Free skin grafting for treatment of distal limb skin defects in cats

The technique and results of free skin grafts have been described in dogs, horses, rabbits, goats and mice. The procedure in cats is, however, described only indirectly in papers relating to dogs. A standard technique has been developed by the authors for use in cats, and is reported for 17 grafts in 16 cats with traumatic injury to the legs resulting in large areas of skin loss. This paper describes the preparation of the wound for grafting, the harvesting of the graft, graft placement, postoperative care and the results of the application of this technique. The success rate in this series of cases was high. This was attributed to proper preparation of the recipient site, collection of the graft and postoperative bandaging. The results suggest that the success rate of free skin grafts in cats is considerably higher than that achieved by the present authors in dogs, and reported for dogs by other surgeons in the literature.     

Anatomy of the distal limb.

A detailed knowledge of anatomy is essential to understand the various pathologic processes and to perform different surgical techniques involving the limbs of cattle. This article reviews macroscopic anatomy of the distal limb, muscle-tendon units, neurovascular anatomy, and external and microanatomy of the claw.     

Distal limb and paw injuries.

Distal limb reconstruction is complicated by the paucity of local tissues and the frequent association of orthopedic injury with cutaneous loss. Second-intention healing or skin stretching techniques are used for wounds involving less than a 30% circumference of the limb. Skin grafts are recommended for reconstruction of larger superficial wounds after establishing a bed of granulation tissue or for immediate reconstruction of clean wounds overlying healthy muscle. Wounds complicated by orthopedic injury benefit from early reconstruction using vascularized tis-sue. Weight-bearing surface reconstruction and management of partial amputation injuries are functionally difficult because of the environmental stress placed on the paw pads. Paw pad grafts, paw pad transposition techniques, centralization of digits, and microvascular free tissue trans-fer of paw pads can be considered for weight-bearing surface reconstruction. Definitive guidelines describing when each of these techniques should be used have not been established.     

Prolonged, continuous distal limb cryotherapy in the horse

REASONS FOR PERFORMING STUDY: The recommended duration of cryotherapy in horses is currently extrapolated from human medicine. Prolonged, continuous cryotherapy (days rather than minutes) may be of therapeutic value if it is safe and well tolerated. OBJECTIVES: To evaluate the effect of prolonged, continuous application of ice and water to the equine distal limb. METHODS: A slurry of ice and water was applied to the right forelimb of 4 Standardbred horses for 48 h. Hoof temperature, ambient temperature and ice boot temperature were logged continuously and clinical observations recorded every 2 h. Lameness examinations were performed prior to application and 1 week, 6 months and 1 year after removal of the ice boot. RESULTS: Continuous cryotherapy was well tolerated and resulted in marked cooling of the treated foot. No significant variation in clinical parameters was noted, and no lameness or gross pathology noted in the treated limbs at any examination period. CONCLUSIONS: The continuous application of ice and water is a safe and effective means of cooling the equine distal limb. The extremely low, constant temperatures achieved may be of benefit in the management of various distal limb conditions. POTENTIAL RELEVANCE: Providing clinicians and research workers with a potent therapeutic/prophylactic modality for disorders of the equine distal limb.     

Ultrasonographic examination of the distal limb of cattle.

Ultrasonography has proven its worth in both small animal and equine musculoskeletal work. It allows visualization of soft tissue that is not possible with anything barring magnetic resonance imaging. In bovine practice, ultrasound has been used to great effect in reproductive work and has also shown itself to be of value in the evaluation of the thorax, abdomen, and the udder. Ultrasound examination of the bovine limb is certainly feasible because of the availability of small portable and affordable equipment. The restraint necessary is dependent on the animal. Cattle, because of their size and inherent dislike of restraint, pose a challenge for ultrasonographic examination. However, if proper restraint is used, it seems possible that ultrasonography may become a helpful tool in the evaluation of soft tissue injuries. It should prove to provide valuable information that may be used to offer better advice with regard to treatment and prognosis.     

Management of anorexia in dogs and cats.

The management of anorexia should center first on the urgent and emergent medical management of the patient and be followed by feeding of a highly palatable food in a low-stress environment and manner. Diet palatability can potentially be improved by increasing dietary moisture, fat, or protein, and, in the dog, by adding sugar or salt as well as by using a variety of fresh, pleasantly aromatic, and uncommon foods. Caution should be used when increasing or adding nutrients that may be harmful to patients with specific diseases. Concurrent drug therapy that may reduce appetite should be minimized, and physical barriers to eating should be removed. Patients that consume less than resting energy requirement of longer than 3 to 5 days with no trend toward improving should receive parenteral or enteral nutrition.     

The risk of severity of limb injuries in racing thoroughbred horses.

A retrospective study was carried out to identify factors which predisposed Thoroughbred horses to severe injuries, as compared to less severe injuries, while racing on New York Racing Association (NYRA) tracks during the period of January 1986 to June 1988. A severe injury was defined as an injury which led to humane destruction of the horse. A less severe injury was defined as a horse which didn't race within 6 months following a muscular, ligament, tendon, or skeletal injury on the racetrack. The data were obtained from the Horse Identification Department records kept by the Chief Examining Veterinarian of NYRA and included 55 severely injured horses and 245 less severely injured horses. Multiple logistic regression analysis was used to identify factors associated with the risk of severe injuries compared to less severe injuries in those horses. There was a significant association between track and the risk of severe injury (horses raced on Belmont and Saratoga were more likely to develop a severe injury compared to horses raced on Aqueduct Main). The track surface was also associated with the risk of severe injury (horses raced on a firm turf had a significantly lower risk of severe injury associated with the track was significantly modified by the track condition (horses raced at Belmont when it was muddy had a significantly increased risk compared to Aqueduct dirt). Horses were more likely to experience severe injury in the early part of the race (less than or equal to 6 furlongs) than the latter part of the race (greater than 6 furlongs). The risk of severe injury decreased with the age of the horse.     

A review of regional limb perfusion for distal limb infections in the horse

Regional limb perfusion (RLP) is a technique widely used for the treatment of limb infections in horses. The objective is to deliver high concentrations of an antimicrobial to a focal region to optimise the bacterial kill with minimal systemic effects. However, experimentally, realising these objectives has been unreliable because conflicting methodologies have produced highly variable results. The aim of this study is to review all of the experimental and clinical literature on RLP between 1990 and 2019 to determine whether there is evidence that RLP has a consistent and practical application for the treatment of distal limb infections in equine practice. A large number of reports have been published on RLP in the horse; however, there are many variations in the technique including the drug used, dose, volume and concentration of perfusate, dosing interval, the type, method and duration of application of the tourniquet and whether the procedure is performed standing or anaesthetised. Prospective clinical studies are lacking, retrospective studies are limited by their nature, while wide differences in treatment regimen and methodology in retrospective and experimental studies have complicated the interpretation of the findings and make it difficult to rationalise an approach that provides a reliable and repeatable outcome. The optimal method of performing RLP has not been established, so the apparent clinical benefits of the technique are often difficult to confirm and quantify. Future studies need to standardise methodologies to enable meaningful comparisons.     

Management of equine hoof injuries.

Hoof injuries are common in horses. Some wounds can pose diagnostic and treatment challenges because of the rigid nature of horn,the tissue involved, the deeper underlying structures eventually invaded, or the pattern of healing. By combining knowledge about the anatomy and biomechanical properties of the foot and healing characteristics of the hoof with adapted general principles of wound management, satisfactory clinical outcomes usually result.     

Ultrasonographic examination of injuries to the achilles tendon in dogs and cats.

The value of ultrasonography in the diagnosis of lesions of the Achilles tendon was Investigated in 42 dogs and seven cats. A standardised four-part ultrasonographic examination was established. Linear transducers with a frequency of more than 7.5 MHz were used. Ultrasonography allowed identification and differentiation of total ruptures and the differentiation of partial ruptures into deep or superficial ruptures, or those comprising muscular tears. The healing process could be monitored and imaged using this technique. Suture material was readily visible in surgically treated cases. Displacement of the superficial digital flexor tendon could be identified. In such cases, the tendon tissue was seen either medially or laterally to the calcaneus. The healing process of the Achilles tendon could also be documented using ultrasonography. However, it was not possible to determine the age of the injury and the exact end of the healing process. Ultrasonography therefore proved to be an excellent diagnostic method for imaging lesions of the Achilles tendon and associated injuries in dogs and cats. After physical examination, the technique should be the next logical step in the evaluation of a suspected injury to the Achilles tendon.     

Owners' observations of domestic cats after limb amputation

Questionnaires were distributed to owners of cats that had undergone limb amputation in the UK, through 1000 veterinary clinics or publications relating to companion cats, or online. Between July 2009 and February 2010, responses were received relating to 234 cats, and data for 204 of these were included in subsequent analyses. The responses received provided data on signalment, aetiology, quality of life, behavioural changes and pain observed in cats after partial or total amputation of a limb. Young male domestic shorthair cats were over-represented in the sample; the most common reason for amputation was a fractured bone, and the hindlimb was almost twice as likely to be amputated as the forelimb. Although 89 per cent of the cats received analgesics/anti-inflammatories after discharge, the owners of 35 per cent of the animals observed some signs of pain during recovery. Eighty-nine per cent of the cats were thought to have regained a 'normal' quality of life as defined by the owner and 94 per cent of the owners stated that they would agree with the decision to amputate the affected limb in a pet if faced with the same decision again.     

Trauma-induced growth abnormalities of the distal radius in three cats

Three immature cats with growth abnormalities of the distal radius secondary to trauma were presented between July 2001 and July 2003. Initial injuries included a Salter-Harris type II fracture of the distal radial physis in one cat, fractures of the styloid process of the ulna in two cats, and metacarpal fractures in one cat. The cats were between 3.5 and 4.5 months of age at the time of injury. Damage to the distal radial physis resulted in a variable degree of shortening of the radius in all cats. Asymmetrical closure caused widening of the lateral aspect of the radiocarpal joint space in two cats. Elbow incongruity was not observed. One cat was treated with osteotomies of the radius and ulna and realignment of the radius, stabilised with external skeletal fixation. Another was treated by ulnar ostectomy alone. Radius and ulna osteotomies and distraction osteogenesis of the radius were performed in the third cat. Clinical outcome was satisfactory in all three cases.