Risk factors for severe postoperative complications in dogs with cranial cruciate ligament disease-A survival analysis

Objective: To analyze the effect of surgical technique and other risk factors on severe postoperative complications in dogs with cranial cruciate ligament disease (CCLD). Materials and Methods: A cohort study of 255 dogs (287 stifles) surgically treated for CCLD at two veterinary university hospitals (2011 & ndash;2016) was performed. The electronic medical records were reviewed and dog owners and referring veterinarians contacted for additional information. The complications were classified as minor, major and catastrophic, where major and catastrophic were considered severe. A multivariable Cox proportional hazards model was applied to assess risk factors for severe postoperative complications.Results: Three surgical techniques were used; lateral fabellotibial suture (LFS, 141 stifles), tibial plateau leveling osteotomy (TPLO, 77 stifles) and tibial tuberosity advancement (TTA, 69 stifles). The most common severe postoperative complications were surgical site infections or complications related to the surgical implant. Severe postoperative complications occurred in 31 % of the stifles treated with TPLO, 22 % of the stifles treated with LFS and 25 % of the stifles treated with TTA. The multivariable Cox proportional hazards model identified surgical technique (p = 0.0258) as a risk factor for severe postoperative complications; TPLO had a significantly lower hazard than LFS (hazard ratio (HR) = 0.37, p = 0.007) when controlling for body weight and age, which also were identified as risk factors (HR = 1.05, p < 0.001 and HR = 0.91, p = 0.047, respectively).Conclusion and Clinical relevance: Although TPLO procedures had the highest occurrence of severe postoperative complications, the hazard was lower than for LFS after adjusting for body weight and age. This implies that it is important to consider potential effect-modifiers when comparing postoperative complications after CCLD surgery

Long-term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

BackgroundCranial cruciate ligament disease (CCLD) is common in dogs, but studies on the long-term treatment outcome are scarce. MethodsThe long-term outcome in a cohort of 71 dogs with CCLD treated with tibial plateau levelling osteotomy (TPLO, n = 18), tibial tuberosity advancement (TTA, n = 23) or lateral fabellotibial suture (LFS, n = 30) was evaluated using the canine orthopaedic index. ResultsThe risk of stiffness and lameness was increased in dogs treated with TPLO (stiffness: incidence rate ratio [IRR] 1.33, p = 0.015; lameness: IRR 1.34, p = 0.020) or TTA (stiffness: IRR 1.26, p = 0.035; lameness: IRR 1.31, p = 0.026) when compared to LFS at a median follow-up time of 4.6 years. LimitationsNo follow-up veterinary examination was performed. Data were collected from only two university animal hospitals, and thus, a referral bias towards more complicated cases is possible, which may limit the generalisability of the results. ConclusionClinicians can use the results to inform dog owners about the expected long-term outcome in dogs with CCLD

Disease-related and overall survival in dogs with cranial cruciate ligament disease, a historical cohort study

Objective: To analyse the effect of treatment method and other risk factors on survival in dogs with cranial cruciate ligament disease (CCLD).Methods: A historical cohort study of 333 dogs presenting with CCLD at two University Hospitals (2011-2016) was performed. Signalment, history, treatment and follow-up details were retrieved from medical records, dog owners and referring veterinarians. Treatment groups were defined; conservative or surgical with either lateral fabellotibial suture (LFS) or osteotomy procedures. Multivariable Cox proportional hazards models were applied to evaluate risk factors for disease-related and overall survival.Results: Sixty-five dogs were conservatively managed, 125 treated with LFS and 143 with osteotomy techniques. At follow-up (autumn 2018), 164 dogs (49.3 %) were alive and 169 (50.7 %) were dead. Both final Cox proportional hazards models included variables for treatment, age, weight and hospital. In addition, the final disease-related model included a variable for orthopaedic comorbidity, while non-orthopaedic comorbidities and a time-varying effect for age on a linear scale were included in the overall survival model. Treatment method was found to have an effect on both disease-related and overall survival and surgical treatment was associated with a lower hazard than conservative treatment.Conclusion: Survival in dogs with CCLD is influenced by treatment strategy, comorbidities, age and weight

C-reactive protein, glucose and iron concentrations are significantly altered in dogs undergoing open ovariohysterectomy or ovariectomy

Abstract Background There are relatively few studies about the canine surgical stress response, a sequence of events orchestrated by the body in response to a surgical trauma which is sometimes, as shown in human surgery, deleterious to the patient. There is a need to identify objective markers to quantify this response in order to estimate tissue trauma and use the markers as potential early indicators of surgical complications. The study objective was to investigate the surgical stress response, measured by C-reactive protein (CRP), glucose and iron serum concentrations, to gonadectomy in female dogs, and to compare the response to ovariohysterectomy (OHE) with the response to ovariectomy (OVE). A randomized clinical trial was performed on a sample of 42 female dogs, which were divided into two groups: one group underwent OHE, the other OVE. Results Blood samples were collected immediately before surgery (T0), and at 1 (T1), 6 (T6), and 24 (T24) h after surgery, and serum frozen and stored at − 80 °C for later analysis. Upon thawing, the serum samples were subjected to measurement of CRP, glucose and iron concentration. Seventeen dogs in the OHE group and 19 dogs in the OVE group were included in the statistical analysis. There was a significant increase in glucose concentration at all time points compared with T0, and an increase of CRP at T6 and T24. Iron concentration was significantly decreased at T6 and T24. Differences between the two groups could not be detected for any of the three variables. Conclusions The study showed that both OHE and OVE induce a moderate surgical stress response in female dogs, measured by CRP, glucose and iron. A difference between the surgical techniques could not be detected for any of the variables, and hence; with regards to the parameters studied recommendations of one procedure over the other cannot be made and preferred technique remains the surgeon’s choice