unchanged position of the implants and progressive healing of the osteotomies. At the 6 and 12 months recheck evaluation the dog had no evidence of lameness or stifle pain and radiographs revealed complete healing of the osteotomy site and no implant failure. The diaphyseal CORA based osteotomy allowed accurate correction of a proximal tibial deformity associated with negative TPA

Partial pancreatectomy and splenectomy using a bipolar vessel sealing device in a cat with an anaplastic pancreatic carcinoma

A 14-year old domestic shorthair cat was presented because of vomiting, anorexia and an abdominal mass. A diagnosis could not be made preoperative and during surgery the mass was assigned to the gastric part of the pancreas. A partial pancreatectomy and splenectomy was performed using a Ligasure® vessel sealing device. No surgery related complications occurred. Histological examination revealed an anaplastic carcinoma of the pancreas. The cat was in a good clinical condition 14 days after surgery. After 2 months the cat was euthanized with the suspicion of a bone tumor. Findings of this case demonstrate that pancreatic carcinoma in cats has a poor prognosis but pancreatectomy can be performed using a bipolar vessel sealing device as a safe and fast alternative to standard surgical techniques

Biomechanical comparison of ex vivo lumbar vertebral fracture luxations stabilized with tension band or polymethylmethacrylate in cats

Objective: To evaluate spinal stabilization with tension band stabilization (TS) in cats compared to screw and polymethylmethacrylate fixation (SP). Study design: Ex vivo study. Sample population: Sixteen feline thoracolumbar spinal specimens. Methods: The intact specimens were mounted in a six‐degree‐of‐freedom biaxial testing machine for nondestructive testing to obtain the neutral zones (NZ) and range of motion (ROM) in flexion and extension. Thereafter, nondestructive testing was consecutively performed after destabilization by disc fenestration and partial L1 corpectomy and after treatment with either TS or SP. Load to failure was compared after surgical treatment in flexion. Significance was assessed by Student's t test or Wilcoxon signed‐rank test. Results: Range of motion was 26.4° ± 2.2° in TS constructs and 13.4° ± 2.1° in SP constructs (P = .0005). When flexion and extension were analyzed separately, no difference was found for ROM in flexion (SP, 7.0° ± 3.7°; TS, 8.3° ± 2.1°; P = .38). In extension, the mean displacement was 6.4° ± 2.7° and 18.1° ± 5.1° in SP and TS constructs, respectively (P = .0001). Neutral zone was 2.9° ± 0.6° and 7.5° ± 0.8° for the SP and TS groups, respectively (P = .0003). Screw and polymethylmethacrylate fixation constructs were two times stiffer (P = .045). Conclusion: Tension band stabilization provided stability comparable to SP in flexion. In extension, ROM of SP constructs was half that of TS constructs. The mode of failure of TS was related to the limited dorsal bone stock of feline lumbar vertebrae. Clinical significance: Surgeons should be aware of the limited stability in extension provided by TS when it is used to stabilize thoracolumbar spinal injuries. Our results provide evidence to justify additional studies to clarify the type of fractures amenable to TS

Novel avulsion pattern of the left principal bronchus with involvement of the carina and caudal thoracic trachea in a cat

A 2-year-old, 4.5 kg, neutered male domestic shorthair cat was presented to the emergency service with dyspnoea, anorexia and apathetic behaviour. Thoracic radiographs showed typical signs for a thoracic trauma and a tracheal lesion in the region of the carina consistent with pseudoairway formation. Computed tomography (CT) was performed in the conscious cat to avoid aggravation of air leakage associated with ventilation. The additional CT findings were consistent with a novel pattern of a traumatic avulsion of the left principal bronchus expanding into the carina and caudal thoracic trachea. Despite the complex avulsion pattern successful treatment was achieved surgically by performing an end-to-end anastomosis via a fifth right intercostal lateral thoracotomy. The cat was ventilated with a feeding tube and jet ventilation throughout. The cat showed excellent recovery 6 months after surgery

Clinical presentation, diagnosis, and treatment of cholelithiasis in a pet Guinea Pig (Cavia porcellus)

A 2.5-year-old female guinea pig (Cavia porcellus) presented for reduced appetite, signs of abdominal pain, increased respiratory effort, and a distended abdomen. Cholelithiasis was diagnosed by radiography and ultrasonography. The cholelith was surgically removed using cholecystectomy. After surgery the animal recovered quickly and clinical signs resolved. Stone analysis revealed a composition of 20% weddellite (calcium oxalate dehydrate) and 80% apatite (calcium phosphate). Histologic examination of the gallbladder revealed no significant pathologic changes. Three months after the surgical procedure the patient continued to do well and diagnostic imaging revealed no abnormalities. Surgical therapy was straightforward and effective

An anatomical study of plate-rod fixation in feline tibiae

OBJECTIVE: To investigate the feasibility of placing bi-cortical cortex (B-cort) or mono-cortical locking screws (M-lock) in a plate-rod construct applied to the feline tibia in combination with different intramedullary (IM) pins. METHODS: Twenty-four feline tibiae of cats were divided into 4 groups, corresponding to IM pin sizes filling approximately 30% (1.0 mm), 40% (1.4 mm), 45% (1.6 mm), and 50% (1.8 mm) of the medullary canal. Computed tomography (CT) was performed to trace potential screw trajectories in each group. A 12-hole, 2.4 mm locking compression plate was then applied on the medial aspect of the tibia. M-lock and B-cort screws were inserted subsequently in each plate hole. Success rates of screw insertion based on CT analysis and cadaveric simulation were compared with screw type, IM pin diameter, and anatomic location as variables. RESULTS: Screw insertion rates were underestimated on CT compared to cadaveric specimens. During cadaveric simulation, B-cort screws could be inserted in all specimens in the 3 most proximal plate holes and in at least 1 of the 3 distal plate holes. The smallest pin size (30%) allowed placement of a greater number of B-cort screws (P < .05) compared to other pins. Fewer B-cort screws could be inserted in the distal diaphyseal region (P < .05) compared to other regions. A total of 99.3% of M-lock screws could be inserted regardless of IMP size. CLINICAL SIGNIFICANCE: Plate rod constructs can include bicortical screws in the proximal and distal metaphysis, and monocortical screws in the diaphysis, combined with an IM pin filling up to 50% of the medullary canal

Chronic expanding haematoma in a cat

A 5-year-old cat developed a recurrent haematoma in the right hindlimb after receiving an intramuscular injection. Cold packs and a compressive bandage were applied without success. The haematoma resolved initially but recurred twice within a week after conservative treatment. Contrast computed tomography was performed after the second recurrence. A large cavernous lesion was found craniolateral to the right stifle. The lesion was removed surgically. No recurrence occurred during a 5 month follow-up. On histopathology the lesion was characterised as a chronic expansive haematoma. To our knowledge, this type of lesion has not previously been described in a small animal

Chronic expanding haematoma in a cat

A 5-year-old cat developed a recurrent haematoma in the right hindlimb after receiving an intramuscular injection. Cold packs and a compressive bandage were applied without success. The haematoma resolved initially but recurred twice within a week after conservative treatment. Contrast computed tomography was performed after the second recurrence. A large cavernous lesion was found craniolateral to the right stifle. The lesion was removed surgically. No recurrence occurred during a 5 month follow-up. On histopathology the lesion was characterised as a chronic expansive haematoma. To our knowledge, this type of lesion has not previously been described in a small animal

Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

Objective: To compare the stiffness and strength of three plate and rod fixation constructs applied to a feline tibial gap model. Study design: Ex vivo study. Sample population: Thirty-three unpaired tibiae obtained from skeletally mature cats. Methods: The tibiae were randomly divided into three groups. The following implants were then applied to the feline tibiae prior to the creation of a 10 mm diaphyseal gap. Group 1: 2.4 mm locking compression plate (LCP) and 1.0 mm intramedullary pin (IMP). Group 2: 2.4 mm LCP and 1.6 mm IMP. Group 3: 2.7 mm LCP. Subsequently, each specimen was tested for torsion, axial compression, and axial load until construct failure. Student's t-tests were used to compare the torsional and axial stiffness, yield load, and maximum axial force. Results: Group 2 had higher axial stiffness than group 3 (p = .013). Group 1 showed a lower maximum axial force and yield point than groups 2 and 3 (p < .01; p < .05, respectively). There were no among-group differences in torsional stiffness. Conclusion: Constructs with a 2.4 mm LCP and 1.6 mm IMP provided the strongest and most rigid constructs in a feline tibia gap model. Clinical significance: A plate-rod construct combining a 2.4 mm LCP and a 1.6 mm IMP is appropriate for achieving high implant stiffness and resisting maximum axial force in treatment of tibial fractures in cats