Diagnostics and treatment of cranial cruciate ligament rupture

Prednji križni ligament jedan je od glavnih stabilizatora koljenog zgloba kod pasa i ljudi. Puknuće prednjega križnog ligamenta najčešći je razlog šepanja i bolnosti stražnje noge kod pasa te može biti različite etiologije. U većini se slučajeva radi o kroničnom procesu, a ne o akutnoj traumatskoj ozlijedi. Puknuće može biti djelomično ili potpuno. Prilikom ortopedskog pregleda bitno je odrediti o kakvom se puknuću radi te je li došlo do ozljede meniska. Ortopedski se pregled preporučuje izvoditi u sedaciji zbog boljih rezultata i smanjene bolnosti pri pregledu. Liječenje može biti konzervativno i kirurško, a odabir ovisi o starosti i veličini psa, starosti procesa te mogućnostima i željama vlasnika.The cranial cruciate ligament is one of the most important stabilizers of the stifle (knee) joint in dogs and humans. Rupture of cranial cruciate ligament is one of the most common reasons for hind limb lameness and pain and it has various different etiologies, most of the cases are chronic processes rather than acute trauma. Rupture can be partial or full rupture. When doing an orthopedic exam it is important to discern what kind of rupture it is, and whether the meniscus is damaged or not. It is advised to sedate the animal prior to the orthopedic exam. When the animal is calm, the muscles are relaxed and the examination is less painful which ensures more accurate results. Treatment can be non – surgical and surgical, depending on the dog size, age, duration of the lesion, and on the wishes and possibilities of the owner

Ventralna abdominalna hernija u nimfe (Nymphicus hollandicus) - prikaz slučaja

Not many abdominal hernias in small birds have been clearly described. As in other animals, ventral abdominal hernias have been characterized as a separation of the abdominal musculature on the ventral midline. Hernias are often related to breeding, egg binding or influenced by hormones. This article describes one case of abdominal hernia in a five year old female cockatiel. A painless, 3cm in diameter and non-reducible mass was located in the ventral abdominal region. The mass was less than 1 cm from the cloaca. The bird had had problems with defecation for several months. After clinical examination and contrast radiogram, an abdominal hernia was diagnosed. Surgical repair was performed under general anesthesia and herniorrhaphy was indicated. After skin incision, a large mass of yellowish fat tissue was discovered and the intestines within with adhesions. The hernial sack contents were resected using blunt cotton swabs soaked in saline. For repair of the abdominal hernial ring and the abdominal wall, a simple continuous suture pattern with polyglyconate 4-0 was used. The skin was also sutured with a simple continuous pattern. Normal defecation returned within hours post op. The follow up examination after one month revealed no complications and no recurrence of the hernia.U danas dostupnoj literature nema puno prikaza slučajeva kila u malih ptica. Kao i u drugih životinja ventralne abdominalne kile opisane su kao razdvajanje mišićja trbušnog zida u središnjoj ventralnoj liniji. Kile u ptica su često povezane sa reprodukcijom, zaostalim jajetom ili hormonima. Ovaj članak prikazuje slučaj ventralne trbušne kile u pet godina stare nimfe. Bezbolna, 3 cm u promjeru, nereponibilna tvorba primjećena je na ventralnom dijelu trbuha. Tvorba je bila smještena manje od 1 cm od kloake. Nimfa je imala problema sa začepom nekoliko mjeseci. Nakon kliničkog pregleda i kontrastnog rendgenograma, dijagnosticirana je ventralna trbušna kila. Kirurško liječenje provedeno je u općoj anesteziji te je učinjena herniorafija. Nakon kožnog reza primjećena je velika žuta masa masnog tkiva te zavoji tankog crijeva sa priraslicama. Sadržaj hernijalne vreće je reseciran i prepariran tupo pomoću štapića s vatom natopljenih u fiziološku otopinu. Za šivanje i rekonstrukciju hernijalne vreće i trbušne stijenke korišten je produžni šav poliglikonatom 4-0. Koža je sašivena također produžnim šavom. Nekoliko sati poslije operacije ptica je dobila stolicu. Mjesec dana poslije operacije ptica nije pokazivala nikakve simptome povrata kile i obstipacije

Surgical Treatment of Scapular Fractures in Dogs and Cats

Lomovi lopatice rijetko se pojavljuju u veterinarskoj medicini. Uzroci su tupe traume, no u mladih životinja mogu se pojaviti i avulzijski lomovi. Nestabilni lomovi i artikularni lomovi lopatice zahtijevaju kirurško liječenje. Veće koštane fragmente na lopatici stabiliziramo upotrebom ortopedskih pločica, igala i vijaka ili serklažne žice, te kombinacijom ovih metoda. Lomovi manjih koštanih fragmenata stabiliziraju se priteznim ortopedskim vijcima, serklažnom žicom i ortopedskim iglama. Artikularni lomovi povezani su s dugoročnom rezidualnom hromošću. Moguće metode očuvanja dijela uda uključuju djelomičnu ili potpunu skapulektomiju ili artrodezu ramenog zgloba. Izostankom dubokog bola prognoza je nepovoljna i u tom se slučaju preporučuje kompletna amputacija.Scapular fractures are rarely seen in veterinary medicine. They are caused by blunt force trauma, but still, avulsion fractures can also occur in young animals. Unstable fractures, as well as articular fractures, require surgical treatment. Bone plates, Kirschner wire, bone screws, orthopedic wire and their combination stabilize larger fragments. Smaller bone fragments are stabilized with lag screws, orthopedic wire, and Kirschner wire. Articular fractures are linked with long-term residual lameness. Amputation with scapulectomy or shoulder arthrodesis is a viable salvage procedure. Loss of deep pain sensation is linked with poor long-term prognosis and warrants amputation

Management of Long Bone Fractures in Young Animals

U mladih životinja koje još nisu završile s rastom ploče rasta građene su od hrskavice koja će se s procesom sazrijevanja mineralizirati. U najčešće lomove u mladih životinja ubrajamo greenstick-lomove, avulzijske lomove te fizne lomove. Lomove koji zahvaćaju fize prema Salter-Harrisovoj klasifikaciji dijelimo na šest tipova. Specifičnost je mladih kostiju da stvaraju snažniji kalus nego odrasle, a sam je proces cijeljenja brži. Konzervativno liječenje lomova jest stabilizacija upotrebom imobilizacijskih povoja te udlaga bez otvorenoga kirurškog pristupa. Operacijsko liječenje loma jest primjena kirurškog pristupa kako bi se mogla postići anatomska repozicija, odnosno rekonstrukcija fragmenata pomoću implantata koji bi ih držali na mjestu. Najčešće se upotrebljavaju vanjski fiksatori, ploče i vijci te intramedularni čavli.In young animals that have not yet finished growing, the growth plates are made up of cartilage that will mineralize with skeletal maturation. The most common fractures in young animals include: greenstick fractures, avulsions and physeal fractures. Fractures involving the physis are classified into 6 types according to the Salter-Harris classification. The specificity of young bones is that they create a stronger callus than adult bones, and that the healing process itself is faster. Conservative treatment of fractures involves stabilization using immobilization bandages and splints, without creating a surgical wound and opening a surgical field. Surgical treatment of a fracture is the use of a surgical approach in order to achieve anatomical reposition and reconstruction of fragments using implants to hold them in place. The most commonly used implants are external fixators, plates and screws, and intramedullary pins

Surgical Treatment of Scapular Fractures in Dogs and Cats

Lomovi lopatice rijetko se pojavljuju u veterinarskoj medicini. Uzroci su tupe traume, no u mladih životinja mogu se pojaviti i avulzijski lomovi. Nestabilni lomovi i artikularni lomovi lopatice zahtijevaju kirurško liječenje. Veće koštane fragmente na lopatici stabiliziramo upotrebom ortopedskih pločica, igala i vijaka ili serklažne žice, te kombinacijom ovih metoda. Lomovi manjih koštanih fragmenata stabiliziraju se priteznim ortopedskim vijcima, serklažnom žicom i ortopedskim iglama. Artikularni lomovi povezani su s dugoročnom rezidualnom hromošću. Moguće metode očuvanja dijela uda uključuju djelomičnu ili potpunu skapulektomiju ili artrodezu ramenog zgloba. Izostankom dubokog bola prognoza je nepovoljna i u tom se slučaju preporučuje kompletna amputacija.Scapular fractures are rarely seen in veterinary medicine. They are caused by blunt force trauma, but still, avulsion fractures can also occur in young animals. Unstable fractures, as well as articular fractures, require surgical treatment. Bone plates, Kirschner wire, bone screws, orthopedic wire and their combination stabilize larger fragments. Smaller bone fragments are stabilized with lag screws, orthopedic wire, and Kirschner wire. Articular fractures are linked with long-term residual lameness. Amputation with scapulectomy or shoulder arthrodesis is a viable salvage procedure. Loss of deep pain sensation is linked with poor long-term prognosis and warrants amputation

Spororastući osteosarkom lopatice u psa mops pasmine - prikaz slučaja

A scapular bone tumor in a 7-year-old male Pug is described. The Pug accidentally ran into a door six years before and started to limp on his front right leg. A small mass was noticed by the Pug’s owners on his right shoulder which was ignored by the veterinarian. The mass increased in size until it became 9 cm in diameter and the dog was not using his leg occasionally. Finally the dog was referred to the Surgery, Ophthalmology and Orthopedics Clinic for further diagnostics. Following complete clinical and orthopedic examinations, an X-ray of the right scapula was performed and a neoplasia of the scapulae was suspected. A biopsy and histopathological examination was recommended in order to rule out osteosarcoma. The histopathological examination established the diagnosis of a highly productive, osteoblastic osteosarcoma of the right scapula with pulmonary metastasis. Prognosis was unfavorable due to metastases to the lungs evidenced by the X-ray. We report a case concerning an untreated scapular neoplasia with X-ray detectable lung metastases upon presentation at the Clinic. Proper diagnosis should be based on clinical examination, radiograph evaluation of the process and histopathological findings after bone biopsy. Blunt trauma can be a trigger for development of slow growing periosteal osteosarcoma, as described here. Treatment often include subtotal scapulectomy or forequarter amputation with adjuvant chemotherapy. Despite aggressive treatment, scapular osteosarcoma has a poor prognosis with low median survival time and disease free interval in dogs. Unfortunately the Pug’s owners refused the recommended treatment and the dog was euthanized 2 months later.Opisan je tumor lopatice u sedmogodišnjega muškog mopsa. Kao štene, slučajno je naletio na vrata i počeo šepati na prednju desnu nogu. Vlasnici su primijetili malu tvorbu, oteklinu na desnoj lopatici koju je veterinar ignorirao. Tvorba se s godinama povećavala do veličine od 9 cm u promjeru, a pas je povremeno šepao. Nakon kliničkog i ortopedskog pregleda te rendgenografskog oslikavanja desne lopatice posumnjalo se na neoplaziju lopatice. Preporučena je biopsija i histopatološka pretraga tvorbe kako bi se potvrdila sumnja na osteosarkom. Histopatološki nalaz upućivao je na vrlo produktivan, osteoblastični osteosarkom desne lopatice s plućnim metastazama. Prognoza je bila nepovoljna zbog rendgenografski dokazanih metastaza na plućima Kao što je ovdje opisano, trauma može biti okidač za razvoj spororastućeg periostalnog osteosarcoma, a pravilno dijagnosticiranje treba temeljiti na kliničkom pregledu, rendgenografskoj procjeni procesa i histopatološkom nalazu. Liječenje osteosarkoma lopatice često uključuje potpunu skapulektomiju ili amputaciju prednje noge s odgovarajućom kemoterapijom. Unatoč agresivnom liječenju, skapularni osteosarkom ima lošu prognozu, s niskim srednjim vremenom preživljenja i kratkim razdobljem bez bolesti u pasa. Nažalost, vlasnici mopsa odbili su preporučeno liječenje i pas je nakon dva mjeseca eutanaziran

Causes of Achilles tendon inflammation in animals

Uzroci upala Ahilove tetive u životinja mogu biti traumatske i atraumatske prirode. Patološke promjene u smislu upale mogu se dogoditi na čitavoj tetivi, bilo na prijelazu prema mišiću, na samoj ovojnici bilo na hvatištu Ahilove tetive za petnu kost. Etiologija upalnog procesa u samoj tetivi raznovrsna je, najčešće je traumatske, odnosno mikrotraumatske, metaboličke i, rjeđe, infektivne prirode. Djelovanjem različitih čimbenika, poput citokina interleukina-1, prostaglandina, dušikova oksida i metaloproteinaza, nastaje degradacija stanične i vlaknaste strukture tetiva. Degradacija je okarakterizirana kao slabljenje biomehaničkih svojstava tetive te smanjenje elastičnosti uz povećanu plastičnost i krutost te promjene u gustoći i debljini kolagenih vlakana koja postaju tanja. Nastaju promjene u sastavu i omjeru kolagena te izgledu vlakana karakteristične za tendinopatije. Poznavanje etiologije i čimbenika nastanka upale Ahilove tetive u životinja važno je za pravodobno prepoznavanje znakova upale, sprečavanje nastanka kroničnog oblika upala i njihovo liječenje. Za uspješno i brzo liječenje upale tetive liječenje treba započeti u što ranijoj fazi. Ako upalno stanje traje, nastaju oštećenja, a upala prelazi u subakutni ili kronični oblik. U slučaju da upala prelazi na hvatište tetive, nastaje upalno stanje ‒ entezitis. Tkivo takve tetive je degenerativno promijenjeno i slabije opskrbljeno krvlju. Uz nakupljanje stranih tvari, poput kalcijevih soli, stvaraju se kalcifikati. Tetiva gubi svoju karakterističnu histološku građu i biomehanička svojstva, a svaki pokret postaje izvor bola. U ovom je radu sažeto prikazana problematika tendinopatija Ahilove tetive u životinja.Causes of Achilles tendon injury in animals can be traumatic or atraumatic. Pathological changes in relation to inflammation may occur throughout the entire tendon, either at the transition towards the muscle, on the tendon sheath itself, or on the Achilles tendon insertion into the back of the heel bone. The etiology of the inflammatory process in the tendon itself is diverse, most commonly it’s traumatic, that is, microtraumatic, metabolic and less common infective. By the action of numerous factors such as cytokine interleukin-1, prostaglandin, nitric oxide and metalloproteinase, the cellular and fibrous structure of the tendon is degraded. Degradation is characterized as the weakening of biomechanical tendon properties and reduced elasticity while plasticity and stiffness are being increased. Changes in thickness and density of collagen fibres occurs and fibres are becoming thinner. Composition changes, collagen ratio and appearance of the fibres are characteristic of tendinopathies. Knowing the etiology and the cause of the Achilles tendon inflammation in animals is important for timely recognition of signs of inflammation, prevention of chronic inflammation and successful treatment. For successful and quick treatment of tendon inflammation it is crucial to start treatment in the early stage. If the inflammatory condition lasts it causes damage and inflammation passes into a subacute or chronic form. In case when inflammation transits on the Achilles tendon insertion it forms inflammatory state, called enthesitis . The tissue of such tendon has been degenerately changed, less supplied with blood, with the accumulation of foreign substances such as calcium salts and calcifications. Tendon loses its characteristic histological structure and biomechanical properties, and each movement becomes a source of pain. This paper summarizes the problems of Achilles tendon tendinopathy in animals

Mnemonic evaluation of osteosynthesis in dogs and cats

Koštani sustav životinja jest čvrsti dio lokomotornog sustava te sa skeletnim mišićjem sudjeluje u kretanju organizma i pruža zaštitu središnjem živčanom sustavu. S obzirom na to da je koštani sustav izložen raznim mehaničkim silama, često dolazi do ozljeda koje rezultiraju prekidom kontinuiteta kosti ili hrskavice, odnosno lomom. Većina tih ozljeda zahtijeva operacijsko liječenje odnosno osteosintezu. Rendgensko snimanje mjesta prijeloma treba napraviti prije operacije, odmah nakon operacije te u redovitim vremenskim razmacima poslije operacije kako bi se nadziralo stanje i napredak pacijenta te na vrijeme reagiralo ako cijeljenje kosti izostane ili bude usporeno. Za analizu i praćenje cijeljenja prijeloma nakon osteosinteze te uspješnosti osteosinteze primjenjuje se 4A metoda kojom promatramo sljedeće čimbenike: poravnavanje fragmenata (Alignment), apozicija fragmenata (Apposition), stanje implantata (Apparatus) i aktivnost kosti (Activity). U ovom je radu opisana 4A mnemonička procjena osteosinteze u nekoliko kliničkih slučajeva.The skeletal system of animals is the solid part of the locomotory system and together with the skeletal muscles, it participates in the movement of the organism and provides protection to the central nervous system. Due to the fact that the skeletal system is exposed to various mechanical forces, injuries often occur which result in breaking of the continuity of bone or cartilage, i.e. fractures. Most of these injuries require treatment or osteosynthesis. Radiology of the fracture should be performed before surgery, immediately after, and at regular intervals after surgery, in order to properly monitor the patient\u27s condition and progress and to promptly respond promptly if bone healing is not progressing or has slowed down. For analysis and monitoring of fracture healing after osteosynthesis and the success of osteosynthesis, the 4A method is used to observe the following factors: Aligment, Fragment Apposition, Apparatus, and Activity. This paper describes a 4A mnemonic evaluation of osteosynthesis through several case study examples

Usporedba pokazatelja procjene boli u pasa s operacijskim liječenjem puknuća prednjeg križnog ligamenta

The objective of this study was to compare postoperative pain, as assessed by multiple objective and subjective methods, after Tibial Tuberosity Advancement and Modified Retinacular Imbrication Technique, procedures that differ significantly in the extent of the operative trauma. We compared the preoperative, 2, 6, 10, 20, 44 and 68-hour postoperative results of the University of Melbourne Pain Scale and visual analogue scale with the dynamics of the physiologic, biochemical and behavioural parameters. The integration of various parameters increases the objectivity of pain assessment. The invasiveness of the surgical technique does not necessarily correlate with the level of postoperative pain.Cilj ovog istraživanja bila je usporedba poslijeoperacijske boli, procijenjene višestrukim objektivnim i subjektivnim metodama, nakon kranijalne transpozicije goljenične kvrge i modificiranog postupka zatezanja retinakula, kirurških zahvata koji se prema opsegu operacijske traume znatno razlikuju. Usporedili smo rezultate bodovnog sustava intenziteta boli Sveučilišta u Melbourneu i vizualne analogne skale s dinamikom fizioloških, biokemijskih i bihevioralnih pokazatelja prije operacije te 2, 6, 10, 20, 44 i 68 sati poslije operacije. Objedinjavanje različitih pokazatelja povećava objektivnost procjene boli. Invazivnost operacijske tehnike ne mora se nužno podudarati sa stupnjem poslijeoperacijske boli

Complications of fracture healing in dogs and cats

Prilikom odabira liječenja loma kosti potrebno je uzeti u obzir stanje životinje (dob, tjelesna masa i zdravstveno stanje), vrstu loma te financijsko stanje i angažman vlasnika. Zbog raznih uzroka, na koje se može ili ne može utjecati, može doći do komplikacija cijeljenja kosti, poput odgođenog cijeljenja, pseudoartroze ili nesrastanja, nepravilna srastanja, osteomijelitisa, sekvestracije, kutne deformacije te komplikacije cijeljenja zbog utjecaja implantata. Svako cijeljenje prijeloma dulje od očekivanoga naziva se odgođeno cijeljenje, a uzroci mogu biti neadekvatna fiksacija fragmenta, nedovoljna vaskularizacija kosti i okolnoga mekog tkiva, starost i drugi. Nesrastanje se odnosi na prijelome kod kojih nisu prisutni znakovi osteogenetske aktivnosti te je za sanaciju tih prijeloma potrebna kirurška intervencija. Možemo ih klasificirati u dvije skupine: biološki aktivne i biološki neaktivne. Nepravilno srasli lomovi jesu oni u kojima fragmenti kosti tijekom cijeljenja nisu bili anatomski poravnati. Vrste nepravilnog srastanja su valgus, varus, translacijsko nepravilno srastanje, rekurvatum, antekurvatum i torzijsko nepravilno sraštavanje. Osteomijelitis je infekcija kosti koja uključuje Haversove i Volkmanove kanale, te uglavnom medularni kanal i periost. Može nastati zbog otvorenog prijeloma, ali i zbog nekih trauma. Sekvestar je avitalan ulomak kosti koji se izolirao procesom nekroze i okružen je eksudatom, koji može biti ili sterilan ili neinficiran. Kutna deformacija nastaje nakon traume fize kod životinja koje nisu završile rast, kao posljedica preranog zatvaranja dijela ili čitave zone rasta te zaustavljanja rasta tog dijela kosti. U ovom ćemo radu pobliže objasniti svaku od komplikacija i njihove uzroke.When choosing a method of fracture repair, patient considerations (such as age, weight, overall general health), type of fracture and the ability of the owner to perform postoperative care, and the financial status of the owner should all be carefully considered. For various reasons that may or may not be preventable, complications of fracture treatment may be observed, such as delayed union, non-union, malunion, osteomyelitis, sequestration, angular deformities and implant failure. A delayed union is a fracture that takes longer to heal than anticipated. Causes may be inadequate fracture fixation, inadequate vascularity of the bone and soft tissue, the patient\u27s age, etc. A nonunion is a fracture that has failed to heal, and does not show any further signs of progression towards consolidation. Nonunions may be classified as biologically active (viable), and biologically inactive (nonviable). Malunions are healed fractures in which anatomical bone alignment was not achieved or maintained during healing. Malunions include: deviations in the limb axis (angular deformities), rotational limb deformities and shortening of the limb. Osteomyelitis is defined as a bone inflammation involving the Haversian spaces, Volkmann canals, and generally the medullary cavity and periosteum. Bone infection is usually associated with open fractures or other trauma. Sequestra are, by definition, dead bone fragments separated from a blood supply, that may be associated with infection. Angular deformities appear after physeal fractures as a result of injury to the growth plate. This paper explains each of the complications of fracture repair and their causes