Isometry of Potential Attachment Sites for the Iliotrochanteric Suture in Dogs: an ex vivo Study

Background: Coxofemoral luxation is the most common traumatic luxation in dogs and the iliotrochanteric suture is one of the surgical treatment options. The orthopedic suture aimed at surgically restoring joint movement should be employed in an isometric manner in order to maintain adequate tension throughout the arc of motion. This study aimed to determine the isometric points for the iliotrochanteric suture in dogs during the joint extension and flexion movements. This evaluation was performed both in the intact hip joint and in the luxation model, establishing the best combination, among the determined points, for the reestablishment of normal joint movement.Materials, Methods & Results: Radiographic analyses of 12 canine cadaveric hips, both intact and in craniodorsal luxation model, were performed in a neutral position, flexion at 50°, and extension at 150°. In the trochanteric segment, two parallel lines were drawn, creating the central vertical axis and the secondary vertical axis. Three points were then determined on each axis, from proximal to distal, corresponding to 25, 50, and 75% of the height of the axis, and were labelled as T1, T2, and T3 and T4, T5, and T6, respectively. In the iliac segment, a line perpendicular to the longitudinal axis of the ilium was drawn, and 25, 50, and 75% of this height corresponded to points I1, I2, and I3, respectively. The lengths between the points were measured, with the objective of evaluating which combination of points presented less variation in the joint positions. The central location of the iliac and trochanteric segments, determined respectively by I2 and T2, provided smaller variations during the maximal movements of hip flexion and extension.Discussion: The surgical techniques of iliotrochanteric suture target to maintain the internal rotation of the femoral head inside the acetabulum and abduction of the femur until the soft tissues have healed. The described techniques for the iliotrochanteric suture present a great anatomical variety in the arrangement of the anchor points of the suture. It is known that if during motion, the attachment sites move closer to one another, the suture will become lax and, if the attachment sites move away from one another, the suture will tighten. Therefore, the implantation in isometric sites assists in reducing the variation of the distance between the points of origin and insertion of the suture during joint movement, keeping the suture tension constant and allowing the functional recovery of the joint. This study demonstrates that there are some locations for the origin and insertion of an iliotrochanteric suture that are associated with less length change than others. I2-T2 combination is the point closest to isometry for the iliotrochanteric suture during hip extension and flexion, so that, T2 is the most central point of the greater trochanter, corresponding to 50% of the height of its central vertical axis, as well as I2, which corresponds to the most central point of the ilium, representing 50% of the height of the most caudal portion of its body. The isometric point found by us details the exact location of perforation in all aspects (height and length), both in the ilium and the trochanter. In addition, it is a personalized point created for each patient from its radiographic examination and taking into consideration its anatomical variations, so that there is no damage to the suture during hip extension and flexion movements

Cervical Laminectomy for the Treatment of Chronic Caudal Cervical Spondylomyelopathy in a Dog

 Background: Cervical spondylomyelopathy (CSM) is a common disease of the cervical spine, and causes neurogenic disorders commonly diagnosed in large and giant breeds dogs. There are many surgical procedures proposed for the treat­ment of CSM. Although many authors report a high success rate (between 70% and 90%) after surgical procedures, the high number of techniques described reflects the difficulty in treating this disorder. The objective of this paper is to report a case of CSM with chronic ventral compression (intervertebral disc extrusion) that was treated with dorsal decompres­sion, and to demonstrate the effectiveness of the decompressive technique through pre- and post-operative myelograms.Case: A 9-year-old Doberman Pinscher dog weighing 41.8 kg presented due to a history of tetraparesis. Neurological exami­nation did not reveal any alteration in mental status. There was absence of conscious proprioception on the four limbs; the pelvic limbs were more severely affected. Bilateral patellar hyperreflexia and normal flexor withdrawal reflex were observed on the hind limbs. There was decreased flexor withdrawal reflex and increased extensor tone on the forelimbs. The patient exhibited pain during caudal cervical palpation, and no alterations were seen on the cutaneous trunci reflex. Superficial pain was absent in the hind limbs; forelimbs exhibited presence of motor function with severe paresis. Survey radiographs revealed intervertebral disc space narrowing between C6-C7. A myelogram revealed ventral and dorsal compressions of the spinal cord in the C6-C7 area. Surgical treatment was elected, and laminectomy of the sixth and seventh cervical vertebrae was performed. Improvements were progressive on evaluations made on the seventh, eighteenth, forty-fifth, and sixtieth days after surgery. On the forty-fifth day after surgery, the patient was able to walk with the aid of a support sling, but was incapable of standing and walking without help. Muscle atrophy and paresis progressively improved up to the sixtieth day after surgery, but such improvement was not enough for the patient to get up and walk without the aid of the sling. In view of the evolution of the clinical signs during the post-operative period, another myelogram was performed to check if the extruded intervertebral disc, which was not removed during laminectomy, was still causing spinal cord compression. In comparison to the first myelogram, the compression was significantly attenuated by the surgical procedure. In this examination, the contrast medium columns were minimally compromised by the presence of herniated material; because of that, we opted not to perform a second surgical intervention for removal of herniated disc content.Discussion: Cervical laminectomy is indicated primarily for cases of dorsal compression associated with osteoarthritic changes of facet joints, malformation of the dorsal lamina, or ligamentum flavum hypertrophy however, this technique has also been used to treat ventral compressions, especially if they are multiple. There are no reports of direct comparison between laminectomy and other surgical techniques for the treatment of chronic ventral compressions; consequently, the choice of the technique depends on the surgeon’s experience and preference. Some authors argue that cervical laminec­tomy is not enough to attenuate the compression caused by the disc because this technique does not allow removal of the herniated disc material located ventrally. However, in the case reported here, a comparison between pre- and postopera­tive myelograms revealed that even though the herniated material was not removed, dorsal decompression allowed dorsal dislocation of the spinal cord and, consequently, promoted considerable attenuation of ventral compression.Keywords: Wobbler syndrome, nervous system, spinal cord, cervical vertebrae

Ovarian dysgerminoma causing multifocal metastases in young bitch

The ovarian neoplasias are unusual in canine species, mainly originated from germinative cells. Among these, dysgerminoma is a rare neoplasm in bitches, predominantly affecting senile and small and medium breeds. They are large, rounded, smooth surface, painless and firm in consistency. The clinical signs commonly demonstrated by patients with this neoplasia are abdominal distension and secondary signs of hyperestrogenism. The diagnosis should be based on the association of history, clinical signs, radiographic, ultrasonographic, cytological, histopathological and immunohistochemical exams. The treatment is the surgical castration and metastases are uncommon. Due to the rarity in bitches, specifically the young animals, this study aimed to describe a case of left ovarian dysgerminoma, of considerable size and adherence in adjacent organs, in a Brazilian Fila, whose showed considerable increase in abdominal volume and progressive weight loss. The diagnosis was confirmed by means of complementary x-ray, ultrasound, histopathological and immunohistochemical tests. Even with the recommended surgical treatment (castration), the patient demonstrated severe respiratory symptoms and increased abdominal volume after two months, and the complementary exams suggested pulmonary and multifocal metastases and the tutor chose euthanasia. As presented by the results, although rare in bitches, dysgerminoma should be included in the differential of ovarian neoplasias, including the young ones

Relevance of periodontal disease as a precursor to systemic disorders in companion animals / Relevância da doença periodontal como precursora de afecções sistêmicas em animais de companhia

Periodontal disease (periodontitis) is an oral condition characterized by the involvement of the periodontium, that is, structures that protect and support the teeth. It is commonly diagnosed in small animals, especially in the elderly, and is a frequent cause of tooth loss in both dogs and cats. The etiological factor of periodontal disease is the organized sub- and supragingival plaque and numerous factors are responsible for the predisposition of the disease such as age, race, size and immunity of the patient. The symptomatology of the affected animals varies according to the degree of involvement of the disease, but they usually include halitosis, hyperemia, bleeding and gingival retraction, odontoliths, contact gingival ulcers, furcation exposure and tooth loss. The diagnosis is based on history, complete anamnesis, thorough examination of the oral cavity associated with extra and intraoral x-rays. The periodontal treatment has the purpose of eliminating the causal agent, removing dental stones, tooth extractions and polishing the remaining dental elements. In addition to local changes, periodontal disease can cause systemic damage, due to the rich vascularization of the periodontium and tooth movement in the tooth socket, allowing bacteria and their metabolites to enter the lymphatic and blood vessels during patient chewing, causing organ failure. In view of the high incidence of periodontal disease in pets and the consequent local and systemic changes, the objective of the current work was to carry out a bibliographic survey on this oral condition in dogs and cats, highlighting the damage to other organs due to bacteremia. In this context, the scientific literature emphasizes that the systemic immune response secondary to bacteremia predisposes the formation of immune complexes in the bloodstream that adhere to the walls of the endothelium causing local inflammation and endothelial lysis of the heart, kidneys, liver, lungs, bones, among others, reflecting on diverse symptomatology. Thus, it is assumed that early diagnosis and treatment of periodontal disease can prevent the establishment and local progression of oral disease and, consequently, systemic impairments that directly affect the quality of life and survival of the affected.Periodontal disease (periodontitis) is an oral condition characterized by the involvement of the periodontium, that is, structures that protect and support the teeth. It is commonly diagnosed in small animals, especially in the elderly, and is a frequent cause of tooth loss in both dogs and cats. The etiological factor of periodontal disease is the organized sub- and supragingival plaque and numerous factors are responsible for the predisposition of the disease such as age, race, size and immunity of the patient. The symptomatology of the affected animals varies according to the degree of involvement of the disease, but they usually include halitosis, hyperemia, bleeding and gingival retraction, odontoliths, contact gingival ulcers, furcation exposure and tooth loss. The diagnosis is based on history, complete anamnesis, thorough examination of the oral cavity associated with extra and intraoral x-rays. The periodontal treatment has the purpose of eliminating the causal agent, removing dental stones, tooth extractions and polishing the remaining dental elements. In addition to local changes, periodontal disease can cause systemic damage, due to the rich vascularization of the periodontium and tooth movement in the tooth socket, allowing bacteria and their metabolites to enter the lymphatic and blood vessels during patient chewing, causing organ failure. In view of the high incidence of periodontal disease in pets and the consequent local and systemic changes, the objective of the current work was to carry out a bibliographic survey on this oral condition in dogs and cats, highlighting the damage to other organs due to bacteremia. In this context, the scientific literature emphasizes that the systemic immune response secondary to bacteremia predisposes the formation of immune complexes in the bloodstream that adhere to the walls of the endothelium causing local inflammation and endothelial lysis of the heart, kidneys, liver, lungs, bones, among others, reflecting on diverse symptomatology. Thus, it is assumed that early diagnosis and treatment of periodontal disease can prevent the establishment and local progression of oral disease and, consequently, systemic impairments that directly affect the quality of life and survival of the affected.

Association of Rush Pin and Intramedular Pin Techniques for the Stabilization of Salter Harris Type I Fracture in Rabbit (Oryctolagus cuniculus)

Background: In domestic rabbits, fractures are usually the result of household accidents. Fractures of the distal femoral physis are frequently observed in animals with immature skeletons and may cause future orthopedic problems. With this type of fracture, early reduction and stabilization are necessary to prevent additional damage to the physis and to preserve the growth potential of the bone. This report aims to describe the clinical and radiographic findings, as well as the surgical method used that combined Rush pins with an intramedullary pin, associated with a Salter Harris type I fracture of the right distal femur in a rabbit.Case: A 4-month male domestic rabbit (Oryctolagus cuniculus) weighing 1.2 kg, was referred to the Veterinary Hospital with a right pelvic limb lameness after an episode of trauma. Orthopedic examination revealed swelling, instability, crepitation, and increased pain sensitivity in the distal aspect of the right femur. Following physical and radiographic examination,a Salter Harris type I fracture of the right distal femur was diagnosed. The patient was premedicated with a combination of xylazine (2 mg/kg IM) and ketamine (10 mg/kg IM), which allowed placement of an IV catheter for the administration of fluids and intubation using an endotracheal tube with an internal diameter of 2 mm. Anesthesia was maintained with isoflurane, and an epidural was performed with a combination of lidocaine (2 mg/kg) and bupivacaine (0.75 mg/kg). Osteosynthesis was performed with two Rush pins and an intramedullary pin. Radiographic examination 110 and 330 days after the surgical procedure showed good alignment of the bone and adequate healing of the fracture. The combination of techniques used in this case report proved to be effective, resulting in functional recovery of the limb and rapid bone healing.Discussion: Preoperative planning for orthopedic surgery in rabbits is different from that of dogs and cats, due to the particularities of the species. Familiarity with the regional anatomy, patient preparation, and appropriate instrumentation are necessary when contemplating osteosynthesis in a rabbit. Salter Harris fractures affect young animals, where the physis is considered an area of fragility in the bone. Surgical planning should take into account the function of the growth plates.It is recommended that implants passing through the physis do so perpendicularly, since angulation greater than 45° may predispose the bone to premature closure of the growth plate. Another important consideration involves the choice of implants, since the use of trocar-tipped pins facilitates their precise placement in the bone. The use of threaded pins should be avoided due to their weakness at the thread-shaft interface, and the risk of impaired longitudinal bone growth and thedifficulty of removal if necessary. Steinman pins and Kirschner wires can be used to stabilize a variety of different fractures. In Salter-Harris type I and II fractures, the use of pins neutralizes bending forces but not rotational or compressive forces. In contrast, Rush pinning and cross-pinning techniques are effective in neutralizing the forces acting on the physis, and are frequently used for the fixation of fractures in this region. Complications, often associated with poor reduction and alignment, can result in varus or valgus deviation and are associated with a high risk of implant failure or migration, malunion, and patellar luxation. It was concluded that the combination of Rush pins and an intramedullary pin resulted in adequate stabilization of the Salter Harris type I fracture of the distal femur in this rabbit.Keywords: Orthopedic implants, osteosynthesis, trauma, bone repairing, lagomorph

Comparison of Intraoperative Nociception and Postoperative Acute Pain After Traditional or Minimally Invasive Ovariohysterectomy in Dogs

Background: Many variations of ovariohysterectomy techniques have been described, including the traditional one and minimally invasive procedures. Non-laparoscopic Snook hook technique is an alternative for performing minimally invasive ovariohysterectomy. Few studies have been carried out in order to assess pain in animals submitted to minimally invasive surgeries, especially involving one of the most performed surgical procedures in veterinary practice. The aim of this study was to evaluate surgical duration, intraoperative nociception and acute postoperative pain after traditional ovariohysterectomy or minimally invasive non-laparoscopic technique in dogs using Snook hook. The hypothesis is that non-laparoscopic minimally invasive ovariohysterectomy would be faster and less painful than the conventional technique.Material, Methods & Results: Thirty dogs were divided into Traditional Group (TG = 15) and Minimally Invasive Group (MIG = 15). Heart rate, respiratory rate, systolic blood pressure, body temperature, oxyhemoglobin saturation, end-tidal carbon dioxide concentration (ETCO2) and end-tidal isoflurane concentration were evaluated before the surgery to start (M0), during incision (M1), clamping of the first ovarian pedicle (M2), second ovarian pedicle (M3), uterine cervix (M4), abdominal suture (M5) and at the end of surgery (M6). The modified Glasgow Pain Scale was used for acute postoperative pain assessment and Visual Analogue Scale (VAS) was used to assess the sensitivity of surgical wound. The level of significance established for all statistical analyzes was 5%. Statistical differences were not observed between groups considering total surgical time and postoperative acute pain intensity (P > 0.05), in spite of MIG having shorter duration of surgery. There was no statistical difference between groups considering all intraoperative parameters except respiratory rate (TG < MIG; P < 0.05) and ETCO2 (MIG < TG; P < 0.05) at the moment of traction of the first ovarian pedicle (M2). Pain assessment by VAS showed statistical difference 24h after the end of surgery (TG < MIG) (P < 0.05). Discussion: Both procedures were similar regarding intraoperative nociception and acute postoperative pain. It is possible that the sensation of pain in both procedures was blocked by the effectiveness of analgesics, once they might cause an inhibition of painful behaviors limiting a possible difference in pain identification. Higher respiratory stress observed in MIG at M2 and higher pain score by VAS noted in MIG 24 h after the end of surgery can be justified by greater traction of ovarian pedicle, due to limited surgical access of minimally invasive technique. Minimally invasive ovariohysterectomy non-laparoscopic seems to be potentially faster, probably due to the smaller size of the abdominal incision, which takes less time to be closed. In the present study, both techniques were performed by an experienced surgeon, providing safe procedures, nevertheless it is important to emphasize that iatrogenic injury can be caused by surgeons not proficient in the Snook hook technique, considering the limited visualization of anatomical abdominal structures. Data obtained indicate that traditional ovariohysterectomy and non-laparoscopic Snook hook technique promote similar intraoperative nociception and acute postoperative pain, however minimally invasive procedure is potentially faster and with less surgical trauma

Osteossíntese de tíbia com uso de fixador esquelético externo conectado ao pino intramedular tie-in em cães

A incidência de fratura de tíbia em cães representa 21% das que ocorrem nos ossos longos. Vários métodos são utilizados nas osteossínteses deste osso, tais como: pinos intramedulares; fixadores esqueléticos externos; placas ósseas e; associações entre eles. O método usado foi uma modificação da configuração denominada tie-in, na qual um PIM é conectado externamente a pinos de Schanz ou parafusos de aço inoxidável fixados com metil-metacrilato. O PIM é introduzido através de um orifício confeccionado na face medial da tíbia, próximo à crista tibia!. A configuração foi utilizada em 21 cães com fratura de tíbia atendidos no Hospital Veterinário do Câmpus da UNESP de Jaboticabal-SP. Os animais foram avaliados clínica e radiograficamente, no período pré e pós-operatório imediato e a cada 30 dias, até completar quatro meses. Os animais recuperaram, clinicamente, a função do membro no período médio de 11 dias após a cirurgia. Nove animais tiveram a configuração dinamizada, por meio da desconexão do PIM; remoção do PIM ou dos implantes de fixação e retirada dos implantes de fixação e manutenção do PIM. Radiograficamente verificou-se consolidação óssea em média de 76 dias de pós operatório, e apenas um animal apresentou não-união. A configuração tie-in mostrou se eficaz como método de osteossíntese em fraturas tibiais de cães.The incidence of tibial fractures in dogs assumes 21 % of ali fractures that occur in long bones. Several methods are used in the osteosynthesis, of these fractures like external skeletal fixator, bone plates and associated techniques. The aim of this study is to describe the method and perform a radiographic and clinical evaluation of a group of 21 dogs with tibial fractures from the veterinary teaching hospital of the UNESP SÃO PAULO STATE UNIVERSITY- CAMPUS OF JABOTICABAL. The used method was a modification of the termed tie-in configuration, in that an IMP was connected externally with Schanz pins or stainless steel screws fixed together with methylmethacrylat. The pin was applied through hole on the medial tibia near the tibial crest. Clinical and radiographic evaluations were performed in pre-and post-operatory period and at 30, 60, 90 and 120 days. Animais recovered the function of the affected limb in a mean period of 11 days afier the surgery. Nine dogs underwent dynamization through: a) IMP disconnection, b) IMP or, c) fixation pins takeout and d) fixation pins takeout and maintenance of the IMP. Radiographicaly, the fracture union occurred in 20 dogs, in a mean period of 76 days; non-union was observed in only one dog. T~erefore, the tie-in modificated frame configuration showed efficacy as a method of osteosynthesis in tibial fractures of dogs.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Desenvolvimento e aplicação clínica de haste intramedular bloqueada angulada no tratamento de fraturas tibiais em cães

As fraturas de tíbia em cães representam 20% das que ocorrem em ossos longos. Vários métodos são utilizados nas osteossínteses desse osso, contudo, atualmente as hastes bloqueadas vêm ganhando espaço, especialmente por suas vantagens biomecânicas quando comparadas às demais técnicas. O presente trabalho teve por objetivo desenvolver e avaliar o uso de haste intramedular bloqueada angulada para fraturas tibiais em cães, visando minimizar erros de bloqueio de parafusos e consequentemente problemas na consolidação óssea. Hastes anguladas, de aço inoxidável da série 316L, foram confeccionadas nos diâmetros de 5, 6, 7 e 8 mm, com comprimentos variados. Num período de 17 meses, ocorreu a implantação destas em 15 cães com fratura de tíbia. As avaliações clínica e radiográfica ocorreram no pré e pós-operatório imediato e a cada 30 dias até completar quatro meses. Clinicamente, a recuperação da função do membro se deu no período médio de 10 dias após a cirurgia. Em três animais, utilizou-se além da haste angulada e parafusos, pinos de Schanz como bloqueio (fixador externo), que posteriormente foram retirados. Radiograficamente verificou-se consolidação óssea em média de 70 dias de pós-operatório. A haste intramedular bloqueada angulada mostrou-se eficaz como método de osteossíntese em fraturas tibiais de cães.In dogs, tibial fractures account for approximately 20% of all long bone fractures. Different methods of fracture repair are used in this bone; however, interlocking nails have gained popularity in recent years owing to its biomechanical advantages when compared to other techniques. The present study aimed to develop and to evaluate the usefulness of an angulated interlocking nail model in tibial fractures of dogs to minimize blocking errors arising from inaccurate bolt stabilization, responsible for generation osseous consolidation. Angulated stainless steel pins from series 316L were manufactured with 5, 6, 7 and 8 mm of diameter, and variable length. During 17 months, pins were implanted in 15 dogs with tibial fracture. Clinical and radiographic findings were recorded on preoperative and on the immediate postoperative period, and every 30 days, until the last recheck, 4 months latter. Clinically, animals recovered the hind function on an average of 10 days after surgery. In three dogs, in addition to the angulated interlocking nail and bolts, scat pins (external fixator) were used. Radiographically, bone consolidation was evident on an average of 70 days of postoperative period. The angulated interlocking nail is a feasible method to repair tibial fractures of dogs.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Description of six autochthonous cases of canine visceral leishmaniasis diagnosed in Pedregulho (São Paulo, Brazil)

Visceral leishmaniasis is an infectious disease of chronic, emerging and zoonotic nature that presents various degrees of severity. In Brazil, this illness is caused by Leishmania infantum (Leishmania chagasi), which is transmitted by the bite of the sand fly Lutzomyia longipalpis, and dogs are its main reservoir. Given the increasing spread of this disease across Brazil, the aim of this study was to report on six cases of canine visceral leishmaniasis, diagnosed in June 2013, in the city of Pedregulho, State of São Paulo, considered to be a non-endemic area and free of phlebotomine sand flies. The diagnosis was based on clinical signs of the patients and additional tests (serological and parasitological). It was concluded that the diagnosis of leishmaniasis is complex because the clinical signs are similar to other systemic diseases, thus justifying the importance of parasitological test of bone marrow, considered "gold standard", in the confirmation of the disease. In addition, the area was not, until now, considered risk place, despite notification

Palatoplasty with flap superimposed in dog - Case report

ABSTRACT. Gonçalves Dias L.G.G., Gonçalves Dias F.G.G., Ikenaga F.M., Honsho C.S., Souza F.F., Selmi A.L. & Mattos Junior E. [Palatoplasty with flap superimposed in dog - Case report.] Palatoplastia com retalho sobreposto em cão - Relato de caso. Revista Brasileira de Medicina Veterinária, 37(3):179-185, 2015. Curso de Graduação em Medicina Veterinária e Programa de Pós-Graduação Stricto Sensu em Medicina Veterinária de Pequenos Animais, Universidade de Franca, Av. Dr. Armando Salles de Oliveira, 201, Parque Universitário, Cx. Postal 82, Franca, SP 14404-600, Brasil. E-mail: [email protected] The oral cleft palate deformities are characterized by disruption in the integrity of the bone and palatal mucosa, having variable extensions and multifactorial etiologic character. Frequently are unnoticed by owners and veterinarians at birth and are diagnosed only when the animal begins to demonstrate clinical respiratory signs. Affected patients have direct communication between the oral and nasal cavity, which can cause aspiration pneumonia and hinder the negative intraoral pressure necessary for the suction of milk, these being factors contributors to the deficit in body growth and death. This paper aimed to highlight important points about this rare oral disease in small animals, moreover, report the case of a dog with cleft palate treated successfully with the technique of overlapping flap palatoplasty