Diagnosis and management of a fracture of the lateral trochlear ridge of the talus in a dog.

An eight-month-old, 31.2 kg, entire male Golden Retriever was presented for evaluation because it had a four-week history of right hindlimb lameness and audible popping occurring in association with movement of the right hindlimb. Mild right hindlimb lameness was noted upon gait analysis. Moderate to severe effusion and pain on extension were appreciated on palpation of the right tarsus. Dorsoplantar and lateral radiographs of the right tarsus revealed significant soft tissue swelling over the lateral aspect of the tarsus and widening of the joint space over the lateral trochlear ridge of the talus. A fracture of the lateral ridge was appreciated upon evaluation of the flexed dorsoplantar view. Un-enhanced computed tomography of the right tarsus confirmed fracture of the talus; one large and two small bone fragments were noted adjacent to the lateral aspect of the lateral trochlear ridge and medial to the fibula. The fracture was surgically repaired via a lateral approach; a fibular osteotomy was performed. The fragment was manually reduced and secured with a 1.5 mm cortical screw placed in lag fashion. The fibular osteotomy site was reduced and fixed with two 1.6 mm Kirshner wires and a tension band composed of 0.9 mm cerclage wire. The patient made a complete clinical recovery, however, the union was fibrous and evidence of mild osteo- arthritis was noted on postoperative radiographs.

Successful treatment of intratracheal cuterebrosis in two cats.

Two cases of feline intratracheal myiasis due to Cuterebra spp. larvae are reported. Both cats presented with inspiratory dyspnea and a nonproductive cough. One larva was successfully removed during thoracotomy, and the other was removed during bronchoscopy using forceps passed through a bronchoscope operating channel. Clinical signs were alleviated following removal of the larvae.

Health screening examinations: the patient's perspective.

Periodic preventive screening programs will require patient cooperation if they are to be successful. To determine the level of patient interest on a broad scale, 1,788 adult patients were surveyed in 47 family physicians' offices over a statewide area. Seventy percent said they had participated in a screening health checkup in the preceding two years. Nine percent of these patients reported discovering a previously unknown condition as a result of their recent screening examination. The majority of surveyed patients said they would agree to be screened or treated with the complete list of eight suggested procedures for men and ten procedures for women. Rates of patient acceptance of specific health maintenance recommendations ranged from a low of 54 percent for influenza immunization to a high of 91 percent for a blood pressure check. Listing typical costs did not alter the selection rates of patients with insurance coverage compared with those without it. The geriatric age group was the least willing to be screened. Seventy-two percent of patients indicated that they wanted to discuss at least one wellness topic with their physician. Overall, most patients are willing to participate in the concept of a periodic health maintenance examination as recommended to them by their physician.