Surgical Decompression in Dogs with Thoracolumbar Intervertebral Disc Disease and Loss of Deep Pain Perception: A Retrospective Study of 46 Cases

The case details and outcome after surgical decompression of 46 dogs with thoracolumbar intervertebral disc disease with loss of deep pain perception prior to surgery were reviewed. Nineteen dogs (41.3%) recovered with a median follow-up period of 12.5 months. Recovery was defined as an ambulatory paraparesis, or better, with urinary and fecal continence. There was a better outcome in dogs with loss of deep pain for less than 24 hours prior to surgery (19/41; 46.3% recovered) than in dogs without deep pain perception for more than 24 hours (0/5; 0% recovered). Dogs with deep pain perception present at two weeks postoperatively had significantly higher success rate (8/12; 66.7% recovered) than dogs without deep pain perception at this time period (1/10; 10.0% recovered). The return of deep pain perception by two weeks postoperatively can be a useful positive prognostic indicator.     

Laminectomy for 34 dogs with thoracolumbar intervertebral disc disease and loss of deep pain perception

The case details and the results of treatment of 34 dogs with thoracolumbar intervertebral disc disease, without deep pain perception, that had been treated by laminectomy and fenestration, are presented. The association of a number of potential prognostic factors with the neurological outcome is examined. Twenty-one dogs (62 per cent) recovered neurological function, seven (21 per cent) failed to recover neurological function and three (9 per cent) developed progressive myelomalacia postoperatively, while three dogs (9 per cent) were euthanized intraoperatively because of diffuse myelomalacia. Twenty of the dogs that recovered neurological function showed a return of deep pain perception within two weeks of decompressive surgery. Statistical analysis showed significant differences in the outcome between dogs that took less than one hour to lose the ability to ambulate and dogs with a longer duration of onset of inability to ambulate. The extent of spinal cord swelling determined by myelography was not found to be a useful prognostic indicator.     

Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001)

OBJECTIVE: To determine long-term (> 6 months) outcome of dogs with paraplegia and loss of hind limb deep pain perception (DPP) resulting from intervertebral disk herniation or trauma. DESIGN: Retrospective study. ANIMALS: 87 dogs. PROCEDURE: Outcome was determined as successful or unsuccessful. The association of neuroanatomic localization, breed, age, weight, sex, and (for dogs with intervertebral disk herniation) speed of onset of signs and duration of paraplegia prior to surgery with outcome was evaluated. Owners were contacted by telephone to identify long-term health problems. RESULTS: Nine of 17 dogs with traumatic injuries were treated, and 2 regained the ability to walk; none of the 17 dogs regained DPP. Sixty-four of 70 dogs with intervertebral disk herniation underwent surgery; 9 (14%) were euthanatized within 3 weeks after surgery (7 because of ascending myelomalacia), 37 (58%) regained DPP and the ability to walk, 7 (11%) regained the ability to walk without regaining DPP, and 11 (17%) remained paraplegic without DPP. Outcome was not associated with any of the factors evaluated, but speed of recovery of ambulation was significantly associated with body weight and age. Fifteen (41%) and 12 (32%) dogs that regained DPP had intermittent fecal and urinary incontinence, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the prognosis for paraplegic dogs without DPP because of trauma was guarded, while dogs with disk herniation had a better chance of recovering motor function. A third of the dogs that recovered motor function had intermittent incontinence. Persistent loss of DPP did not preclude recovery of motor function, but such dogs remained incontinent.     

Evaluation of intravenous administration of meloxicam for perioperative pain management following stifle joint surgery in dogs

OBJECTIVE: To compare preoperative administration of meloxicam and butorphanol to perioperative administration of butorphanol alone for control of postoperative signs of pain in dogs. ANIMALS: 40 client-owned dogs scheduled for surgical repair of a cranial cruciate ligament rupture. PROCEDURE: Group-1 dogs received butorphanol (0.2 mg/kg, IV) and meloxicam (0.2 mg/kg, IV) just prior to surgery. Group-2 dogs received butorphanol just prior to surgery (0.2 mg/kg, IV) and at incision closure (0.1 mg/kg, IV). Pain assessment began 1 to 2 hours before surgery and from extubation until 24 hours after surgery by obtaining the following measurements: the visual analog scale (VAS) score, cumulative pain score (CPS), adjusted cumulative pain score, modified cumulative pain score, and the adjusted modified cumulative pain score (AMCPS). Serum cortisol concentration was measured between 12 to 24 and between 1 to 2 hours prior to surgery, and at 30 minutes, and 1, 2, 4, 8, 18, and 24 hours after extubation. RESULTS: No significant differences between treatment groups were observed in CPS or VAS score. At 8, 9, 10, and 11 hours after extubation, meloxicam-butorphanol-treated dogs had a significantly lower AMCPS, compared with butorphanol-alone-treated dogs. Total serum cortisol concentration (area under the curve) during the measurement period was significantly lower in meloxicam-butorphanol-treated dogs, compared with butorphanol-alone treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Preoperative single dose administration of meloxicam-butorphanol is equivalent to or slightly better than the administration of 2 perioperative doses of butorphanol for the control of postoperative signs of pain in dogs.     

Transplantation of adipose derived mesenchymal stem cells for acute thoracolumbar disc disease with no deep pain perception in dogs

Thirty-four dogs with no deep pain perception due to acute thoracolumbar intervertebral disc disease underwent decompression surgery within 1 week of diagnosis. All dogs underwent hemilaminectomy. Adipose derived mesenchymal stem cells (AD-MSCs) were transplanted into the injured spinal cord parenchyma for the AD-MSCs transplant dogs. Long-term outcome was evaluated at the end of the follow-up period (> 6 months). AD-MSCs combination treatment showed better recovery outcomes compared to decompression surgery alone. These results indicate that this stem cell therapy is a potential therapeutic strategy to overcome the limitations of treatment for spinal cord injury in clinical medicine.     

Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000-2003)

OBJECTIVE: To determine whether magnetic resonance imaging findings in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion were predictive of clinical outcome. DESIGN: Retrospective case series. ANIMALS: 77 dogs. PROCEDURE: Medical records and magnetic resonance images were reviewed; clinical outcome was classified as successful (regained ability to walk with no more than mild neurologic deficits) or unsuccessful (severe neurologic deficits persisted). The prognostic value of magnetic resonance imaging was compared with prognostic value of deep pain perception, duration of clinical signs, and rate of onset of clinical signs. RESULT: 33 (43%) dogs had areas of hyperintensity of the spinal cord greater than or equal to the length of the L2 vertebral body on T2-weighted magnetic resonance images. All 44 dogs without areas of hyperintensity on T2-weighted images had a successful outcome, but only 18 of the 33 (55%) dogs with an area of hyperintensity did. Only 5 of 16 dogs with an area of hyperintensity that had also lost deep pain perception had a successful outcome. The odds ratio for an unsuccessful outcome for a dog with an area of hyperintensity (29.87) was higher than the odds ratio for a dog that had lost deep pain perception (5.24). Duration and rate of onset of clinical signs were not associated with clinical outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggest that results of magnetic resonance imaging can be used to predict clinical outcome in dogs with paraplegia caused by intervertebral disk extrusion.     

Postoperative Analgesia for Stifle Surgery: A Comparison of Intra-articular Bupivacaine, Morphine, or Saline

A prospective study was undertaken to compare the analgesic effect of intra-articular bupivacaine, morphine, or saline in the 24-hour period following cranial cruciate ligament repair in dogs. Thirty-six clinical patients with ruptured cranial cruciate ligaments were randomly assigned to one of three groups. After surgical stabilization, and before skin closure, an intra-articular injection was given; group one (n = 12) received 0.5% bupivacaine HCl at 0.5 mL/kg, group two (n = 12) received morphine at 0.1 mg/kg diluted with saline to a volume of 0.5 mL/kg, and group three (n = 12) received saline at 0.5 mL/kg. Heart rate, respiratory rate, mean arterial blood pressure, cumulative pain score, visual analog pain score, and pain threshold test on both stifles were recorded preoperatively and at 0 to 6 and 24 hours postoperatively. Surgeons and pain scoring investigators were unaware of the intra-articular medication given. Supplemental analgesia, if needed, was provided in the postoperative period according to subjective assessment of patient discomfort. Postoperative pain scores were lowest in the bupivacaine group and highest in the saline group. Pain threshold, measured by applying calibrated loads to the knee, was higher postoperatively in the bupivacaine group than in the saline group. Dogs in the morphine and bupivacaine groups required less supplemental analgesia than dogs in the saline group. The local provision of analgesia reduces the need for systemic drugs with potential side effects. Both intra-articular morphine and intra-articular bupivacaine provided better postoperative analgesia than intra-articular saline, with intra-articular bupivacaine showing the greatest effect.     

Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs

OBJECTIVE: To describe a simple method of laparoscopic-assisted ovariohysterectomy (LAOHE) and compare duration of surgery, complications, measures of surgical stress, and postoperative pain with open ovariohysterectomy (OHE) in dogs. DESIGN: Randomized, prospective clinical trial. ANIMALS: 20 healthy sexually intact female dogs weighing >10 kg (22 lb). PROCEDURES: Dogs were randomly allocated to receive conventional OHE or LAOHE. Intraoperative complications, anesthetic complications, total anesthesia time, and total surgery time were recorded. Serum cortisol and glucose concentrations, temperature, heart rate, and respiratory rate were measured preoperatively and 1, 2, 4, 6, 12, and 24 hours postoperatively. Pain scores were assigned by a nonblinded observer at 1, 2, 4, 6, 12, and 24 hours postoperatively. Duration of surgery, pain scores, objective measures of surgical stress, anesthetic complications, and surgical complications were compared between OHE and LAOHE. RESULTS: Age, weight, PCV, and duration of surgery did not differ between treatment groups. Nine of 10 dogs in the OHE group required additional pain medication on the basis of pain scores, whereas none of the dogs in the LAOHE group did. Blood glucose concentrations were significantly increased from preoperative concentrations in the OHE group at 1, 2, 4, and 6 hours postoperatively and at 1 hour postoperatively in the LAOHE group. Cortisol concentrations were significantly increased at 1 and 2 hours postoperatively in the OHE group. CONCLUSIONS AND CLINICAL RELEVANCE: LAOHE caused less pain and surgical stress than OHE and may be more appropriate for an outpatient setting.     

Syringosubarachnoid shunt as a management for syringohydromyelia in dogs

Objective : To evaluate retrospectively the efficacy of syringosubarachnoid shunt for the management of syringohydromyelia/syringomyelia. Methods : Eleven dogs diagnosed with syringohydromyelia/syringomyelia by magnetic resonance imaging associated with Chiari‐like malformation underwent placement of a syringosubarachnoid shunt at the cervical (nine dogs) or lumbar (two dogs) spinal cord. In one dog, a suboccipital decompression (foramen magnum decompression) was performed 4 months before inserting a syringosubarachnoid shunt. All dogs were evaluated neurologically a few hours after surgery, 2 weeks and 6 months postoperatively. Retrospectively, cases were assigned a preoperative and postoperative pain score. Results : There were no intra‐ or peri‐operative complications. One dog (9%) was euthanased 5 weeks after surgery. Progressive neurological improvement was observed in nine dogs (81·8%) 2 weeks and 6 months postoperatively. No clinical improvement was seen in another dog (9%). One dog (9%) had replacement of the syringosubarachnoid shunt. Seven dogs (63·6%) were still alive 1 to 4 years (mean, 2·6 years) after surgery. Clinical Significance : Placement of a syringosubarachnoid shunt in the presence of a sufficiently large syrinx appears to be beneficial in dogs with Chiari‐like malformation and associated syringohydromyelia/syringomyelia.     

Comparison of hemilaminectomy and dorsal laminectomy for thoracolumbar intervertebral disc extrusion in dachshunds

Neurological improvement after decompressive surgery, without routine therapeutic or prophylactic disc fenestration, was evaluated retrospectively in a consecutive series of 93 dachshunds with thoracolumbar disc extrusion. In 24 per cent of procedures, deep pain sensation was not elicited in at least one hind paw before surgery. Median neurological status one to seven days after surgery, at the time of discharge, was significantly improved after hemilaminectomy compared with dorsal laminectomy (P < 0·05). After hemilaminectomy, deep pain sensation was not elicited in one or both hind paws of 8 per cent of dogs in which pain sensation was elicited before surgery, compared with 21 per cent after dorsal laminectomy (P > 0·05). Improvement in neurological grade at follow-up examination two to 12 weeks after hemilaminectomy was not significantly different compared with dorsal laminectomy (P > 0·05). Of dogs which were unable to walk before surgery, 83 per cent regained the ability to walk after hemilaminectomy, compared with 74 per cent after dorsal laminectomy (P > 0·05). In both groups, 50 per cent of dogs in which deep pain sensation was abnormal before surgery eventually regained the ability to walk after surgery (P = 1). One to two years after the first operation, a second laminectomy was performed in only 5 per cent of dogs because of extrusion of a different intervertebral disc which had not been fenestrated.     

Cardiovascular and subjective evaluations of oxymorphone/diazepam and hydromorphone/diazepam induction in experimentally induced hypovolemic dogs

Carprofen is an oral nonsteroidal anti-inflammatory drug commonly used for treatment of chronic osteoarthritic pain. The injectable formulation has some efficacy for treatment of acute surgical orthopedic pain. The purpose of this project was to assess the efficacy of oral preoperative carprofen for control of postoperative pain in dogs undergoing knee surgery for repair of ruptured cranial cruciate ligaments.
This was a randomized, placebo controlled, parallel study that investigated the effectiveness of carprofen compared to placebo. Nineteen dogs, presented to the CSU VTH, were entered into the study and randomly assigned to the carprofen (C) ( n  = 10) or placebo (P) ( n  = 9) group. Dogs received either a loading dose of carprofen (2.2 mg kg⁻¹ PO BID) or placebo starting 24 hours prior to surgery including the morning of surgery. The placebo contained lactose and liver flavoring. Pain was assessed using a pain scoring system, visual analog scale, and a loaded pressure threshold device preoperatively, and at 1, 2, 4, 6, 24, and 48 hours and 10 and 21 days postoperatively. The treatment continued for 21 days. Blood for cortisol analysis was drawn at all assessment times. Data were analyzed using a likelihood-based mixed effect model repeated measures. Data were considered significant if p  < 0.05.
Eight of 10 C dogs and 5/9 P dogs were given at least 1 dose of morphine. The mean relative dose of morphine was greater in the C group at 1 hour ( p  = 0.01) and 24 hours ( p  = 0.02). The heart rate and respiratory rate decreased postoperatively in a similar manner for both groups. There were no significant postoperative differences in cortisol levels or any measured variable. It appears that the scoring system used was not sensitive enough to detect differences in pain between a known analgesic and a placebo.     

Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs

OBJECTIVE: To evaluate use of electroacupuncture combined with standard Western medical treatment versus Western medical treatment alone for treatment of thoracolumbar intervertebral disk disease in dogs. DESIGN: Prospective controlled study. ANIMALS: 50 dogs with signs of thoracolumbar intervertebral disk disease. PROCEDURES: Dogs were randomly allocated to 1 of 2 treatment groups and classified as having grade 1 to 5 neurologic dysfunction. Dogs in group 1 received electroacupuncture stimulation combined with standard Western medical treatment; those in group 2 received only standard Western medical treatment. A numeric score for neurologic function was evaluated at 4 time points to evaluate effects of treatments. RESULTS: Time (mean +/- SD) to recover ambulation in dogs with grade 3 and 4 dysfunction in group 1 (10.10 +/- 6.49 days) was significantly lower than in group 2 (20.83 +/- 11.99 days). Success (able to walk without assistance) rate for dogs with grade 3 and 4 dysfunction in group 1 (10/10 dogs) was significantly higher than that of similarly affected dogs in group 2 (6/9 dogs). Dogs without deep pain perception (grade 5 dysfunction) had a success (recovery of pain sensation) rate of 3 of 6 and 1 of 8 in groups 1 and 2, respectively, but the difference was not significant. Overall success rate (all dysfunction grades) for group 1 (23/26; 88.5%) was significantly higher than for group 2 (14/24; 58.3%). CONCLUSIONS AND CLINICAL RELEVANCE: Electroacupuncture combined with standard Western medical treatment was effective and resulted in shorter time to recover ambulation and deep pain perception than did use of Western treatment alone in dogs with signs of thoracolumbar intervertebral disk disease.     

Combination of serum phosphorylated neurofilament heavy subunit and hyperintensity of intramedullary T2W on magnetic resonance imaging provides better prognostic value of canine thoracolumbar intervertebral disc herniation

The aim of this study was to evaluate the prognostic value of concurrent measurement of serum phosphorylated neurofilament heavy subunit (pNF-H) concentration and intramedullary T2W hyperintensity in paraplegic to paraplegic dogs. Our hypothesis was that concurrent measurement of these would provide a more accurate prediction of functional outcome in dogs with thoracolumbar intervertebral disc herniation (IVDH). A prospective case-control clinical study was designed using 94 dogs with acute onset of thoracolumbar IVDH. The association of serum pNF-H concentration, T2W hyperintensity on sagittal MRI (T2H/L2), deep pain perception and surgical outcome were evaluated with logistic regression analysis after three months for all 94 surgically treated dogs. Sensitivity to predict non-ambulatory outcome was compared among pNF-H and T2H/L2 and combination of both. Logistic regression analysis indicated that serum pNF-H concentration and T2H/L2 were significantly correlated with surgical outcome (P<0.05); however, deep pain perception was not (P=0.41). The results of logistic regression analysis indicated that the odds ratios of unsuccessful long-term outcome were 2.6 for serum pNF-H concentration, 1.9 for T2H/L2 and 2.3 for deep pain sensation. The sensitivity and specificity to predict non-ambulatory outcome for using serum parameter pNF-H>2.6 ng/ml, using T2H/L2 value of>0.84 and using both serum pNF-H and T2H/L2, were 95% and 75.7%, 65% and 86.5%, and 90.0% and 97.5%, respectively. Therefore, combined measurements of serum pNF-H and T2H/L2 might be useful for predicting long-term outcome in dogs with thoracolumbar IVDH.     

Use of low doses of ketamine administered by constant rate infusion as an adjunct for postoperative analgesia in dogs

OBJECTIVE: To compare indicators of postoperative pain and behavior in dogs with and without a low-dose ketamine infusion added to usual perioperative management. DESIGN: Prospective, randomized, blinded clinical study. ANIMALS: 27 dogs undergoing forelimb amputation. PROCEDURE: Dogs were anesthetized with glycopyrrolate, morphine, propofol, and isoflurane. Thirteen dogs were treated with ketamine IV, as follows: 0.5 mg/kg (0.23 mg/lb) as a bolus before surgery, 10 microg/kg/min (4.5 microg/lb/min) during surgery, and 2 microg/kg/min (0.9 microg/lb/min) for 18 hours after surgery. Fourteen dogs received the same volume of saline (0.9% NaCl) solution. All dogs received an infusion of fentanyl (1 to 5 microg/kg/h [0.45 to 2.27 pg/lb/h]) for the first 18 hours after surgery. Dogs were evaluated for signs of pain before surgery, at the time of extubation, and 1, 2, 3, 4, 12, and 18 hours after extubation. Owners evaluated their dogs' appetite, activity, and wound soreness on postoperative days 2, 3, and 4. RESULTS: Dogs that received ketamine infusions had significantly lower pain scores 12 and 18 hours after surgery and were significantly more active on postoperative day 3 than dogs that received saline solution infusions. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that perioperative administration of low doses of ketamine to dogs may augment analgesia and comfort in the postoperative surgical period.     

Effect of perioperative oral carprofen on postoperative pain in dogs undergoing surgery for stabilization of ruptured cranial cruciate ligaments

A randomized, placebo-controlled, parallel study was conducted to investigate the effectiveness of oral carprofen for the control of postoperative pain in dogs undergoing knee surgery for stabilization of ruptured cranial cruciate ligaments. Dogs were randomly assigned to treatment with carprofen (n = 10) or placebo (n = 9). Pain was assessed at 1, 2, 4, 6, 24, and 48 hours and 10 and 21 days postoperatively. Eight of 10 dogs treated with carprofen and five of nine dogs treated with placebo were given at least one dose of morphine as rescue therapy. The mean relative dose of morphine given at 1 hour (P =.01) and 24 hours (P =.02) after surgery was greater for dogs treated with carprofen than for dogs given a placebo. There were no significant postoperative differences in cortisol levels or any measured variable. It appears that the scoring system used was not sensitive enough to detect differences in pain between a known analgesic and a placebo.     

A keratoprosthesis prototype for the dog

Objective  To describe the technique for implantation of a novel keratoprosthesis (KP) prototype and evaluate its application for the treatment of corneal blindness in dogs.
Animals studied  Seven dogs, all of them being clinically blind before surgery as a result of severe corneal endothelial disease (5/7) or chronic superficial keratitis (2/7) that were unresponsive to prior therapy.
Procedures  A silicone KP was implanted unilaterally, just anterior to Descemet's membrane, after creating a stromal pocket by deep stromal lamellar dissection.
Results  Implantation of the KP was accomplished without complication in six of seven operated dogs. In the remaining case, an intra-operative complication (perforation of Descemet's membrane) was associated with extrusion of the KP 8 weeks postoperatively. All operated eyes regained limited vision after surgery. Three to six months after implantation purulent keratitis occurred in all five eyes with endothelial disease, necessitating surgical removal of the KP 6 months postoperatively in 5/7 eyes.
Conclusions  This KP prototype shows promise as a treatment for certain blinding corneal diseases. However, changes in the design of this KP, allowing improved stromal integration, will be necessary before its clinical application can be approved.     

Chiari-like malformation with syringomyelia in the Cavalier King Charles spaniel: long-term outcome after surgical management

Objective– To evaluate long-term success of cranial cervical decompression for management of canine Chiari-like malformation with syringomyelia (CM/SM).
Study Design– Retrospective clinical study.
Animals– Cavalier King Charles spaniels (n=15).
Methods– After diagnosis by magnetic resonance imaging (MRI) dogs had cranial cervical decompression with durotomy. Seven dogs had the durotomy patched with biocompatible collagen matrix. Clinical outcome was monitored for >12 months.
Results– All dogs either improved (80%) or were unchanged (20%) postoperatively. Postoperative MRI in 6 dogs revealed persistence of syringomyelia. Seven dogs (47%) subsequently deteriorated, 0.2–2.3 years after surgery (mean, 1.3 years) and 2 dogs were eventually euthanatized as a consequence. Twelve dogs were still alive, 1–6.5 years after surgery (mean, 2.5 years).
Conclusion– Cranial cervical decompression surgery is associated with low mortality and morbidity, and results in clinical improvement in most dogs. The procedure seemingly does not result in syrinx collapse and resolution. Clinical improvement may not be sustained and some dogs can be expected to deteriorate.
Clinical Relevance– Cranial cervical decompression surgery may have a role in management of CM/SM. In dogs with severe pain, it can improve quality of life for several years; however, it does not appear to adequately address the primary cause of syringomyelia. Further prospective study is needed to better understand the pathogenesis and treatment of this disorder. Because this condition causes neuropathic pain but does not necessarily result in euthanasia more information is needed on appropriate pain management for these patients.     

Thoracolumbar disc extrusion associated with extensive epidural haemorrhage: a retrospective study of 23 dogs

OBJECTIVES: To describe the clinical features and outcome in dogs suffering from thoracolumbar disc extrusion associated with extensive epidural haemorrhage (DEEH) and treated with extensive hemilaminectomy (from three to seven vertebrae). METHODS: The records of 23 dogs with surgically confirmed DEEH were reviewed retrospectively. RESULTS: All cases were characterised by rapid progression to severe neurological dysfunction (grade III, V and VI). Myelography was performed in 21 cases and showed an absence (16 cases) or attenuation (five cases) of contrast medium column along three to seven vertebrae. In two dogs, magnetic resonance imaging was accurate in confirming extradural compression due to disc material and haemorrhage, determining the extent of compression and side of the lesion. All cases were treated surgically with extensive hemilaminectomy involving all the compressed spinal segments. Twenty-one dogs (91 per cent) recovered and regained ambulatory function. Two dogs, without deep pain perception before surgery, did not improve. A two-year follow-up history was available for 15 dogs. Disc extrusion recurred in two dogs (9 per cent), two and 20 months after surgery. CLINICAL SIGNIFICANCE: Extensive hemilaminectomy can adequately decompress the spinal cord after DEEH and may produce a recovery and recurrence rate similar to thoracolumbar disc extrusion not complicated by extensive epidural haemorrhage.     

Toggle rod stabilization for treatment of hip joint luxation in dogs: 62 cases (2000-2005)

OBJECTIVE: To determine outcome of open toggle rod stabilization in dogs with luxation of the hip joint. Design-Retrospective case series. ANIMALS: 62 dogs. PROCEDURES: Information on signalment, surgical procedure, and postoperative care was obtained from the medical records. A questionnaire was sent to all owners to solicit follow-up information. RESULTS: The distribution for time between luxation and surgery was bimodal, with 24 (39%) dogs examined < or = 2 days after injury and 23 (37%) examined > 7 days after injury. Postoperative complications developed in 16 of the 62 (26%) dogs, with complications developing within 1 week after surgery in 10 of the 16. The most common complication was reluxation, which occurred in 7 dogs. Dogs in which surgery time was < 2 hours were significantly less likely to have a reluxation (2/40 [5%]) than were dogs in which surgery time was > or = 2 hours (5/22 [23%]). When asked to rate current limb function (0 = no lameness and 5 = non-weightbearing lame) a minimum of 6 months after surgery, 23 of 27 (85%) owners indicated a score of 0 or 1. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggest that toggle rod stabilization is an effective treatment for hip joint luxation in dogs. However, complications, particularly reluxation, were common.     

Comparison of ketoprofen and carprofen administered prior to orthopedic surgery for control of postoperative pain in dogs.

OBJECTIVE: To compare analgesic and adverse effects of ketoprofen and carprofen when used to control pain associated with elective orthopedic surgeries in dogs. DESIGN: Prospective randomized clinical trial. ANIMALS: 93 client-owned dogs: 46 undergoing reconstruction of the cranial cruciate ligament, 47 undergoing femoral head and neck excision, and 15 control dogs anesthetized for radiographic procedures. PROCEDURE: Dogs undergoing surgery were randomly given ketoprofen, carprofen, or saline (0.9% NaCl) solution, SC, prior to surgery. Pain score and serum cortisol concentration were recorded for 12 hours after surgery for all dogs. When pain score was > or = 7, oxymorphone was administered i.m. Bleeding time was measured prior to and during surgery. RESULTS: The proportion of dogs that required oxymorphone was significantly higher for the carprofen and placebo groups than for the ketoprofen group. Pain score for the placebo group was significantly higher than for the ketoprofen and carprofen groups, 2, 8, and 9 hours after surgery. Cortisol concentration was significantly higher for the placebo group than for the carprofen group at 4 and 6 hours after surgery. Significant differences were not detected between ketoprofen and carprofen groups with respect to pain score and cortisol concentration. Bleeding time was significantly longer for the ketoprofen group than for the other groups during surgery. One dog treated with ketoprofen developed a hematoma at the surgical site. CONCLUSIONS AND CLINICAL RELEVANCE: Ketoprofen and carprofen given prior to surgery were effective for postoperative pain relief in dogs. However, ketoprofen should not be used when noncompressible bleeding may be a problem.