Clinical Assessment of a Lateral Epicondylar Anatomical Plate for the Stabilization of Humeral Condylar Fractures in Dogs.

OBJECTIVE: To report the use of a Lateral Epicondylar Anatomical Plate for the management of humeral condylar fractures (HCF) in dogs. STUDY DESIGN: Medical records of dogs with HCF stabilized using the Lateral Epicondylar Anatomical Plate at six UK veterinary referral centres between April 2018 and February 2021 were reviewed. Long-term follow-up (>6 months) was obtained via owner questionnaire, which incorporated the Liverpool Osteoarthritis in Dogs clinical metrology instrument. RESULTS: Sixty-two HCF were treated in 61 dogs (44 lateral condylar fractures [LCF] and 18 intracondylar (T/Y) fractures [ICF]). Fifty-one dogs were Spaniels or Spaniel crossbreeds. Intraoperative contouring of the plate was required for one dog-a French Bulldog. Postoperative complications occurred in 14/42 LCF and 6/18 ICF; overall there were 14 minor, 8 major, and 2 catastrophic complications. On final follow-up imaging, there was evidence of partial or complete osseous continuity of the condylar part of the fracture 32/53 HCF (24/39 LCF and 8/14 ICF) and lateral epicondylar part of the fracture in 53/53 HCF (39/39 LCF and 14/14 ICF). At final reexamination, 20/28 dogs with LCF and 5/13 dogs with ICF were not lame and the remaining dogs demonstrated mild lameness. According to the owner questionnaire, 17/17 dogs with LCF and 8/10 dogs with ICF returned to full limb use and median Liverpool Osteoarthritis in Dogs scores were 2/52 for LCF and 6.5/52 for ICF. CONCLUSION: The Lateral Epicondylar Anatomical Plate can be used successfully for the surgical stabilization of HCF in dogs.

Predicting tibial plateau angles following four different types of cranial closing wedge ostectomy.

OBJECTIVE: To investigate how tibial long axis (TLA) shift affects the postoperative tibial plateau angle (TPA) in four cranial closing wedge ostectomy (CCWO) techniques. STUDY DESIGN: In silico study. SAMPLE POPULATION: A total of 15 client-owned dogs. METHODS: Computed tomography (CT) scans of 15 client-owned dogs were reviewed using an open-source 3D computer graphics editor. Each computer-generated 3D tibia model underwent a CCWO, with cranial cortex alignment, in 10° increments up to 70° using each of the four previously described techniques. The TLA shift, TPA and mechanical tibial length (mTL) were calculated, using trigonometry, for each model. Equations for predicting final TPA were generated with linear regression. RESULTS: A total of 433 3D computer generated tibial models were analyzed. With each technique, the TPA varied in a linear fashion within the studied range of wedge angles. The TLA shift and tibial shortening magnitude varied between the four different CCWO techniques, with maximum mTL reduction of ranging from 7.5% to 40.9%. All predicted TPAs using the generated equations were within the target range of 4-6°. CONCLUSION: A linear relationship between ostectomy wedge angle and TPA correction was observed in this study, which allowed for generation of accurate corrective equations. CLINICAL SIGNIFICANCE: These results allow extrapolation of the wedge angle required to reach a postoperative TPA of 5°, by considering the TLA shift. The use of the generated corrective equations may thus increase CCWO planning precision.

Accuracy of Caudocranial Canine Femoral Radiographs Compared to Computed Tomography Multiplanar Reconstructions for Measurement of Anatomic Lateral Distal Femoral Angle.

OBJECTIVE: This study aimed to compare the accuracy of sternal recumbency caudocranially obtained radiographs of canine femora to computed tomographic (CT) frontal plane reconstructions of the same femora for assessing anatomic distal lateral femoral angles (aLDFA). STUDY DESIGN: Multicentre, retrospective study utilizing 81 matched radiographic and CT studies of clinical patients undergoing assessment for various issues were reviewed. Anatomic lateral distal femoral angles were measured, and accuracy assessed with descriptive statistics and Bland-Altman plot analysis, with CT considered the reference standard. Sensitivity and specificity of a cut-off for measured aLDFA (102 degrees) were determined to assess radiography as a screening tool for significant deformity. RESULTS: Radiographs on average overestimated aLDFA by 1.8 degrees compared to CT. Bland-Altman analysis identified a 15.4 degrees 95% limit of agreement range and a tendency for greater overestimation at higher average measured value. Radiographic measurement of aLDFA of 102 degrees or less had a 90% sensitivity, 71.83% specificity, and 98.08% negative predictive value for the CT measurement being less than 102 degrees. CONCLUSION: Accuracy of aLDFA measurement by caudocranial radiographs does not demonstrate sufficient accuracy when compared to CT frontal plane reconstructions with unpredictable differences. Radiographic assessment is a useful screening tool to exclude animals with a true aLDFA of greater than 102 degrees with a high degree of certainty.

Lateralization of the diaphragm for thoracic wall reconstruction in a dog.

CASE DESCRIPTION: A 7-year-old 35-kg (77-lb) neutered male Labrador Retriever was evaluated because of a 1-month history of a rapidly growing mass associated with the right caudal aspect of the thoracic wall. CLINICAL FINDINGS: CT examination revealed an aggressive, osteolytic mass lesion centered around the ventral aspect of the right ninth rib with osteolysis of that rib and focal invasion into the right external abdominal oblique muscle. Preoperative cytologic and histologic findings were most consistent with a chondrosarcoma. TREATMENT AND OUTCOME: The mass and the eighth, ninth, and tenth ribs were resected, and thoracic wall reconstruction was performed with a novel surgical technique involving lateralization of the diaphragm. The dog recovered rapidly and without complications other than a small seroma; no paradoxical chest movement developed, and the cosmetic outcome was good. An excellent quality of life was reported after surgery until the dog was euthanized because of underlying disease progression 6 months later. CLINICAL RELEVANCE: Diaphragmatic lateralization was a simple method of caudal thoracic wall reconstruction that had good clinical results in this case. Research is needed to further assess the safety, reliability, and potential complications of this procedure in dogs.

A case of gastric leiomyosarcoma in a domestic shorthair cat.

CASE SUMMARY: A 10-year-old male neutered domestic shorthair cat presented with nausea and 1.2 kg weight loss over a 6 month period. Physical examination was unremarkable, and haematological and biochemical results were considered clinically unremarkable. Abdominal ultrasound revealed an 18 mm diameter heterogeneous mass in the stomach at the pyloric sphincter, protruding into the gastric lumen with loss of gastric wall layering. The remainder of the intestinal tract and abdominal viscera were unremarkable and no free fluid was detected. The mass was surgically resected via celiotomy and the adjacent lymph node excised for histopathology. Histopathology of the mass demonstrated neoplastic spindle cell proliferation, which was considered most likely to be of smooth muscle origin, and so a preliminary diagnosis of gastric leiomyosarcoma was given. Complete excision was confirmed. Immunohistochemistry excluded a gastrointestinal stromal cell tumour as a differential and strongly supported the diagnosis of gastric leiomyosarcoma. The cat recovered well postoperatively with supportive treatment. Repeat abdominal ultrasonography 3 and 6 months postoperatively showed no evidence of mass regrowth. Survival time at the time of reporting is 10 months. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this is the first report of gastric leiomyosarcoma in a cat. Based on this case, gastric leiomyosarcoma should be a differential diagnosis for cats presenting with a gastric mass.

Bilateral bronchial stent deployment for palliative treatment of a compressive intrathoracic mass in a cat.

CASE SUMMARY: Bronchial stents may be useful to relieve clinical signs of extraluminal compression. Herein we describe a case which, to our knowledge, is the first cat where bilateral bronchial stents have been used clinically. Respiratory signs of principal bronchial compression were alleviated after the stent procedure. Minor complications occurred, specifically: severe hypoxia during stent deployment; a transient, self-limiting postoperative pneumothorax possibly associated with ventilation-induced lung injury; bronchopneumonia (possibly pre-existing); and transient worsening of cough postoperatively. Stents were well- tolerated long- term. The cat was euthanased at 44 weeks post-stent procedure, owing to clinical signs of regurgitation, seemingly related to oesophageal dysfunction associated with tumour invasion. RELEVANCE AND NOVEL INFORMATION: In this case, it appeared that bronchial stents were feasible and the procedure was associated with long-term improvement in respiratory signs related to extraluminal bronchial compression.

Effects of sample site and size, skin tension lines, surgeon, and formalin fixation on shrinkage of skin samples excised from canine cadavers.

OBJECTIVE: To assess the effects of sample size and location, skin tension lines, surgeon, and formalin fixation on the extent of shrinkage that occurs in excised canine skin samples. ANIMALS: Cadavers of 4 adult purpose-bred mixed-breed hound dogs with grossly normal skin. PROCEDURES: 54 circular areas of skin (2-, 4-, and 6-cm-diameter samples from each of 9 body regions on each side) were excised by 1 of 2 surgeons from each cadaver. The diameter of each sample was measured in 4 orientations (parallel to previously reported tension lines, perpendicular to tension lines, in a dorsoventral orientation, and in a craniocaudal [or rostrocaudal] orientation) at 3 time points (before and immediately after excision and after 24 hours of formalin fixation). RESULTS: 216 samples were measured in all 4 orientations at all 3 time points. For all samples, mean ± SE decrease in diameter after fixation, compared with pre-excision findings, was 6.2 ± 0.7 mm. No significant correlations were found between percentage of skin shrinkage and surgeon, body side or region, or measurement orientation in relation to skin tension lines. The mean sample diameter immediately after excision differed significantly from that before excision (mean diameter decrease, 5.5 ± 0.7 mm). Overall, sample diameter immediately after excision and after formalin fixation did not differ. CONCLUSIONS AND CLINICAL RELEVANCE: The extent of shrinkage of skin samples from hound cadavers that occurred immediately after excision was notable. A better understanding of the effectors of excised skin sample shrinkage is needed, especially when histopathologic findings provide guidelines for surgical margins.

The S-measurement in the diagnosis of canine hip dysplasia.

OBJECTIVE: To propose a direct measure of subluxation of the femoral head (S) in the assessment of hip joint laxity and evaluate it for clinical use. STUDY DESIGN: Method comparison study. ANIMALS: Dogs (n = 51). METHODS: Dogs were sedated or anesthetized for a dorsolateral subluxation (DLS) examination. Two sets of radiographs were acquired, 1 each by a different technologist. A calibrated measuring bar was included on the image at the height of the hip to assess magnification. The DLS was calculated for each hip and different persons unaware of these details measured the "S"-value. One person measured the S-value 3 times over 3 days. Box plots were used to determine a cut-off for the empiric (8 mm) and corrected (4 mm) S-value. RESULTS: Of 51 dogs, 33 were dysplastic based on a DLS score <55%. Magnification and body weight were strongly correlated (r = 0.4922, P = .0006). Both empiric and corrected S measurements showed good agreement with the DLS score (κ = 0.688 and κ = 0.681, respectively). The corrected S measurement produced more false negatives. Bland-Altman analysis showed interobserver and technician variance acceptable for clinical use (limits of agreement < ±3 mm). Intraobserver repeatability was acceptable for the right hip (95% of differences were ≤1.3 mm and 100% ≤ 1.9) but not for the left hip. CONCLUSION: Using a cut-off value of 5 mm, the empirical S measurement can be used to exclude hip dysplasia in young dogs of various body proportions.

Imaging diagnosis--Congenital lobar emphysema in a dog.

A 14-week-old female West Highland White Terrier developed acute dyspnea. Radiographically there was an enlarged, hyperlucent caudal portion of the left cranial lung lobe and a diffuse, severe interstitial-to-alveolar pattern in the remaining lung lobes that was accentuated caudodorsally. Computed tomography confirmed the presence of the emphysematous lobe and further showed it to have focal lobar bronchial collapse. Lung lobe resection was performed, and the diagnosis was congenital lobar emphysema secondary to bronchial cartilage hypoplasia.

Outcome of and complications associated with tube cystostomy in dogs and cats: 76 cases (1995-2006).

OBJECTIVE: To determine indications for cystostomy tube use in dogs and cats, complications associated with their use, and outcome of dogs and cats in which cystostomy tubes had been inserted. DESIGN: Retrospective case series. ANIMALS: 37 dogs and 39 cats. PROCEDURES: Information was obtained from medical records. Long-term follow-up information was obtained by use of a client questionnaire. RESULTS: Indications for cystostomy tube placement were bladder dysfunction, urinary tract rupture, obstructive urinary tract neoplasia, urinary diversion following urogenital surgery, obstructive urolithiasis, and feline lower urinary tract disease. Median time tubes were in place was 11 days, but duration of tube use was significantly longer for animals with bladder dysfunction than for animals with urinary tract trauma, urinary diversion, or urinary tract obstruction. Thirty-seven (49%) animals had tube complications. Development of complications was not significantly associated with species, age, body weight, duration of tube use, or tube type, except that animals were significantly more likely to develop complications following long-rather than short-term use. In 42 animals, the underlying condition resolved and the tube was removed; 22 animals died or were euthanatized with the tube in place. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that cystostomy tubes may be used for animals with various conditions related to problems with urine outflow. Nearly half the animals in the study developed complications related to the cystostomy tube, suggesting that potential complications should be discussed with owners prior to tube placement. However, most complications were easily resolved.