Isolated fracture of the talus with asymptomatic contralateral talar fissure in two dogs.

CASE HISTORY: Two adult male dogs were separately presented for acute-onset, severe hind limb lameness isolated to the tarsus. There were no prior orthopaedic concerns and there was no significant trauma associated with the onset of lameness in either case. CLINICAL FINDINGS: Pain and effusion of the affected tarsus were found in both cases. Lameness was not responsive to oral analgesia. Radiography was insufficient to fully determine the extent of the damage in the tarsus; the fracture was visible in one case only. CT imaging demonstrated an isolated, lateral, trochlear ridge talar fracture in both cases and contralateral talar abnormalities of comparable location and direction to the fracture. DIAGNOSIS: Isolated lateral trochlear ridge fracture of the talus without significant trauma or concurrent injury. Abnormalities of talus of the contralateral limb were demonstrated on CT imaging. CLINICAL RELEVANCE: A previously unrecognised pathological process may affect the talus of adult dogs that could predispose them to develop fracture of the lateral talar ridge without significant trauma. Further investigations are required to determine the prevalence and risk of fracture associated with this abnormality.Abbreviations: HIF: Humeral intercondylar fissure.

Treatment of acute traumatic nasopharyngeal stenosis with balloon dilation in two dogs.

CASE HISTORY: Two dogs were referred to Veterinary Specialists Aotearoa for evaluation and treatment after sustaining significant head trauma. Case 1 was a 7-month-old, female Staffordshire Bull Terrier who was hit by a car at low speed. Case 2 was a 2-year old, male neutered German Shepherd who sustained a gunshot wound to the head whilst on duty for the New Zealand Police Dog Unit. CLINICAL FINDINGS: The dog in Case 1 suffered numerous facial fractures which caused collapse of the ventral nasal meatus and dorsal nasopharyngeal wall. The dog in Case 2 had extensive osseous and soft tissue damage to the nose, nasopharynx and cervical region with severe narrowing of the ventral meatuses, nasopharyngeal meatus and rostral nasopharynx due to multiple fracture fragments and shrapnel pieces. A diagnosis of traumatic nasopharyngeal stenosis was made in each case by computed tomography. Mechanical balloon dilation was used to treat the stenosis in both dogs. The balloon dilations were performed using a 12-mm balloon dilation catheter inserted in an antegrade fashion. In the first dog, the procedure was performed blind and was repeated three times with 5- and 9-day intervals between dilations. In the second dog, the procedure was performed under endoscopic guidance and again, was repeated three times with a 7-day interval between dilations. Clinical success was reported in both patients following treatment and the second dog also underwent a follow-up computed tomography scan which confirmed resolution of the stenosis. DIAGNOSIS: Traumatic nasopharyngeal stenosis that was successfully treated with balloon dilation. CLINICAL RELEVANCE: Findings suggest that balloon dilation may be an effective technique for the treatment of traumatic nasopharyngeal stenosis in dogs. Multiple dilation procedures are likely required, but the procedure can ultimately result in long term clinical resolution.Abbreviations: CT: Computed tomography; VSA: Veterinary Specialists Aotearoa.

Long term use of hydraulic artificial urethral sphincters in nine dogs from New Zealand with urethral sphincter mechanism incompetence.

AIMS: To report on the long-term outcomes of hydraulic artificial urethral sphincter (HAUS) placement for the correction of urethral sphincter mechanism incompetence (USMI) in New Zealand dogs. METHODS: Retrospective data were obtained from cases of dogs which had a HAUS placed after failed medical and/or surgical management of USMI between August 2012 and November 2016. Owner assessment of urinary incontinence was evaluated by an online survey in May 2017 using a visual analogue scale (0 being normal, 100 being severely affected) for the frequency, volume and severity of any straining to urinate, immediately prior to the placement of the HAUS and at the time of the survey. The number of days between surgery and the completion of survey were recorded. RESULTS: Seven females and two male dogs, which were all desexed except for one female, were eligible for inclusion in the study. The period of follow-up following HAUS placement ranged from 206-1,685 days. Following HAUS placement, frequency and volume of urinary incontinence decreased for six dogs and were practically unchanged for three dogs. The median frequency score decreased from 70 to 13 and the volume score decreased from 73 to 12. There was no consistent change in the perceived degree of straining to urinate. Complications occurred in three dogs; one required repositioning of a dislodged injection port, one required management for haematuria and a hypoplastic bladder, and one required surgical removal of fibrous tissue around the HAUS cuff. CONCLUSIONS AND CLINICAL RELEVENCE: HAUS placement was an effective method for the treatment of persistent USMI in most dogs and provided good clinical results based on owner assessment. The technique was associated with few complications and allowed successful long-term control of urinary incontinence without the need for medical management.

Stabilisation of metacarpal or metatarsal fractures in three dogs, using circular external skeletal fixation.

CASE HISTORY: Three dogs that presented with multiple metacarpal or metatarsal fractures, between January 2004 and November 2008. CLINICAL FINDINGS: Case 1 had sustained closed fractures of metacarpal bones II-V, resulting in a valgus angulation of the manus. Case 2 had 2-week-old open, infected, comminuted diaphyseal fractures of metatarsal bones II-IV. Case 3 had sustained open fractures of metacarpal bones II-V, that were initially stabilised with intramedullary Kirschner wires, but had gone to non-union 5 months after the initial surgery. TREATMENT: Circular external skeletal fixation was used in each of the three dogs. In Case 1, the fixator was used to perform a closed reduction, to align the overridden, angulated fractured metacarpus, by distracting the frame. In Case 2, the fixator was applied after a limited open reduction, and was used to provide stable fixation of the comminuted infected fractures while facilitating open wound management. In Case 3, the fixator was applied in buttress fashion, following open debridement and placement of an autogenous cancellous bone graft at the non-union fracture sites. CLINICAL OUTCOME: All three dogs developed drainage tracts from the fixator wire. There was minimal associated lameness or pain in two of the dogs, but Case 3 developed a transient lameness ascribed to infection associated with the wire tracts, which resolved following administration of antibiotics. Inflammation of wire tracts resulted in the fixator being removed prior to radiological evidence of union of all fractures in each dog, and the mean time from surgery to removal of the frame was 12 (range 7-24) weeks. None of the dogs had residual lameness or discomfort associated with the fractures at the time of long-term evaluation, which ranged from 10-45 months following surgery. CLINICAL RELEVANCE: These three cases illustrate the utility of circular external skeletal fixation for the stabilisation of complicated fractures of the metacarpus and metatarsus. The fixators were applied without inducing substantial iatrogenic trauma, and the small-diameter fixation wires provided effective stability of the short metacarpal and metatarsal fracture segments, allowing the fractures to heal. Although complications associated with wire tracts should be anticipated, circular external skeletal fixation should be considered as a viable method for managing complex fractures of the metacarpus and metacarpus in dogs.

Radiation therapy for canine appendicular osteosarcoma.

Radiation therapy (RT) for the management of canine appendicular osteosarcoma (OSA) can be described as either palliative- or curative intent. Palliative RT uses coarsely fractionated external beam RT or radiopharmaceuticals to provide relief of pain and lameness associated with OSA while resulting in minimal, if any, radiation-induced acute adverse effects. Limb amputation and chemotherapy are considered (together) the standard of care for curative-intent treatment of canine appendicular OSA. When limb amputation is not possible, RT can be used for limb sparing and is supplemented with chemotherapy for presumed micrometastatic disease. Fractionated tumour irradiation with curative intent appears to be ineffective and local disease control can more likely be achieved when stereotactic radiosurgery or intra-operative extracorporeal irradiation is combined with strict case selection and adjunctive chemotherapy. The availability of limb-sparing RT is limited by experience and availability of specialised equipment. When planned and administered appropriately, radiation-associated adverse effects are often mild and self-limiting.