Retrospective risk factor assessment for complication following tibial tuberosity transposition in 137 canine stifles with medial patellar luxation.

This study identified risk factors for complication following tibial tuberosity transposition by retrospective examination of cases that used various surgical techniques. Records and radiographs of 113 dogs with 137 stifles undergoing tibial tuberosity transposition for medial patellar luxation were reviewed. Patient-specific factors, surgical factors, and complication information were recorded. Owners were contacted as necessary to attain a minimum of 30 days follow-up. Of 137 stifles, 59 (43%) had complications, with 24 (18%) identified as major complications. Factors significantly associated with reduced risk of complication included increased age [odds ratio (OR) 0.8] and concurrent cranial cruciate ligament rupture (OR 0.3). Factors significantly associated with increased risk of complication included large breed compared to toy breed (OR 5.5), increased weight (OR 1.3), and use of a screw for tibial tuberosity fixation (OR infinity). While significant, these associations do not imply causality and prospective study is necessary to determine the ideal fixation method for individual patients.

Évaluation rétrospective du facteur de risque pour une complication après une transposition de la tubérosité tibiale à l'aide de diverses techniques chirurgicales dans 137 grassets atteints d'une luxation patellaire médiale. Cette étude a identifié les facteurs de risque pour une complication après la transposition de la tubérosité tibiale en effectuant l'examen rétrospectif de cas qui utilisaient des techniques chirurgicales diverses. Les dossiers et les radiographies de 113 chiens avec 137 grassets subissant une transposition de la tubérosité tibiale pour une luxation patellaire médiale ont été examinés. Les facteurs particuliers des patients, les facteurs chirurgicaux et les renseignements sur les complications ont été consignés. Au besoin, on a contacté les propriétaires pour obtenir un suivi d'au moins 30 jours. Parmi les 137 grassets, 59 (43 %) ont connu des complications et 24 (18 %) ont été identifiés comme des complications majeures. Les facteurs significativement associés à un risque réduit de complication incluaient un âge avancé [rapport de cotes (RC) de 0,8] et une rupture du ligament croisé antérieur (RC 0,3). Les facteurs qui étaient significativement associés à un risque de complication incluaient les grandes races comparativement aux races de petits chiens (RC 5,5), un poids supérieur (RC 1,3) et l'utilisation d'une vis pour la fixation de la tubérosité tibiale (RC infini). Même si elles étaient importantes, ces associations n'impliquaient pas la causalité et une étude prospective est nécessaire pour déterminer la méthode de fixation idéale pour les patients individuels.(Traduit par Isabelle Vallières).

Successful outcome of hepatectomy as treatment for liver lobe torsion in four domestic rabbits.

CASE DESCRIPTION: 4 rabbits (1.5 to 6 years old) were evaluated at the Angell Animal Medical Center from June 2007 to March 2009 because of nonspecific clinical signs including anorexia, lethargy, and decreased fecal output. CLINICAL FINDINGS: Physical examination revealed signs of pain in the cranial portion of the abdomen, gas distention of the gastrointestinal tract, and diminished borborygmi. Serum biochemical analyses and CBCs revealed moderately to markedly high alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase activities and mild to moderate anemia with polychromasia. Abdominal radiographic findings were nonspecific. Three of the 4 rabbits underwent abdominal ultrasonography; abnormalities in shape, size, echogenicity, and blood flow of the liver, indicative of liver lobe torsion, were detected. TREATMENT AND OUTCOME: All 4 rabbits underwent surgery, during which liver lobe torsion was confirmed and the affected liver lobe was resected. Histologic examination of sections of the excised lobe obtained from 3 of the 4 rabbits revealed severe, diffuse, acute to sub-acute hepatic ischemic necrosis. All rabbits recovered from surgery; owners reported that the rabbits were doing well 22 to 43 months after surgery. CLINICAL RELEVANCE: Liver lobe torsions in any species are rarely reported, yet 4 cases of liver lobe torsion in domestic rabbits were treated at 1 referral center in a 2-year period. In rabbits, clinical signs of this condition are nonspecific and results of additional tests, including abdominal ultrasonography and serum biochemical analysis, are necessary for diagnosis. Prompt diagnosis and hepatectomy of the affected lobe are recommended and appear to be associated with an excellent prognosis.