Client-based evaluation of the effects of localized vibration therapy on pain and mobility scores in dogs with radiographic bilateral hip dysplasia.

Introduction: This study evaluated the effects of localized vibration (LV) in 37 dogs with bilateral hip dysplasia (HD). HD is a common cause of lameness in dogs, and is a contributory factor to osteoarthritis, which can reduce the dog's overall quality of life. Materials and methods: This was a multi-center, prospective survey-based study of 37 dogs with bilateral HD and no prior history of surgical management. Dogs were given LV therapy daily for 14 consecutive days using the same commercially available handheld vibration device. Canine Brief Pain Index (CBPI) data was collected prior to the initiation of therapy, then for 14 days following daily LV therapy. The dogs' medications, supplements, additional rehabilitation modalities, and activity level were unchanged during the study period. Baseline CBPI pain severity and pain interference scores were compared to scores after 7 or 14 days of LV. Results: There were significant decreases in average pain severity and average pain interference CBPI scores in response to 7 and 14 days of therapy compared to baseline. When response to therapy was defined as a decrease in both pain severity score and pain interference score, 62% (23/37) of dogs responded to therapy at 7 days of treatment and 73% (27/37) responded at 14 days of treatment. Of the individuals that responded to treatment at 7 days, 91% (21/23) continued to respond at 14 days. Conclusion: Daily LV resulted in a significant reduction in CBPI scores in 73% of dogs with bilateral HD in this study. Randomized and blinded studies should be performed to further assess daily LV as a treatment modality for canine HD.

Corrigendum: Internet-based survey evaluating the impact of ground substrate on injury and performance in canine agility athletes.

[This corrects the article DOI: 10.3389/fvets.2022.1025331.].

Internet-based survey evaluating the impact of ground substrate on injury and performance in canine agility athletes.

Agility is a rapidly growing canine performance sport worldwide, yet the literature is sparse regarding the impact of ground substrate on performance and injury. Approximately 1/3 of dogs participating in agility trials will experience a performance-related injury. The impact of ground material has been well-documented in racing greyhounds, equine athletes, and humans, but has been minimally investigated in agility dogs. In this retrospective, cross-sectional study, 300 respondents (handlers, owners, and trainers) of 308 agility dogs completed an online survey regarding their dog's training and competition regimen, history of injury, perceived association between injury and substrate and/or agility obstacle, markers of decreased performance (MDPs) observed on different substrates, and changes to routine following injury. 35.7% of dogs sustained a training injury (TI) and 11.2% sustained a competition injury (CI). The most commonly reported sites of injury were the shoulder (TI: 33.9%, CI: 25.4%), forelimb digits (TI: 14.7%, CI: 11.9%) and iliopsoas muscle (TI: 11.9%, CI: 13.6%). Dogs most commonly trained on natural grass (85.3%), artificial turf (50.8%), and dirt (34.5%). Significantly fewer MDPs were observed on natural grass than any other substrate except dirt. Significantly more MDPs were noted on rubber mat compared to natural grass, artificial turf, dirt, sand, or foam mat. Rubber mat had the highest Incidence Proportion (IP) (32.0%) of TI and was perceived to be related to TI in 87.5% of cases. Obstacles perceived to be associated with injuries included jumps (TI: 37.5%, CI: 27.8%), contacts (TI: 29.7%, CI: 22.2%), weaves (TI: 11.9%, CI: 13.9%), and tunnels (CI: 25.0%). Overall, agility dogs were perceived to perform best on natural grass and dirt, while rubber mat was associated with injury and decreased performance. Respondents were willing to make significant alterations to their dog's routine due to a perceived association between substrate, injury, and performance. Further prospective studies are needed to assess the impact of substrate composition and maintenance, and inform evidence-based recommendations to maximize performance and minimize performance-related injury in agility dogs.

Case factors for selection of femoral component type in canine hip arthroplasty using a modular system.

OBJECTIVE: To describe a femoral stem selection process based on case features in dogs treated with total hip replacement (THR) by an expert surgeon, compare complications between implant types, and develop an algorithm for stem type selection. STUDY DESIGN: Retrospective study. ANIMALS: 128 dogs, 135 THR. METHODS: Data collected included breed, age, weight, canal flare index (CFI), and implant type: cementless (BFX), cementless with a collared stem (BFX-C), hybrid (cementless acetabular component with cemented stem), and cemented (CFX). RESULTS: Of the 135 THRs, 69 BFX, 47 hybrid, and 18 BFX-C were performed. Dogs receiving hybrid (mean 5.5 years) were older than those receiving BFX (2.5 years, p < .0001) and BFX-C implants (2.5 years, p = .0014). The mean weights of dogs with hybrid, BFX, and BFX-C implants were 40.0, 31.0, and 35.3 kg, respectively, with dogs receiving hybrid heavier than those receiving BFX (p < .0001). Mean CFI for hybrid (1.52) was lower than for BFX (1.79, p < .0001) and BFX-C (1.76, p = .0021). Total complication rate was 14.0% with catastrophic complications in 1.5% and no association between implant type and risk of complications (p = .36). Femur fractures occurred in 2.9% of all cases and 1.1% of cementless THR cases. CONCLUSIONS: Dogs receiving hybrid THR were older with lower CFI than dogs receiving BFX and BFX-C and heavier than dogs receiving BFX. There was no difference in complications between groups. Catastrophic complications and femur fractures occurred less frequently compared to recent studies of BFX THR. CLINICAL SIGNIFICANCE: Careful preoperative assessment and implant selection can reduce complications of canine THR.

Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis.

The present study aimed to describe the ultrasonography technique and analyze the ultrasonographic findings of the proximal sciatic nerve and deep gluteal muscles in dogs with suspected sciatic neuritis. The records of 29 dogs that underwent musculoskeletal ultrasound of the sciatic nerve and deep gluteal muscles were retrospectively evaluated. Both right and left sides were evaluated. Abnormal findings were unilateral in 28/29 (97%) of the dogs. The muscles examined included the piriformis muscle, gemelli muscles, internal obturator muscle, and medial gluteal muscle. Data included signalment, purpose of the dog, orthopedic examination findings, lameness examination findings, other diagnostic imaging findings, and ultrasonography findings. Irregular margins of the sciatic nerve were recorded in 76% of the dogs. The diameter of the sciatic nerve on the affected limb was significantly larger than the nerve on the contralateral, unaffected side (p < 0.00001). The mean ± standard deviation (SD) of the sciatic nerve inner diameter between the unaffected and affected limbs was 15 ± 14.66%. The mean ± SD in sciatic nerve outer diameter was 12 ± 7.71%. Abnormal ultrasonographic findings in at least one of the examined muscles were found in 28/29 (97%) of the dogs and included changes in echogenicity in 28/29 (97%) of the dogs, loss of detail in muscle fiber pattern in 5/29 (17%) of the dogs, and impingement between the sciatic nerve and piriformis muscle in 6/29 (21%) of the dogs. The most common underlying diagnosis was lumbosacral stenosis in 9/29 (31%) of the dogs. The most common sport was agility for 21/29 (71%) of the dogs. Repetitive jumping may predispose to both lumbosacral disease, through dynamic compression, and changes within the piriformis muscle, due to overuse of the muscle leading to irritation to sciatic nerve. Ultrasonography is considered a safe and non-invasive diagnostic method to evaluate the sciatic nerve and deep gluteal muscles of dogs, and provides additional guidance for diagnostics and rehabilitation planning. This is the first study documenting ultrasonography findings in a case series of the sciatic nerve and deep gluteal muscles and their pathology in dogs.

Average Tibial Plateau Angle of 3,922 Stifles Undergoing Surgical Stabilization for Cranial Cruciate Ligament Rupture.

OBJECTIVE: The aim of this study was to report the average tibial plateau angle (TPA) from a large sample of dogs and to determine if breed or gonadectomy had a significant association with abnormal TPA. STUDY DESIGN: This was a retrospective case study. MATERIALS AND METHODS: Medical records from 2006 to 2015 were reviewed for dogs that were diagnosed with cranial cruciate ligament (CrCL) rupture and underwent dynamic surgical stabilization. Signalment, examination findings, preoperative TPA and surgical report were reviewed. RESULTS: A total of 3,249 dogs underwent CrCL stabilization surgery from 2006 to 2015. Of the 3,249 dogs, 3,054 dogs met the inclusion criteria for a total of 3,922 stifles to be evaluated. The average preoperative TPA was 29° ± 3.7°. Average breed-specific preoperative TPA ranged from 27° to 35.1°, with four breeds having significantly lesser TPA and four breeds significantly greater TPA than the overall mean of dogs. Neutered dogs had a higher TPA of 28.87° ± 3.8° than non-neutered dogs with an average TPA of 26.88° ± 4.0°, p < 0.001. There was not a significant difference in average TPA between females and males, regardless of the neuter status. CONCLUSION AND CLINICAL RELEVANCE: Our reported preoperative TPA in a large sample of dogs is higher than what has been previously published. In reviewing 3,922 stifles, the average preoperative TPA was 29°. We report the average preoperative TPA in specific breeds and report that neutered dogs have a significantly higher TPA than intact dogs. This updated information may guide clinicians in management decisions regarding treatment for CrCL rupture.

Knowledge, attitudes, and practices of telemedicine in Ophthalmology in a Tertiary Hospital: A cross-sectional survey

Objective@#The purposes of this study were to (1) describe the perceptions and practices of telemedicine among ophthalmologists in a tertiary hospital; and (2) evaluate knowledge, satisfaction, and perceived patient outcomes in using telemedicine to provide eye care in a time of a global pandemic.@*Methods@#This was a descriptive, cross-sectional study using a self-administered online survey. Thirty-two (32) ophthalmology consultants and residents-in-training in a single tertiary, private hospital who practiced telemedicine participated in this study. Descriptive statistics was used to summarize the data. Responses to open-ended questions were analyzed thematically@*Results@#The respondents were somewhat knowledgeable (75%) and somewhat confident (72%) in using telemedicine. Respondents strongly conveyed their satisfaction with telemedicine outcomes (56%). Majority also believed that their patients were satisfied with teleconsults (69%). Majority agreed that telemedicine can be effective for select types of care [i.e., chronic condition management (66%), follow- up care (62%), and acute non-emergency care (53%)]. Telemedicine also proved to be a boon during a pandemic due to its convenience (59%) and efficiency (63%). However, it is limited by the imperative need for face-to-face consults (69%) and technological constraints (44%).@*Conclusions@#Telemedicine was perceived to be a valuable solution during the present pandemic due to its convenience, safety, and ability to provide remote diagnosis and management of urgent and non-urgent cases. Although the current practice of telemedicine still has plenty of room for improvements in the standardization of training, connectivity and technological constraints, and addressing liability concerns, it can serve as an adjunct to face-to face consultations to provide optimal care for patients.

A randomized controlled trial on the effect of Lutein Supplementation on Macular Pigment Optical Density and Macular Function in Pseudophakic Patients

Objective@#To evaluate the efficacy of oral lutein supplementation on macular pigment optical density (MPOD) levels and macular function in pseudophakic eyes that underwent phacoemulsification. @*Methods@#This was a prospective, randomized, parallel-arm, single-masked study comparing oral lutein supplement 20 mg/tablet (Lutax 20) with non-supplementation in pseudophakic eyes. We assessed MPOD, low-luminance deficit (LLD), visual recovery time (VRT) using photostress test, and adverse events. One hundred twenty-eight (128) eyes were enrolled and randomized 1:1 to active treatment (lutein supplementation) or no treatment (no supplementation). The supplementation period was 12 weeks and patients were assessed every 4 weeks over a period of 16 weeks.@*Results@#Sixty-four (64) eyes in each group completed the study. A significant increase in MPOD (p<0.001) was observed in the lutein supplemented group, from 0.36 DU at baseline to 0.55 DU at week 12, with a mean increase of 6.32 ± 1.72% per 4 weeks of supplementation compared with a mean MPOD decrease rate of 0.63 ± 0.48% in the non-supplementation group. A significant reduction in LLD was observed in the lutein-treated group, from LogMAR 0.063 at baseline to LogMAR 0.023 at Week 12 (p=0.003). VRT was also significantly shorter in the treatment from a baseline of 83.06 to 68.80 seconds at Week 12 (p<0.001).@*Conclusion@#Lutein supplementation (20 mg/tablet; Lutax 20) demonstrated a significant degree of MPOD augmentation, and reductions in LLD and VRT among patients who underwent phacoemulsification with lens implantation.

Rate of return to agility competition for dogs with cranial cruciate ligament tears treated with tibial plateau leveling osteotomy.

OBJECTIVE To determine rate of and factors associated with return to agility competition for dogs with cranial cruciate ligament (CrCL) rupture treated with tibial plateau leveling osteotomy (TPLO). DESIGN Retrospective case series with nested case-control study. ANIMALS 31 dogs involved in agility competition with CrCL tears treated by TPLO at a private veterinary clinic from 2007 through 2013. PROCEDURES Medical records were reviewed to collect information on dog signalment, lesion characteristics, and surgical data. Owners completed a survey regarding whether and when their dog returned to agility competition after TPLO and, if so, how the dog performed. Performance data before and after TPLO were compared. RESULTS 20 of 31 (65%) dogs returned to agility competition after TPLO, 16 (80%) of which returned within 9 months after TPLO. The mean convalescent period for returning dogs was 7.5 months (range, 3 to 12 months). No dog that returned to competition sustained an injury to the affected limb during the follow-up period. No significant difference was identified between dogs that returned or did not return to agility competition regarding severity of osteoarthritis or proportions with meniscal injury or partial (vs complete) CrCL tears. CONCLUSIONS AND CLINICAL RELEVANCE These data suggested that the prognosis for returning to agility competition was good for dogs undergoing TPLO. None of the evaluated lesion characteristics were associated with return to competition. Rate of return to competition and duration of the convalescent period may be useful outcome variables for future investigations involving orthopedic procedures in dogs.

Sensitivity and Specificity of a Weight Distribution Platform for the Detection of Objective Lameness and Orthopaedic Disease.

INTRODUCTION: Weight distribution and off-loading at the stance are commonly used subjective assessments during the orthopaedic examination. The clinical relevance, sensitivity and specificity of limb off-loading have not yet been established. The aim of the study was to assess off-loading on a weight distribution platform (WDP) and determine the sensitivity and specificity at various cut-off points for the detection of objective lameness (OL) and orthopaedic disease (OD). MATERIALS AND METHODS: The total pressure index was used to determine OL on a pressure-sensitive walkway (PSW). Normal weight distribution on both the PSW and WDP was considered 30/30/20/20. A total pressure index standard deviation of 2 was used. The sensitivity and specificity of the WDP for the identification of OL and OD was determined at cut-off points 1 to 6 below normal weight distribution values. RESULTS: All patients in the study (n = 50) had confirmed OD. The PSW identified 36/50 (74%) patients as OL; these were deemed to be OL for sensitivity and specificity analysis of WDP data. At cut-off point 1, the WDP had the highest sensitivity for OD (84%) and OL (97%). At cut-off point 6, the WDP had the highest specificity for OD (98%) and OL (98%). The highest combination of sensitivity and specificity for both OD (1.65) and OL (1.80) was at cut-off point 2. DISCUSSION/CONCLUSION: The WDP provided the highest combined sensitivity and specificity at cut-off point 2 below the normal value for the detection of both OL and OD.

Ultrasonographic Findings in 41 Dogs Treated with Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for a Supraspinatus Tendinopathy: A Retrospective Study.

OBJECTIVE: To report sonographic findings for dogs with a supraspinatus tendinopathy (ST) treated with an ultrasound-guided intratendinous injection of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP). METHODS: Medical records for dogs diagnosed with an ST and treated with a BMAC-PRP injection were reviewed. Data collected included patient signalment, radiographic findings at the time of initial evaluation, and sonographic findings, including cross-sectional area (CSA), fiber pattern, and echogenicity. RESULTS: Of 70 records reviewed, 41 met the inclusion criteria. Mean CSA of the supraspinatus tendon decreased by 0.06 cm2 between baseline and 45 days post-treatment (p = 0.0025), and 0.09 cm2 between baseline and 90 days post-treatment (p < 0.0001). Analysis of CSA in dogs with a unilateral ST at baseline revealed a difference of 0.08 cm2 between the affected and unaffected tendon at baseline, with the affected tendon measuring larger than the contralateral tendon (p < 0.0001). This difference became statistically insignificant by 45 days after treatment (u1-u0 = 0.04 cm2, p = 0.2855) and remained so 90 days post-treatment (u1-u0 = 0.03 cm2, p = 0.1910). In most cases (90.6%), the fiber pattern and echogenicity was considered improved 90 days post treatment. In a minority of these cases (13.8%) the fiber pattern and echogenicity abnormalities were considered resolved. CONCLUSIONS: Using qualitative and quantitative sonographic measures, BMAC-PRP was associated with an improvement in supraspinatus tendon size, fiber pattern, and echogenicity. Given the protracted nature of tendon healing, long-term evaluation may reveal continued improvements in chronic structural changes not captured during the current study. Functional studies are required to evaluate the clinical benefits of BMAC-PRP in the treatment of STs in dogs. CLINICAL SIGNIFICANCE: An ST is a common contributor to forelimb lameness in dogs and remains notoriously difficult to treat. Previous studies have been associated with inconsistent treatment outcomes. In the current study, BMAC-PRP is investigated as a minimally invasive treatment option, revealing positive sonographic results.

Effects of low-intensity pulsed ultrasound on radiographic healing of tibial plateau leveling osteotomies in dogs: a prospective, randomized, double-blinded study.

OBJECTIVE: To determine the influence of low-intensity pulsed ultrasound (LIPUS) on radiographic healing and limb function after uncomplicated, stable osteotomies in dogs. STUDY DESIGN: In vivo, prospective, randomized, double-blinded, placebo-control study. SAMPLE POPULATION: Fifty client-owned dogs. METHODS: Fifty client-owned dogs with naturally occurring unilateral cranial cruciate ligament rupture were enrolled prior to tibial plateau leveling osteotomy. Dogs were assigned to an active (LIPUS) treatment group or a placebo control (SHAM) treatment group via block randomization on the basis of age, weight, and affected limb. Dogs in the LIPUS treatment group underwent LIPUS treatments for 20 minutes daily: 1.5-MHZ ultrasound wave pulsed at 1 kHZ with a 20% duty cycle at an intensity of 30 mW/cm2 for the duration of the study (12 weeks). Radiographic evaluation was performed at 4, 8, 10, and 12 weeks postoperatively to evaluate bone healing. Limb function was assessed with temporal-spatial gait analysis preoperatively and at 4, 8, and 12 weeks postoperatively by using a pressure-sensitive walkway system. RESULTS: Both groups had significant improvement in radiographic score and limb use over time. However, there was no significant difference in radiographic bone healing, or limb use as measured by objective gait analysis detected between the LIPUS treatment group and SHAM treatment group at any point in the study. CONCLUSION: LIPUS treatment did not improve healing in this stable osteotomy model. CLINICAL SIGNIFICANCE: This study does not provide evidence to support the clinical application of LIPUS to stimulate the healing of stable, uncomplicated osteotomies to accelerate bone healing.

Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013).

OBJECTIVE To investigate clinical outcomes for dogs surgically treated for medial shoulder joint instability (MSI) by extracapsular stabilization with a prosthetic ligament. DESIGN Retrospective multicenter case series. ANIMALS 39 client-owned dogs. PROCEDURES Medical records of 3 veterinary medical centers were searched to identify dogs with MSI diagnosed by clinical examination and arthroscopic assessment and treated by extracapsular stabilization with a prosthetic ligament. A minimum 6-month follow-up period was required for study inclusion. Signalment, function or use of the dog, duration of clinical signs, clinical and diagnostic imaging data, MSI grade (1 [mild] to 4 [complete luxation]), follow-up duration, complications, and outcome data were recorded. RESULTS All grades of MSI were represented. Implants were placed successfully in all dogs. Complications (4 major and 2 minor) were recorded for 6 of 39 (15%) dogs; all were treated successfully. Function at the time of last follow-up (6 to 68 months) was deemed full in 30 of 39 (77%) dogs and acceptable in 9 (23%). CONCLUSIONS AND CLINICAL RELEVANCE Surgical treatment of MSI in dogs by extracapsular stabilization with a prosthetic ligament was associated with a complication rate considered acceptable for orthopedic procedures. All patient outcomes were considered successful.

Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study.

OBJECTIVE: To evaluate outcomes in 36 dogs with a partial cranial cruciate ligament (CCL) tear treated with autologous bone marrow aspirate concentrate (BMAC) or adipose-derived progenitor cells (ADPC) with platelet-rich plasma (PRP) combination. MATERIALS AND METHODS: Medical records of client-owned dogs diagnosed with an early partial (≤50%) tear of the craniomedial band of the CCL that was treated with BMAC-PRP or ADPC-PRP were reviewed from 2010 to 2015. Signalment, medical history, physical and orthopedic examination, objective temporospatial gait analyses, radiographs, day 0 and day 90 diagnostic arthroscopy findings, treatment, and outcome were among the data collected. A functional owner questionnaire, including the validated Helsinki chronic pain index (HCPI), was sent to owners whose dog was known to not have had a tibial plateau leveling osteotomy (TPLO). Statistical analysis was performed on data, where significance was established at p < 0.05. RESULTS: Stifle arthroscopy findings at 90 days posttreatment were available on 13 of the 36 dogs. In nine dogs, a fully intact CCL with marked neovascularization and a normal fiber pattern was found with all previous regions of disruption healed. One dog revealed significant improvement and received an additional injection. The remaining three dogs had a >50% CCL tear, and a TPLO was performed. Four additional dogs were known to have had a TPLO performed elsewhere. Baseline and day 90 posttreatment objective gait analyses were available on 11 of the 36 dogs. A significant difference was found between the treated limb total pressure index percent (TPI%) at day 0 and day 90 (p = 0.0124), and between the treated limb and contralateral limb TPI% at day 0 (p = 0.0003). No significant difference was found between the treated limb and contralateral limb TPI% at day 90 (p = 0.7466). Twelve questionnaires were returned, of which eight were performance/sporting dogs. Seven of the eight had returned to sport; the remaining dog had just begun a return to sport conditioning program 6 months posttreatment. All 12 respondents believed that their dog had an excellent or very good quality of life and rated their dog's procedural outcome as excellent or good. CONCLUSION: The use of BMAC-PRP and ADPC-PRP shows promise for the treatment of early partial CCL tears in dogs. Further studies are needed and should be randomized, blinded, and controlled.

The Use of Adipose-Derived Progenitor Cells and Platelet-Rich Plasma Combination for the Treatment of Supraspinatus Tendinopathy in 55 Dogs: A Retrospective Study.

OBJECTIVE: To report clinical findings and outcomes for 55 dogs with supraspinatus tendinopathy (ST) treated with adipose-derived progenitor cells and platelet-rich plasma (ADPC-PRP) therapy. METHODS: Medical records of client-owned dogs diagnosed with ST that were treated with ADPC-PRP combination therapy were reviewed from 2006 to 2013. Data collected included signalment, medical history, limb involvement, prior treatments, physical and orthopedic examination, objective temporospatial gait analysis findings, diagnostic imaging results (radiography, magnetic resonance imaging, musculoskeletal ultrasonography), arthroscopy findings, and outcome. RESULTS: Following ultrasound-guided injection of ADPC-PRP, objective gait analysis was available on 25 of the 55 dogs at 90 days post ADPC-PRP therapy. Following treatment, a significant increase in total pressure index percentage (TPI%) was noted in the injured (treated) forelimb at 90 days post treatment (p = 0.036). At 90 days following treatment, 88% of cases had no significant difference in TPI% of the injured limb to the contralateral limb. The remaining 12% of cases had significantly improved (p = 0.036). Bilateral shoulder diagnostic musculoskeletal ultrasound revealed a significant reduction in tendon size (CSA) in the treated tendon at 90 days following treatment when compared to the initial CSA (p = 0.005). All cases showed significant improvement in fiber pattern of the affected supraspinatus tendon by the ultrasound shoulder pathology rating scale. CLINICAL RELEVANCE: These findings suggest that ADPC-PRP therapy should be considered for dogs with ST.

Adhesive Capsulitis in Eight Dogs: Diagnosis and Management.

OBJECTIVE: To describe clinical and diagnostic findings as well as management of adhesive capsulitis in dogs. BACKGROUND: Adhesive capsulitis, also known as frozen shoulder, is a syndrome defined by loss of range of motion of the shoulder and may be the end-stage manifestation of several primary conditions. EVIDENTIARY VALUE: This is a case series report of eight dogs with chronic forelimb lameness diagnosed with adhesive capsulitis. METHODS: Medical records (June 1, 2010-September 1, 2015) including, physical examination findings, radiographic findings, magnetic resonance imaging (MRI) findings, arthroscopy findings, and treatment plans were reviewed. RESULTS: All dogs presented with a chronic, grade III-VI/VI forelimb lameness. On orthopedic examination, all dogs had moderate to significant discomfort on shoulder extension and flexion and severe restriction of range of motion. Six of the eight dogs had evidence of bone remodeling and sclerosis in the affected shoulder on radiographs. Six of the dogs had an initial diagnostic ultrasound performed, which revealed evidence of fibrous scar tissue. Five dogs had MRI performed that revealed moderate shoulder effusion and enhancement of the synovial lining of the shoulder. Arthroscopy was performed in five of the eight patients. Three were noted to have significant contracture, adhesions, and fibrous scar tissue of the joint capsule. Severe inflammation was noted throughout the synovium of two patients. All eight patients tried conservative management consisting of oral medications and rehabilitation therapy. Five of the eight patients received extracorporeal shockwave therapy. Three patients received regenerative medicine treatment in the affected supraspinatus and shoulder. Regardless of the treatment elected, none of the dogs were reported to have significant improvement. CONCLUSION: Adhesive capsulitis is an uncommon cause of chronic forelimb lameness. Further investigation is needed to describe the etiology and pathogenesis of adhesive capsulitis in dogs to evaluate the effectiveness of both non-surgical and surgical treatment modalities, establish treatment protocols, and evaluate short- and long-term clinical outcome of patients. APPLICATION: Adhesive capsulitis should be considered in patients with chronic forelimb lameness and moderate to significant discomfort and restriction on shoulder range of motion.

Traumatic fracture of the medial coronoid process in 24 dogs.

OBJECTIVE: To describe traumatic fracture of the medial coronoid process in dogs as a clinically distinct disease unrelated to congenital elbow dysplasia. METHODS: Clinical records of dogs with acute, traumatic, unilateral lameness attributable to medial coronoid process disease were reviewed retrospectively. Clinical interpretation included findings on physical examination, orthopaedic examination, and subjective gait analysis. Radiographs of the affected and contralateral elbows were obtained and reviewed for pathology. Arthroscopy of the elbow joints was performed by one of three surgeons and findings were compared to preoperative diagnostics. Postoperative follow-up was continued for 16 weeks. RESULTS: Twenty-four dogs were included in this study. All dogs in this study were free of radiographic evidence of medial coronoid pathology. All dogs were diagnosed with a single, large, displaced or non-displaced fracture of the medial coronoid process, with no other joint pathology. Dogs generally had an excellent short-term outcome following arthroscopic treatment of the fractured medial coronoid process. CLINICAL SIGNIFICANCE: Traumatic fracture of the medial coronoid process should be considered a clinical disease distinct from dysplasia-related fragmentation and should be considered as a differential diagnosis in dogs that are presented with the complaint of acute unilateral elbow discomfort or lameness, especially after concussive activities involving the forelimb. .

Association of cumulative dissipated energy and postoperative foveal thickness among patients with age-related cataract who underwent uncomplicated phacoemulsification

@#<p style="text-align: justify;"><strong>PURPOSE:</strong> Cumulative dissipated energy (CDE) is a phacoemulsification unit parameter designed to monitor the amount of energy delivered during phacoemulsification. Studies have already shown that lower CDE levels have better surgical outcomes, specifically in corneal recovery. However, few literature exists regarding the correlation between CDE and foveal thickness.</p> <p style="text-align: justify;"><strong>METHODS:</strong> In this prospective study, subjects with age-related cataract underwent cataract surgery by phacoemulsification. Central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) of the macula were measured by spectral-domain optical coherence tomography (OCT) at three separate time-points: preoperative, 1 day, and 14 days after cataract surgery. To determine the correlation between parameters, Pearson's correlation coefficients and degree of association, and coefficient of determination (r2 ) were used.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> One hundred eyes from 93 subjects were analysed. Preoperatively, mean CST was 247.71 ± 21.44 µm, CV was 9.38 ± 0.82 mm3 , and CAT was 262.94 ± 22.15 µm. At 12.42 + 11.05 of mean CDE exposure, the fovea increased in thickness in all measured parameters. The relationship between CDE and the change in foveal thickness values from baseline to postoperative Day 1 and Day 14 were examined. The correlation coefficients obtained for CST, CV, and CAT had low association to CDE. Furthermore, only the correlation coefficients of the difference between baseline and Day 1 of CST, and the difference between baseline and Day 14 observations of CV were significant (0.279 and -0.206, p=0.005 and p=0.040, respectively) but still with a low degree of association.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> There is a low, significant, direct association of the difference of CST on Day 1 from baseline with CDE, and a low, significant, indirect association of the difference of CV on Day 14 from baseline with CDE after routine phacoemulsification.</p>