RADIOGRAPHIC EVALUATION OF FELINE APPENDICULAR DEGENERATIVE JOINT DISEASE VS. MACROSCOPIC APPEARANCE OF ARTICULAR CARTILAGE

Degenerative joint disease (DJD) is common in domesticated cats. Our purpose was to describe how radiographic findings thought to indicate feline DJD relate to macroscopic cartilage degeneration in appendicular joints. Thirty adult cats euthanized for reasons unrelated to this study were evaluated. Orthogonal digital radiographs of the elbow, tarsus, stifle, and coxofemoral joints were evaluated for the presence of DJD. The same joints were dissected for visual inspection of changes indicative of DJD and macroscopic cartilage damage was graded using a Total Cartilage Damage Score. When considering all joints, there was statistically significant fair correlation between cartilage damage and the presence of osteophytes and joint‐associated mineralizations, and the subjective radiographic DJD score. Most correlations were statistically significant when looking at the different joints individually, but only the correlation between the presence of osteophytes and the subjective radiographic DJD score with the presence of cartilage damage in the elbow and coxofemoral joints had a value above 0.4 (moderate correlation). The joints most likely to have cartilage damage without radiographic evidence of DJD are the stifle (71% of radiographically normal joints) followed by the coxofemoral joint (57%), elbow (57%), and tarsal joint (46%). Our data support radiographic findings not relating well to cartilage degeneration, and that other modalities should be evaluated to aid in making a diagnosis of feline DJD.     

Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994-1997)

OBJECTIVE: To determine prevalence of radiographic evidence of degenerative joint disease (DJD) in geriatric cats. DESIGN: Retrospective study. POPULATION: 100 cats > 12 years of age. PROCEDURE: One investigator reviewed radiographs and for each articulation (or group of articulations) that was visible assigned a grade of severity (0, 1, 2, 3) for DJD. Another investigator reviewed medical records and recorded signalment, environment, previous disease, diseases evident at time of radiography, FeLV vaccination and infection status, feline immunodeficiency virus serologic status, serum creatinine concentration, serum globulin concentration, and any other important findings. Associations between DJD of grade 2 or 3 and variables recorded from the medical record were determined. RESULTS: Radiographic evidence of DJD was evident in 90% of cats. Neurologic disease was associated with lesions in the lumbosacral portion of the vertebral column. Severe lesions were found in 17% of the elbow joints, but an underlying cause was not determined. CONCLUSIONS AND CLINICAL RELEVANCE: Degenerative joint disease was detected radiographically in most geriatric cats and may be an overlooked cause of clinical disease. Clinicians should be alert to the possibility that DJD is associated with neurologic signs.     

Radiographic and clinical survey of degenerative joint disease in the distal tarsal joints in Icelandic horses

The prevalence of degenerative joint disease (DJD) in the distal tarsal joints and the relation between radiographic and clinical signs compatible with the disease were estimated in a population of Icelandic horses used for riding. The material consisted of 614 horses age 6-12 years (mean age = 7.9 years). Radiographs with 3 projections of each tarsus were made and a clinical examination, including palpation of the medial aspect of the distal tarsus and motion evaluation of the hindlimbs before and after a flexion test of the tarsus, was performed. Radiographic signs of DJD in the distal tarsal joints were found in 30.3% of the horses and the prevalence was strongly correlated with age. Hindlimb lameness before and after flexion test and palpation abnormalities were significantly associated with the radiographic findings. The lameness was usually mild and, in most cases, detectable only after the flexion test. The prevalence of lameness was not significantly correlated with age. Lameness could not be predicted by details of the radiographic findings.     

Risk factors associated with hindlimb lameness and degenerative joint disease in the distal tarsus of Icelandic horses

The aim of this study was to evaluate potential risk factors associated with hindlimb lameness and radiographic signs of degenerative joint disease (DJD) in the distal tarsus in Icelandic horses. The material consisted of riding horses (n = 420) age 6-12 years sired by 17 selected sires representing all major breeding lines, and of riding horses (n = 194) in the same age range sired by other sires. The examination protocol included the following: interview with owners/trainers, assessment of conformation, motion evaluation and radiographic examination. At the interview, data related to factors outside the horse (environmental variables) and data associated directly with the horse (intrinsic variables) were obtained. Data analysis was performed in 2 steps: screening using bivariate analysis, followed by testing with a multivariate logistic regression model. In the multivariate analysis, the factors of sire, age when broken to saddle and stud show participation were strongly associated with the prevalence of lameness. Height at the croup and ability to perform different gaits were also associated with the prevalence of lameness, but to a lesser degree. The risk factors of age, tarsal angle and birthplace were significantly associated with radiographic signs of DJD in the distal tarsus. Neither the variation in applied training intensity, the use of a professional or amateur trainer nor the temperament or front limb action of the individual horse was significantly associated with the prevalence of hindlimb lameness and/or radiographic signs of DJD in the distal tarsus in the Icelandic horse.     

Evaluation of a Therapeutic Diet for Feline Degenerative Joint Disease

Background: Feline degenerative joint disease (DJD) is common and there are no approved therapies for the alleviation of the associated pain. Objective: To test a diet high in eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) content and supplemented with green‐lipped mussel extract and glucosamine/chondroitin sulfate (test‐diet) for its pain‐relieving and activity‐enhancing effects in cats with painful, mobility‐impairing DJD over a 9‐week period. Animals: Forty client‐owned cats. Methods: Randomized, controlled, blinded, parallel group, prospective clinical study. Cats with no detectable systemic disease, and with at least 1 appendicular joint with radiographic evidence of DJD where manipulation elicited an aversive response were included. Cats were randomly allocated to the test‐diet or control diet (C‐diet). Outcome measures were subjective owner and veterinarian assessments, and objective activity monitoring (accelerometry). Nonparametric statistics were used to evaluate changes within and between groups for both subjective and objective data, and locally weighted scatterplot smoothing regression analysis was used to predict activity changes. Results: The primary objective outcome measures indicated that activity declined significantly (P < .001) in the C‐diet group, significantly increased (P < .001) in the test‐diet group and there was a significant difference between the groups (P < .001). Conclusion and Clinical Importance: A diet high in EPA and DHA and supplemented with green‐lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility. Dietary modulation might be 1 method to use to improve mobility in cats with DJD‐associated pain.     

Evaluation of a radiographic caudolateral curvilinear osteophyte on the femoral neck and its relationship to degenerative joint disease and distraction index in dogs

OBJECTIVE: To determine prevalence of a radiographic caudolateral curvilinear osteophyte (CCO) on the femoral neck in various breeds and age groups of dogs and to evaluate its contemporaneous relationship with degenerative joint disease (DJD) and distraction index (DI). DESIGN: Cross-sectional prevalence study. ANIMALS: 25,968 dogs, including 3,729 German Shepherd Dogs, 4,545 Golden Retrievers, 6,277 Labrador Retrievers, and 1,191 Rottweilers. PROCEDURE: Data from the University of Pennsylvania Hip Improvement Program database were analyzed, including ventrodorsal hip-extended, compression, and distraction radiographs. The CCO and radiographic signs of DJD were considered independent events and were interpreted as either present or absent. Statistical methods were used to evaluate the CCO as a possible risk factor for DJD and assess its association with DI, as measured by use of distraction radiography. RESULTS: When all breeds were pooled, DJD was detected in 8.6% of dogs, and the CCO was detected in 21.6% of dogs. Among dogs with a CCO, 25.1% had radiographic evidence of DJD. Among dogs without a CCO, only 4% had DJD. Dogs with a CCO were 7.9 times as likely to have DJD as were those without a CCO. Additionally, DI, weight, and age were significant risk factors for the CCO. CONCLUSION AND CLINICAL RELEVANCE: Results confirm the contemporaneous association between the CCO and DJD and that passive hip laxity, as measured by use of the DI, is associated with both the CCO and DJD.     

Meniscal Mineralization in Domestic Cats

Objective: To (1) determine prevalence of radiographically detectable meniscal mineralization in domestic cats and (2) to evaluate the association between meniscal mineralization and degenerative joint disease (DJD). Study Design: Prospective study. Animals: Client‐owned cats (n=100) and 30 feline cadavers. Methods: Randomly selected client‐owned cats were used to determine the prevalence of meniscal mineralization. Stifles from feline cadavers were used to evaluate the relationship between meniscal mineralization (using high‐resolution X‐ray), radiographic DJD, and cartilage damage. Menisci were evaluated histologically. Results: Forty‐six percent of the client‐owned cats had meniscal mineralization detected in 1 or both stifles. Pain scores were not significantly different between stifles with meniscal mineralization and those with no radiographic pathology (P=.38). Thirty‐four of 57 cadaver stifles had meniscal mineralization, which was always located in the cranial horn of the medial meniscus. Percentage mineralization of the menisci was significantly correlated with the cartilage damage score of the medial femoral (r²=0.6; P<.0001) and tibial (r²=0.5; P<.0001) condyles as well as with the total joint cartilage damage (r²=0.36; P<.0001) score and DJD score (r²=0.8; P<.0001). Conclusion: Meniscal mineralization is a common condition in domestic cats and seems to indicate medial compartment DJD. Clinical Relevance: Clinical significance of meniscal mineralization is uncertain. Further work is needed to determine if the meniscal mineralization is a cause, or a consequence of joint degeneration.     

Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats

To assess clinical signs and relevance of osteoarthritis (OA) in cats, the radiographic prevalence of OA in the appendicular skeleton of 100 client-owned cats (?6 years old) was assessed. Possible associations between radiographic OA, clinical locomotor system examination, and owner-perceived behavioural changes were evaluated. OA was most prevalent in the shoulders, elbows, hips and tarsal joints with 61% of cats having OA in at least one joint and 48% in more than one joint. Overall, clinical examination of the larger peripheral joints had the highest sensitivity and specificity for radiographic OA. Regression analysis showed age to be related to OA (P = 0.002), as were decreased mobility and grooming (P = 0.008), although there was a correlation with age. Finally, increased inappropriate elimination was associated with OA (P = 0.046). It was concluded that the prevalence of OA in cats is strikingly high and increases with age. OA in cats seems to be associated with behavioural changes.     

Feline Degenerative Joint Disease

Objective: To critically review and collate published information on feline degenerative joint disease (DJD) and identify areas in which information is lacking.
Study Design: Critical literature review.
Methods: Literature search through Pub Med, Commonwealth Agricultural Bureau Abstracts published in the English Language, or translated into English (January 1940–August 2008).
Results: Although there are no prospective studies, the prevalence of radiographic DJD appears to be high and can be associated with clinical signs of decreased mobility. There appears to be a mismatch between radiographic and clinical examination findings (pain response). There is little information on the cause of DJD in different joints. There are no fully validated subjective or objective assessment systems for the measurement of chronic DJD-associated pain in the cat. Development of a feline model of chronic DJD-associated pain may speed the development and evaluation of candidate pain-alleviating compounds and treatments.
Conclusions: The high prevalence of feline DJD and lack of information about it, suggests further investigation is needed.
Clinical Relevance: Feline DJD occurs with high frequency, and yet there is little to guide the clinician on prevention or treatment.     

Clinical findings and diagnostic value of post-traumatic thoracic radiographs in dogs and cats with blunt trauma

Objective: To characterize the clinical findings in dogs and cats that sustained blunt trauma and to compare clinical respiratory examination results with post‐traumatic thoracic radiography findings. Design: Retrospective clinical study. Setting: University small animal teaching hospital. Animals, interventions and measurements: Case records of 63 dogs and 96 cats presenting with a history of blunt trauma and thoracic radiographs between September 2001 and May 2003 were examined. Clinical signs of respiratory distress (respiratory rate (RR), pulmonary auscultation) and outcome were compared with radiographic signs of blunt trauma. Results: Forty‐nine percent of dogs and 63.5% of cats had radiographic signs attributed to thoracic trauma. Twenty‐two percent of dogs and 28% of cats had normal radiographs. Abnormal auscultation results were significantly associated with radiographic signs of thoracic trauma, radiography score and presence and degree of contusions. Seventy‐two percent of animals with no other injuries showed signs of thoracic trauma on chest radiographs. No correlation was found between the radiographic findings and outcome, whereas the trauma score at presentation was significantly associated with outcome and with signs of chest trauma but not with the radiography score. Conclusion: Thoracic trauma is encountered in many blunt trauma patients. The RR of animals with blunt trauma is not useful in predicting thoracic injury, whereas abnormal chest auscultation results are indicative of chest abnormalities. Thorough chest auscultation is, therefore, mandatory in all trauma animals and might help in the assessment of necessity of chest radiographs.     

Progression of radiographic evidence of osteoarthritis following tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 295 cases (2001-2005)

OBJECTIVE: To determine whether radiographic signs of osteoarthritis became progressively worse and tibial slope angle (TSA) changed substantially following tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs. DESIGN: Retrospective case series. ANIMALS: 295 dogs (373 stifle joints). PROCEDURES: Medical records were reviewed. Radiographs obtained before and 8 weeks after surgery were used to determine the degenerative joint disease (DJD) score, calculated as the sum of individual scores (0 through 3) assigned to 30 radiographic factors. Radiographs obtained immediately and 8 weeks after surgery were used to measureTSA. For dogs that underwent bilateral surgery, data for the first joint treated were used in analyses. Data for the second joint treated in dogs that underwent bilateral surgery were analyzed separately. RESULTS: A small, but significant, increase was found in mean DJD score 8 weeks after surgery, compared with mean preoperative score. An inverse relationship was found between preoperative DJD score and the difference between postoperative and preoperative DJD scores. Mean TSA 8 weeks after surgery was significantly higher than mean TSA immediately after surgery. Analysis of data for the second stifle joints in the 78 dogs that underwent bilateral surgery yielded similar results. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that there was a small, but measurable, increase in the severity of radiographic changes attributed to osteoarthritis in the stifle joints of dogs that underwent tibial plateau leveling osteotomy because of cranial cruciate ligament rupture.     

Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002)

OBJECTIVE: To describe clinical signs and results of treatment in cats with patellar luxation. DESIGN: Retrospective case series. ANIMALS: 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. PROCEDURES: Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. RESULTS: 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.     

Clinical and Radiographic Evaluation of Intertrochanteric Osteotomy in Dogs: A Retrospective Study of 18 Dogs

Objective- To determine whether intertrochanteric osteotomy (ITO) can prevent the progression of degenerative joint disease (DJD) in dysplastic hip joints.
Study Design- The results of ITO were assessed retrospectively by using owner questionnaires, physical examination, and radiographic evaluation.
Animals- Eighteen client-owned dogs (29 coxofemoral joints were evaluated).
Methods- Lameness was scored according to a grading system. A scoring system was also developed to assess radiographically evident osteoarthritis on a ventrodorsal projection of the coxofemoral joints in extension.
Results- Twenty-nine ITO were performed in 18 dogs with varying degrees of hip dysplasia. The dogs were lame on 19 of 29 rear limbs on physical examination before surgery. In 22 of the 29 hip joints, palpation caused signs of pain. The median age at the first and second surgical procedure was 14.5 months and 18 months, respectively. Follow-up evaluation was performed on average at 9.77 (FU I), 22.52 (FU II), and 47.50 months (FU in) after surgery. Based on the owners' evaluation, there was a tendency toward improvement after surgery. The results of the physical examination at the preoperative examination and at the three follow-up examinations did not differ significantly. The follow-up radiographic scores showed significantly worse DJD than the preoperative scores.
Conclusions- ITO does not prevent progression of DJD in the dysplastic hip.
Clinical Relevance- Knowledge of the long-term effects of ITO is essential for surgeons trying to achieve improvement in dogs with hip dysplasia.     

Radiographic and scintigraphic evaluation of spondylosis in the equine thoracolumbar spine: A retrospective study

Reasons for performing study: Clinical, radiographic and scintigraphic signs associated with spondylosis of the equine thoracolumbar spine have been poorly documented. Objectives: To establish an objective radiographic and scintigraphic grading system for spondylosis lesions; to estimate the prevalence of spondylosis in a population of horses with back pain; and to compare the results of radiography and scintigraphy Methods: Radiographic images of the thoracolumbar spine from 670 horses with clinical signs of back pain were graded. Scintigraphic images from horses with spondylosis lesions underwent subjective and objective analysis. Sensitivity and specificity of scintigraphy for detection of spondylosis relative to radiography for identification of spondylosis were calculated, and Chi‐squared analysis was performed to test for an association between location and severity of lesions. Results: Twenty‐three of 670 horses (3.4%) with back pain had radiographic evidence of spondylosis. Of these horses, 14 (61%) had more than one lesion and 44% (n = 22) of lesions occurred between T11‐T13 vertebral bodies. Only 33% (n = 28) of locations with radiographic changes had increased radiopharmaceutical uptake. Conclusion: Spondylosis occurs at a low prevalence in horses with back pain. It may be present alone or in association with other osseous abnormalities. The clinical significance of spondylosis needs further investigation. Potential relevance: Spondylosis is uncommon but may be a contributor to back pain in the horse.     

COMPARISON OF RADIOGRAPHIC AND SCINTIGRAPHIC FINDINGS OF THE SPINOUS PROCESSES IN THE EQUINE THORACOLUMBAR REGION

Back pain is common in horses, but there has been no large‐scale in‐depth study describing radiographic changes of the spinous processes, the relationship between radiographic and scintigraphic findings, and the effect of size, age, breed, or discipline. The objectives were to investigate the frequency of occurrence in horses with perceived back pain of: (1) radiographic alteration of the spinous process structure; (2) increased radiopharmaceutical uptake (IRU) in the spinous processes; and (3) to compare radiographic and scintigraphic findings; and to determine if there was breed, gender, age, bodyweight, height, or work discipline predisposition for close, impinging, or overriding spinous processes. Radiographic and scintigraphic images of the thoracolumbar spine of 604 horses were graded. A radiographic grade for each spinous process (T8–L6) was assigned (0–7). The maximum radiographic grade for each horse was defined as the highest grade assigned to any spinous process; the total radiographic grade was the sum of all grades for each horse. A scintigraphic grade for each spinous process was determined (0–3). The maximum scintigraphic grade for each horse was defined as the highest grade assigned to any spinous process; the total scintigraphic grade was the sum of all grades for each horse. Associations between radiology and scintigraphy and age, gender, breed, height, weight, and discipline were analyzed statistically. The severity of radiographic lesions of the spinous processes was associated with the severity of scintigraphic abnormalities. The caudal thoracic spine (T14–T17) was most frequently affected. There was a significant breed and age effect, with Thoroughbreds and older horses having higher total and maximum radiographic grades. The severity of the lesions of the spinous processes was significantly associated with the presence of osteoarthritis of the articular process joints. It was concluded that there is a wide range of radiographic abnormalities of the spinous processes seen in horses with or without back pain. There is an association between radiographic and scintigraphic grades of the spinous processes.     

Intraaticular treatment of tarsal degenerative joint disease in cattle.

Tarsal degenerative joint disease (DJD) in 12 cattle was classified as primary or secondary, based on age, evidence of hereditary or congenital joint conformation defects, faulty hindlimb alignment, duration and type of usage joints were subjected to, and history or signs of repeated trauma. Three of the cattle had bilateral primary tarsal DJD, 7 had bilateral secondary tarsal DJD, and 2 had secondary DJD of the left tarsus. Analyses of synovial fluid samples provided a means of characterizing pathologic changes of tarsal DJD, Results of blood and synovial fluid analyses were grouped in compilation of data for cattle affected with either primary or secondary tarsal DJD. Corticosteroids and a long-acting synthetic progestational agent were injected singly or in combination with aqueous antibiotics into affected tarsal joints. Tarsal joints of 5 of the cattle responded favorably to a single intraarticular treatment, as manifested by palliative relief and functionally usable joints. Seven joints of 5 cattle were subjected to repeated intraarticular treatment. Serial synovial fluid analyses in 7 of the cattle provided a means of assessing tarsal joint response to intraarticular treatment or to therapeutic arthrocentesis, exclusive of patient objective response. One cow developed a mild self-limiting bilateral postinjection synovitis that was resolved after the 2nd and final intraarticular injection. Usable function returned to tarsal joints of cattle that responded favorably to intraarticular treatment at different periods after single or repeated injections. Three cattle with advanced tarsal DJD experienced minor temporary relief and were euthanatized at their owner's request. Improvement did not occur in the tarsal joint of 1 cow subjected to therapeutic aspiration only. Intraarticular treatment in all cattle was considered supportive to the animal's well-being rather than curative.     

Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in German Shepherd Dogs, Golden Retrievers, Labrador Retrievers, and Rottweilers.

OBJECTIVE: To determine whether age, breed, sex, weight, or distraction index (DI) was associated with the risk that dogs of 4 common breeds (German Shepherd Dog, Golden Retriever, Labrador Retriever, Rottweiler) would have radiographic evidence of degenerative joint disease (DJD) associated with hip dysplasia. DESIGN: Cross-sectional prevalence study. ANIMALS: 15,742 dogs. PROCEDURE: Hips of dogs were evaluated radiographically by use of the ventrodorsal hip-extended view, the compression v ew, and the distraction view. The ventrodorsal hip-extended view was examined to determine whether dogs had DJD. For each breed, a multiple logistic regression model incorporating age, sex, weight, and DI was created. For each breed, disease-susceptibility curves were produced, using all dogs, regardless of age, and dogs grouped on the basis of age. RESULTS: Weight and DI were significant risk factors for DJD in all breeds. For German Shepherd Dogs, the risk of having DJD was 4.95 times the risk for dogs of the other 3 breeds combined. In all breeds, the probability of having DJD increased with age. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the probability of having hip DJD increased with hip joint laxity as measured by use of DI. This association was breed-specific, indicating that breed-specific information on disease susceptibility should be incorporated when making breeding decisions and when deciding on possible surgical treatment of hip dysplasia.     

Absolute and relative cell counts for synovial fluid from clinically normal shoulder and stifle joints in cats

OBJECTIVE: To determine absolute and relative cell counts for synovial fluid from grossly, radiographically, and histologically normal shoulder and stifle joints in healthy cats. DESIGN: Clinical study. ANIMALS: 52 cats scheduled to be euthanatized for unrelated reasons. PROCEDURE: Arthrocentesis of the shoulder and stifle joints was performed bilaterally, and synovial fluid was analyzed for absolute WBC count, WBC morphology, and percentages of neutrophils and mononuclear cells. Joints were examined grossly and radiographically, and synovial membrane specimens were submitted for histologic examination. Synovial fluid samples that were contaminated with blood and samples from joints with any gross, radiographic, or histologic abnormalities were excluded. RESULTS: 82 of the 208 synovial fluid samples were excluded because abnormalities were identified during physical examination; the volume of fluid obtained was insufficient for analysis; there was evidence of blood contamination; or the joint had gross, radiographic, or histologic abnormalities. Median WBC count for the remaining 126 synovial fluid samples was 91 cells/microL (96.4% mononuclear cells and 3.6% neutrophils); WBC count was not significantly different between left and right joint samples or between shoulder and stifle joint samples. Body weight was associated with synovial fluid WBC count, with WBC count increasing as body weight increased. Sixteen of the 52 (30%) cats had radiographic evidence of osteoarthritis involving at least 1 joint. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that synovial fluid can be obtained reliably from shoulder and stifle joints in cats.     

Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats with degenerative joint disease

Medical records (2005-2009) of a feline-only practice were searched for cats with degenerative joint disease (DJD) treated using meloxicam. DJD was diagnosed by the presence of at least two of the following: (i) altered mobility (observed by the owner), (ii) abnormal physical findings, (iii) characteristic radiographic changes. The primary study cohort consisted of cats older than 7 years that had received meloxicam for variable intervals in excess of 6 months, and for which complete records were available. These cats were subdivided according to whether detectable chronic kidney disease (CKD) was present ('renal group'), or not ('non-renal group'), and, for the 'renal group', according to the cat's IRIS category. Serum biochemistry, urinalysis (including urine specific gravity [USG]), body mass and condition score were monitored regularly. Progression of CKD in the 'renal group' and 'non-renal group' of cats was compared to two groups of age- and IRIS-matched control cats not receiving meloxicam (from the same clinic, over the same time period). The study was thus a case-control design, with two study groups. Thirty-eight cats with DJD receiving long-term meloxicam therapy met the inclusion criteria. Of these, 22 cats had stable CKD at the start of treatment (stage 1, eight cats; stage 2, 13 cats; stage 3, one cat). No cats initially had an elevated urinary protein to creatinine ratio. The remaining 16 cats initially had normal renal analytes and adequately concentrated urine. The median age of the 'renal' and 'non-renal' meloxicam groups was 15.5 and 13.4 years, respectively. The median treatment duration was 467 days in the 'renal group' and 327 days in the 'non-renal group'. After titration (to the lowest effective dose), the median maintenance dose was 0.02 mg/kg/day in both groups (range 0.015-0.033 mg/kg/day). There was no difference in sequential serum creatinine concentration or USG measurements between the 'non-renal group' treated with meloxicam compared to control cats not treated with meloxicam. There was less progression of renal disease in the 'renal group' treated with meloxicam compared to the age- and IRIS-matched cats with CKD not given meloxicam. These results suggest that a long-term maintenance dose of 0.02 mg/kg of meloxicam can be safely administered to cats older than 7 years even if they have CKD, provided their overall clinical status is stable. Long-term meloxicam therapy may slow the progression of renal disease in some cats suffering from both CKD and DJD. Prospective studies are required to confirm these findings.     

Relationships between results of the Ortolani method of hip joint palpation and distraction index, Norberg angle, and hip score in dogs

OBJECTIVE: To determine whether results of the Ortolani method of hip joint palpation in dogs were related to distraction index (DI), Norberg angle, or radiographic hip score. DESIGN: Cross-sectional study. ANIMALS: 459 clinically normal dogs. PROCEDURE: Dogs were sedated for radiography and palpation of the hip joints. Results of hip joint palpation were classified as negative, mild positive, moderate positive, or severe positive. Distraction indices were measured for all dogs. Norberg angles were measured for 380 dogs for which ventrodorsal hip-extended radiographic projections were available. Hip scores assigned by the Orthopedic Foundation for Animals (OFA) were available for 95 dogs. RESULTS: Age, weight, and sex were not significantly associated with results of hip joint palpation. There was moderate correlation between results of hip joint palpation and DI (r = 0.636), low-moderate correlation between results of hip joint palpation and OFA hip scores (rs = 0.437), and weak negative correlation (r = -0.236) between results of hip joint palpation and Norberg angle. For joints without degenerative joint disease (DJD), there was a significant linear relationship between results of hip palpation and DI; however, for joint with DJD, there was not. Results of hip joint palpation were 5.3-fold as likely to be negative for dogs with DJD as for dogs without. CLINICAL IMPLICATIONS: Results of hip joint palpation were at best moderately correlated with radiographic measures of hip joint laxity. Therefore, hip joint palpation should be combined with hip-extended and stress radiography when assessing hip joint quality.