Iliopsoas strain demographics, concurrent injuries, and grade determined by musculoskeletal ultrasound in 72 agility dogs.

The objective of this study was to describe patient demographics associated with iliopsoas strains, frequency of common concurrent injuries, and associated strain grades based on musculoskeletal ultrasound. The medical records of 72 client-owned agility dogs that had an iliopsoas musculoskeletal ultrasound (MSK-US) between 2009 and 2015 were retrospectively reviewed. Analyses included patient signalment, physical examination, and diagnostic findings. Twenty-four breeds of canine athletes from 1.5 to 10 y old (median: 5 y, SD: 2.2 y) were included in the study. Of the 72 records reviewed, border collies were the most common breed (27.8%, 20/72) reported. Isolated iliopsoas strains occurred in 26.4% (19/72) of cases. Concurrent pathology was noted in 73.6% (53/72) of cases. Cranial cruciate ligament (CCL) instability was the most common concurrent pathology, representing 27.8% (20/72) of all cases, with hip (8.3%, 6/72), lumbosacral (23.6%, 17/72), other non-CCL hind limb (6.9%, 5/72), and forelimb (6.9%, 5/72) pathologies making up the remainder of cases with concurrent pathology. In patients with a concurrent hind limb injury, 96.7% (30/31) of dogs had their most severe iliopsoas strain grade on the same limb. MSK-US revealed Grade I strains in 54.2%, Grade II strains in 22.2%, Grade III strains in 5.2%, and chronic changes in 18.1% of cases. There were no statistically significant associations between iliopsoas strain grade and age, body weight, sex, breed, concurrent pathology, anatomic location of concurrent pathology, or sidedness of concurrent pathology. Iliopsoas strains are one of the most common agility dog injuries; however, patient demographics, prevalence of concurrent injury and correlation with MSK-US findings have not been previously reported. To the authors' knowledge, this is the first retrospective analysis reporting iliopsoas strain demographics, concurrent injury frequency and correlation with MSK-US evaluation in agility dogs. Although 26.4% of iliopsoas strains occurred as isolated injuries, 73.6% had concurrent injuries, with CCL instability present most commonly, occurring in 27.8% of cases. Dogs should be thoroughly evaluated for concurrent injuries when presenting with an iliopsoas strain.

L'objectif était de décrire les données démographiques des patients associées aux douleurs de l'iliopsoas, la fréquence des blessures concomitantes courantes et les degrés de douleur associés sur la base d'une échographie musculosquelettique.Les dossiers médicaux de 72 chiens d'agilité appartenant à des clients qui ont subi une échographie musculosquelettique de l'iliopsoas (MSK-US) entre 2009 et 2015 ont été examinés rétrospectivement. L'analyse comprenait le signalement du patient, l'examen physique et les résultats de diagnostic.Vingt-quatre races d'athlètes canins âgés de 1,5 à 10 ans (médiane 5, SD 2,2) ont été incluses dans l'étude. Sur les 72 enregistrements examinés, les border collies étaient la race la plus fréquemment signalée (27,8 %, 20/72). Des douleurs isolées du psoas iliaque sont survenues dans 26,4 % (19/72) des cas. Une pathologie concomitante était notée dans 73,6 % (53/72) des cas. L'instabilité du ligament croisé crânien (CCL) était la pathologie concomitante la plus fréquente, représentant 27,8 % (20/72) de tous les cas, avec hanche (8,3 %, 6/72), lombo-sacrée (23,6 %, 17/72), autres pathologies des membres postérieurs du CCL (6,9 %, 5/72) et des membres antérieurs (6,9 %, 5/72) constituent le reste des cas avec une pathologie concomitante. Chez les patients présentant une lésion concomitante du membre postérieur, 96,7 % (30/31) des chiens présentaient leur degré de douleur de l'iliopsoas le plus grave sur le même membre. MSK-US a révélé des douleurs de grade I dans 54,2 %, des douleurs de grade II dans 22,2 %, des douleurs de grade III dans 5,2 % et des modifications chroniques dans 18,1 % des cas. Aucune association statistiquement significative n'a été trouvée entre le degré de douleur de l'iliopsoas et l'âge, le poids corporel, le sexe, la race, la pathologie concomitante, la localisation anatomique de la pathologie concomitante ou le caractère latéral de la pathologie concomitante.Les douleurs d'iliopsoas sont l'une des blessures les plus courantes chez les chiens d'agilité; cependant, la démographie des patients, la prévalence des blessures concomitantes et la corrélation avec les résultats MSK-US n'ont pas été rapportées auparavant. À la connaissance de l'auteur, il s'agit de la première analyse rétrospective faisant état de la démographie de la douleur de l'iliopsoas, de la fréquence des blessures concomitantes et de la corrélation avec l'évaluation MSK-US chez les chiens d'agilité. Bien que 26,4 % des douleurs de l'iliopsoas se soient produites sous forme de blessures isolées, 73,6 % avaient des blessures concomitantes. L'instabilité du CCL était présente le plus souvent, survenant dans 27,8 % des cas.Les chiens doivent être soigneusement évalués pour les blessures concomitantes lorsqu'ils présentent une douleur de l'iliopsoas.(Traduit par les auteurs).

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.

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.

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.

Select modalities.

Physical rehabilitation modalities such as therapeutic ultrasound (TU), transcutaneous electrical neuromuscular stimulation (TENS), neuromuscular electrical stimulation (NMES), cold or low-level laser therapy (LLLT), and pulsed magnetic field therapy (PMF) can all, when used properly, assist in treating orthopedic injuries, neurological conditions, and chronic conditions brought about by normal aging in our small animal companions. TU uses sound waves to produce both thermal and nonthermal effects that aid in tissue healing, repair, and function. TENS uses different frequencies of electrical current to decrease pain and inflammation. NMES also uses an electrical current to stimulate muscle contraction to assist in normal neuromuscular function in postorthopedic and neurological injuries. LLLT uses light energy to reduce pain, decrease inflammation, and stimulate healing at a cellular level. PMF uses magnetic field to stimulate normal cellular ion exchange and oxygen utilization and promote generalized healing of tissues. These modalities are discussed in detail covering mechanism of action, parameters, settings, and indications/contraindications of use in our small animals. Although these modalities are important in the physical rehabilitation of small animals, they need to be incorporated with a proper diagnosis, manual therapy, and home exercise program into a specific and individualized patient treatment protocol.