The management of elbow instability caused by premature closure of the distal radial growth plate in dogs

The clinical and radiographic findings associated with premature closure of the distal radial growth plate are described in 17 dogs. An increase in the humero-radial joint space with elbow instability and pain was noted in all cases. Radial lengthening procedures were used to treat three dogs, while in seven others, the ulna was shortened to correct elbow instability. Seven dogs were treated conservatively. The results of treatment are discussed in the light of previously published findings.     

Surgical management of premature closure of the distal ulnar growth plate in a growing dog

Surgical management of deformity due to premature closure of the distal ulnar growth plate in a growing dog is discussed. The method of management selected was ulnar diaphyseal ostectomy with transphyseal wiring of the distal radius. Elbow subluxatin and degenerative joint disease as a consequence of premature ulnar closure are also discussed.     

Distraction osteogenesis to treat premature distal radial growth plate closure in a dog

A 4-month-old Labrador was presented for forelimb lameness and elbow pain. Radiography revealed asymmetric premature closure of the distal radial physis resulting in humeroradial and humero-ulnar subluxation. A four-ring circular external fixator applied to the antebrachium was used to perform distraction osteogenesis. After a 4 day latency period, varying rates of linear distraction were used to lengthen the radius by 50% of its original length, which is significantly longer than has been previously reported. By 69 days after performing the radial osteotomy, the distraction callus had achieved clinical union and the fixator was removed. One year postoperatively, mild lameness was present after exercise and minimal elbow osteo-arthritis was evident radiographically. Complications observed included pin tract drainage, transient carpal contracture and radio-ulnar synostosis.     

Correction of angular deformities caused by premature closure of the distal ulnar epiphyseal plate in dogs

Surgical correction of angular deformities caused by premature closure of the distal ulnar growth plate in dogs. Correction of angular deformities in 14 cases of premature closure of the distal ulnar growth plate is described. Angular deformities were most frequently seen in large breeds during the most active phase of growth at 3-5 months of age. Preoperative axial deviations measured on radius were from 7 to 38 degrees in valgus and 0 to 35 degrees in antecurvation compared with the contralateral leg. According to the kind of treatment, the dogs were divided into two groups: In group I which consisted of cases with sufficient remaining growth potential of the radius, segmental ostectomy of ulna with insertion of an autologous fat graft in the ostectomy diastasis was performed to allow spontaneous correction by asymmetrical epiphyseal growth. In group II reconstructive osteotomy and stable, internal fixation with a plate was accomplished. The cosmetic result was judged as excellent in 10 cases, good in 3 and less favourable in 1. Postoperative follow up time was in average 33 months. On control 43% of the dogs showed no lameness, 57% were slightly lame after exercise or rest. None of the cases turned out to be permanently lame at the end of the follow up investigation.     

Osteochondrosis of the elbow joint in young dogs

Osteochondrosis is a failure of the normal process of endochondral ossification. In the elbow joint there are three manifestations of osteochondrosis, namely osteochondritis dissecans of the medial condyle of the humerus, ununited coronoid process and ununited anconeal process. This paper describes a series of sixty-eight cases diagnosed at a referral centre over a 10-year period. Ununited coronoid process and OCD of the medial condyle are not readily diagnosed because the lesions are difficult to demonstrate radiographically, but signs of degenerative joint disease of the elbow in young dogs of the medium to large breeds is strongly suggestive. Surgical treatment is indicated and the surgical approach to the medial aspect of the joint is described.     

Computed tomographic osteoabsorptiometry of the elbow joint in clinically normal dogs

OBJECTIVE: To evaluate subchondral bone density patterns in elbow joints of clinically normal dogs by use of computed tomographic (CT) osteoabsorptiometry. SAMPLE POPULATION: 20 cadaver forelimbs from 10 clinically normal dogs. PROCEDURE: Each elbow joint was imaged in parasagittal and transverse planes of 1.5-mm thickness. Slice data were converted to dipotassium phosphate equivalent density (PPED) values. Sagittal, parasagittal, and transverse medial coronoid process topographic maps were constructed. Defined zones were created for each of the 3 CT planes, and confluence and peak PPED values were determined. RESULTS: The lowest PPED value was 340 mg/ml (articular and subchondral confluence), and the highest was 1780 mg/ml (peak subchondral density). Detectable effects of joint laterality were not found in the confluence or peak PPED measurements or in the peak-to-confluence PPED ratio for all 3 CT planes. Significant differences were found among zones in all 3 planes for confluence and peak PPED measurements and between sagittal and transverse planes for peak-to-confluence PPED ratios. Subjectively, the pattern of density distribution among dogs was fairly consistent for the sagittal and parasagittal slices. Three specific patterns of density distribution were apparent on the transverse topographic maps of the medial coronoid process that corresponded to conformational differences. CONCLUSIONS AND CLINICAL RELEVANCE: The use of CT osteoabsorptiometry provides a repeatable technique that can be used to noninvasively examine bone density and the effects of stress acting on joints in vivo. Variability in density values for any of the CT planes was not identified among clinically normal dogs.     

Correlation of ultrasonographic observations with anatomic features and radiography of the elbow joint in dogs

OBJECTIVE: To define the ultrasonographic appearance of the elbow joint of dogs and to develop an ultrasonographic imaging protocol to reliably accomplish complete evaluation of that joint. ANIMALS: 11 clinically normal mixed-breed dogs. PROCEDURE: Ultrasonographic observations (by use of a 5 to 10 MHz linear array probe) were made of 22 elbow joints in cadaveric forelimbs from clinically normal dogs. Images in standard anatomic planes were recorded with a multi-image camera, on videotape, or onto a computer. The anatomic plane of the ultrasonographic beam and position of the ultrasonographic probe were also recorded. Dissection of each elbow joint was performed, and anatomic features were correlated with ultrasonographic images. RESULTS: Structures clearly identified ultrasonographically included the lateral and medial humeral epicondyles, the humeroradial and humeroulnar joints, anconeal process, medial coronoid process, hyaline cartilage covering the proximal articular surface of the radius, collateral ligaments, tendons of triceps brachii and supinator muscles, and the supinator tendon and sesamoid in the supinator cartilage. An ultrasonographic imaging protocol for examination of the elbow joint was developed. CONCLUSIONS AND CLINICAL RELEVANCE: Precise correlations were established between the gross anatomic appearance of the elbow joint and the ultrasonographic images of its component structures. The ultrasonographic imaging protocol will enable complete examination of all regions of the joint for detection of pathologic lesions.     

Fast resolution of hypercortisolism in dogs with portosystemic encephalopathy after surgical shunt closure

The aim of this study was to investigate whether hypercortisolism in dogs with congenital portosystemic shunts disappeared after surgical closure of the shunts concomitantly with recovery from hepatic encephalopathy. We examined 22 dogs before and four weeks after partial surgical closure of a single, large congenital portosystemic shunt (PSS). Parameters measured to characterise the basal activity of the pituitary-adrenal axis were the cortisol:creatinine (c/c) ratio in home-sampled urine and total and free cortisol in plasma. The binding characteristics of cortisol binding globulin (CBG) in pooled pre- and postoperative plasma were also determined. Ammonia and bile acid concentrations were measured in plasma to characterise the liver perfusion and function. Clinical symptoms relevant to liver function, cortisol excess, and hepatic encephalopathy were recorded semiquantitatively using a standardized questionnaire. The dogs had hypercortisolism before surgery, which had normalized four weeks later. The pre- and postoperative concentrations (means +/- SEM) were, respectively, 238+/-45 nM and 126+/-19 nM for total cortisol, 15.5+/-2.6 nM and 8.4+/-1.3 nM for free cortisol in plasma, 13.4+/-4.3 x 10(-6) and 3.9+/-0.4 x 10(-6) for c/c in urine. The pre- and postoperative Bmax values of CBG were 41 and 79, and Kd values were 3.8 and 5.5. The concentrations of ammonia were 217+/-23 microM and 32+/-3.1 microM, and of bile acids 1 10+/-33 and 11.1+/-2.0 microM, respectively. We conclude that there is a close relation between portosystemic encephalopathy and hypercortisolism in dogs with PSS and that both deviations resolve completely within four weeks of closure of the shunt.     

Bacterial growth associated with metallic implants in dogs

Tissue and swab specimens for bacteriologic culture were obtained from the operative wound in 40 dogs in which plates and screws were applied and then removed from the sites of healed fractures or arthrodeses. Implants were removed after a mean (+/- SD) application period of 15.7 +/- 9.3 months. Bacteria were isolated from the plate-bone interface in 17 dogs. Of the 17 dogs, 9 had had complications associated with initial management (eg, osteomyelitis, open fractures, or multiple surgical procedures). Control specimens were obtained from 30 dogs that had clean elective orthopedic procedures that did not involve implantation of metallic prostheses. None of the dogs of the control group were given antibiotics. Bacteria were isolated from 2 of 30 specimens obtained from control dogs. The difference between the number of culture-positive specimens from dogs of the implant group and those from dogs of the control group was significant (P less than 0.01).     

The surgical treatment of osteochondritis dissecans and ununited coronoid process in the canine elbow joint

The case details of ten dogs with osteochondritis dissecans of the medial condyle of the humerus and seven dogs with ununited coronoid process are presented. Seventeen dogs were treated surgically and the medial approach to the elbow is described.     

Clinical radiographical and pathological aspects of arthritis of the elbow joint in dogs

A survey of 120 Persian Shepherd stray dogs collected from the City of Shiraz was carried out in the Department of Clinical Studies, School of Veterinary Medicine, Pahlavi University, primarily for the purpose of establishing the incidence and aspects of elbow joint arthritis. In thirteen dogs arthritic changes were discovered in either one or both joints. The age and sex incidence of affected dogs is noted and the clinical, radio-graphical and pathological aspects of the condition, together with the changes discovered following maceration, are described and discussed. Résumé. On a fait, dans le Service des Etudes Cliniques, Ecole Vétérinaire de Médecine, Université de Pahlavi, une étude de 120 chiens de berger, persans, chiens errants ramassés dans la cité de Shiraz. Cette étude a été faite principalement dans le but d'établir l'incidence et les aspects de l'arthrite de l'articulation du coude. On avait découvert des changements arthritiques chez treize chiens soit dans une ou soit dans les deux articulations. L'incidence de l'âge et du sexe des chiens affectés est notée. On décrit et on discute des aspects cliniques, radio-graphiques et pathologiques de la condition de même que les changements découverts suivant la macération. Zusammenfassung. Ein Überblick von 120 streunenden persischen Schäferhunden, von der Stadt Shiraz aufgesammelt, wurde von der Abteilung für Klinische Studien, Schule der Tierärztlichen Medizin, Pahlavi Universität, ausgefürht - hauptsächlich für den Zweck, um das Vorkommen und die Aspekte von Ellbogengelenkarthritis festzustellen. In 13 Hunden entdeckte man arthritische Veränderungen in entweder einem oder beiden Gelenken. Das Alterund Geschlechtovorkommen und die klinischen, radiographischen und pathologischen Aspekte der Kondition, zusammen mit den Veränderungen die man nach Mazeration entdeckte, sind beschrieben und diskutiert.     

In vitro determination of contact areas in the normal elbow joint of dogs

OBJECTIVE: To evaluate areas of articular contact of the proximal portions of the radius and ulna in normal elbow joints of dogs and the effects of axial load on size and location of these areas. SAMPLE POPULATION: Forelimbs obtained from cadavers of 5 adult mixed-breed dogs. PROCEDURE: After forelimbs were removed, liquid-phase polymethyl methacrylate was applied to articular surfaces of the elbow joint, and limbs were axially loaded. Articular regions void of casting material were stained with water-soluble paint. Relative articular contact areas were determined by computer-assisted image analyses of stained specimens. Repeatability of the technique was evaluated by analyses of casts from bilateral forelimbs of 1 cadaver. Incremental axial loads were applied to left forelimbs from 4 cadavers to determine effects of load on articular contact. RESULTS: Specific areas of articular contact were identified on the radius, the craniolateral aspect of the anconeus, and the medial coronoid process. The medial coronoid and radial contact areas were continuous across the radioulnar articulation. There was no articular contact of the medial aspect of the anconeus with the central trochlear notch. Coefficients of variation of contact areas between repeated tests and between contralateral limbs was < 20%. Significant overall effects of axial load on contact area or location were not identified. CONCLUSIONS: Three distinct contact areas were evident in the elbow joint of dogs. Two ulnar contact areas were detected, suggesting there may be physiologic incongruity of the humeroulnar joint. There was no evidence of surface incongruity between the medial edge of the radial head and the lateral edge of the medial coronoid process.     

The use of vacuum-assisted closure in the management of septic peritonitis in six dogs

The purpose of this study was to describe the appropriate surgical technique, postoperative monitoring, and complications encountered with use of vacuum-assisted closure (VAC) in six dogs with confirmed septic peritonitis. Initial diagnosis of septic peritonitis was performed by measuring either the blood-to-fluid lactate ratio and glucose concentration differences or cytologic verification of intracellular bacteria. After appropriate surgical procedures were performed to manage the primary cause of peritoneal sepsis, a VAC was performed. Serum and abdominal fluid protein levels were measured, and all complications were noted during the postoperative period. Three of the six dogs (50%) survived to the secondary closure and were subsequent discharged, which is similar to previous studies where the abdomen was either closed primarily or treated with open abdominal drainage. No major complications occurred with bandage management during hospitalization. The results of this study support VAC as a feasible technique for managing septic peritonitis.     

Arthrosis in the elbow joint of young rapidly growing dogs: a genetic investigation

In cooperation with breed clubs and practising veterinarians throughout Norway, the elbow joints of rottweilers, Bernese mountain dogs and Newfoundlands were screened for osteophyte formation/arthrosis, indicating primary elbow lesions. The changes were graded 0 to 3 and the results subjected to statistical analysis regarding frequencies, frequencies relative to sex, relative risks, differences between offspring groups and heritability. The number of dogs examined were: rottweilers, 1423, Bernese mountain dogs, 414 and Newfoundlands, 209. The frequency of elbow arthrosis varied from 30 to 50 per cent, males being more often and more severely affected than females. The relative risk of developing arthrosis among offspring of affected animals compared to offspring of non-affected animals, was 1–6. Heritability varied from 10-4 per cent to 47-8 per cent, depending on the method used. Based on these results, it is concluded that elbow screening programmes should be carried out in breeds disposed to elbow lesions. Breeding animals should be selected on the basis of the elbow status of parents and other relatives, if possible.     

Rupture of the cranial cruciate ligament associated with deformity of the proximal tibia in five dogs

Excessive mechanical stress due to caudal sloping of the tibial plateau may result in early breakdown of the cranial cruciate ligament (CrCL). Five dogs with CrCL rupture associated with caudal sloping of the proximal tibial plateau are described. All were small dogs, of between three and six years of age, with a mean bodyweight of 9.3 kg, which had acute hindlimb lameness. Radiographic examination revealed cranial displacement of the tibia, with a tibial angle varying from 58 to 60 degrees. All cases were treated with a lateral fabellotibial suture and cranial cuneiform osteotomy of the proximal tibia. All dogs were using the operated limb three days after surgery, with normal gait re-established after a mean period of 10 days. Excessive tibial plateau sloping is not a frequent cause of hindlimb lameness in small animals, although it is important to consider it as a predisposing factor for rupture of the CrCL.     

Effects of electrostimulated acupuncture on ground reaction forces and pain scores in dogs with chronic elbow joint arthritis

OBJECTIVE: To determine whether use of electrostimuluated acupuncture (ESA) would result in significant improvements in ground reaction forces and lameness scores in dogs with chronic elbow joint osteoarthritis secondary to elbow joint dysplasia. DESIGN: Randomized, controlled, crossover clinical trial. ANIMALS: 9 dogs with chronic forelimb lameness and radiographic evidence of elbow joint osteoarthritis. PROCEDURES: All dogs had a 3-week control acclimation period during which gait analysis was performed weekly. Dogs then received ESA once weekly for 3 weeks followed by a sham treatment once weekly for 3 weeks or received the sham treatment followed by ESA. Gait analysis was repeated prior to each treatment, and owners were asked to provide pain scores by use of a visual analog scale method. RESULTS: Treatment (control, acupuncture, or sham) did not have a significant effect on ground reaction forces for any limb. Owners of 8 of the 9 dogs were able to correctly guess the time period when ESA was delivered. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that ESA did not have any significant effects on severity of lameness, as determined by measurement of ground reaction forces, or severity of pain, as determined by visual analog scale pain scores, in dogs with chronic elbow joint osteoarthritis secondary to elbow joint dysplasia.