Idiopathic ischemic necrosis of an accessory carpal bone in a dog

Abstract Case Description—A 6-year-old neutered female mixed-breed dog was evaluated because of a 6-week history of left forelimb lameness that varied in severity. Clinical Findings—Radiography revealed expansile and lytic changes of the left accessory carpal bone (ACB). Results of histologic evaluation of ACB core biopsy specimens indicated areas of bone necrosis. The entire left ACB was excised and submitted for histologic evaluation; results confirmed a diagnosis of idiopathic ischemic necrosis. Treatment and Outcome—Left pancarpal arthrodesis was performed to treat carpal hyperextension and persistent lameness. The dog had an excellent functional outcome with no other problems related to the carpus until its death 4 years later, further decreasing suspicion that the problem was attributable to an undetected neoplasm or bacterial or fungal osteomyelitis. Clinical Relevance—The radiographic and histologic findings for the dog of this report were similar to previously reported findings for dogs with ischemic femoral head necrosis and humans with ischemic carpal (pisiform or lunate bone) necrosis. The etiology of the ischemic ACB necrosis in this dog was not determined. To the authors’ knowledge, this is the first report of a dog with idiopathic ischemic ACB necrosis. Idiopathic ischemic necrosis should be included as a differential diagnosis for dogs with lameness and destructive and expansile ACB radiographic lesions. An excellent functional outcome may be attained by means of ACB excision and pancarpal arthrodesis.</jats:p

Associations between early neutering, obesity, outdoor access, trauma and feline degenerative joint disease

OBJECTIVES: The aim of this case-control study was to identify early-life risk factors associated with the occurrence of owner-reported mobility changes in 6-year-old cats by examining prospective data from a longitudinal cohort study of pet cats, the Bristol Cats study. METHODS: Data on potential risk factors were obtained from seven sequential questionnaires completed between the ages of 2–4 months and 5 years. Mobility-related questions from the study questionnaire distributed at the age of 6 years were used to calculate each cat’s mobility score. Cats with mobility scores of ⩾2 and 0 were allocated to the case and control groups, respectively, and the cat’s status was the outcome variable. RESULTS: Of the 799 cats included for analysis, 238 (29.8%) had owner-reported mobility changes. Binomial logistic regression using backwards elimination identified four risk factors for owner-reported mobility changes at 6 years of age: entire neuter status at 6 months of age (odds ratio [OR] 1.97; 95% confidence interval [CI] 1.26–3.07), sustained trauma before 6 years of age (OR 1.85; 95% CI 1.30–2.60), outdoor access at 6 years of age (OR 1.67; 95% CI 0.96–2.90) and overweight/obese status at 6 years of age (OR 1.62; 95% CI 1.13–2.33). CONCLUSIONS AND RELEVANCE: Risk factor analysis demonstrated that obesity, outdoor access and a history of trauma may predispose cats to developing owner-reported mobility changes associated with degenerative joint disease, whereas neutering before 6 months of age appears to decrease that risk

Combined physeal fractures of the distal radius and ulna: complications associated with K-wire fixation and long-term prognosis in six cats

Objectives The objective was to describe the complications and long-term outcome associated with Kirschner (K)-wire fixation of combined distal radial and ulnar physeal fractures in six cats. Methods Medical records (2002-2014) of six referral institutions were searched for cats with combined distal radial and ulnar physeal fractures. Cases with complete clinical files, radiographs and surgical records were retrospectively reviewed. Long-term outcome was assessed via telephone interviews using an owner questionnaire. Results Complete files were available for 6/9 identified cases (cases 1-6). All fractures were classified as Salter-Harris type I or II. Five cases underwent open reduction and internal fixation via cross-pinning of the distal radius and intramedullary pinning of the ulna (cases 1-3); fixation of the distal radial and ulnar physes with one K-wire each (case 4); and K-wire fixation of the radial physis in combination with two transulnoradial K-wires (case 5). One case underwent closed reduction and percutaneous cross-pinning of the distal radius under fluoroscopic guidance (case 6). The complications encountered were: reduced radiocarpal range of motion (ROM) (cases 1, 3, 4, 5); implant loosening/migration (cases 1, 2, 5); and radioulnar synostosis (case 4). None of the cats developed angular limb deformity. Long-term outcome (12 months to 7 years after surgery) was graded as 'excellent' by the owners in all cases. Conclusions and relevance Prognosis is favourable for feline combined distal radial and ulnar physeal fractures following K-wire fixation in cats over 7 months of age. Implant removal after bony union is recommended to minimise reduction in ROM and to prevent implant loosening/migration

Treatment of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome

The aim of this study is to describe the treatment and outcome of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods: Data were collated on cats with PADS that were reported to have sustained humeral fractures or had fractures or fissures of the humerus identified on radiographs. The details of the fractures were recorded in addition to any treatment and outcome information. Results: Of the 207 cases reported with PADS, 18 cats (8.7%) were found to have humeral condylar fractures, none of which was known to have resulted from significant trauma. Where treatment occurred, it involved the placement of transcondylar positional or lag screws. In some cases additional implants, including supracondylar bone plates and screws or Kirschner wires (K-wires), were used. Follow-up data revealed that only two cats were euthanased owing to the presence of the humeral fractures, with at least eight achieving some degree of recovery of function. Conclusions and relevance: These humeral fractures all have the characteristics of stress insufficiency fractures, being simple isolated fractures that are short oblique, with increased radio-density at the fracture line and occurring following minimal or no trauma. Humeral intracondylar fissures were identified in two cats and it is possible that some of the other fractures may have occurred secondary to pre-existing fissures. To our knowledge, no prior reports exist of fissures in cats that do not meet the criteria for PADS. Surgical repair primarily consisted of the placement of transcondylar lag or positional screws with, in some cases, adjunct implants such as bone plates and screws or K-wires. Though there were insufficient data to determine the prognosis for these fractures in the long term, unlike patellar fractures, many of these fractures will heal if treated appropriately

Open-mouth jaw locking in cats:a literature review and use of CT in three cases

Case series summary This report summarises and reviews the published cases of open-mouth jaw locking in cats and describes three further cases. Case 1 was a 5-year-old, 5.3 kg male neutered domestic shorthair cat. CT identified changes consistent with temporomandibular joint (TMJ) dysplasia with osseous degenerative changes, and the cat subsequently underwent bilateral partial zygomectomy with bilateral partial coronoidectomy. Case 2 was a 10-year-old, 6.0 kg male neutered Exotic Shorthair. Aside from a fracture of the left maxillary canine tooth crown and absence of the left maxillary fourth premolar tooth, no abnormalities were found on CT scan. The cat also underwent bilateral partial zygomectomy with bilateral partial coronoidectomy. The third case was a 1-year-old, 4.0 kg male neutered Persian cat. Changes on CT were consistent with bilateral TMJ dysplasia, and the cat underwent staged bilateral partial zygomectomy with bilateral partial coronoidectomy. There was no recurrence of open-mouth jaw locking in any of the cases on long-term follow-up. Relevance and novel information Open-mouth jaw locking has been reported in cats of a wide range of ages, from 1–10 years. Cats with all skull types (brachycephalic, mesaticephalic and dolichocephalic) may be affected, but brachycephalic breeds seem to be over-represented. A CT scan with the jaw locked in place is recommended for diagnosis and surgical planning purposes; two of the cases reported here document the first cases of TMJ dysplasia in cats to be definitively diagnosed using CT. Trauma and symphyseal or TMJ laxity may also predispose to development of the condition. Partial coronoidectomy and partial zygomatic arch resection performed alone or in combination are generally successful at preventing recurrence. Bilateral partial zygomectomy with bilateral partial coronoidectomy has not previously been reported as a surgical treatment, and is recommended when open-mouth jaw locking occurs bilaterally. </jats:sec

Complications and outcomes associated with 13 cases of triceps tendon disruption in dogs and cats (2003-2014).

This study reports data from a larger number of cases of triceps tendon disruption. Records from 10 veterinary referral hospitals between 2003 and 2014 were searched for canine and feline cases diagnosed with triceps tendon disruption, based on orthopaedic examination confirmed during surgery. Long-term follow-up and owner satisfaction were assessed using a questionnaire. There were 13 cases of triceps tendon disruption diagnosed across seven hospitals (nine dogs, four cats). Trauma, history or presence of a wound, surgery in the region of tendon attachment or corticosteroid treatment preceded triceps tendon disruption. Radiographic signs or histopathology suggestive of a chronic tendinopathy was common. All cases underwent surgical repair involving a tendon suture pattern, 12 of which were secured through bone tunnels. Immobilisation was used in all cases in the form of transarticular external skeletal fixation (TAESF) (8/9 dogs) or spica splint (four cats, two dogs; in one dog a TAESF was applied after complications associated with the spica splint). Complications occurred in 11 cases (17 total complications), frequently associated with the immobilisation method. One case had traumatic tendon rerupture two years following surgery. A wound at presentation was associated with the development of multiple complications. Nine cases had long-term follow-up; five achieved normal function, four achieved acceptable function. Despite the complications, overall return to subjective normal or acceptable function, as assessed by the owners, was achieved in the majority of cases