Evaluation of two sedation protocols for use before diagnostic intra-articular anaesthesia in lame dogs

Objectives : To assess the influence of two sedation protocols on the degree of lameness in dogs. Methods : Fifty lame dogs were allocated to one of two sedation protocols. Group ACPM (acepromazine + methadone; n=25) was sedated with acepromazine and methadone. Group MED (medetomidine antagonised with atipamezole; n=25) was sedated with medetomidine and reversed with atipamezole. Each dog was evaluated for lameness before and after sedation using videotapes. Four experienced clinicians allocated global lameness scores before and after sedation to each dog using a numerical rating scale. Results : In 80% of the dogs in group ACPM and in 72% in group MED lameness was not affected by the sedation. In 12% of the dogs in group ACPM and 20% of the dogs in group MED the observers noticed an increase of lameness of 1 or 2 degrees on a scale of 0 to 10. In 8% of the dogs in both groups lameness decreased with 1 degree. Clinical Relevance : A possible diagnostic test for investigation of obscure lameness is intra‐articular anaesthesia. Sedation is necessary to allow intra‐articular injection. This study provided evidence that the effect of sedation with the proposed protocols on the degree of lameness is negligible.     

Mineralization of the supraspinatus tendon in dogs

Mineralization of the supraspinatus tendon is proposed as a cause of forelimb lameness in dogs. A new radiographic position (cranioproximal-cranio-distal) is advanced to detect abnormalities of the craniomedial aspect of the proximal portion of the humerus. Four dogs had surgery to remove mineralized debris from the supraspinatus tendon insertion and have improved limb function. Two dogs were evaluated in depth, with no signs of relapse 2 to 4 years after surgery. Other dogs, without apparent forelimb lameness, have had mineralization detected by use of radiography, thus emphasizing the need for thorough forelimb evaluation before determining that the mineralization is indeed the cause of lameness.     

Prospective evaluation of techniques for differentiating shoulder pathology as a source of forelimb lameness in medium and large breed dogs

Objective— To assess lameness evaluation, shoulder abduction angles, radiography, and ultrasonography for determining presence, location, and severity of forelimb pathology. Study Design— Prospective cohort study. Animals— Dogs ≥20 kg (n=30). Methods— Each dog was assigned lameness scores. Shoulder abduction angles were determined. Radiographs of shoulders and elbows were subjectively graded for pathology. One investigator unaware of dog history (lameness, radiographic findings) performed ultrasonographic assessment of shoulders with subjective grading of pathology. Another investigator unaware of dog history (lameness, radiographic, ultrasonographic findings) performed arthroscopic assessment of shoulders with subjective grading of pathology. Elbows were disarticulated and evaluated for gross pathology. Histologic pathology scoring of shoulder tissues was performed. Data were compared for differences among groups, sensitivities, specificities, positive and negative predictive values, and positive and negative likelihood ratios were calculated. Results— Twenty‐seven forelimbs were considered clinically normal, 26 had shoulder pathology, 5 had elbow pathology, and 2 had pathology of both the shoulder and elbow. Dogs with shoulder pathology were twice as likely to be lame compared with dogs with elbow pathology. Limbs with medial shoulder instability had significantly higher abduction angles than normal limbs and those with elbow pathology. Radiographs were clinically useful for diagnosing elbow, but not shoulder, pathology. Ultrasonography was clinically useful for diagnosing shoulder pathology other than instability. Abduction angles, ultrasonographic evaluation, and arthroscopic assessments had strong, significant correlations with reference standards. Conclusions— Clinically relevant diagnostic techniques yielded characteristic, repeatable differences in objective and subjective assessments for distinguishing presence, location, and severity of forelimb lameness in dogs. Clinical Relevance— The diagnostic approach to forelimb lameness in dogs should include shoulder pathology as a differential with multiple assessments used to determine the clinical cause of lameness.     

Effects of treatment with polysulfated glycosaminoglycan on serum cartilage oligomeric matrix protein and C-reactive protein concentrations, serum matrix metalloproteinase-2 and -9 activities, and lameness in dogs with osteoarthritis

OBJECTIVE: To investigate the effects of polysulfated glycosaminoglycan (PSGAG) treatment on serum cartilage oligomeric matrix protein (COMP) concentration, matrix metal-loproteinase-2 (MMP-2) and -9 (MMP-9) activities, C-reactive protein (CRP) concentration, and lameness scores in dogs with osteoarthritis. ANIMALS: 16 dogs with osteoarthritis and 5 clinically normal dogs. PROCEDURES: Dogs with osteoarthritis had a history of chronic lameness, and osteophytes were observed on radiographic evaluation of the affected joint. Polysulfated glycosaminoglycan was administered IM twice a week for a total of 8 treatments to all dogs with osteoarthritis and to clinically normal control dogs. RESULTS: Lameness scores after PSGAG treatment in osteoarthritic dogs improved in 12 of the 16 dogs. Serum COMP concentrations in osteoarthritic dogs were significantly higher than in control dogs before treatment. Lameness scores in osteoarthritic dogs decreased significantly after treatment, compared with before treatment. Lameness scores of 9 dogs with hind limb lameness improved significantly after treatment; these dogs had corresponding decreases in serum COMP concentrations. After treatment, serum COMP concentrations and lameness scores of 7 dogs with forelimb lameness remained high and were significantly higher than those of dogs with hind limb lameness. Serum MMP-9 activities of dogs with forelimb lameness were significantly higher than in dogs with hind limb lameness after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: IM administration of PSGAG inhibited COMP degradation in dogs with osteoarthritis. Results indicate that decreases in serum COMP concentrations might be related to improvement in lameness after PSGAG treatment.     

Meniscal Release in Cruciate Ligament Intact Stifles Causes Lameness and Medial Compartment Cartilage Pathology in Dogs 12 Weeks Postoperatively

Objective— To evaluate after 12 weeks the effects of caudal medial meniscal release (MR) in the cranial cruciate ligament-intact canine stifle.
Study Design— Blinded, prospective in vivo study.
Animals— Purpose-bred hound dogs (n=10).
Methods— Either MR (n=5) or a sham (SH) surgery (n=5) was performed via arthroscopy. Orthopedic examination and subjective lameness evaluation were performed in each dog preoperatively and at 4, 8, and 12 weeks after surgery. Twelve weeks postoperatively, ultrasonographic, radiographic, and arthroscopic examinations were performed on the operated stifles. Gross pathology of the articular cartilage, cruciate ligaments, and menisci was assessed. India ink staining of the femoral and tibial articular surfaces was performed to determine the percent area of articular cartilage damage.
Results— At 8 and 12 weeks after surgery, MR dogs were lamer than SH dogs. At 12 weeks, the degree of radiographic OA was significantly higher in MR stifles than in SH stifles. Gross and sonographic meniscal pathology was more severe in MR stifles compared with SH stifles. MR stifles had significantly more severe articular cartilage pathology compared with SH stifles 12 weeks after surgery; pathology was most severe in the medial compartment.
Conclusions— MR alone is associated with articular cartilage loss, further meniscal pathology, degenerative joint disease, and lameness.
Clinical Relevance— Subsequent osteoarthritis and dysfunction of the stifle joint should be considered when making clinical decisions regarding MR in dogs.     

Supraspinatus tendinosis associated with biceps brachii tendon displacement in a dog

A 4-year-old spayed female Australian Cattle Dog (Blue Heeler) was evaluated because of right forelimb lameness of 5 months' duration. Orthopedic evaluation revealed signs of pain localized to the cranial aspects of both shoulder joints. Via magnetic resonance imaging, the mass of the supraspinatus tendon insertion in both shoulder joints was increased, compared with findings in cadavers of clinically normal dogs; additional imaging procedures revealed that, compared with clinically normal tendons, the tendon had increased signal intensity that was consistent with increased fluid content. The increased supraspinatus tendon mass in each shoulder joint was associated with medial displacement of the biceps brachii tendon, which was more severe in the right limb. Arthroscopic evaluations of both shoulder joints revealed no abnormalities. The dog underwent surgery, and the abnormal parts of the tendons were resected. The most prominent finding on histologic examination of excised tissues was severe myxomatous degeneration. The lameness resolved, and at 22 months after surgery, the dog was reported to have had no recurrence of lameness. The clinical signs and histologic appearance of the tendons in this dog strongly resemble findings associated with tendinosis in humans. Decompression of the biceps brachii tendon may have contributed to the successful outcome after surgery in this dog. Supraspinatus tendinosis should be considered among the differential diagnoses in dogs with uni- or bilateral forelimb lameness.     

Nonweightbearing lameness secondary to synovial sarcoma in a young dog

Synovial sarcoma was diagnosed in the right carpus of a 2 1/2-year-old mixed-breed dog. The dog had developed a right forelimb lameness before one year of age. The lameness was progressive for nearly 2 years, resulting in severe disuse atrophy of the right forelimb musculature and pronounced osteopenia. A definitive diagnosis was not made until the dog was referred after 2 years of conservative treatment was ineffectual. Right forelimb amputation was done and the dog survived an additional 15 months. The protracted clinical course before definitive diagnosis underscores the need for aggressive pursuit of a diagnosis when conservative treatment of a lameness is not efficacious.     

Partial rupture of the cranial cruciate ligament of the stifle in dogs: 25 cases (1982-1988)

Partial rupture of the cranial cruciate ligament was diagnosed in 25 dogs. In all dogs, the primary problem at the time of physical examination was hind limb lameness. The mean time from initial onset of lameness to diagnosis at exploratory surgery was 17 weeks. A cranial drawer sign was detected in 13 of the 25 dogs; in 9, the cranial drawer sign was evident only when the stifle was positioned in flexion. Of the 25 dogs, 12 had no detectable cranial drawer sign in response to manipulation of the involved stifle. In all dogs, lateral stifle arthrotomy was performed in routine manner, and the cranial cruciate ligament was found to be incompletely torn. Lesions identified during arthrotomy were rupture of the craniomedial band (n = 20 dogs), interstitial tear (n = 4 dogs), and rupture of the caudolateral band (n = 1 dog).     

RADIOGRAPHIC FEATURES OF AORTIC BULB/VALVE MINERALIZATION IN 20 DOGS

The radiographic features of aortic bulb/valve mineralization in 20 dogs were reviewed. Extent, shape, number, and location of mineralization were recorded. Five of the dogs had additional alternate imaging examinations, including bone scintigraphy, echocardiography, and thoracic computed tomography. A necropsy was done on one dog, and the area of mineralization was evaluated using routine histology. The median age was 10 (mean 9.7; SD +/- 2.7) years. There were five males, seven neutered males, one female, and seven neutered females. The breeds were: Irish setter (6); rottweiler (7); chow-chow (1); miniature dachshund (1); borzoi (1); English setter (1); English springer spaniel (1); great Dane (1); and greyhound (1). Dogs with both right and left lateral radiographs (n = 17) had mineralization visible on both views, more conspicuously on the right lateral radiograph (n = 12). Aortic bulb mineralization was identified on the ventrodorsal radiograph of only one dog. On lateral radiographs, the aortic bulb mineralization was localized within the 4th intercostal space and in the craniodorsal quadrant of the cardiac silhouette. In nine of the dogs, there were complex or multiple mineralizations and in 11 dogs, there was a single curvilinear mineral opacity oriented in a caudoventral to craniodorsal direction. In all radiographs, the mineralization was in the expected position of the aortic bulb, and echocardiography (n = 4), spiral computed tomography (n = 2), and necropsy (n = 1) confirmed that the mineralization was within the aortic bulb. Clinical pathologic data of the dogs suggested no reason for metastatic mineralization. Exact etiopathogenesis of the lesions were not determined in this study. Based on the histologic findings in one dog, the mineralization seen in the aortic root is similar to a form of dystrophic mineralization called Monckeberg's calcific arteriosclerosis in humans. No clinical signs attributable to the mineralization were observed.     

Percutaneous Cementoplasty in the Palliative, Multimodal Treatment of Primary Bone Tumors of the Distal Aspect of the Radius in Four Dogs

Objective— To (1) evaluate the analgesic effect of percutaneous cementoplasty (PC) in dogs with primary bone tumor (PBT) of the distal aspect of the radius and (2) evaluate the impact on the course of disease by adding PC to a palliative, multimodal treatment protocol in these dogs.
Study Design— Prospective pilot study.
Animals— Dogs (n=4) with PBT of the distal aspect of the radius.
Methods— Tumor lesions were filled percutaneously with polymethylmethacrylate under fluoroscopic guidance. Pamidronate was administered once in a week before PC. Radiotherapy and chemotherapy were initiated 2 and 6 weeks after PC, respectively. Force plate analysis was performed immediately before 2, and 6 weeks after PC. Survival time was defined from PC to euthanasia.
Results— Two dogs had a significant increase in peak vertical force 2 weeks after PC ( P =.043) and remained free of lameness for 18 and 20 weeks, respectively. One dog had an acute relapse after an initially lame-free period of 10 days. The remaining dog failed to improve ( P =.686). Three dogs developed at least 2 complications including transient worsening of the lameness after PC, cement leakage, wound infection and suspected thromboembolism in combination with cough and anemia. Median survival was 4.8 months (range, 1–5.7 months).
Conclusions— PC in combination with pamidronate significantly improved lameness in 2 dogs; however, PC is not risk-free. Deep wound infection, intraarticular cement leakage, and venous thrombosis were the main complications.
Clinical Relevance— PC might be a useful addition to established palliative, multimodal treatment protocols in dogs with PBT; however, because of the complications encountered PC warrants further study before routine use can be considered.     

Tumours involving the nerve sheaths of the forelimb in dogs

Nerve sheath tumours were diagnosed in 10 dogs over a three-year period. The age at presentation ranged from three to 12 years (mean 6-3 years) and the sexes were equally represented. All the dogs were of medium to large breeds. The cases were assigned to two distinct clinical groups, which corresponded with the location of the neoplasia. One group presented as a chronic progressive, unilateral forelimb lameness; these dogs had peripherally located tumours. The other group had an acute onset of signs associated with spinal cord compression without previous forelimb signs. These were associated with tumours at the level of the spinal nerve roots.     

Autogenous osteochondral grafting for treatment of stifle osteochondrosis in dogs

Objective— To develop and assess clinical outcomes for osteochondral autografting for treatment of stifle osteochondrosis (OC) in dogs. Study Design— Retrospective case series. Animals— Dogs with stifle OC (n=10). Methods— Osteochondral autografting was developed and optimized in canine cadavers and purpose‐bred research dogs using the Osteochondral Autograft Transfer System (OATS). Dogs with stifle OC (n=10 dogs, 12 stifles) were then treated using the OATS system. Outcomes were assessed by radiography (n=12), magnetic resonance imaging (1), second‐look arthroscopy (9), lameness scoring (12), and telephone survey of owners (10 clients, 12 stifles) 6–15 months after surgery. Results— Complications were documented in 4 of the 12 stifles treated and included peri‐incisional seromas (3) and marked stifle effusion (1). Subjective assessment of follow‐up radiographs revealed evidence of integration of the grafts with maintenance of subchondral bone surface architecture. Subjective assessment of follow‐up MRI in 1 stifle revealed evidence for incorporation of grafts with restoration of articular surface contour. Second‐look arthroscopy 6–30 weeks after surgery revealed maintenance of articular cartilage at the graft site. Dogs were significantly (P<.001) less lame at follow‐up compared with preoperative scores. Based on follow‐up owner surveys, only 2 dogs had no pain or lameness; the other dogs were judged to have mild pain and/or lameness. All owners noticed improvement in the dogs' quality of life after surgery. Conclusion— Osteochondral autografting deserves consideration and further evaluation as a primary treatment option for stifle OC in dogs. Clinical Relevance— Osteochondral autografting for treatment of lateral femoral condylar OC lesions in dogs using OATS instrumentation is safe and results in improved function and quality of life based on owners' perception 6–15 months after treatment.     

Surgical Treatment of Mineralized and Nonmineralized Supraspinatus Tendinopathy in Twenty-four Dogs

Objective— To report and compare the clinical diagnosis, surgical treatment, histopathologic changes, and outcomes of dogs with mineralized and nonmineralized supraspinatus tendinopathy (ST).
Study Design— Case series.
Animals— Dogs (n=24) with ST.
Methods— Medical records (1995–2006) of dogs with ST that had surgical treatment were reviewed. Results of clinical examination, diagnostic imaging, surgery, histopathology of resected tendon tissue, and outcome were compared between dogs with mineralized and nonmineralized ST.
Results— There were 15 dogs with mineralized ST and 9 with nonmineralized ST. Chronic, unilateral, intermittent or waxing-waning lameness, and pain elicited on palpation of the cranial aspect of the shoulder were the most consistent findings. On ultrasonographic or magnetic resonance imaging (MRI) of 35 shoulders, enlargement of the supraspinatus tendon (54%), increased fluid content (63%), and medial displacement of the biceps tendon (60%) were observed. Eleven of 12 dogs with bilateral abnormalities only had unilateral lameness. Surgery was performed in 30 shoulders. Resected tendon specimens had myxomatous degeneration and/or cartilaginous metaplasia in 11 of 13 dogs in the mineralized group and all 9 dogs in the nonmineralized group. Functional outcome after surgery was poor in 3 dogs and good-to-excellent in 16.
Conclusions— Mineralized and nonmineralized ST have many similarities. Although lameness is usually unilateral, the supraspinatus tendon may be affected bilaterally.
Clinical Relevance— Ultrasonography and MRI are good imaging techniques for detection of ST especially the nonmineralized form. Surgical treatment results in good recovery of limb function. Nonmineralized ST is a recently described disorder in dogs and evaluation of more cases is necessary to determine outcome after surgical or medical treatment.     

Tibiotarsal arthroscopy. Applications and long-term outcome in dogs.

The objective of this retrospective article was to describe the use of, and to determine long-term outcome of, tibiotarsal arthroscopy in dogs. The medical records of 20 client-owned dogs with tibiotarsal joint disease with arthroscopic treatment were reviewed. Long-term follow-up evaluation of lameness, force plate gait analysis, and radiographs to assess progression of degenerative joint disease (DJD) were performed. Arthroscopy was utilized in the diagnosis of talar osteochondritis dissecans (OCD), collateral ligament injury, septic arthritis, immune mediated arthritis, and a distal talar fragment. Sixteen joints with OCD treated resulted in 10/14 dogs with lameness after exercise only, progression of DJD in most cases, and chronic lameness when comparing operated to unoperated limbs with force plate evaluation at a mean follow-up of 35 months. Following treatment, three dogs with collateral ligament injury had reduced weight bearing on the operated limb, radiographic progression of DJD, and minimal lameness at a mean follow-up of 27 months. Tibiotarsal arthroscopy can be successfully used to help diagnose, and often to treat: OCD, collateral ligament injury, fractures, septic and non-septic arthritis in the dog. The minimally invasive nature of arthroscopy preserved joint stability while allowing complete examination of the articular cartilage. In most cases long term tibiotarsal DJD advancement was the rule.     

Circular external skeletal fixation stabilization of antebrachial and crural fractures in 25 dogs

Fracture stabilization using circular external skeletal fixation was evaluated in 14 dogs with antebrachial fractures and 11 dogs with crural fractures. Most dogs were consistently weight bearing on the stabilized limb by 3 days following surgery. Although all dogs developed minor wire/pin tract inflammation and eight dogs developed major wire/pin tract inflammation, postoperative lameness was not consistently associated with wire/pin tract complications. Fractures in 23 dogs achieved radiographic union (mean +/- standard deviation [SD], 61 +/- 21 days; median, 57 days) without additional surgery; two dogs required restabilization of their fractures with linear fixators. Twenty of the 21 owners that could be contacted felt their dog had no (n=15) or only a mild (n=5) intermittent lameness at the time of final, long-term (mean +/- SD, 37 +/- 17 months; median, 42 months) assessment.     

Compensatory load redistribution in naturally occurring osteoarthritis of the elbow joint and induced weight-bearing lameness of the forelimbs compared with clinically sound dogs

The current study investigated the compensatory load redistribution due to osteoarthritis of the elbow joint using ground reaction forces of all four legs, simultaneously measured on a treadmill with integrated force plates. Three groups of dogs were used: the first group was clinically sound; the second group suffered from a naturally occurring osteoarthritis of the elbow joint, and a reversible lameness was induced in the third group. The naturally occurring osteoarthritis resulted in a compensatory gait pattern to reduce the stress on the affected limb. The load was reduced on the lame limb and increased on the contralateral hindlimb. The symmetry index indicated a weight-shift to the contralateral forelimb and diagonal hindlimb, which resulted in a more balanced weight distribution than in normal dogs. Dogs with induced lameness showed comparable but less pronounced alterations. These results suggested that forelimb lameness could lead to overload on non-affected extremities and the vertebral spine.     

Wound Healing and Brain Stem Auditory Evoked Potentials After Experimental Ventral Tympanic Bulla Osteotomy in Dogs

Ventral tympanic bulla osteotomy was performed in 13 normal dogs to evaluate healing and retention of brain stem auditory evoked potentials (BSAEP). Healing was evaluated by gross and microscopic examination of the middle ears after 1 (n = 2), 4 (n = 8), 5 (n = 1), and 6 (n = 1) weeks. One dog was eliminated from the study. Brain stem auditory evoked potentials were measured using an air-conducted sound stimulus before and after surgery and before killing. Nine of 12 dogs re-formed the tympanic bulla by formation of fibrous connective tissue lined with cuboidal epithelium in the osteotomy site. Four of the nine dogs had a reduced tympanic bulla volume (estimated 20% to 40% volume reduction) caused by soft tissue ingrowth through the osteotomy. Nine of 12 dogs had proliferation of subperiosteal new bone from the inner surface of the tympanic bulla that varied in severity. Three of these nine dogs had nearly complete obliteration of the tympanic cavity by proliferating subperiosteal new bone. Eight dogs had nodules of granulation tissue containing new bone and mineralization diffusely distributed on the surfaces of the middle ear. The measured BSAEP sensitivity before killing was equivalent to preoperative levels in 11 dogs. The remaining dog had no change in auditory sensitivity after surgery but had a markedly reduced BSAEP detection threshold before killing. This appeared to be attributable to mechanical impingement on the ossicles and tympanic membrane by proliferating bone within the tympanic cavity. This study showed that after ventral tympanic bulla osteotomy the tympanic bulla rapidly re-forms with no deleterious effect on hearing in most dogs treated. However, the internal surfaces of the middle ear appear to be sensitive to surgical trauma, and extensive new bone proliferation is easily induced. This response may be extreme, resulting in middle ear obliteration and reduced auditory sensitivity.     

Nerve sheath tumours in the dog and cat

Schwannomas were diagnosed in twelve dogs and five cats at Massey University Small Animal Clinic and Hospital over a 15-year period (1977-92). A further two feline cases were reported at the Batchelar Animal Health Laboratory. In six dogs, the tumour involved nerves of the brachial plexus. Clinical signs observed in these dogs were forelimb lameness, muscle wasting and pain on movement of the affected limb or neck. Hindlimb paresis was observed in two dogs. Surgical excision of the brachial plexus tumour was attempted in one dog, leading to an 8-month remission of signs. In one dog, the tumour involved the sacral nerves, and in two dogs the cranial nerves were affected. Three dogs had skin nodules. Seven of the twelve affected dogs were destroyed. In five cats, the tumours developed on the carpus, tarsus or interdigital area of a forelimb or hindlimb as a slowly developing nodular lesion. In the other two cats, the site of the tumour was the flank and the lateral thigh respectively. Surgical excision of the tumour was successful in three cats.     

Samarium Sm 153 lexidronam for the palliative treatment of dogs with primary bone tumors: 35 cases (1999-2005)

OBJECTIVE: To evaluate survival times and palliative effects associated with the use of samarium Sm 153 lexidronam in dogs with primary bone tumors. DESIGN: Retrospective case series. ANIMALS: 35 dogs with primary appendicular (n = 32) or axial (3) bone tumors. PROCEDURES: 1 to 4 doses of samarium Sm 153 lexidronam were administered at a rate of 37 MBq/kg (16.8 MBq/lb), IV. Response to treatment, measured by lameness improvement, and survival time were determined. RESULTS: Of the 32 dogs with appendicular tumors, 20 (63%) had an improvement in the severity of lameness 2 weeks after administration of the first dose of radioactive samarium, 8 (25%) had no change in the severity of lameness, and 4 (12%) had a worsening. Overall median survival time was 100 days, with 3 dogs (8.6%) alive after 1 year. Median survival time for the 32 dogs with appendicular tumors was 93 days, with 3 (9.4%) alive after 1 year. This was not significantly different from the median survival time of 134 days for a historical cohort of 162 dogs with appendicular osteosarcoma that underwent amputation as the only treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that samarium Sm 153 lexidronam may be useful in the palliation of pain in dogs with primary bone tumors that are not candidates for curative-intent treatment.     

Pathologic fracture in dogs with suspected or confirmed osteosarcoma

Objective: To evaluate clinical presentation of pathologic fractures associated with suspected or confirmed osteosarcoma in dogs and to assess treatment and survival times. Study design: Case series. Animals: Dogs (n=25) appendicular pathologic fracture. Methods: Medical records (January 1997–May 2008) of dogs with pathologic fracture associated with a suspected or confirmed osteosarcoma were reviewed. Dogs were included if they had radiographic evidence of a pathologic fracture and a presumptive or definitive diagnosis of osteosarcoma. Radiographic details, histopathology, and/or cytology findings were recorded. Overall median survival time (MST) and MST of treated dogs were calculated. Age, sex, breed, and other concurrent treatment were evaluated. Results: Rottweilers, Irish Wolfhounds, and Greyhounds were the most common breeds represented. Most dogs had minor trauma and 60% had lameness preceding the fracture. Most commonly, fractures were nondisplaced with minimal comminution. None of the dogs had radiographic evidence of pulmonary metastases at admission. Immediate (13 dogs; 52%) and delayed (4; 16%) euthanasia were performed. One dog was not treated and died 90 days after diagnosis. Three dogs (12%) were treated by amputation alone, 1 (4%) with amputation and chemotherapy, and 3 (12%) with internal fixation using an interlocking nail. Overall MST was 1 day (range, 0–623 days) and MST of treated dogs was 406.5 days. Histologic confirmation of osteosarcoma was available in all treated dogs and 6 euthanatized dogs. Conclusions: Treatment of pathologic fracture associated with presumptive osteosarcoma should be considered as an option to amputation or euthanasia if owners desire other options.