Pharmacokinetic Disposition of Cefazolin in Serum and Tissue during Canine Total Hip Replacement

Intraoperative cefazolin concentrations were measured in serum, joint capsule, cancellous bone of the acetabulum, and proximal cancellous bone of the femur in 15 dogs undergoing total hip replacement. Cefazolin (22 mg/kg intravenously [IV]) was administered every hour for three doses. The mean peak serum concentrations (+/- SEM) were 387.79 +/- 27.56 micrograms/mL, 521.71 +/- 28.00 micrograms/mL, and 542.20 +/- 30.91 micrograms/mL, respectively. Mean serum concentrations just before administration of doses 2 and 3 were 51.77 +/- 2.39 micrograms/mL, and 64.84 +/- 3.46 micrograms/mL, respectively. The mean cefazolin concentrations in the joint capsule, cancellous bone of the acetabulum, and cancellous bone of the femur were 34.71 +/- 2.50 micrograms/g, 28.70 +/- 7.40 micrograms/g, and 36.20 +/- 3.80 micrograms/g, respectively. The minimum inhibitory concentration of cefazolin for 90% of the common contaminants (MIC90) in this clinic is less than or equal to 2 micrograms/mL or per gram of tissue. Serum concentrations never fell below 15 times the MIC90 (lowest trough, 35.93 micrograms/mL), and the lowest tissue concentration (6.57 micrograms/mL in cancellous bone from the acetabulum) was still more than 3 times the MIC90. The mean tissue concentration was 15 times the MIC90.     

A Comparison of Acute Pull-Out Strength Between Two-Way and One-Way Transfixation Pin Insertion for External Skeletal Fixation in Canine Bone

This study tested the hypothesis that two-way insertion of an external skeletal fixator trans-fixation pin would weaken the pin-bone interface. Smooth and partially threaded (end) trans-fixation pins were placed in tibiae of 32 cadavers by slow speed drilling or hand placement through a predrilled pilot hole. In one bone of each tibial pair, pins were inserted 2 cm beyond the distal cortex and retracted to a predetermined position (two-way). In the contralateral limb, the pins were inserted in one forward motion to the predetermined position (one-way). The peak force (Newtons) required to extract the pins (pull-out strength) axially at a rate of 1 mm/sec was determined by using a universal testing machine. A significant (p < .05) decrease in pull-out strength was found in pins placed by two-way insertion (674 +/- 410) as opposed to one-way insertion (766 +/- 432). The results of this in vitro study suggest that one-way insertion should be used clinically to decrease weakening of the pin-bone interface and prevent possible failure of external fixators. A significantly greater pull-out strength was found for threaded pins placed in the proximal diaphysis (1459 +/- 330 Newtons) compared to the distal metaphysis (873 +/- 297 Newtons).     

Arthroscopy of the Coxofemoral Joint of Foals

An arthroscopic procedure for examination of the coxofemoral joint was developed in nine foals (four cadavers, five anesthetized) to determine if access was sufficient for evaluation and surgical treatment of intra-articular lesions. The joint was distended and the arthroscope inserted through the notch (incisura trochanterica) between the cranial and caudal parts of the greater trochanter. This portal allowed examination of the cranial, lateral, and caudal aspects of the joint. Mechanical distraction of the joint through an instrument portal located 2 to 4 cm cranial and 1 to 2 cm ventral to the arthroscope portal allowed examination of the ligament of the head of the femur, the femoral head, and articular and nonarticular surfaces of the acetabulum. Adduction and rotation of the limb improved visualization of the craniomedial and caudomedial portions of the femoral head. Traction applied to the distal limb allowed visualization of the same structures that were observed when mechanical distraction was used. Traction also created space for placement of surgical instruments into the joint through the instrument portal. Access to most regions of the joint was adequate, but access to the caudal and medial aspects of the joint was limited. Three foals were killed while they were anesthetized, and their coxofemoral joints were dissected. Two foals were allowed to recover from anesthesia and were observed for 30 days after surgery. One foal was mildly lame for 2 days after surgery. The other foal was not lame after surgery. The incisions healed, and the coxofemoral joints were radiographically normal by postoperative day 30.     

Controlled Tissue Expansion in the Distal Extremities of Dogs

Controlled tissue expansion using a 100 cc rectangular silicone elastomer expander was performed in the mid-antebrachium and mid-crus of eight adult mixed-breed dogs. Two expander inflation schedules were followed. Group 1 dogs (n = 4) underwent expander inflation using 10 cc sterile saline every other day, and group 2 dogs (n = 4) underwent expander inflation using 15 cc sterile saline every other day until the nominal volume (100 cc) was attained. Significant mean postexpansion increases in skin surface area of 94.1 cm² (35.9%) and 108.9 cm² (37.3%) were measured in the antebrachium and crus, respectively (p < .05). In a second procedure, the expanders were removed and skin flaps were developed from the redundant tissue generated during the expansion process. Single pedicle advancement flaps and transposition flaps were used to cover surgically created defects measuring 5 times 10 cm in the antebrachium and cms. Single pedicle advancement flaps consistently measured 10 × 10 cm and could be advanced to cover defects involving one third of the mid-antebrachial or mid-crural circumference. Transposition flaps were rotated up to 170 and the donor site defects were easily closed under minimal or no tension. Complications included an abscess in one dog and seroma formation in four dogs. Differences in success or complication rates between group 1 dogs and group 2 dogs were not observed; an accelerated inflation schedule using 15 cc sterile saline every other day was recommended.     

Cystourethropexy to Correct Refractory Urinary Incontinence Due to Urethral Sphincter Mechanism Incompetence Preliminary Results in Ten Bitches

Cystourethropexy was performed in 10 bitches with refractory urinary incontinence due to urethral sphincter mechanism incompetence. All animals had an abnormally shaped vesico-urethral junction. The bladder neck was located in the pelvic canal in nine dogs (pelvic bladder). Surgery alone restored urinary continence in two cases and markedly improved incontinence in two cases. Surgery combined with medical therapy (phenylpropanolamine, 1.5 mg/kg orally once or twice a day, using a sustained-action preparation) restored urinary continence in four cases and markedly improved continence in one case. Surgery, with medical therapy, was completely ineffective in one case. No major complications were encountered in any dogs. In four cases, histopathologic evaluation of the dorsal bladder wall and neck revealed the presence of a single, perinuclear, clear vacuole in the cytoplasm of smooth muscle fibers. Electron microscopic examination showed that the vacuoles represented a dilatation of normal membrane organelles. Such abnormalities have the potential to alter the smooth muscle motility. This study indicates that cystourethropexy alone restored urinary continence only temporarily in the majority of the patients. The significance and frequency of the histopathologic findings requires further investigation.     

Quantitative Ingrowth Analysis of a Porous-coated Acetabular Component in a Canine Model

Histomorphometric analysis of bone ingrowth into a porous-coated acetabular component was evaluated in a canine model. A total of nine prostheses were evaluated, 3 at 6 months, 3 at 12 months, and 3 at 24 months after implantation. All implants were grossly stable at the time of retrieval. The mean percentage of bone ingrowth was 12% at 6 months, 24% at 12 months, and 24% at 24 months. Narrow radiolucent lines noted on microradiographs were more evident at the 6 month time period than at the 12 or 24 month time periods. Bone ingrowth into a porous-coated acetabular component in a weight-bearing model may continue beyond the 6 month time period, and early evaluation of bone ingrowth may underestimate final bone ingrowth.     

Palmar Digital Neurectomy in Horses 57 Cases (1984–1990)

The medical records of 57 horses that had palmar digital neurectomy performed between 1984 and 1990 were reviewed. Neurectomies were performed either by transection and elec-trocoagulation (47 horses) or by the guillotine technique (10 horses). Middle-aged geldings, Quarter Horses, and Thoroughbreds were significantly over-represented when compared with the hospital population. Horses used as hunter/jumpers also appeared to be over-represented. Complications occurred in 17 (34%) of the 50 horses for which follow-up information was obtained. Recurrence of heel pain was the most common complication (14 horses). Palpable painful neuromas were detected in three horses. One year after neurectomy, 74% of the horses were sound; this decreased to 63% after 2 years.     

Effect of dietary cation-anion balance in mineral balance in anaerobically exercised and sedentary horses

Eight geldings and four mares were randomly assigned treatments within three 4x4 Latin square design experiments to study the effects of dietary cation-anion balance (DCAB) on mineral balance and dry matter digestibility in sedentary and anaerobically exercised horses. Four diets with an average DCAB (calculated as meq ((Na+K+) - Cl-)/kg of diet dry matter) of +24 (Low, L), +127 (Medium Low, ML), +227 (Medium High, MH) and +352 (High, H) were fed for a 21 day adjustment period followed by a 72 hour collection period. Diets consisted of a pelleted base concentrate of com, soybean meal and cottonseed hulls fed with either native prairie grass or bermuda grass hay in a 60:40 ratio. Diet L was formed by adding calcium chloride and ammonium chloride to the base concentrate, diet ML was formed by adding calcium chloride, and diet H was formed by adding potassium citrate and sodium bicarbonate. Diet MI-I received no supplementation and served as the control. Representative samples of feed, feces and urine were analyzed for mineral content and mineral balances were calculated by difference. Fecal output was greater (p <.05), and thus, dry matter digestibility was lower in exercised homes consuming diet L versus diet H. Sodium balance was greater (p <.05) in sedentary horses consuming diet MH as compared to those consuming diets ML and L Sodium balance was greater (p <.05) in exercised homes consuming diet H as compared to those consuming diets ML and L Potassium balance was greater (p <.05) in sedentary horses consuming diet H as compared to those horses consuming diet ML, however, potassium balance was not affected by DCAB in exercised horses. No significant differences were detected in chloride or magnesium balances in the sedentary horses, although chloride balance was greater (p <.05) and magnesium balance was lower (p <.05) in exercised homes consuming diet L as compared to all other diets. In sedentary homes, phosphorus balance was reflective of intake with differences (p <.05) observed between all treatments. However, in exercised homes, phosphorus balance was lower (p <.05) oniy for those consuming diet L. Calcium balance decreased significantly as DCAB decreased between all treatments in sedentary horses, while calcium balance in exercised homes was greater (p <.05) for homes consuming diet H as compared to those consum- ing diet L.Previous research from our laboratory has shown that both exercised and sedentary horses consuming diets with a low DCAB experience a nutritionally induced metabolic acidosis. The current data indicate that anaerobically exercised and sedentary horses consuming these diets excrete significantly more calcium in the urine resulting in decreased calcium balances. Prolonged consumption of diets with a low DCAB may lead to a significant demineralization of bone and a subsequent weakening of the skeleton.     

Efficacy and Toxicity of Doxorubicin/Cyclophosphamide Maintenance Therapy in Dogs with Multicentric Lymphosarcoma

Doxorubicin/cyclophosphamide were evaluated as maintenance drugs for dogs with multicentric lymphosarcoma (n = 28). Median remission time of all dogs was 173 days. Remission duration was shorter, however, in dogs with stage IV/V disease, in dogs with pretreatment hypoalbuminemia, and in dogs that had received glucocorticoids before initiation of chemotherapy (P less than 0.04). Nineteen dogs were evaluable for toxicity. Dose-limiting gastrointestinal toxicosis was observed in three dogs, neutropenia was observed in three dogs, and cardiomyopathy was observed in three dogs. The doxorubicin/cyclophosphamide protocol described in this report is safe and effective in treating canine multicentric lymphosarcoma. Clinical stage, pretreatment steroid therapy, and hypoalbuminemia are prognostic factors for response to this protocol.