Application of Ventral Pins and Polymethylmethacrylate for the Management of Atlantoaxial Instability: Results in Nine Dogs

Objective — The purpose of this report was to determine the efficacy of the application of ventral pins and polymethylmethacrylate for the management of congenital and traumatic atlantoaxial instability (AAI) in dogs.
Study Design — Medical records and radiographs of nine dogs with AAI were reviewed for neurological deficits, clinical diagnosis, surgical technique, and long-term outcome.
Sample Population — Six toy breed dogs with congenital AAI and three medium or large breed dogs with traumatic AAI were identified for inclusion in the study.
Methods — The atlantoaxial joints of nine dogs with AAI were surgically stabilized using ventral application of pins and polymethylmethacrylate. Follow-up evaluation for resolution of clinical signs and possible complications of surgery was performed in all dogs. The median follow-up time for surviving dogs (8) was 11.5 months with a mean of 13 months.
Results — An excellent outcome was identified in five patients. Three dogs had a good outcome and one dog died of respiratory complications. Cervical pain was eliminated or significantly reduced in all dogs that survived and none of the dogs had major residual neurological deficits.
Conclusions — Arthrodesis could not be confirmed on follow-up radiographs due to the presence of the polymethylmethacrylate; however, adequate stabilization of C1-C2 appears to have been achieved based on the resolution of clinical signs.
Clinical Relevance — Application of ventral pins and polymethylmethacrylate is an effective means of surgical treatment for congenital and traumatic AAI.     

Longitudinal bone transport for treatment of primary bone tumors in dogs: technique description and outcome in 9 dogs

OBJECTIVE: To describe a surgical technique for bone transport osteogenesis (BTO) limb salvage and report outcome in 9 dogs with primary bone tumors. ANIMALS: Nine dogs with spontaneously occurring primary bone tumors. RESULTS: BTO surgery was performed as a primary means of limb salvage in 7 dogs and as a salvage procedure after catastrophic allograft infection and failure in 2 dogs. Mean defect size was 9.5 cm with a mean of 123 days distraction until docking. Mean time from surgery to fixator removal was 205 days. Minimum follow-up was 9 months. There were 2 histologically confirmed local recurrences where although limb function was excellent, eventually resulted in limb amputation. Limb function was good to excellent in all but 2 dogs; 1 was chronically non-weight bearing before BTO surgery because of complications associated with an allograft limb salvage that had been performed previously on the same limb. The cause of lameness in the other dog was undetermined. CONCLUSIONS: BTO limb salvage can be successful in dogs with primary bone tumors. Whereas allograft limb salvage may be simpler from an initial management perspective, BTO has some unique advantages when compared with the allograft technique. CLINICAL RELEVANCE:BTO has an emerging role in limb salvage surgery for dogs with primary bone tumors. BTO provides excellent long-term outcomes in some dogs with primary bone tumors and will likely become increasingly more attractive as technique modifications allow the duration of the treatment to be shortened.     

Intercalary bone grafts for joint and limb preservation in 17 dogs with high-grade malignant tumors of the diaphysis

OBJECTIVE: To evaluate postoperative complications, limb function, and tumor control after intercalary resection and reconstruction for preservation of limb and joint function in dogs with high-grade malignant tumors of diaphyseal bone. STUDY DESIGN: Retrospective study. ANIMALS: Seventeen client-owned dogs. METHODS: The bone tumor database and medical records were reviewed (1986-2002) for dogs with diaphyseal tumors treated with intercalary resection and reconstruction with either an allograft or irradiated autograft. Clinical presentation, diagnostic findings, surgical management, and outcome were determined from medical records and telephone interviews with veterinarians and owners. Statistical analyses included chi2 to test associations between intra- and postoperative variables with complications, and Kaplan-Meier survival analysis for disease-free interval, metastasis-free interval (MFI), and median survival time. RESULTS: Intercalary limb-sparing surgery was performed in 17 dogs with diaphyseal tumors: osteosarcoma (OSA) (15), histiocytic sarcoma (1), and solitary metastasis from a pulmonary adenocarcinoma (1). One dog was excluded from further analysis when the spared limb was amputated 4 days postoperatively because of incomplete tumor resection. In 16 dogs, limb function was good to excellent. Complications occurred in 5 dogs (31.3%) and included superficial infection in 2 dogs (12.5%) and implant failure in 4 dogs (25%). All implant failures occurred in the ulna and there was a significant association between implant failure and non-cemented allografts (P=.042). Non-union of 1 or both osteotomies was diagnosed in 10 dogs (83.3%) and, despite lack of clinical signs in all cases, was significantly associated with the use of intracavitary locally released cisplatin (P=.046) and cemented intercalary grafts (P=.046). Local tumor recurrence was diagnosed in 1 dog (6.3%) and metastatic disease in 12 dogs (75.0%), including 10 dogs with OSA. The median MFI was 137 days. The local disease-free and overall limb-salvage rate was 94% and 100%, respectively. Overall median survival time was 393 days and the median survival time for dogs with OSA was 449 days. CONCLUSION: Intercalary limb-sparing surgery results in better postoperative limb function with fewer and less severe complications than historical reports of dogs treated with non-intercalary limb-sparing surgery. CLINICAL RELEVANCE: In dogs with diaphyseal tumors, intercalary limb-sparing surgery preserves normal joint function and results in good to excellent limb use with few complications and good local tumor control.     

Pes varus correction in Dachshunds using a hybrid external fixator

Objective— To describe surgical correction of pes varus deformity in Dachshunds by acute medial opening wedge osteotomy of the distal aspect of the tibia stabilized with a hybrid external skeletal fixator (HESF), and report clinical and radiographic outcomes.
Study Design— Multicenter, retrospective clinical study.
Animals— Immature Dachshunds (n=13) with pes varus deformity.
Methods— Limb function and lameness scores were assigned before and after surgery, and correction was determined visually at surgery. Tibiotarsal joint orientation (TTJO) and medial and lateral tibial cortex lengths, measured on radiographs of deformed and normal (when available) limbs, were compared before correction and after fixator removal.
Results— Pes varus deformities (n=14) were corrected; 93% had good to excellent clinical outcome. None of the dogs had a normal preoperative gait. Mean TTJO of abnormal and normal tibiae before surgery were 29° varus (median, 28°), and 12° valgus (median, 12°). Angular correction ranged from 20° to 51° (mean, 36±8°; median, 36°). M e an TTJO after fixator removal was 7° valgus (median, 7°). Two dogs had minor transient postoperative complications whereas 3 had major complications; only 1 of which was resolved.
Conclusions— Pes varus deformity in Dachshunds can be corrected by acute medial opening wedge osteotomy of the distal aspect of the tibia stabilized by HESF. Technique modifications are needed to improve correction precision.
Clinical Relevance— Visual inspection of limb alignment during surgery resulted in good to excellent clinical outcomes; however, 91% of tibiae were under- or overcorrected (mean, 6°; median, 5°). Limb alignment should be based on evaluation of immediate postoperative TTJO measurements, not solely on intraoperative visual assessment.     

Evaluation of Functional Outcome After BFX® Total Hip Replacement Using a Pressure Sensitive Walkway

Objective— To evaluate stance phase limb use after cementless (BFX^®) total hip replacement (THR) in dogs and to relate postoperative radiographic variables to static bodyweight distribution after surgery.
Study Design— Prospective clinical study.
Animals— Dogs (n=35) that had THR.
Methods— THR was performed using the BFX^® THR technique. Postoperative pain management regimens were similar for all dogs. Standing bodyweight distribution (%BW_distrib) was measured using a pressure sensitive walkway and radiographs made before surgery and at 3, 6, and 12 months after surgery. Repeated measures models (with backwards-stepping to obtain the final model) were used for statistical analysis.
Results— Temporally, %BW_distrib to the operated limb increased ( P <.0001; normal by 3 months) and decreased to the unoperated limb ( P =.0001) and also increased to the pelvic limbs and decreased to the thoracic limbs. %BW_distrib to the unoperated limb was significantly less than the operated limb at 3, 6, and 12 months after surgery. Postoperative canal fill and femur flare were significantly negatively correlated with change in %BW_distrib (estimate=−0.24, P =.0413).
Conclusion— BFX^® THR results in normal %BW_distrib to the operated limb by 3 months after surgery. A greater fill of the proximal femur may be associated with a suboptimal outcome.
Clinical Relevance— BFX^® THR normalizes standing bodyweight distribution dogs with hip osteoarthritis. Objective evaluation of THR outcome and radiographic features may reveal factors that could be improved through changes in prosthesis design or surgical technique.     

Surgical Excision of Soft Tissue Fibrosarcomas in Cats

Objective — The purpose of this study was to determine the tumor-free interval and survival times of cats who had one (group 1) or more (group 2) surgeries, or surgery and radiation therapy (RTH) (group 3) for treatment of soft tissue fibrosarcomas (FSA).
Study Design — Retrospective study.
Animals or Sample Population — 45 client-owned cats.
Methods — Medical records of cats with soft tissue FSA were examined. Vaccination and feline leukemia virus (FeLV) status, age, sex, breed, tumor location, number of surgeries, completeness of excision, and histopathological grade were evaluated to correlate with tumor-free interval and survival periods.
Results — Overall median tumor-free interval and survival times were 10 and 11.5 (range, 1 to 40) months. Median tumor-free interval and survival times were more than 16 months each in group 1, more than 5 and 13 months in group 2, and 4.5 and 9 months in group 3. Age, sex, breed, vaccination or FeLV status, tumor location, or histopathological grade did not affect median tumor-free interval or survival times ( P <.05). Cats with complete excisions had significantly longer median tumor-free interval (>16 versus 4 months) and survival time (>16 versus 9 months) than those with incomplete excisions ( P =.008). Radiation therapy did not seem to extend tumor-free interval and survival times ( P =.013). However, most group 3 cats had incomplete surgical excisions, resulting in recurrent or progressive disease.
Conclusions — Complete surgical excision of FSA in cats is possible and can be curative.
Clinical Relevance — Aggressive surgical excision with wide margins appears to contribute to extended tumor-free interval and survival times in cats with soft tissue FSA. Controlled prospective studies are needed to determine the efficacy of RTH in treatment.     

TP53 gene mutations in canine osteosarcoma

Objective— To investigate mutations of the TP53 gene in canine osteosarcoma (OS).
Study Design— Clinical historic cohort study.
Animals— Client-owned dogs.
Methods— OS (n=59) were screened for mutations of the complete TP53 gene using polymerase chain reaction and the mutation was analyzed by single-strand conformational polymorphism. Clinical outcome of dogs with TP53-mutated OS were compared with dogs with OS without a mutation after complete surgical excision of the primary tumor.
Results— TP53 gene mutations were observed in 24 of 59 (40.7%) OS; 3 mutated OS had 2 mutations. The alterations consisted mainly of point mutations (74%). Dogs with mutated OS had a significantly shorter survival time (ST) after surgery than dogs with normal tumor TP53 gene expression ( P =.03). Other significant prognosticators for ST and disease-free interval included elevated serum alkaline phosphatase ( P <.01) and tumor grade ( P =.01).
Conclusion— TP53 genetic mutations are common in canine OS and may have a prognostic value.
Clinical Relevance— Mutations of the TP53 gene may influence survival and should be considered when evaluating canine OS.     

Intraoperative extracorporeal irradiation for limb sparing in 13 dogs

OBJECTIVE: To evaluate extracorporeal intraoperative radiation therapy (IORT) as a treatment method for limb and joint sparing in dogs with appendicular sarcomas in sites other than the distal aspect of the radius. STUDY DESIGN: Retrospective study. ANIMALS: Thirteen client-owned dogs. METHODS: The bone tumor database and medical records (1998-2002) were reviewed for dogs with primary appendicular bone tumors treated with IORT limb-sparing surgery and adjuvant chemotherapy. The segment of bone containing the tumor was isolated from adjacent soft tissue and an osteotomy performed distant to the tumor. The bone segment was exteriorized, irradiated (70 Gy single fraction), and then stabilized with internal fixation. Adjuvant chemotherapy was administered. Lameness was graded and local and distant tumor control was determined. Associations between intra- and postoperative variables with complications and Kaplan-Meier survival analysis for median disease-free interval and survival time were calculated. RESULTS: Limb function was good or excellent in 10 dogs (77%). Postoperative complications (9 dogs, 69%) included deep infection, fracture of the irradiated bone, and implant failure. Surgical failure was more likely if a single implant was used to stabilize the osteotomized bone and if deep infection developed postoperatively. In 3 dogs, tumors recurred locally within bone in the radiation field. The disease-free and overall success rates of extracorporeal IORT for limb and joint preservation were 46% and 54%, respectively. CONCLUSIONS: Extracorporeal IORT provides a novel alternative to traditional techniques for preservation of joint and limb function in dogs with primary appendicular sarcomas. A minimum of 2 implants and intramedullary bone cement should be used to stabilize the osteotomized bone to minimize postoperative complications. Extracorporeal IORT should be used with caution in dogs with tumors of the distal tibia because of a high complication rate. Dogs with tumors in areas of good soft-tissue coverage, such as the humerus and femur, may be good candidates for limb and joint-sparing surgery using extracorporeal IORT. CLINICAL RELEVANCE: Extracorporeal IORT is a surgical technique that can be used for limb and joint salvage in dogs with primary appendicular sarcomas in sites usually not amenable to traditional limb-sparing techniques.     

Characteristics and outcomes in surgical management of severe acute pancreatitis: 37 dogs (2001–2007)

Objective – Describe clinical characteristics and outcomes associated with canine patients undergoing surgical intervention for treatment of acute pancreatitis.
Design – Retrospective outcome study from 2001 to 2007.
Animals – Thirty-seven dogs.
Interventions – None.
Measurements and Main Results – The following data were collected for dogs who underwent surgical intervention in the course of treatment for severe acute pancreatitis: preoperative clinicopathologic and physical data, ultrasonographic findings, surgical procedure detail, histopathologic findings, and transfusion requirements. The survival rate was 80.8% in dogs with extrahepatic biliary obstruction, 64.3% in dogs undergoing necrosectomy, and 40.6% with pancreatic abscess. Overall survival was 63.6%. Surgical complications included intraoperative and postoperative hemorrhage in 12 dogs, postoperative development of diabetes mellitus in 3 dogs, exocrine pancreatic insufficiency in 1 dog, and bacterial peritonitis in 2 dogs.
Conclusion – Surgical intervention and aggressive postoperative care may be pursued in select dogs with severe acute pancreatitis. In dogs with extrahepatic biliary obstruction secondary to acute pancreatitis, surgical intervention may be associated with a good prognosis whereas dogs with pancreatic abscess formation may have a more guarded prognosis.     

Cosmetic rostral nasal reconstruction after nasal planum and premaxilla resection: technique and results in two dogs

Objective— To describe a novel reconstructive technique after nasal planum and premaxilla resection.
Study Design— Case report.
Animals— Dogs (n=2) with squamous cell carcinoma (SCC) of the nasal planum.
Methods— A 9-year-old neutered female Labrador retriever (dog 1) and an 11–year-old neutered male Golden retriever (dog 2) had resection of the nasal planum and premaxilla for treatment of locally invasive SCC. Reconstruction of a nasal planum facsimile was based on use of the nonhaired pigmented margins of bilateral labial mucocutaneous rotation-advancement flaps.
Results— Reconstruction of the premaxilla by construction of a nasal planum facsimile resulted in uncomplicated wound healing and improved cosmesis. There was no tumor recurrence at 1290 (dog 1) and 210 (dog 2) days after surgery.
Conclusion— Reconstruction of a nasal planum facsimile was successfully performed without complications in 2 dogs with high owner satisfaction with cosmetic appearance.
Clinical Relevance— This technique represents a significant advancement in surgical cosmetic outcome, may potentially reduce postoperative complications, and should be considered for dogs requiring nasal reconstruction after nasal planum resection with premaxillectomy.     

Analysis of outcome in dogs that undergo secondary amputation as an end‐point for managing complications related to limb salvage surgery for treatment of appendicular osteosarcoma

Appendicular osteosarcoma (OSA) remains a prevalent musculoskeletal cancer in dogs and definitive local control followed by adjuvant cytotoxic chemotherapy is considered the gold standard approach. Several studies support surgical limb salvage as a means of local control with similar outcomes compared with limb amputation. Complications are well described for limb salvage but little is known of dogs that undergo secondary amputation as a result of complications and outcomes specific to this group. A retrospective analysis of dogs in an institutional primary bone tumour registry was performed to identify dogs diagnosed with histologically confirmed OSA treated with surgical limb salvage with a technique that required an implant to reconstruct the osseous defect. A total of 192 dogs were identified with 31 dogs undergoing secondary amputation representing a limb preservation rate of 84%. A total of 111 dogs were analysed: 31 secondary amputation cases and 80 controls were selected for comparison. The most common reasons for secondary amputation were local recurrence (LR) and surgical site infection (SSI), with odds ratios of 3.6 and 1.7, respectively. Dogs that underwent secondary amputation had a significantly (P = .05) longer median disease specific survival time (ST) (604 days) compared with the control group (385 days). Dogs lived for a median of 205 days beyond secondary amputation and 97% had good functional outcome. Significant independent factors that positively influenced ST were secondary amputation, moderate SSI, severe SSI and age.     

Outcome following removal of canine spindle cell tumours in first opinion practice: 104 cases

O bjectives : To define the outcome of a cohort of canine patients with a histological diagnosis of spindle cell tumour of soft tissue managed solely by surgery in first opinion practice.
M ethods : Clinical details of 104 spindle cell sarcomas submitted to Finn Pathologists during the year 2000 were reviewed. Questionnaires were sent to the submitting veterinarians, requesting details about the tumour, surgery performed and ultimate outcome of the patient.
R esults : The method of surgical resection was described as marginal in 45 dogs (44·2 per cent). Excision margins of 3 cm or more were described in less than 10 per cent of cases. Tumours recurred locally in 29 dogs (27·9 per cent). Eighteen dogs (21·7 per cent) died of tumour-related causes. Most deaths were unrelated to sarcoma (50 dogs, 60·2 per cent) or unknown (15 dogs, 18 per cent). The median survival time was 1013 days. Tumour size, location or degree of surgical resection were not significantly related to survival or tumour recurrence. A palpable assessment of tumour invasion into underlying tissues was significantly associated with decreased disease-free interval (P<0·0001) and survival time (P = 0·0070).
C linical S ignificance : The results of this retrospective study indicate that many spindle cell tumours managed in first opinion practice exhibit a low-grade biological behaviour and may respond well to more conservative surgery than current recommendations advise.     

The Effect of Laparoscopic Versus Open Ovariectomy on Postsurgical Activity in Small Dogs

Objective— To describe a technique for laparoscopic ovariectomy (LapOVE) in small dogs, and compare the surgical time, complications, and postoperative activity of dogs undergoing LapOVE to those undergoing conventional traditional open ovariectomy (OOVE).
Study Design— A randomized, controlled clinical trial.
Animals— Intact small breed (<10 kg) female dogs (n=20).
Methods— Ventral median celiotomy was performed for OOVE. A 2-midline portal technique using a 3.5 mm laparoscope port and a 6 mm instrument portal was used for LapOVE. An accelerometer was attached to the collar of each dog to record 24-hour preoperative and 48-hour postoperative activity. Total activity counts recorded before surgery were compared with total counts recorded after surgery. The percent change in counts after surgery was compared between OOVE- and LapOVE-treated dogs.
Results— No major complications occurred and surgical time for LapOVE was significantly longer than for OOVE cases ( P =.005). Dogs in the LapOVE group had a 25% decrease in total activity counts after surgery (95% confidence interval [CI]: 11–38%), whereas dogs in the OOVE group had a 62% decrease in total activity counts after surgery (95% CI: 48–76%).
Conclusions— Both procedures were performed with reasonable surgical times and without major complication. Postoperative activity, as measured by accelerometry, was significantly different between the 2 groups.
Clinical Relevance— Laparoscopy is a safe method for ovariectomy in small dogs and results in increased postoperative activity counts when compared with an open technique.     

Comparison of surgical treatment options for cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle

Objective— To identify surgical techniques performed by veterinary surgeons for the treatment of cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle (eTPA), compare their outcomes, identify risk factors for postoperative complications, and compare outcome and complication rate with tibial plateau leveling osteotomy (TPLO) in dogs without eTPA.
Study Design— Multicenter, case–control study.
Animals— eTPA group (TPA≥35°)=58 dogs (78 stifles); control group (TPA≤30°)=58 dogs (72 stifles).
Methods— Control and eTPA group dogs were identified. Medical records, radiographic reviews, and pet-owner interviews were used to identify surgical treatments performed, their complications, and outcome. Odds ratios with 95% confidence intervals, χ² tests, and t-tests were calculated to discern differences between eTPA and control-group dogs.
Results— TPLO was the most common treatment for eTPA. Owner-perceived outcome was superior for eTPA group dogs when TPLO resulted in TPA≤14° compared with those with postoperative TPA>14°. Loss of tibial plateau leveling during convalescence was the most commonly observed major complication; addition of ancillary implants to TPLO significantly reduced its incidence. Postoperative complications were more common in dogs with eTPA than in dogs without eTPA; however, no difference in owner-perceived outcome was identified.
Conclusions— Surgical treatment of dogs with eTPA has a higher complication rate, but comparable outcome to that of dogs without eTPA.
Clinical Relevance— Postoperative TPA≤14° and addition of ancillary implants are recommended when using TPLO to treat dogs with eTPA.     

Transsphenoidal Hypophysectomy in Beagle Dogs: Evaluation of a Microsurgical Technique

Objective — Assessment of a microsurgical technique for transsphenoidal hypophysectomy in dogs.
Study Design — Prospective study using physical examination, pituitary function testing, computed tomography (CT), and histological examination at autopsy.
Animals or Sample Population — Eight laboratory beagle dogs.
Methods — Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary).
Results — CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of die eight dogs had somatotropic, gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no cortico-tropic response and four (ACTH responders) had small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders man in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded in fibrous tissue in the sella turcica.
Conclusions — The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy.
Clinical Relevance — The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs.     

Use of a Medial Bone Plate for Repair of Radius and Ulna Fractures in Dogs and Cats: A Report of 22 Cases

Objective —This study evaluates the technique of medial bone plating in the repair of radius fractures in dogs and cats.
Study Design —A retrospective study was made of patients diagnosed with fractures of the radius that were stabilized by application of a bone plate to the medial side of the bone.
Animal Population —Sixteen client-owned dogs and 4 client-owned cats. The animals' ages varied from 5 months to 8 years, and their weight varied from 1.3 to 49 kgs.
Methods —Animals were evaluated using radiography or client assessment, or both.
Results —Medial plate application was technically easier to do than cranial plate application, the technique avoided the extensor tendons, and permitted greater versatility in the selection of smaller plates for the fixation of distal radius fractures. All fractures repaired by this method healed with no postoperative complications.
Conclusions —Medial plate application may be used for osteosynthesis of distal or middiaphy-seal radius fractures. Further studies are needed to evaluate the use of this technique in morphologically complex fractures. In patients with fractures of the proximal radius, cranial plate application is considered more appropriate.
Clinical Relevance —Medial plating of radial fractures has significant advantages compared with conventional plate application; it provides the surgeon with an alternative method of fixation for selected radius fractures in dogs and cats.     

Hinged Ilizarov External Fixation for Correction of Antebrachial Deformities

Objective —To evaluate hinged circular external fixation for correction of antebrachial deformities in dogs.
Study Design —Uncontrolled clinical trial.
Animal Population —Seven client-owned dogs.
Methods —Six dogs had one radius corrected and one dog had both radii corrected. Preoperative planning included measurement of the craniocaudal and mediolateral angular deformities, rotational deformity, length deficit, origin of deformity, graphical or mathematical determination of the amplitude and direction of the actual limb deformity, and frame assembly.
Results —Preoperatively, function and cosmesis were assessed to be fair to poor in all dogs. Deformity correction started 48 to 60 hours postoperatively and ranged from 0.46 mm to 1.36 mm twice daily. Hospitalization time ranged from 4 to 6 days. Corrections were mostly made by the owners, at home. Lengthening and angular correction ranged from 3 to 38 mm and 18° to 48°. Mean residual deformities were 2.7% of radial length and 2.7°. The time duration with the circular external fixators in place ranged from 29 to 71 days. Two additional surgeries were necessary in one dog because of wire breakage. Mean follow-up was 40 months. Long-term function and cosmesis were good to excellent in all dogs.
Conclusion—Although complications were present in six of seven dogs, the outcome of hinged Ilizarov external fixation was successful in all dogs treated for deformities of the antebrachium.
Clinical Relevance —Despite complex preoperative planning, the placement of hinged circular external fixators is straightforward, and allows precise correction of complex antebrachial deformities with minimal tissue trauma.     

Use of a latissimus dorsi myocutaneous flap for one-stage reconstruction of the thoracic wall after en bloc resection of primary rib chondrosarcoma in five dogs

Objective— To describe a thoracic wall reconstructive technique using a latissimus dorsi myocutaneous flap after en bloc resection of primary rib chondrosarcoma and report outcome in 5 dogs.
Study Design— Retrospective study.
Animals— Dogs (n=5) with primary rib chondrosarcoma.
Methods— Medical records (2003–2005) were reviewed for signalment, staging investigations, surgical findings, complications, and outcomes. Owners and veterinary surgeons were contacted for outcome information.
Results— A latissimus dorsi myocutaneous flap provided an air-tight thoracic wall closure after chondrosarcoma resection. Paradoxical respiratory movement of the flap occurred; however, from physical examination and blood gas analysis (2 dogs), ventilation was adequate. All flaps survived, 1 had superficial skin necrosis distally and 2 had minor wound dehiscence. One dog without tumor-free margins died of tumor-related disease 56 days after surgery. Tumor recurrence did not occur in 4 dogs with tumor-free margins. One dog was euthanatized 10 months after surgery for unrelated disease; 3 dogs were alive at writing (median follow-up: 20 months; range, 18–27 months) and all had a satisfactory functional and cosmetic outcome.
Conclusions— Reconstruction of ventral thoracic wall defects using a latissimus dorsi myocutaneous flap yields a functional, cosmetic outcome.
Clinical Relevance— A latissimus dorsi myocutaneous flap can be used as a successful 1-stage reconstructive technique for ventral thoracic wall defects.     

Limb‐sparing in dogs using patient‐specific,three‐dimensional‐printed endoprosthesis for distal radial osteosarcoma: A pilot study

Limb‐sparing for distal radial osteosarcoma has a high rate of complications. Using personalized three‐dimensional (3D)‐printed implants might improve outcome. The goals of this study were to optimize use of patient‐specific, 3D‐printed endoprostheses for limb‐sparing in dogs in the clinical environment and to report the outcome. This was a pilot study where five client‐owned dogs were enrolled. Computed tomography (CT) of the thoracic limbs was performed, which was used to create patient‐specific endoprostheses and cutting guides, and repeated on the day of surgery. Intra‐arterial (IA) carboplatin was introduced in the clinical management. Limb‐sparing was performed. Outcome measures were time required to produce the endoprosthesis and cutting guide, fit between cutting guide and endoprosthesis with host bones, gait analysis, size of the tumour, percent tumour necrosis, complications, disease‐free interval (DFI) and survival time (ST). Four dogs received IA carboplatin. Excessive tumour growth between planning CT and surgery did not occur in any dog. The interval between the CT and surgery ranged from 14 to 70 days. Fit between the cutting‐guide and endoprosthesis with the host bones was good to excellent. At least one complication occurred in all dogs. Two dogs were euthanized with STs of 192 and 531 days. The other dogs were alive with a follow up of 534 to 575 days. IA chemotherapy is a promising strategy to minimize the risk of excessive tumour growth while waiting for the endoprosthesis and cutting‐guide to be made. The design of the cutting‐guide was critical for best fit of the endoprosthesis with host bones.