Use of an interlocking nail-hybrid fixator construct for distal femoral deformity correction in three dogs.

Our purpose was to report the use of an interlocking nail-hybrid external fixator construct to correct distal femoral deformities in three dogs. Radiographs, computed tomography and a three-dimensional model were used to plan the surgical procedure. A femoral osteotomy or ostectomy was performed at the level of the centre of rotation of angulation in all three dogs. Angular and rotational deformities were corrected acutely. Distraction osteogenesis was performed to lengthen each femur postoperatively. All three dogs had additional anatomic abnormalities of the affected hindlimb complicating the correction of the distal femoral deformity. While the interlocking nail-hybrid fixator construct allowed for stable distraction of the femur, all three dogs developed complications during the postoperative convalescent period, and each had some degree of residual lameness. Lengthening the femur following acute deformity correction is problematic and additional experimental and clinical studies are warranted to decrease postoperative morbidity and improve functional results.

Effects of intra-articular botulinum toxin type A (Botox) in dogs with chronic osteoarthritis.

OBJECTIVES: To evaluate the effects of intra-articular botulinum neurotoxin type A (BoNT/A) in dogs with chronic osteo- arthritis. METHODS: Client-owned dogs with lameness and discomfort attributed to unilateral elbow or hip osteoarthritis were eligible for inclusion (n = 5). All dogs had BoNT/A (25 units) administered to the affected joint (2 elbows, 3 hips). Dogs were evaluated by pressure platform gait analysis before and at two, four, eight, and 12 weeks post-injection, and by client perception of outcome. RESULTS: In experimental limbs, ground reaction forces (peak vertical force and vertical impulse) consistently improved for a variable period of time following intra-articular BoNT/A therapy. These changes were not, however, observed in the contralateral limbs, in which values remained relatively unchanged or decreased. Four out of five owners reported at least some improvement in their dog's condition following treatment. CLINICAL SIGNIFICANCE: A multimodal approach with the intra-articular administration of BoNT/A may be an option for osteoarthritis patients that are unresponsive to medical management and unable to undergo surgery. However, the findings of this study are preliminary and must be verified by further investigation.

Traumatic fragmented medial coronoid process in a Chihuahua.

Fragmented medial coronoid process (FMCP) is a disease process that has not previously been reported in toy-breed dogs. This report describes a presumptive case of FMCP in a 14-month-old Chihuahua that was presented for evaluation approximately four weeks following acute onset of moderate lameness in the left forelimb. Definitive diagnosis of a fragmented medial coronoid process was based upon computed tomography (CT) scan. A CT scan also demonstrated moderate joint incongruity in the affected elbow. Surgical removal of the fragment and subtotal coronoidectomy were performed via a medial arthrotomy. An ulnar ostectomy was also performed to address joint incongruity. Histology of specimens removed at surgery did not demonstrate evidence of microdamage as characteristic of FMCP in large breed dogs, and instead, suggested that the fracture was acute and traumatic in nature. Rapid return to function was observed following surgery.

Bilateral correction of metatarsal rotation in a dog using circular external skeletal fixation.

An 8-month-old castrated male Saint Bernard was evaluated for bilateral hind limb lameness. Lameness was ascribed to bilateral metatarsal rotational abnormalities on the basis of the physical examination and radiographic evaluations. Staged, bilateral deformity correction and tarsometatarsal arthrodeses were performed using circular external skeletal fixators. The dog's gait improved following surgery and the fixators were removed 3 (left hind paw) and 4 (right hind paw) months following surgery. Twenty months after the initial surgery, the owner reported that the dog was walking well without apparent lameness. Previous reports suggest that metatarsal rotation is untreatable; however, our results suggest that surgical correction of this deformity can substantially improve limb function in dogs affected with metatarsal rotation.

Promoting breastfeeding in the neonatal intensive care unit.

The technology and separation of the mother and baby in the neonatal unit make bonding difficult and create barriers to breastfeeding. This pilot study aimed to define those nursing interventions that promote breastfeeding. The neonatal nurse plays a vital role in the influence of the breastfeeding outcome. Forty-one preterm babies had their breastfeeding activities, (including kangaroo care), recorded daily. The specific phases in preterm infants of 32 weeks or more were identified as 1. stabilisation and assessing ability, 2. controlled challenge, 3. progression and regression and 4. stability of feeding activity. This study has increased the awareness among the neonatal nurses involved as to the nursing practices that promote breastfeeding and has provided a basis from which nurses can promote breastfeeding to mothers of preterm babies.

Mathematical prediction of ileal pouch capacity.

Restorative proctocolectomy is an operation still in the stage of development. Three main types of ileal pouch construction are used, but the advocacy of each probably arises more from familiarity and convenience than from scientific considerations. Since, other things being equal, pouch capacity can be expected to affect stool frequency, it seemed reasonable to examine calculable pouch capacity geometrically for different methods of construction. A mathematical model was therefore used to compare the double loop ('J') type with the quadruple loop ('W') construction. The W was estimated to have a capacity more than half as great again as the J. Similarly anastomotic methods which encroach on the ileal circumference by creating an inverted edge can be expected to reduce resultant capacity by 10 per cent or more.