Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis.

Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012-2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats' ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.

Pantarsal arthrodesis in cats using orthogonal plating.

Case series summary Pantarsal arthrodesis (PTA) was performed in seven tarsi of six cats, using orthogonal (dorsal and medial) veterinary cuttable plates (VCPs) without postoperative external coaptation. Short-term outcomes, arthrodesis progression and complications were assessed using a retrospective review of case notes (veterinary examination) and radiographs. Long-term outcomes were assessed via owner questionnaire (Feline Musculoskeletal Pain Index [FMPI]). Mean angle of PTA was 136° (range 116-166°). Intraoperative complications were recorded in two cases, both involving failure of the drill bit during drilling for calcaneotibial screws. Postoperative complications were encountered in a case of bilateral single-session PTA. These included gastrocnemius myotendinopathy on the right, and long-term protrusion of a screw head from the skin on the left. Both complications were resolved surgically, through resection of the implicated gastrocnemius tendon of insertion and removal of the plate, respectively. FMPI assessment was performed for all six cats a mean of 8.8 months (range 6-16 months) following surgery. Mean score for the first part (assessing ability to perform normal activities) was 92.2% (range 80.9-97.1%). Mean score for the second part (owner perception of pain) was 95.8% (range 87.5-100%). Mean overall score (mean score for parts 1 and 2 combined) was 92.3% (range 81.6-97.4%). PTA may be performed in cats using orthogonal VCPs to treat severe tarsal injuries. It may be prudent to avoid single-session bilateral PTA in cats. Relevance and novel information This case series documents a novel technique as an alternative for PTA in cats with talocrural injuries. Long-term outcome and complications presented in this case series are evaluated and discussed.

Evaluation of variables influencing success and complication rates in canine total hip replacement: results from the British Veterinary Orthopaedic Association Canine Hip Registry (collation of data: 2010-2012).

The objective of this study was to assess the variables associated with complications of total hip replacement (THR) and report owner-assessed outcomes. Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between September 2011 and December 2012 were reviewed separately and in conjunction with previous data (January 2010-August 2011). An outcomes assessment questionnaire was used to collect data from owners. Incidences of surgeon-reported and owner-reported complications were 8.2 per cent and 4.3 per cent, respectively. THR using the BioMedtrix BFX cup/stem prosthesis had a greater incidence of complications compared with THR using the BioMedtrix CFX cup/stem prosthesis (P=0.002); complications were 4.48 times more likely when using the BioMedtrix BFX cup/stem prosthesis versus the BioMedtrix CFX cup/stem prosthesis. THR using the BioMedtrix BFX cup/stem prosthesis had a higher incidence of complications compared with THR using a hybrid prosthesis (BioMedtrix BFX cup/CFX stem, BioMedtrix CFX cup/BFX stem) (P=0.046); complications were 2.85 times more likely when using the BioMedtrix BFX cup/stem prosthesis versus a hybrid prosthesis. In 95 per cent of cases, owner satisfaction with the outcome of THR was 'very good' or 'good'. Complication rates from the BVOA-CHR are similar to previous studies. The data suggest that prosthesis type is associated with complication rate, with BioMedtrix BFX (circa 2012) having a high short-term complication rate.

Integrating metabolomics and transcriptomics data to discover a biocatalyst that can generate the amine precursors for alkamide biosynthesis.

The Echinacea genus is exemplary of over 30 plant families that produce a set of bioactive amides, called alkamides. The Echinacea alkamides may be assembled from two distinct moieties, a branched-chain amine that is acylated with a novel polyunsaturated fatty acid. In this study we identified the potential enzymological source of the amine moiety as a pyridoxal phosphate-dependent decarboxylating enzyme that uses branched-chain amino acids as substrate. This identification was based on a correlative analysis of the transcriptomes and metabolomes of 36 different E. purpurea tissues and organs, which expressed distinct alkamide profiles. Although no correlation was found between the accumulation patterns of the alkamides and their putative metabolic precursors (i.e., fatty acids and branched-chain amino acids), isotope labeling analyses supported the transformation of valine and isoleucine to isobutylamine and 2-methylbutylamine as reactions of alkamide biosynthesis. Sequence homology identified the pyridoxal phosphate-dependent decarboxylase-like proteins in the translated proteome of E. purpurea. These sequences were prioritized for direct characterization by correlating their transcript levels with alkamide accumulation patterns in different organs and tissues, and this multi-pronged approach led to the identification and characterization of a branched-chain amino acid decarboxylase, which would appear to be responsible for generating the amine moieties of naturally occurring alkamides.

Tibial plateau leveling osteotomy in small breed dogs with high tibial plateau angles using a 4-hole 1.9/2.5 mm locking T-plate.

OBJECTIVES: To report clinical experiences with tibial plateau leveling osteotomy (TPLO) to address cranial cruciate ligament (CCL) disease in small breed dogs with high tibial plateau angles (TPA) using a specific 4-hole locking T-plate. STUDY DESIGN: Retrospective case series. ANIMALS: Small breed dogs (<15 kg) with high TPA (>30°): n = 19 (29 CCL ruptures). METHODS: TPLO was performed by standard technique using a 1.9/2.5 mm 4-hole locking T-plate. Preoperative, immediate postoperative, and 6-8 weeks postoperative TPA were measured from radiographs. Lameness was scored subjectively preoperatively and 6-8 weeks postoperatively. Mid to long term follow-up was by client telephone questionnaire (mean, 12.1 months after surgery). RESULTS: Mean ± SD preoperative TPA was 37.0 ± 4.9°, immediate postoperative TPA, 6.4 ± 2.8° and 6-8 weeks postoperative TPA, 8.0 ± 4.9°. Postoperative complications occurred in 4 dogs (13.8%) all of which had been operated as single-session bilateral procedures. Three stifles had failure of a single screw and postoperative increase in TPA. Periprosthetic infection necessitated plate removal in 1 dog. Lameness scores by veterinary assessment reduced from mean 3.4/5 preoperatively to 0.4/5 at 6-8 weeks postoperatively. Mid to long-term follow-up revealed no lameness by owner assessment. CONCLUSION: A 4-hole 1.9/2.5 mm locking T-plate may be used in the stabilization of unilateral TPLO in small breed dogs with high TPA.

Complications and owner assessment of canine total hip replacement: a multicenter internet based survey.

OBJECTIVE: To assess the variables associated with the complications of total hip replacement (THR) and report owner-assessed outcomes, through surgeon-based registration of cases via an online database, informed owner consent, and prospective outcomes assessment using a client-administered clinical metrology instrument. STUDY DESIGN: Prospective case series ANIMALS: Dogs (n = 170) METHODS: Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between January 2010 and August 2011 were reviewed. Variables evaluated included dog age, body weight, breed, and indication for THR and prosthesis. Associations between each variable and the incidence of complications were assessed using logistic regression. Additionally, an on-line, owner-administered outcomes assessment questionnaire (modified from the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire) was used to collect data from owners. RESULTS: One hundred and seventy cases met the inclusion criteria. Surgical indications included hip dysplasia and coxofemoral osteoarthritis (n = 150), Legg-Calves-Perthes disease (7), coxofemoral luxation (6), fracture (4), slipped capital physis (2), and femoral head and neck ostectomy revision (1). Surgical implants were from 4 systems. The incidence of surgeon-reported complication was 9.4%. No significant association was identified between weight, age, sex, breed, indication for THR, surgical technique and prosthesis, and the incidence of complications. In 82% of the cases, owners described their satisfaction with the outcome of THR as "very good" and a total of 20% complication rate was reported. There was a statistically significant improvement in owner-assessed questionnaire score before and after THR (P < .001). CONCLUSIONS: The BVOA-CHR offers a novel framework for the prospective studies on THR and on a national/international scale. Initial complication rates from the BVOA-CHR are similar to previous studies.