Collagen fragmentation in ruptured canine cranial cruciate ligament explants

Collagen fragmentation in cranial cruciate ligament (CCL) explants and stifle synovial fluid was investigated in dogs with ruptured and intact CCL. Cathepsin K and tartrate-resistant acid phosphatase (TRAP) activities were determined in CCL explant supernatants. Formation of collagen fragments was determined in explant supernatants and stifle synovial fluid. Cathepsin K(+) and TRAP(+) cells were stained specifically in histological sections of CCL. Formation of telopeptide collagen fragments was increased in ruptured CCL explants and stifle synovial fluid from dogs with ruptured CCL. In ruptured CCL explants, release of collagen fragments was associated with extracellular release of TRAP and the presence of cathepsin K(+) cells within CCL tissue. Cathepsin K(+) and TRAP(+) cells were only seen in ruptured CCL. It was concluded that infiltration of the CCL with TRAP(+) cells in dogs with CCL rupture is associated with increased collagenolysis. It is hypothesized that recruitment and activation of TRAP(+) mononuclear cells within the synovium and CCL precipitates CCL rupture through upregulation of collagenolytic enzymes and collagen degradation.

Scleral rupture in dogs, cats, and horses

OBJECTIVES

The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes.

RESULTS

In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% presented eyelid and conjunctival swelling, 67% hyphema, subconjunctival hemorrhage, and collapsed anterior chamber. Ultrasonographic findings were an area with ill-defined scleral margins (90%), echoic/hyperechoic contents in the anterior and posterior chamber (55%) and in the vitreous (80%). In small animals, scleral rupture location noted on gross examination was: at the posterior pole (4), close to the optic nerve (3), near the limbus (2), and in the dorsal aspect of the globe (1). In horses, the lesion was located at the limbus (3). In small animals, histopathology showed presence of hemorrhage in the anterior, posterior chamber, and vitreous (94%), retinal detachment (94%), choroidal edema and hemorrhages (88%), and choroidal detachment as a result of suprachoroidal hemorrhage (88%). The same lesions were found in the globes of two horses. In small animals, rupture location noted on histopathology was: at the posterior pole (8), close to the optic nerve (4), near the limbus (1), near the ciliary body (1).

CONCLUSIONS

The most frequent clinical signs observed were hyphema, subconjunctival hemorrhage, and eyelid and conjunctival swelling. Ultrasonographic findings suggestive for scleral rupture were ill-defined scleral borders and/or echoic/hyperechoic material in the cavities of the globe. On histopathology, lesions severely altering the anatomy of the eye structures were: hemorrhage into the chambers of the globe, subretinal and suprachoroidal hemorrhage leading to retinal and choroidal detachment, respectively. In small animals, the most frequent locations for scleral rupture were the posterior pole and close to the optic nerve, whereas in horses it was the limbus.

Morphometric assessment of the proximal portion of the tibia in dogs with and without cranial cruciate ligament rupture

Based on the clinical observation that dogs with a steep tibial plateau slope had variable tibial morphology, we hypothesized that these dogs could be further characterized using measurements developed by examining computer generated models of specific proximal tibial malformations. A 3D tibial model was created from a normal canine tibia. The model was manipulated to reproduce two specific proximal tibial anomalies representing deformities originating from the tibial plateau or the proximal tibial shaft. Data from these models were used to create specific measurements that would characterize the shape of these anomalies. These measurements included the diaphyseal tibial axis (DTA)/proximal tibial axis (PTA) angle, which defined the orientation of the proximal portion of the shaft in relation to the tibial mid-shaft. These measurements were then made on radiographs of dogs with and without cranial cruciate ligament (CCL) rupture. Models with tibial plateau and proximal shaft deformities had a steep tibial plateau slope (TPS). Models with proximal shaft deformity had a markedly increased DTA/PTA angle. The model with a 10 degree proximal shaft deformity had a DTA/PTA angle of 11.23 degrees. Six dogs (9.0%) had a DTA/PTA angle larger than 11.23 degrees (range, 11.4-13.9 degrees). Dogs in this group had ruptured CCL and a steep TPS. Dogs with CCL rupture had higher TPS (mean, 31.8 +/- 4.1 degrees) and DTA/PTA angle (mean, 6.0 +/- 3.3 degrees) than dogs without CCL rupture (means, 23.6 +/- 3.4 degrees and 4.1 +/- 2.2 degrees, respectively). Dogs with proximal shaft deformity represented a distinct group, which could not be identified using the magnitude of the TPS alone. Characterizing more precisely the shape of the proximal portion of the tibia in dogs contributes to our understanding of the pathogenesis of steep TPS and may facilitate the optimization of the surgical management of dogs with CCL rupture.

Inheritance of rupture of the cranial cruciate ligament in Newfoundlands

OBJECTIVE

To determine prevalence, level of inbreeding, heritability, and mode of inheritance for rupture of the cranial cruciate ligament (RCCL) in Newfoundlands.

DESIGN

Retrospective and recruitment study.

ANIMALS

574 client-owned Newfoundlands.

PROCEDURE

Medical records from January 1, 1996, to December 31, 2002, were evaluated for prevalence of RCCL. A pedigree was constructed by use of recruited Newfoundlands with RCCL status based on results of veterinary examination; level of inbreeding, heritability, and mode of inheritance were calculated.

RESULTS

Hospital prevalence for RCCL was 22%; dogs in the pedigree from the recruitment study had a mean level of inbreeding of 1.19 x 10(4), heritability of 0.27, and a possible recessive mode of inheritance with 51% penetrance for RCCL.

CONCLUSIONS AND CLINICAL RELEVANCE

Identification of a genetic basis for RCCL in Newfoundlands provided evidence that investigators can now focus on developing methods to identify carriers to reduce the prevalence of RCCL.

Prognostic Factors for Successful Outcome Following Urethral Rupture in Dogs and Cats

Twenty dogs and 29 cats were identified with urethral rupture. Males predominated in both groups. The most common cause of urethral rupture in dogs was vehicular trauma, and in cats it was trauma associated with urethral obstruction and catheterization. Clinicopathological findings, type of surgical correction, time to surgery, type of urinary diversion, and duration of urinary diversion were not statistically associated with the outcome. In this study, the presence of multiple traumatic injuries was associated with a poor outcome.

RADIOGRAPHIC AND ULTRASONOGRAPHIC EVALUATION OF THE PATELLAR LIGAMENT FOLLOWING TIBIAL PLATEAU LEVELING OSTEOTOMY

Objective evaluation of patellar ligament changes following tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament injury has not been published to date. In this study, the patellar ligament was evaluated using radiographs and high-resolution ultrasound in 31 stifles (29 dogs) preoperatively and at 1 month (n=31), 2 months (n=18), and 6 months (n=13) postTPLO. A ratio of the thickness of the proximal to distal patellar ligament was determined for all radiographs evaluated. Ultrasound evaluation included proximal, middle, and distal mid-sagittal thickness and transverse thickness, and transverse area measurements. Subjective grading (0 being normal through a scale of 3) of the ultrasound changes was also performed at each evaluation. Significant thickening of the distal patellar ligament was noted postoperatively as evidenced by thickness and area measurements and a decreased radiographic ratio (P < 0.01). Preoperative patellar ligament thickness and area were similar at the proximal, middle and distal sites. Ultrasound-derived thickness and area measurements of the distal patellar ligament were increased at 1 and 2 months (P < 0.01). The radiographic ratio was significantly decreased at 1, 2 and 6 months (P < 0.01). Subjectively, all patellar ligaments scored a 0 preoperatively and 16/31 received a score of 2 or 3 during follow-up evaluation. Additionally, these dogs had ultrasonographic and radiographic changes consistent with distal patellar ligament thickening. Body weight (kg) and postoperative TPLO angle had a significant influence on 1-month postoperative distal patellar ligament area using a stepwise logistic model (P < 0.05). Patellar ligament desmitis is a common postoperative sequela to the TPLO procedure, however its clinical significance (i.e., correlation with a residual lameness) was not evaluated in this study.

Rupture of the biceps brachii tendon sheath in two dogs

Rupture of the biceps brachii tendon sheath was diagnosed in two dogs which were presented with chronic thoracic limb lameness. In each case, diagnosis was achieved by positive contrast arthrography, which revealed obvious leakage of contrast agent from the distal portion of the tendon sheath. Arthroscopy was performed in each affected shoulder joint and no other significant lesions were found. In one dog, concomitant bicipital tendinopathy was confirmed by histopathology. Both dogs were treated by bicipital tendon transposition, and tenodesis and both showed improvement in the degree of lameness following surgery. Tearing of the biceps brachii tendon sheath has not been reported previously but should be included in the differential diagnosis for shoulder lameness in the adult dog.

Análise biomecânica do joelho íntegro e com ruptura do ligamento cruzado cranial quanto ao grau de deslocamento cranial e rigidez articular em cães

OBJETIVO: Avaliar a função biomecânica da articulação do joelho de cães, comparando a medida de deslocamento cranial e a rigidez articular da tíbia em relação ao fêmur em articulações íntegras e com ruptura de ligamento cruzado cranial. MÉTODOS: Para realização do experimento foram utilizados 10 animas da espécie canina, com peso acima de 20 quilos. Avaliou-se biomecanicamente o grau de deslocamento da articulação do joelho com o ligamento cruzado cranial íntegro e seccionado cirurgicamente. Utilizou-se a máquina Kratos 5002, que permite gravar em tempo real os parâmetros força (N) e deslocamento/deformação em mm. O ensaio consitiu em aplicar uma força de (N) registrando assim a gaveta cranial. RESULTADOS: Para o joelho íntegro, a média de deslocamento em milímetros encontrada para três repetições subseqüentes e estatisticamente diferentes entre si foram de 3,39 ; 3,47; 3,53. Para o joelho lesado foram de 12,96; 13,24; 13,34. A análise estatística revelou diferença significante entre os dados do grupo íntegro e lesado, tanto para deslocamento quanto para rigidez (p<0,05) CONCLUSÃO: Este estudo permite-nos concluir que a translação cranial é acrescida em quatro vezes e a rigidez articular é diminuída em uma vez e meia quando comparados.

Comparison of perioperative analgesic protocols for dogs undergoing tibial plateau leveling osteotomy

OBJECTIVE

To compare effects of 3 commonly used perioperative analgesic protocols (epidural injection, intra-articular injection, and intravenous [IV] injection) for management of postoperative pain in dogs after tibial plateau leveling osteotomy (TPLO).

STUDY DESIGN

Prospective, randomized clinical trial.

ANIMALS

Fifty-six healthy dogs with naturally occurring cranial cruciate ligament rupture.

METHODS

Dogs were premedicated with IV hydromorphone and acepromazine and were randomly assigned to receive either E (preoperative epidural injection with morphine and bupivacaine), IA (pre- and postoperative intra-articular injections of bupivacaine), or C (neither epidural morphine and bupivacaine, nor intra-articular bupivacaine). All dogs were administered hydromorphone (0.05 mg/kg IV) at extubation and as needed to maintain comfort postoperatively. Patients were observed and monitored continuously for 24 hours and discomfort was assessed using visual analog pain scores (VASs), multifactorial pain scores (MPSs), and response to a pressure nociceptive threshold (PNT) measuring device. Time to 1st dose and the total doses of hydromorphone required to achieve adequate comfort for each dog were recorded.

RESULTS

No differences in measured indices of postoperative pain were observed between dogs of each treatment group; VAS (P=.190), MPS (P=.371), and PNT (P=.160). Time to 1st analgesic intervention was longer for Group E compared with Group C (P=.005) and longer for Group IA compared with Group C (P=.032). Although time to 1st intervention between Groups E and IA were longer for Group E, differences were not significant. To provide an adequate level of comfort, more analgesic interventions were administered to dogs in Group C compared with dogs in group E (P=.015). On average, more hydromorphone was administered to Group C compared with Group IA (P=.072) and to Group IA compared with Group E (P=.168), but statistical significance was not reached for these data.

CONCLUSIONS

In this study population, significant differences were seen in time to 1st hydromorphone dose between Groups E and IA compared with Group C. As well, more supplemental analgesia was administered to Group C compared with Group E to maintain the same level of postoperative comfort. Although differences between Groups E and IA tended to favor the epidural group, differences were minimal and not statistically significant.

CLINICAL RELEVANCE

Our results suggest that regardless of analgesic protocol, measured indices of pain in dogs after TPLO can be minimized if dogs are continuously observed and appropriately supplemented with parenteral opioids. However, the frequency of postoperative opioid dosing can be minimized and may be a factor when contemplating supplementary use of epidural or intra-articular injections as part of a balanced analgesic approach.

Surgery plus chondroprotection for canine cranial cruciate ligament (CCL) rupture: a proton-NMR study

Rupture of the cranial cruciate ligament (CCL) is one of the most frequent causes of lameness of the rear limb in the dog. Regardless of the type of treatment, CCL rupture inevitably leads to knee osteoarthritis (OA). The purpose of this study was to evaluate the efficacy of associating surgical treatment of spontaneous rupture of the CCL with a chondroprotector, that is called 'supraadditive' because it is formulated to counteract not only chondrodegeneration, but also the oxidative and inflammatory processes of OA. The open-label controlled study used proton NMR spectroscopy to evaluate the synovial fluid of the stifle of 10 dogs with monolateral rupture of the CCL, selected for the study based on specific inclusive criteria. The dogs were assigned randomly into two groups. Five dogs received the supra-additive chondroprotector for 60 days, starting on the day after surgery. Five dogs only underwent surgical reconstruction of the CCL. The results were analysed with the ANOVA unstructured variance matrix-covariance test. The trend over time of the synovial concentration of four metabolites (lactate, alanine, acetyl groups of N-acetylated sugars on glycoproteins and alpha-anomers of glucose) was found to differ to a statistically significant extent between the two groups, suggesting that the supra-additive chondroprotector produces an intra-articular metabolic rebalance. The results support the adjuvant use of the chondroprotector in the management of CCL rupture, in view of its control of the OA changes that accompany this orthopaedic disabling condition.

Fibrotic contracture of the canine infraspinatus muscle: pathophysiology and prevention by early surgical intervention

Fibrotic contracture of the canine infraspinatus muscle (FCIM) is considered a rare musculotendineous disorder mainly affecting hunting dogs. After an acute onset of a painful non-weight bearing lameness, the initial pain and lameness improve over a period of one to four weeks, after which a characteristic circumducted gait abnormality develops in the forelimb. The initial injury to the infraspinatus muscle is not fully recognized or correctly interpreted in most cases, at least not with regard to its potential as a precursor of myopathy and FCIM. A mixed breed hunting dog developed an acute and extremely painful swelling of the infraspinatus muscle. The injury was easily recognized during clinical examination. The clinical signs were interpreted as an osteo-fascial compartment syndrome (OFCS) of the infraspinatus muscle. Immediate surgical decompression of the osteo-fascial compartment to prevent development of FCIM was undertaken. The histopathological and immunohistochemical examinations of the injured infrapinatus muscle revealed tissue changes that indicated acute muscle rupture, without any signs of an initiating degenerative process. On the day following surgery the dog was fully weight bearing. Restriction of activity for four weeks was recommended. Eight months after the initial injury, the dog had completely recovered and had full days of vigorous exercise and hunting activity without any apparent lameness. The findings in this case suggested that the infraspinatus muscle may be considered to be an osteo-fascial compartment in dogs and must be added to the list of compartments that may pose a potential risk for OFCS in the canine extremity.

In Vitro Comparison of Two Techniques for Suture Prosthesis Placement in the Muscular Process of the Equine Arytenoid Cartilage

OBJECTIVE

To compare in vitro the load necessary for a partial and complete rupture of the muscular process arytenoid cartilage when a suture prosthesis is positioned by a bone trocar versus a trocar point needle and to compare failure mode.

STUDY DESIGN

Experimental using cadaver specimens.

SAMPLE POPULATION

Larynges from 18 Thoroughbred race horses, aged 2-20 years.

METHODS

Arytenoid cartilages were separated randomly into 2 groups: group 1-suture prosthesis inserted directly through the muscular process using a curved trocar point needle and group 2-suture passed through a hole predrilled with a 3 mm bone trocar. Distracting force (constant rate, 1 mm/s) was applied to the suture until failure of the muscular process. Partial failure load, maximum load at complete failure, and force-time curve were recorded. Each arytenoid cartilage was examined, radiographed, and classified as having a linear or curved failure plane.

RESULTS

No significant differences in mechanical test variables were detected. Failure mode followed the fissures occurring at the beginning of failure and then followed the tension axis. Significantly more linear failures occurred in group 2 (trocar) and more curved failures occurred in group 1 (needle).

CONCLUSION

Use of a bone trocar for tunneling through the muscular process may reduce fissure formation.

CLINICAL RELEVANCE

Use of bone trocar to create a hole in the muscular process of the arytenoid cartilage for suture passage in laryngoplasty may reduce fissure formation and decrease the risk of cartilage failure from suture pullout.

Outcome following surgical repair of achilles tendon rupture and comparison between postoperative tibiotarsal immobilization methods in dogs: 28 cases (1997-2004)

Surgical treatment of Achilles tendon rupture in dogs is generally associated with a favourable outcome, although the recovery time to best function is relatively long at 20.2 weeks. Dogs with injuries of less than 21 days duration may have a better functional outcome. When comparing external fixator application to splint or cast management, initial tibiotarsal immobilization method does not significantly affect the complication rate, duration of immobilization, recovery time, or functional outcome.

Complications Associated With 696 Tibial Plateau Leveling Osteotomies (2001–2003)

A total of 696 tibial plateau leveling osteotomy (TPLO) procedures were performed over a 30-month period following TPLO training. The overall complication rate was 18.8%.

Complications were classified as perioperative (1%), short-term (9.3%), and long-term (8.5%). Examples of complications encountered during the study were hemorrhage, swelling at the incision site, premature staple removal by the dog, tibial tuberosity fracture, patella tendon swelling, and implant complications. Based on the rate of complications observed, clinical outcomes of TPLO procedures within 30 months of TPLO training were considered good.

Ultrastructural Differences in Cranial Cruciate Ligaments from Dogs of Two Breeds with a Differing Predisposition to Ligament Degeneration and Rupture

Cranial (anterior) cruciate ligament (CCL) samples were obtained from dogs of the Labrador retriever (LR) and greyhound (GH) breeds, of which the former but not the latter is predisposed to CCL rupture. Electron microscopy revealed that the collagen fibril diameters of GHs were larger than those of LRs (P=0.03). Histological examination revealed a "fibrocartilaginous" appearance of CCLs in seven of eight GHs, and, to a lesser extent, in three of eight LRs. The formation of fibrocartilage is clearly not a disadvantage to the healthy racing GH, and cannot be regarded as a pathological degeneration in this breed. It is suggested that fibrocartilage is formed as a beneficial physiological adaptation to the compression of CCLs caused by tensile stress as a result of the tightening of two twisted bands. Fibrocartilage would appear to protect CCLs in the GH, but it may be indicative of a mild degenerative change, which may eventually lead to rupture in the LR.

Rupture of the gastrocnemius muscle in six foals

Rupture of the gastrocnemius muscle and subsequent disruption of the reciprocal mechanism of the hind limb was diagnosed in 6 foals examined at 7 hours to 3 weeks of age. In 2 foals, the musculoskeletal injury was detected as an ancillary finding to clinical signs of neurologic dysfunction ascribed to hypoxic ischemic insult during delivery, whereas in the other 4 foals, musculoskeletal injury, manifested as inability to rise or stand unsupported, was the chief complaint at admission. Five foals had a history of dystocia and assisted delivery. Common clinical signs were inability to rise, disruption of the reciprocal mechanism, swelling in the caudal aspect of the thigh, instability of the stifle joint, and stifle joint effusion. For mild gastrocnemius injury, exercise restriction via forced recumbency, with minimal or no bandaging, may be sufficient treatment. For more severe disruption of the muscle, limb stabilization via splinting and intensive nursing and monitoring are necessary. Four foals had important concurrent problems, including musculoskeletal deformations (joint contractures), hypoxic ischemic disease, and failure of passive transfer and associated problems (ie, sepsis, polyarthritis, and pneumonia). Moderate to severe gastrocnemius muscle injury is difficult to treat successfully, and the long-term prognosis for athletic function should be regarded as guarded.

Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States

OBJECTIVE

To estimate the economic impact to veterinary clients for the medical and surgical treatment of rupture of the cranial cruciate ligament (RCCL) in dogs for the year 2003.

DESIGN

Economic impact survey.

SAMPLE POPULATION

501 diplomates of the American College of Veterinary Surgeons (ACVS) indicating that their area of surgical emphasis was small animal orthopedic surgery or small animal general and orthopedic surgery and 4,000 veterinarians indicating to the AVMA that their professional area was small animal practice exclusive or mixed animal practice (at least 80% small animal).

PROCEDURE

Veterinarians were surveyed concerning the cost for medical and surgical treatment of RCCL for 2003. The economic impact was calculated by multiplying the number of RCCL surgeries performed by the mean cost of surgery. This was added to the number of RCCL cases managed medically multiplied by the mean cost of medical management. This estimate for survey responders was extrapolated to the total number of veterinarians in the study population for the ACVS or AVMA.

RESULTS

Estimates for the total cost of surgery were $171,730,134.72 and $1,020,167,907 for veterinarians in the ACVS and AVMA populations, respectively. The cost of medical management was $2,885,687.86 and $126,558,155.16 for veterinarians in the ACVS and AVMA populations, respectively. After combining the ACVS and AVMA populations, we estimated that owners spent $1.32 billion for the treatment of RCCL in the United States in 2003.

CONCLUSIONS AND CLINICAL RELEVANCE

RCCL is a prevalent, costly injury. Results may motivate veterinary and consumer agencies to prioritize funding for a better understanding of the injury.

Prevalence of cranial cruciate ligament rupture in a population of dogs with lameness previously attributed to hip dysplasia: 369 cases (1994-2003)

OBJECTIVE

To determine the prevalence of cranial cruciate ligament rupture (CCLR) in dogs with lameness previously attributed to canine hip dysplasia (CHD).

DESIGN

Retrospective study.

ANIMALS

369 client-owned dogs.

PROCEDURES

Hospital medical records from 1994 to 2003 were reviewed for dogs in which the referring veterinarian had diagnosed hip dysplasia or hip pain. Dogs were designated as having hind limb lameness because of partial or complete CCLR or CHD.

RESULTS

8% of dogs were sexually intact females, 43% were spayed females, 14% were sexually intact males, and 35% were castrated males. Mean age was 3.8 years (range, 3 months to 15 years). The most common breeds were the Labrador Retriever (21%), German Shepherd Dog (13%), and Golden Retriever (11%). The prevalence of CCLR as the cause of hind limb lameness was 32% (95% confidence interval, 27.2% to 36.8%). The distribution of CCLR among hind limbs was left (29%), right (28%), and bilateral (43%). Of 119 dogs with CCLR, 94% had concurrent radiographic signs of CHD, 92% had stifle joint effusion, and 81% had a cranial drawer sign.

CONCLUSIONS AND CLINICAL RELEVANCE

On the basis of the high prevalence of CCLR in dogs referred for lameness because of CHD, it is important to exclude other sources of stifle joint disease before making recommendations for treatment of CHD.

Comparison of two laparoscopic suture patterns for repair of experimentally ruptured urinary bladders in normal neonatal calves

OBJECTIVE

To compare 2 laparoscopic suture patterns for repair of experimentally ruptured urinary bladders in normal neonatal calves.

STUDY DESIGN

Experimental surgical study.

ANIMALS

Thirty male Holstein calves.

METHODS

A bladder defect was created in 24 anesthetized calves (day 0). They were randomly divided into 4 groups (n=6/group). In groups 1 and 3, the defect was closed laparoscopically using a one layer full thickness simple continuous (FTSC) suture pattern (pattern A). In groups 2 and 4, the defect was closed laparoscopically in 2 layers using a FTSC suture pattern followed by Lembert continuous suture pattern (pattern B). Groups 1 and 2 calves were euthanatized at the end of the surgery and groups 3 and 4 at day 10. Six healthy calves were also euthanatized and used as a control group. The bladders were harvested and tested for bursting strength (BS). The surgical time (ST) data from the two groups for each pattern were pooled. A Student t-test was used to compare ST data. For the BS data, a 2-factor ANOVA test with post-hoc Student t-test was used to determine if treatment, time, or treatment-time interaction was significant. A Dunnett's test was used to compare BS of the 4 treatment groups to the control group. P<.05 was considered significant.

RESULTS

Mean ST was significantly shorter for pattern A than for pattern B. In all treatment groups, the mean bladder BS (MBBS) was significantly lower than the MBBS for the control group. The MBBS was significantly lower for group 1 than for group 2. There was no significant difference in the MBBS between groups 3 and 4.

CONCLUSION

In this study, a 1-layer laparoscopic closure technique had advantages compared with 2-layer laparoscopic closure technique. Further work is required before a 1-layer laparoscopic closure technique can be recommended clinically.

CLINICAL RELEVANCE

One-layer bladder closure is fast and safe in clinically normal calves and permits additional research to evaluate its safety in foals and clinical ruptures.

Rupture of the peroneus tertius tendon in 27 horses

The purpose of the study was to identify factors influencing the outcome and prognosis of rupture of the tendon of the peroneus tertius muscle in 27 horses. Information on history, physical examination findings, diagnosis, treatment, and final outcome was summarized from medical records. Long-term follow-up information on horses was obtained by telephone survey. A stepwise logistic regression model was used to analyze factors influencing the outcome. Rupture occurred in the midbody of the tendon in 11 horses, at the insertion site in 11 horses, and at the origin in 2 horses. Overall, 18/23 (78.3%) horses returned to their previous level of exercise, 5/23 (21.7%) horses were euthanized due to persistent lameness. If the horse was racing at the time of injury or had an additional structure injured besides the peroneus tertius tendon, it was less likely to return to its intended use.

COMMINUTED FRACTURE OF THE DISTAL SESAMOID BONE AND DISTAL RUPTURE OF THE DEEP DIGITAL FLEXOR TENDON

A 10-year-old show jumper was evaluated for an acute severe lameness (grade 4 of 5) of the right foreleg. During weight bearing, the toe of the affected limb rotated dorsally suggesting rupture of the deep digital flexor tendon (DDFT). Upon radiographic examination of the hoof, a severe erosion at the flexor surface and a parasagittal fracture of the distal sesamoid bone were found. Ultrasonographic examination confirmed rupture of the DDFT. These findings were confirmed on post-mortem examination. Prior to the acute lameness, the horse was treated with corticosteroid injections into the podotrochlear bursa. Repeated intra-bursal injections of corticosteroids as a possible cause for DDFT rupture are discussed as well as the possible association between a degenerative distal sesamoid bone, a distal sesamoid bone fracture and a DDFT rupture.

Localization of Cathepsin K and Tartrate-Resistant Acid Phosphatase in Synovium and Cranial Cruciate Ligament in Dogs with Cruciate Disease

OBJECTIVE

To localize cathepsin K and tartrate-resistant acid phosphatase (TRAP) in synovium and cranial cruciate ligament (CCL) of dogs with cruciate disease.

ANIMALS

Dogs (n=15) with cruciate disease and ruptured CCL, and 12 dogs with intact CCL.

METHODS

Synovium and CCL were examined histologically and cells containing cathepsin K or TRAP were identified immunohistochemically and histochemically, respectively.

RESULTS

Increased cellular localization of cathepsin K and TRAP was detected in synovium and ruptured CCL in dogs with cruciate disease, when compared with tissues from dogs with intact CCL. Inflammation of synovium with TRAP+ macrophage-like cells was seen in 73% of dogs with CCL disease, but was not seen in dogs with intact CCL. The presence of cathepsin K and TRAP protein in synovium and CCL tissues was significantly correlated in dogs with CCL rupture.

CONCLUSION

Inflammation of the epiligament of ruptured CCL with cathepsin K+ and TRAP+ macrophage-like cells forms part of a similar, more generalized chronic inflammatory change within the periarticular tissues of the stifle of a large proportion of dogs with CCL rupture.

CLINICAL RELEVANCE

Production of matrix-degrading enzymes by the synovium may induce progressive pathologic rupture of the CCL. Therefore, these collagenolytic pathways may offer a novel target for medical therapy of joint inflammation in canine patients with cruciate disease.

Ultrasonographic evaluation of cranial cruciate ligament rupture via dynamic intra-articular saline injection

Ultrasonographic examination of both stifle joints of five clinically and radiographically normal adult dogs was performed before and after surgical transection of the cranial cruciate ligament (CrCL). At pre- and postsurgery, the hyperechoic patellar ligament and the infrapatellar fat interfered with sonographic visualization of the CrCL. When the stifle joint, however, was imaged via dynamic intra-articular saline injection, the hyperechoic ligament was visualized because of the separation of the infrapatellar fat and the CrCL and the contrasting effect of anechoic saline. When the stifle joint was imaged by real-time scanning after the transection of the CrCL, flutter of the ligament and an anechoic area between the bone and the CrCL were identified. The increased diameter of the ligament and the increased thickness of the joint space were identified as well. Ultrasonographic examination via dynamic saline injection into the joint space has potential as a diagnostic tool for assessing CrCL rupture.