Pelvic osteotomy for axial rotation of the acetabular segment in dogs with hip dysplasia.

Pelvic osteotomy has provided normal function and activity to dogs with hip dysplasia. Physical and radiographic examination and palpation under anesthesia permit evaluation of the degenerative process and provide the specific amount of axial rotation of the pelvis necessary for each dog. The technique consists of an osteotomy of the pubis, ischium, and ilium to reestablish acetabular support of the femoral head.     

Effects of limited food consumption on the incidence of hip dysplasia in growing dogs.

Forty-eight 8-week-old Labrador Retrievers were allotted to 2 groups of 24 dogs each; 1 group was fed ad libitum and the other group was given 25% less of the same feed until the dogs were 2 years old. Radiography of the hip joints was done when the dogs were 30, 42, 54, 78, and 104 weeks old. Subluxation was measured by the Norberg angle on radiographs made with the dog in the standard (extended limb) position. Independent of age at which the radiography was done, there was less subluxation of the femoral heads in the limit-fed dogs. Using the Swedish method of hip joint evaluation on the same radiographs, it was found that fewer dogs on limited food intake had signs of hip dysplasia. Radiographs done when dogs were 2 years old, for all the methods used (Norberg angle in standard and frog-limb position, the Orthopedic Foundation for Animals [OFA] score, and the Swedish score), revealed less hip dysplasia (less joint subluxation and less degenerative joint disease) in the limit-fed dogs. Using the OFA method, 7 of the 24 limit-fed dogs and 16 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. Similarly, using the Swedish method, 5 of the 24 limit-fed dogs and 18 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. The food-intake-related differences were significant both for the OFA score and for the Swedish score.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of anaesthesia on canine hip dysplasia score

Hip dysplasia (HD) scores, based on the five grades, as defined by the Fédération Cynologique Internationale, were compared between anaesthetized (group 1, n = 3839) and non-sedated non-anaesthetized dogs (group 2, n = 1517). Each dog was radiographed in the standard ventro-dorsal hip joint extended position. Each radiograph was evaluated by the same reader blinded regarding the dog's status of anaesthesia. Results showed that there was a significant difference in hip dysplasia prevalence between group 1 (22%) compared with group 2 (9%) (P < 0.005). This difference was the result of a lower rate of hip-joint laxity assessment and the measurement of Norberg-Olsson angle <105 degrees in group 2 compared with group 1. The acetabular and femoral morphologies were not significantly different between the groups. The data confirm that the scoring of dogs for HD on standard radiographs with the hip joints extended is influenced by anaesthesia.     

Effect of dorsal hip loading,sedation, and general anesthesia on the dorsolateral subluxation score in dogs

OBJECTIVE: To determine whether dorsal loading of the pelvis and type of chemical restraint affected the dorsolateral subluxation (DLS) score of dog hips. STYDY DESIGN: In vivo testing of diagnostic method. ANIMALS: Labrador retrievers, Greyhounds, and crosses between both breeds (n = 119 dogs). METHODS: Dorsal load was applied to the hips through a strap that was placed over the hips, and the peak vertical and steady-state vertical, ground-reaction forces exerted on the stifles were measured in the DLS position. The DLS score was measured with their hips under dorsal load and compared with the DLS score without load. For 24 dogs, the DLS score was measured both under chemical restraint (medetomidine) and under general anesthesia. Wilcoxon-signed rank test and paired t test was used to compare effects of dorsal load and restraint method on the left and right DLS hip score, and P <.05 was considered significant. RESULTS: Both stifles together accepted median 15% body weight in the vertical plane in the unloaded steady state. Loading the hips increased the steady-state, vertical ground-reaction force to 34% body weight. At 8 months of age, loading significantly decreased the DLS score from 65% +/- 11% (mean +/- SD) to 60% +/- 12% for left hips and 66% +/- 11% to 63% +/- 13% for right hips. The left hip DLS score was affected by load more consistently than the right hip. In general, loading the hips decreased the DLS score in all breeds by 4% to 6% except for the greyhounds, in which the DLS score was unchanged by dorsal loading. When grouped by their DLS scores, load significantly decreased DLS scores in dogs with unloaded scores greater than 55% (nondysplastic), whereas DLS scores of dogs with unloaded scores between 55% and 45% (dysplastic) and less than 45% did not change significantly with load. Unloaded scores did not change significantly when compared under sedation versus general anesthesia. However, load significantly decreased the DLS score under general anesthesia for the left hip but not for the right hip. CONCLUSIONS: Less than half of the vertical ground-reaction force normally exerted by the hindlegs of a standing dog was sufficient to induce hip subluxation in the DLS position. Although dorsal loading approximately doubled the steady-state, vertical ground-reaction force, the decrease in the DLS score under load was never greater than 6%. Furthermore, the DLS scores of dogs most likely to be dysplastic (based on DLS scores <45%) were not affected by load, whereas load slightly decreased DLS cores of dogs with DLS scores greater than 55%. CLINICAL RELEVANCE: External influences can change the DLS score significantly, but the magnitude of change is unlikely to be of clinical importance, making the method useful as a field screening test for both dysplastic and nondysplastic hips in young dogs.     

Definition and determination of acetabular component orientation in cemented total hip arthroplasty

OBJECTIVE: To describe the spatial orientation of the cemented acetabular component in cemented total hip arthroplasty, based on a ventrodorsal and lateral radiographic projection of the pelvis. METHODS: Equations were derived by using trigonometric relationships that describe the radiographic rotation about the longitudinal pelvic axis (alpha), transverse pelvic axis (beta), acetabular inclination (phi), acetabular inclination corrected for longitudinal pelvic rotation, version (phiC), acetabular version (theta), acetabular version corrected for longitudinal pelvic rotation (thetaC), acetabular inclination corrected for transverse pelvic rotation (phi(beta)), and acetabular version corrected for transverse pelvic rotation (theta(beta)) RESULTS: Alpha was calculated by using the equation alpha = sin(-1) (x/y) where x is the transverse distance between the dorsal spinous processes and the center of the pubis on a ventrodorsal radiograph and y is the distance from the pubis to the dorsal aspect of the first coccygeal vertebra perpendicular to the long axis of the pelvis on a lateral radiograph. Phi was calculated from the long axis (LA) and short axis (SA) of the ellipse formed by the radiopaque acetabular marker ring by using the equation phi = sin(-1) (SA/LA). phiC was calculated by using the equation phiC = phi +/- (alpha - tan(-1) (tan alpha cos thetaC)). Theta was determined as previously described. ThetaC was calculated by using the equation thetaC = tan(-1) (tan theta cos alpha). Theta(beta) and theta(beta) were calculated with the equations phi(beta) = tan(-1) (tan theta cos beta) and theta(beta) = theta - tan(-1) (sin beta), respectively. Beta could not be accurately determined from ventrodorsal and lateral pelvic radiographs. CONCLUSIONS AND CLINICAL RELEVANCE: These techniques allow for more accurate postoperative radiographic assessment of acetabular component positioning. This information can then be used in retrospective or prospective analyses examining that effects of implant positioning on clinical outcome.     

Prevalence of hip dysplasia according to official radiographic screening, among 31 breeds of dogs in France.

In order to determine the prevalence of hip dysplasia (HD) from radiographs that were submitted for authorative grading, and its changes over the time in 31 breeds of dogs in France, a 14 year-retrospective study was conducted. Significant differences were observed between breeds, with HD prevalence ranging from 59.7% (Cane Corso) to 3.9% (Siberian Husky). When comparing the 1993-1999 with the 2000-2006 period in 15 breeds, a significant decrease in HD prevalence was detected in Berger Picard, Bernese Mountain dog, Briard, Gordon Setter, White Swiss Sheepdog and Rottweiler. Modifications observed in the other breeds were not statistically significant.     

EFFECTS OF PELVIC POSITIONING AND SIMULATED DORSAL ACETABULAR RIM REMODELING ON THE RADIOGRAPHIC SHAPE OF THE DORSAL ACETABULAR EDGE

A radiographic study was conducted to evaluate the effect of pelvic rotation and of simulated dorsal acetabular rim (DAR) remodeling on the radiographic appearance of the dorsal acetabular edge (DAE). The DAE is the line connecting the cranial and caudal rims of the acetabulum when viewing a pelvic radiograph made with the dog in the ventrodorsal position with the hind limbs extended. In this study, it was hypothesized that the DAE would change with pelvic rotation and simulated DAR damage. Ventrodorsal radiographs of eight canine pelves were made at 0 degrees, 5 degrees, and 10 degrees of left and right pelvic rotation over its longitudinal axis. These radiographs were repeated following removal of 2, 4, and then 6 mm of bone from the right DAR of each pelvis. The ratio of acetabular width to maximum depth of the DAE was calculated. The area between the DAE and a straight line connecting the cranial and caudal acetabular rims was measured digitally. The DAE depth and area changed with pelvic rotation, and with increasing simulated DAR damage. A linear relationship between the obturator foramina width ratio and pelvic rotation allowed estimation of the degree and direction of pelvic rotation. Equations were developed from the data to assist with the estimation of the amount of DAR remodeling on a clinical radiograph.     

Volume of the ligamentum capitis femoris in osteoarthritic hip joints of adult dogs

Ventrodorsal pelvic radiographs were made of 32 adult dogs under general anaesthesia. The hip joints were evaluated according to the severity of osteoarthritic changes graded as 0, 1, 2 or 3. The dogs were euthanased, the hip joints opened and the ligamentum capitis femoris dissected out in toto. The volume of each ligament was determined using a water displacement technique and the mean volume compared to the four radiographic grades of osteoarthritis. There was an inverse correlation (r = -0.75) between the mean volume of the ligamentum capitis femoris and the increasing severity of osteoarthritis as assessed by radiography. The results confirmed the crucial role of radiography in the clinical evaluation of hip dysplasia and osteoarthritis in the adult dog. Assessment of the volume of the ligamentum capitis femoris revealed that it is an important tool for research in canine hip dysplasia and osteoarthritis.     

Evaluation of multiple radiographic predictors of cartilage lesions in the hip joints of eight-month-old dogs

OBJECTIVE: To determine the radiographic methods that best predict the development of osteoarthritis in the hip joints of a cohort of dogs with hip dysplasia and unaffected dogs. ANIMALS: 205 Labrador Retrievers, Greyhounds, and Labrador Retriever-Greyhound crossbred dogs. PROCEDURE: Pelvic radiography was performed when the dogs were 8 months old. Ventrodorsal extended-hip, distraction, and dorsolateral subluxation (DLS) radiographs were obtained. An Orthopedic Foundation for Animals-like hip score, distraction index, dorsolateral subluxation score, and Norberg angle were derived from examination of radiographs. Osteoarthritis was diagnosed at the time of necropsy in dogs > or = 8 months of age on the basis of detection of articular cartilage lesions. Multiple logistic regression was used to determine the radiographic technique or techniques that best predicted development of osteoarthritis. RESULTS: A combination of 2 radiographic methods was better than any single method in predicting a cartilage lesion or a normal joint, but adding a third radiographic method did not improve that prediction. A combination of the DLS score and Norberg angle best predicted osteoarthritis of the hip joint or an unaffected hip joint. All models that excluded the DLS score were inferior to those that included it. CONCLUSIONS AND CLINICAL RELEVANCE: A combination of the DLS score and Norberg angle was the best predictor of radiographic measures in 8-month-old dogs to determine whether a dog would have normal or osteoarthritic hip joints.     

Role of the Orthopedic Foundation for Animals in the control of canine hip dysplasia.

The objectives of the Dysplasia Control Registry, the procedure for submitting radiographs, and the radiographic evaluation process are described. The results from the radiographic evaluation of 321,183 dogs are reported by hip phenotypic ratings and breed frequency of canine hip dysplasia. Breeds at risk are documented. Comparison of dogs born between 1981 and 1988 with those born between 1972 and 1980 demonstrated that the frequency of canine hip dysplasia was reduced in 79% of breeds, and the frequency of excellent hips was increased in 88% of the breeds. Reliability of preliminary hip evaluations of dogs under 24 months of age is reported to vary by breed, and the results of 9,161 preliminary evaluations are documented.     

USING MACHINE LEARNING TO CLASSIFY IMAGE FEATURES FROM CANINE PELVIC RADIOGRAPHS: EVALUATION OF PARTIAL LEAST SQUARES DISCRIMINANT ANALYSIS AND ARTIFICIAL NEURAL NETWORK MODELS

As the number of images per study increases in the field of veterinary radiology, there is a growing need for computer‐assisted diagnosis techniques. The purpose of this study was to evaluate two machine learning statistical models for automatically identifying image regions that contain the canine hip joint on ventrodorsal pelvis radiographs. A training set of images (120 of the hip and 80 from other regions) was used to train a linear partial least squares discriminant analysis (PLS‐DA) model and a nonlinear artificial neural network (ANN) model to classify hip images. Performance of the models was assessed using a separate test image set (36 containing hips and 20 from other areas). Partial least squares discriminant analysis model achieved a classification error, sensitivity, and specificity of 6.7%, 100%, and 89%, respectively. The corresponding values for the ANN model were 8.9%, 86%, and 100%. Findings indicated that statistical classification of veterinary images is feasible and has the potential for grouping and classifying images or image features, especially when a large number of well‐classified images are available for model training.     

Estimates of prevalence of hip dysplasia in Golden Retrievers and Rottweilers and the influence of bias on published prevalence figures

OBJECTIVE: To estimate prevalence of canine hip dysplasia (CHD) in Golden Retrievers and Rottweilers and identify sources of bias in published reports. DESIGN: Prospective study. ANIMALS: 200 clinically normal Golden Retrievers and 140 clinically normal Rottweilers between 24 and 60 months of age referred for hip evaluation (group 1) and 93 clinically normal dogs evaluated for Orthopedic Foundation for Animals (OFA) hip certification (group 2). PROCEDURE: Hip-extended pelvic radiographs from group 1 dogs were screened for CHD. Radiographs were evaluated twice; the first interpretation used an OFA-type subjective 7-point scoring system, and the second included the caudolateral curvilinear osteophyte as an additional sign of degenerative joint disease. The OFA submission rate of group 2 dogs was determined from the number of official reports returned from the OFA. RESULTS: Prevalence of CHD in Golden Retrievers ranged from 53% to 73% and in Rottweilers ranged from 41% to 69%. Among dogs referred for OFA evaluation, radiographs from 49 (53%) were submitted to OFA. Of submitted radiographs, 45 (92%) were normal; of radiographs not submitted, 22 (50%) were normal. Radiographs with normal-appearing hips were 8.2 times as likely to be submitted to the OFA. Compared with Golden Retrievers, Rottweiler radiographs were significantly more likely to be submitted for OFA certification. CONCLUSIONS AND CLINICAL RELEVANCE: Prevalence of CHD in these 2 breeds may be much higher than previously reported in the United States. Results suggest substantial bias in the OFA database, which causes lower estimates of prevalence of CHD.     

ULTRASONOGRAPHIC FINDINGS IN 14 DOGS WITH ECTOPIC URETER

To evaluate ultrasonography as an alternative to contrast radiography for diagnosis of ectopic ureter in dogs, ultrasonography of the urinary tract was performed prospectively in a series of urinary incontinent dogs anesthetized for contrast radiography. Fourteen dogs had ectopic ureter based on surgical, necropsy or unequivocal contrast radiographic findings. There were eight females and six males of a variety of breeds; five were Labrador retrievers. Mean (range) age at the time of diagnosis was 1.2 (0.2–4) years for females and 3.5 (0.3–5) for males (p < 0.05). Ectopic ureters were unilateral in five dogs (2 left; 3 right) and bilateral in nine dogs. Both ultrasound images and contrast radiographs were positive for 21 (91%) ectopic ureters; the same two ectopic ureters were not detected using either modality. The termination of each of the five normal ureters was visible on ultrasound images; two (40%) were visible on radiographs. Other ultrasonographic findings included dilatation of the ectopic ureter and/or ipsilateral renal pelvis in ten (43%) instances, evidence of pyelonephritis in two dogs (with enlargement of the contralateral kidney in one dog), and urethral diverticuli in one dog. Ultrasonography is a practical diagnostic test for ectopic ureter in dogs. In this series there was close correlation between the ultrasonographic and contrast radiographic findings for each ectopic ureter, but ultrasonography enabled more accurate determination of normal ureteral anatomy.     

Comparison of digitized and conventional radiographic images for assessment of hip joint conformation in dogs

OBJECTIVE: To determine agreement between assessments of canine hip joint conformation provided by board-certified radiologists after evaluation of digitized and conventional radiographic images. SAMPLE POPULATION: 200 pelvic radiographs previously evaluated by radiologists using the Orthopedic Foundation for Animals standard grading system for canine hip joint conformation. PROCEDURES: Each of 20 board-certified radiologists evaluated conventional and digitized pelvic radiographs from each of 200 dogs for hip joint conformation. A weighted kappa coefficient and intraclass correlation were used to determine agreement between assessments derived from digitized radiographic images and conventional radiographs and between the original Orthopedic Foundation for Animals conformation ratings and assessments derived from each image format. RESULTS: Overall, agreement between assessments derived from the digitized images and conventional radiographs was good, with all but 1 radiologist attaining a weighted kappa coefficient > 0.61. Intraclass correlation for each radiologist ranged from 0.75 to 0.98 (95% confidence interval, 0.67 to 0.984). On comparison of conformation assessments, 95.7% of those derived from conventional radiographs and digitized images were within 1 grade. On comparison of digitized radiographic conformation assessments and conformation ratings, 94.2% were within 1 grade. On comparison of conventional radiographic conformation assessments and conformation ratings, 92.3% were within 1 grade. CONCLUSIONS AND CLINICAL RELEVANCE: The use of digitized radiographic images does not appear to impact the radiographic assessments of canine hip joint conformation made by consultant radiologists. Compared with conventional radiographs, the use of digitized radiographic images decreases storage space requirements and enables more rapid reporting of assessment results for individual dogs.     

Radiographic appearance and clinical progress after excision arthroplasty of the canine hip

This paper describes the radiographic appearance of the proximal femur and acetabulum after excision arthroplasty for chronic hip lameness in the dog. An attempt has been made to correlate the various radiographic appearances with the clinical findings. The fate of spurs of bone left at the site of resection has been investigated. A constant finding was remodelling of the acetabulum and proximal femur; the results of this remodelling are described.     

Aortic valvular dysplasia in a dog

A case of aortic valve dysplasia in a 6 year old male cocker spaniel is described. The dog was presented to the veterinarian because of strong dyspnea and frequent coughing. Clinical examination, EKG, radiographs and angiocardiography all pointed towards a tentative diagnosis of aortic insufficiency. Four months after the first appointment the dog was presented again with congestive heart failure, neural symptoms and strong abdominal pain. Electrocardiography and concentrations of LDH and CK were typical of myocardial infarction. Autopsy revealed a narrowing of the aortic valves in combination with a subaortic stenosis and several infarctions localized in the left ventricle as well as a recent infarction in the left kidney.     

EVALUATION OF DIAPHRAGMATIC MOTION IN NORMAL AND DIAPHRAGMATIC PARALYZED DOGS USING M‐MODE ULTRASONOGRAPHY

Diagnosis of unilateral diaphragmatic paralysis in dogs is currently based on fluoroscopic detection of unequal movement between the crura. Bilateral paralysis may be more difficult to confirm with fluoroscopy because diaphragmatic movement is sometimes produced by compensatory abdominal muscle contractions. The purpose of this study was to develop a new method to evaluate diaphragmatic movement using M‐mode ultrasonography and to describe findings for normal and diaphragmatic paralyzed dogs. Fifty‐five clinically normal dogs and two dogs with diaphragmatic paralysis were recruited. Thoracic radiographs were acquired for all dogs and fluoroscopy studies were also acquired for clinically affected dogs. Two observers independently measured diaphragmatic direction of motion and amplitude of excursion using M‐mode ultrasonography for dogs meeting study inclusion criteria. Eight of the clinically normal dogs were excluded due to abnormal thoracic radiographic findings. For the remaining normal dogs, the lower limit values of diaphragmatic excursion were 2.85–2.98 mm during normal breathing. One dog with bilateral diaphragmatic paralysis showed paradoxical movement of both crura at the end of inspiration. One dog with unilateral diaphragmatic paralysis had diaphragmatic excursion values of 2.00 ± 0.42 mm on the left side and 4.05 ± 1.48 mm on the right side. The difference between left and right diaphragmatic excursion values was 55%. Findings indicated that M‐mode ultrasonography is a relatively simple and objective method for measuring diaphragmatic movement in dogs. Future studies are needed in a larger number of dogs with diaphragmatic paralysis to determine the diagnostic sensitivity of this promising new technique.     

Sertl shelf arthroplasty (BOP procedure) in the treatment of canine hip dysplasia.

The BOP/Sertl shelf arthroplasty procedure is not difficult or lengthy. It uses minimal metallic fixation. It is quite physiological with minimal morbidity because there is no change in the bony anatomic pelvis except to create an extension of the lateral rim of the acetabulum. The animal is able to walk the day after surgery. The procedure can be performed bilaterally the same day, thus creating good bony stability and decreasing stretching of the joint capsule, which in turn prevents further subluxation and pain in the hip joint. The aim of this procedure is to return the animal to a satisfactory lifestyle through an effective but less complicated surgical procedure as compared to other available options. This procedure is straightforward and can be done by a surgeon who is familiar with orthopedic surgical techniques and has been trained in this procedure. To date, more than 150 veterinarians have had hands-on training to perform this operation. We are not claiming that this procedure is a cure for CHD; rather, it is a procedure that dramatically slows down the progress of this malady and allows the dog to lead a more normal lifestyle and avoids euthanasia. After 51 months, our study of 200 hips has had a success rate of 99% on the animals available for follow-up as evidenced by returning those animals to a satisfactory lifestyle with stable hips.     

SCINTIGRAPHIC DETECTION OF SUBCUTANEOUS METASTASIS IN A DOG WITH APPENDICULAR OSTEOSARCOMA

This report describes the detection of subclinical soft tissue metastasis of an appendicular osteosarcoma in a dog using bone scintigraphy. A 7-year-old spayed female Rottweiler was presented with a biopsy confirmed diagnosis of osteosarcoma. Initial radiographs revealed an aggressive bone lesion of the left distal radius. At presentation, there was no clinical or radiographic evidence of metastasis; however, a nuclear bone scan showed the primary bone lesion of the distal left radius and numerous soft tissue lesions consistent with diffuse soft tissue metastases. A left foreleg amputation was performed and cisplatin chemotherapy was given post-operatively. A second bone scan performed one month following initial presentation showed progression in size and number of soft tissue masses. Many of the lesions had become apparent on physical exam and survey radiographs. Excisional biopsy was performed on one of the soft tissue masses and a diagnosis of metastatic osteosarcoma was made. The dog was euthanized 2 months after initial presentation at the owners request due to deterioration of the animals physical condition.