Relationship between objective and subjective assessment of limb function in normal dogs with an experimentally induced lameness

GenPup-M: A novel validated owner-reported clinical metrology instrument for detecting early mobility changes in dogs

OBJECTIVE

To use a previously validated veterinary clinical examination sheet, Liverpool Osteoarthritis in Dogs (LOAD) questionnaire, combined with kinetic and kinematic gait analysis in dogs with/without mobility problems to demonstrate the capacity of a novel clinical metrology instrument ("GenPup-M") to detect canine mobility impairments.

DESIGN

Quantitative study.

ANIMALS

62 dogs (31 with mobility impairments and 31 without mobility impairments).

PROCEDURE

The dogs' clinical history was obtained from owners and all dogs underwent a validated orthopaedic clinical examination. Mobility impairments were diagnosed in the mobility impaired group based on clinical history and orthopaedic examination. Owners were asked to complete GenPup-M along with a previously validated mobility questionnaire (Liverpool Osteoarthritis in Dogs (LOAD)) to identify construct validity. As a test of criterion validity, the correlation between instrument scores and the overall clinical examination scores, along with force-platform obtained peak vertical forces (PVF) were calculated. GenPup-M underwent internal consistency and factor analysis. Spatiotemporal parameters were calculated for dogs with/without mobility impairments to define the gait differences between these two groups.

RESULTS

Principal Component Analysis identified GenPup-M had two components with Eigenvalues >1 ("stiffness/ease of movement" and "willingness to be active/exercise"). Cronbach's α was used to test internal consistency of GenPup-M and was found to be "good" (0.87). There was a strong, positive correlation between GenPup-M and LOAD responses (r2 = 0.69, p<0.001) highlighting construct validity. Criterion validity was also shown when comparing GenPup-M to clinical examination scores (r2 = 0.74, p<0.001) and PVF (r2 = 0.43, p<0.001). Quantitative canine gait analysis showed that there were statistically significant differences between peak vertical forces (PVF) of mobility impaired and non-mobility impaired dogs (p<0.05). Analyses of PVF showed that non-mobility impaired dogs more evenly distributed their weight across all thoracic and pelvic limbs when compared to mobility impaired dogs. There were also consistent findings that mobility impaired dogs moved slower than non-mobility impaired dogs.

CONCLUSION AND CLINICAL RELEVANCE

GenPup-M is a clinical metrology instrument (CMI) that can be completed by dog owners to detect all mobility impairments, including those that are early in onset, indicating the versatility of GenPup-M to assess dogs with and without mobility impairments. Results of the study found that GenPup-M positively correlated with all three objective measures of canine mobility and consequently showed criterion and construct validity. Owner-reported CMIs such as GenPup-M allow non-invasive scoring systems which veterinary surgeons and owners can use to allow communication and longitudinal assessment of a dog's mobility. It is anticipated that GenPup-M will be used by owners at yearly vaccinations/health checks, allowing identification of any subtle mobility changes, and enabling early intervention.

Pressure-Sensitive Walkway System for Evaluation of Lameness in Dogs Affected by Unilateral Cranial Cruciate Ligament Rupture Treated with Porous Tibial Tuberosity Advancement

The aim of this study was to objectively evaluate lameness in dogs affected by a unilateral cranial cruciate ligament rupture (CrCLR) treated with porous tibial tuberosity advancement before surgery and at three different timepoints after surgery, using the GAITRite® system (version 4.9Wr), a pressure-sensitive walkway system that is able to calculate several spatiotemporal gait parameters simultaneously for each limb. The dogs walked on the pressure-sensitive walkway before (T0) and 30 (T1), 90 (T2), and 120 (T3) days after surgery. Pressure measurements (gait lameness score and total pressure index %) were collected for S (treated with porous TTA) and C (healthy contralateral limb) at T0, T1, T2, and T3 and statistically evaluated. An ANOVA test was performed to compare the data, and a value of p < 0.05 was considered significant. Twenty dogs (n = 20) of various common breeds and ages with CrCLR were enrolled in the study. The results showed that there was a statistically significant difference in the GAIT4Dog® lameness score (GLS) and TPI% between S and C for each timepoint. Statistically significant differences in the GLS and TPI% between S at T0 and S at T2 and between S at T0 and S at T3 (p < 0.001) were found. The results showed that there was a statistically significant difference in the GAIT4Dog® lameness score (GLS) and TPI% between S and C for each timepoint. Statistically significant differences in the GLS and TPI% between S at T0 and S at T2 and between S at T0 and S at T3 were found. The GLS and TPI% increased statistically significantly from 90 days after surgery compared to the preoperative measurements. Moreover, comparing the GLS and TPI% between the treated limb and the control limb showed that a statistically significant difference remained at each timepoint.

Recall Bias in Client-Reported Outcomes in Canine Orthopaedic Patients Using Clinical Metrology Instruments

OBJECTIVE

 The aim of this study was to determine the accuracy of client recollection of their dogs' preconsultation status using clinical metrology instruments such as the Liverpool Osteoarthritis in Dogs (LOAD) and Canine Brief Pain Inventory (CBPI) questionnaires in dogs presenting to a referral orthopaedic clinic.

STUDY DESIGN

 This is a longitudinal prospective cohort study of client-owned dogs presenting for investigations of lameness (n = 217). LOAD and CBPI questionnaires were completed by the owners at the first consultation (T0). Owners were contacted at 2 (T1), 6 (T2), and 12 (T3) months and asked to recall their dogs' T0 status by completing another LOAD and CBPI questionnaire. The agreement between the T0 and recalled LOAD and CBPI scores was determined using the two-way mixed effects intraclass correlation coefficient (ICC). The Wilcoxon signed-rank test was used to determine the difference between scores.

RESULTS

 For the LOAD scores, there was moderate agreement between T0 and T1 (ICC: 0.64) and T0 and T2 (ICC: 0.53) scores and poor agreement between T0 and T3 (ICC: 0.496). For the CBPI Pain Severity Scores, there was poor agreement between T0 and all three subsequent time points (ICC < 0.5). For the CBPI Pain Interference Scores, there was moderate agreement between T0 and T1 (ICC: 0.57) and T2 (ICC: 0.56) scores and poor agreement between T0 and T3 (ICC: 0.43).

CONCLUSION

 The LOAD and CBPI questionnaires are subject to recall bias. Studies reporting retrospectively acquired CMI data should be interpreted with caution.

Modification of Domestic Animal Lameness Scales for Use in Asiatic Black Bears (Ursus thibetanus)

Lameness in animals is a welfare concern as it can be an indicator of pain. A standardized bear lameness scale would significantly improve the ability of facilities that house bears to monitor, manage, and treat lameness in their animals. The Animals Asia bear rescue center in Vietnam holds over 180 rescued bears with varying health and mobility conditions as a result of the illegal bear bile trade, and a reliable lameness assessment system was needed. Bear locomotion includes a lumbering gait, which differs from domestic animal locomotion, necessitating the modification of domestic animal lameness scales, and a five-point lameness scale was developed. Professionals from various veterinary-related backgrounds scored bear lameness videos to assess interobserver reliability and the intraclass correlation coefficient indicated good to excellent reliability. A 15-min training video with examples of lameness and grades was provided before assessment. The lameness scale developed herein addresses the lack of a published lameness scale for bears, and, due to the similar locomotion of the genus, can be used on any bear species. This scale is a consistent and reliable tool for evaluating and documenting lameness in addition to monitoring response to treatment. It will benefit bear welfare by indirectly characterizing the level of pain a bear is experiencing due to lameness as well as serving to document trends in pain status.

Long-term outcomes in dogs with elbow dysplasia, assessed using the canine orthopaedic index

BACKGROUND

Elbow dysplasia (ED) is an important cause of lameness in dogs. This study aimed to report long-term outcomes in dogs with elbow osteoarthritis.

METHODS

Demographic data, medical management, and scores from The American College of Veterinary Surgeons' Canine Orthopaedic Index (COI) were collected from owners of dogs radiographically screened for ED, graded as normal, mild, or moderate. Telephone interviews were performed in 2017 (Q1), followed by an email survey in 2020 (Q2). The association between ED grade and deterioration in COI scores over time was evaluated with logistic regression.

RESULTS

A total of 765 replies were collected for Q1 and 293 for Q2. At Q2, 222 dogs (76%) were alive, with a median age of 8 years (range 5-12 years). No association was found between ED and changes in COI score over time or between ED and survival (p = 0.071). Dogs with mild and moderate ED were treated with analgesic medications to a higher degree than dogs without ED (p < 0.05).

LIMITATIONS

Only owner-assed data were assessed; no clinical orthopaedic examination or follow-up radiographic evaluation was performed.

CONCLUSIONS

No association was found between the grade of ED and the worsening of clinical signs in dogs with elbow osteoarthritis.

An update on mobility assessment of dogs with musculoskeletal disease

Mobility impairments associated with musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, affect approximately 200,000 dogs annually and pose a notable challenge to canine health and welfare. Osteoarthritis causes the remodelling of synovial joints, alongside inflammation and impaired mechanical function which can be extremely debilitating. Secondary osteoarthritis commonly affects dogs and can be exacerbated by previous joint abnormalities, such as patellar luxation or cranial cruciate ligament rupture. Although musculoskeletal diseases can affect dogs of any age, the early subtle signs of gait abnormalities are perhaps missed by owners, thus, dogs may be in the latter stages of osteoarthritis progression when they are presented to veterinarians. Dogs showing subtle signs of gait abnormalities must be presented to veterinary practices for acute diagnosis to prevent long-term deterioration. Musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, are commonly diagnosed via visible radiographic changes. However, veterinarians can use a combination of subjective and objective clinical scoring systems, such as clinical metrology instruments and gait assessment in conjunction with radiography to aid their diagnosis and longitudinal monitoring of musculoskeletal diseases. These scoring systems may be more sensitive to earlier signs of mobility impairments in dogs, ultimately, promoting increased canine health and welfare by enabling pain reduction, improvement of muscle strength and preservation of joint function. Current canine mobility scoring systems available to veterinarians will be discussed in turn throughout this review for implementation into clinical practice.

Kinetic and Radiographic Outcomes of Unilateral Double Pelvic Osteotomy in Six Dogs

OBJECTIVE

 The aim of this study was to assess the kinetic and radiographic outcome of unilateral double pelvic osteotomy (DPO) using a temporospatial pressure walkway, preoperative and postoperative radiographs.

STUDY DESIGN

 Retrospective case series of six dogs that underwent unilateral DPO for canine hip dysplasia. The untreated limb was unfit for DPO due to radiographic evidence of osteoarthritis and was therefore managed non-surgically. Preoperative and postoperative radiographs and kinetic data were compared between untreated and DPO-treated hips using a Wilcoxon signed-rank test.

RESULTS

 There was no significant difference in British Veterinary Association Hip Dysplasia Scheme (BVA-HD) scores between untreated and DPO-treated hips preoperatively (p-value = 0.09) and postoperatively (p-value = 0.06). The median postoperative GAIT4 Dog Lameness Score was lower in untreated hips than DPO-treated hips but was not statistically different (p-value = 0.18).

CONCLUSIONS

 All dogs in this case series achieved a total pressure index and GAIT4 Dog Lameness Score on the DPO-treated hip comparable to normal limbs. All untreated hips in this series had increased BVA-HD scores at follow-up, whereas all DPO-treated hips had reduced BVA-HD scores. This difference was not significant and warrants further studies. We conclude total pressure index may be preserved in hips treated with unilateral DPO, while the contralateral hip is managed non-surgically.

The value of routine radiographic follow up in the postoperative management of canine medial patellar luxation

OBJECTIVE

To determine the influence of radiographic examination on the recommendations made at the time of planned re-evaluation of dogs after medial patellar luxation (MPL) surgery.

STUDY DESIGN

Retrospective multi-institutional case series.

ANIMALS

Client-owned dogs (N = 825) that underwent MPL surgery.

METHODS

Records of 10 referral institutions were searched for dogs that had been treated surgically for unilateral MPL and underwent a planned follow-up visit, including radiographs. The frequency of, and reasons for, changes in further recovery recommendations were investigated.

RESULTS

Follow up was performed at a median of 6 (range, 4-20) weeks postoperatively. Isolated radiographic abnormalities were identified in 3.3% (27/825) of dogs following MPL surgery and led to a change in recommendations in 3% (13/432) of dogs that were presented without owner or clinician concerns. Lameness, administration of analgesia at follow up, and history of unplanned visits prior to routine re-examination were associated with a change in postoperative plan (P < .001). In the absence of owner and clinician concerns, the odds of having a change in convalescence plans were not different, whether or not isolated radiographic abnormalities were present (P = .641).

CONCLUSION

Routine radiographs at follow up did not influence postoperative management of most dogs after MPL surgery in the absence of abnormalities on clinical history or orthopedic examination.

CLINICAL SIGNIFICANCE

Dogs that were presented for routine follow up after unilateral MPL surgery without owner concerns, lameness, analgesic treatment or a history of unplanned visits, and for which examination by a surgical specialist was unremarkable, were unlikely to benefit from radiographs.

Preoperative and postoperative stance analysis in dogs with patellar luxation confirms lameness improvement after surgery

OBJECTIVE

To document and compare preoperative and postoperative stance analysis measurements in animals with naturally occurring patellar luxation.

ANIMALS

131 client-owned dogs surgically treated for naturally occurring unilateral or bilateral patella luxation between March 30, 2015, and February 12, 2020.

PROCEDURES

Weight bearing as a percent body weight on each limb was recorded with the use of a platform device for analyzing stance (PetSafe Stance Analyzer; LiteCure LLC, Companion Animal Health) preoperatively and postoperatively for all dogs. Signalment, limb affected, lameness grade, luxation direction, luxation grade, and surgical procedure were collected from patient records and assessed for the effects of these variables on weight bearing preoperatively or at the first or second postoperative recheck examination.

RESULTS

There were 61 males and 70 females, with a mean age and body weight of 4.62 years and 13.01 kg, included in the study. As age increased, body weight decreased in these dogs (P = .025). There was a statistically significant improvement in lameness after surgery (P = .008) at the second postoperative recheck examination. Lameness significantly decreased as postoperative time increased (P < .001, r = 0.503). As age increased, lameness at the initial visit decreased compared to younger dogs but not significantly (P = .062). There was no significant effect of preoperative luxation grade, luxation direction, surgical procedure, or sex when comparing initial lameness or lameness at recheck examination.

CLINICAL RELEVANCE

Surgical correction of patella luxation improves lameness as measured by postoperative stance analysis. Preoperative luxation grade or direction, surgical procedure performed, and sex of the animal did not significantly affect outcome in this group of dogs.

Study of the effectiveness of glucosamine and chondroitin sulfate, marine based fatty acid compounds (PCSO-524 and EAB-277), and carprofen for the treatment of dogs with hip osteoarthritis: A prospective, block-randomized, double-blinded, placebo-controlled clinical trial

Introduction

Glucosamine hydrochloride and chondroitin sulfate are commonly used in dogs with OA, but evidence around efficacy is mixed. This study evaluated the effectiveness of glucosamine and chondroitin sulfate, marine based fatty acid compounds (PCSO-524 and EAB-277), and carprofen for the alleviation of canine hip OA pain. This was a prospective, block-randomized, double-blinded, placebo-controlled clinical trial.

Methods

Seventy-five owned pet dogs with hip OA were assigned randomly into five treatment groups: PCSO-524, Glucosamine and chondroitin sulfate, EAB-277, carprofen, and Placebo (sunflower oil). Peak vertical force (PVF) and subjective orthopedic assessment scores (OAS) were evaluated before treatment (week 0), and at weeks 2, 4, and 6 during treatment.

Results

At week 2, the carprofen group showed a significant increase in PVF (3.14 ± 5.33; mean ± SD). After 4 weeks, the increases in PVF of the PCSO-524 (3.90 ± 3.52), EAB-277 (4.17 ± 4.94), and carprofen (3.08 ± 5.87) groups were significant, and significantly greater than placebo (0.08 ± 1.90) and glucosamine (-0.05 ± 6.34) groups. After 6 weeks, the change of PVF in the PCSO-524 (4.14 ± 4.65), EAB-277 (4.45 ± 4.23), and carprofen (4.21 ± 6.52) groups were significant and significantly higher than the placebo group (-0.33 ± 3.65). The change in PVF in the glucosamine group (1.08 ± 5.49) lay between the placebo group and the other treatment groups. The OAS did not show any significant change in any group.

Discussion

PCSO-524 and EAB-277, but not glucosamine/chondroitin, resulted in significant improvements in PVF from baseline after 4 weeks, and 6 weeks, and to a similar degree to that seen with carprofen.

Effect of dog-related parameters on the flexion test outcome: A large cohort retrospective study on physiological and orthopedic pathological-related factors

Objectives

This retrospective study evaluates the dog-related factors of variation influencing the outcome of the flexion test (FT), when performed to localize pain to a joint area, on a large group of canine orthopedic patients.

Materials and methods

The selection criteria for this retrospective study were dogs undergoing a FT in a referral orthopedic clinic between 2009 and 2020 with a complete medical record. The canine FT, described in a previously published protocol, was performed on dogs presented with an orthopedic problem. In summary, a dog's joint, identified as suspected of an orthopedic problem according to the clinical examination, was flexed for 1 min before walking 15 m on a hard and even surface. The FT was considered positive if the lameness increased after the application of the FT and negative when it remained unchanged. Statistical analysis was performed to determine which of the following criteria could influence the outcome of the flexion test: age, gender, neutered status, weight category, tested joint and initial lameness score.

Results

Over 1,161 patients' files were collected and analyzed for this research. The FT showed 82.8% (95%IC: 80.5-84.9) of true positives and 17.2% of false negatives. None of the patient's intrinsic characteristics influenced the outcome of the test (age, gender, neutered status, and weight category). The orthopedic parameters, such as the initial lameness score and the tested joint, showed to have a statistically significant influence on the outcome of the test.

Clinical relevance

The FT is an easy-to-perform technique presenting reliable results on most joints. This test presents an interest when performed in addition to a complete orthopedic examination to localize pain to a joint area. Only the orthopedic pathological-related parameters such as the lameness score and the tested joint seem to influence the outcome of the FT. The FT is not influenced by the physiological-related characteristic of the patient (age, weight category, sex, and neutered status).

Vergleichende Langzeitergebnisse zwischen Tibial Plateau Leveling Osteotomy und Modified Maquet Procedure nach Ruptur des vorderen Kreuzbandes beim Hund

Gegenstand und Ziel Ziel dieser Studie ist es, die Modified Maquet Procedure (MMP) mit der Tibial Plateau Leveling Osteotomy (TPLO) anhand von Langzeitkontrollen über ein Jahr (∅ 3,15 Jahre) mittels klinischer Untersuchung, röntgenologischer Beurteilung der Arthroseprogression und Ganganalyse durch Laufbanduntersuchung zu vergleichen. Zusätzliches Ziel ist es, den Einfluss der Erfahrung der Chirurgen bei der TPLO-Technik zu überprüfen.

Material und Methoden Bei dieser klinischen Studie wurden 67 Kniegelenke von 50 Hunden verschiedener Rassen zwischen 20 und 40 Kilogramm Körpergewicht einbezogen, die mittels TPLO beziehungsweise MMP (n = 19) nach Ruptur des vorderen Kreuzbandes operiert wurden. Die TPLO-Gruppe unterteilte sich in eine Gruppe, welche von 2 erfahrenen Chirurgen (TPLO1, n = 25) operiert wurde und eine zweite Gruppe, die von mehreren Chirurgen unterschiedlicher Erfahrung (TPLO2, n = 23) versorgt wurden. Die Hunde wurden nach mindestens über einem Jahr (3,15 ± 1,21 Jahre) postoperativ orthopädisch, röntgenologisch und ganganalytisch uni- und bilateral getrennt untersucht. Zusätzlich wurden die Daten der Ganganalyse mit einer orthopädisch gesunden Kontrollgruppe verglichen.

Ergebnisse Bei der orthopädischen Untersuchung wurden keine signifikanten und klinisch relevanten Unterschiede zwischen den 3 Gruppen festgestellt.

Die Arthroseprogression zeigte in allen 3 OP-Gruppen ähnliche Werte, wobei die der TPLO2-Gruppe durchschnittlich pro Jahr gerechnet signifikant etwas geringer war als die der TPLO1- und der MMP-Gruppe.

Die ganganalytische Untersuchung im Schritt konnte vor allem im Vergleich mit der gesunden Kontrollgruppe signifikante Unterschiede bei bilateralen Rupturen für die Peak Vertical Force und den Vertical Impulse zeigen. Die Standphasendauer wies keine signifikanten Unterschiede auf. Im Trab konnten keine signifikanten Unterschiede zwischen den 3 OP-Gruppen festgestellt werden.

Schlussfolgerung Beide Operationstechniken erzielten in den 3 Gruppen bei den Langzeitkontrollen gute klinische, radiologische und ganganalytische Ergebnisse auch im Vergleich mit einer gesunden Kontrollgruppe.

Klinische Relevanz Die MMP kann als schnell durchführbare Alternative zur etablierten TPLO mit ebenfalls guten Ergebnissen beim Hund angesehen werden. Die Erfahrung des Chirurgen scheint keinen Einfluss auf das Ergebnis zu haben.

Outcome of cranial cruciate ligament replacement with an enhanced polyethylene terephthalate implant in the dog: A pilot clinical trial

OBJECTIVE

To assess the 6-month outcome and survival of enhanced polyethylene terephthalate (PET) implants as a replacement for the cranial cruciate ligament (CCL) in dogs with spontaneous CCL disease (CCLD).

STUDY DESIGN

Pilot, prospective case series.

ANIMALS

Ten client-owned large breed dogs with unilateral spontaneous CCLD.

METHODS

Dogs were evaluated before and 6 months after intra-articular placement of a PET implant with the Liverpool Osteoarthritis in Dogs questionnaire and force platform gait analysis. Arthroscopy was performed 6 months after surgery to visually assess implant integrity.

RESULTS

Scores on owner questionnaires and limb asymmetry improved in all dogs that reached the 6-month time point, by 51.7% (p = .008) and 86% (p = .002), respectively. The PET implant appeared intact and functioning in two stifles, partially intact and functioning in four stifles and completely torn in three stifles. One dog had an implant infection and was removed from the study. Evidence of deterioration and tearing occurred in the midbody of the implant.

CONCLUSION

Although function improved over the course of this study, only 2/10 implants appeared intact 6 months after placement.

CLINICAL SIGNIFICANCE

Implant survivability prohibits further clinical investigation using this implant.

Initial exploration of the discriminatory ability of the PetPace collar to detect differences in activity and physiological variables between healthy and osteoarthritic dogs

Background

Accelerometry has been used to evaluate activity in dogs with osteoarthritis (OA) pain, especially in relation to effect of treatment; however no studies have compared accelerometry-measured activity in dogs with OA-pain and healthy dogs. The aims of this study were to (1) compare activity output from the PetPace collar with the validated Actical monitor and (2) determine if PetPace collar outputs (overall activity, activity levels, body position, and vital signs) differed between healthy dogs and dogs with OA-pain.

Methods

This was an observational, non-interventional study in healthy dogs and dogs with OA-pain. All dogs were outfitted with the PetPace collar and the Actical monitor simultaneously for 14 days. Output from these devices was compared (correlations), and output from the PetPace device was used to explore differences between groups across the activity and vital sign outputs (including calculated heart rate variability indices).

Results

There was moderate correlation between the PetPace collar and Actical monitor output (R² = 0.56, p < 0.001). Using data generated by the PetPace collar, OA-pain dogs had lower overall activity counts and spent less time standing than healthy dogs. Healthy dogs spent more time at higher activity levels than OA-pain dogs. Certain heart rate variability indices in OA-pain dogs were lower than in healthy dogs.

Conclusions and clinical relevance

The results of this study suggest that the PetPace collar can detect differences between healthy dogs and those with OA-pain, and that OA-pain negatively impacts overall activity levels in dogs, and especially higher intensity activity.

Measurement of Canine Ataxic Gait Patterns Using Body-Worn Smartphone Sensor Data

Ataxia is an impairment of the coordination of movement or the interaction of associated muscles, accompanied by a disturbance of the gait pattern. Diagnosis of this clinical sign, and evaluation of its severity is usually done using subjective scales during neurological examination. In this exploratory study we investigated if inertial sensors in a smart phone (3 axes of accelerometer and 3 axes of gyroscope) can be used to detect ataxia. The setting involved inertial sensor data collected by smartphone placed on the dog's back while walking in a straight line. A total of 770 walking sessions were evaluated comparing the gait of 55 healthy dogs to the one of 23 dogs with ataxia. Different machine learning techniques were used with the K-nearest neighbors technique reaching 95% accuracy in discriminating between a healthy control group and ataxic dogs, indicating potential use for smartphone apps for canine ataxia diagnosis and monitoring of treatment effect.

Relationship between Ground Reaction Forces and Morpho- Metric Measures in Two Different Canine Phenotypes Using Regression Analysis

Simple summary

The force plate gait analysis is considered the gold standard for the objective assessment of limb function in dogs. Force plate analysis has been employed in several studies using a cohort of healthy dogs as a control group. However, these studies do not consider the subject variability within the same breed. Moreover, the lack of a rigorous analysis of morphometric variabilities in the same breed makes these evaluations poorly reliable. This prospective study aims to investigate the relationship between the ground reaction forces obtained by the force plate gait analysis and the morphometric measures in two different domestic dogs’ morphotypes. Our results highlighted how the ground reaction forces are influenced by morphometric measures not so much as a single contribution, but through the interaction between them. Indeed, the interaction between body weight, withers height, and velocity significantly influenced ground reaction forces with a greater unit increase for mesomorphs. Statistical models used in the available literature only partially explain the influence of morphometric measures on ground reaction forces, and the comparison between dogs should be made not referring to the breeds but the canine morphotype.

Abstract

Force plate analysis assesses gait symmetry and limb loading. However, as previously described, individual and breed variability (body size and conformation) is related to breeding, body conformation, and size. This prospective study aimed to evaluate the influence of morphometric measures on the speed (V), peak of vertical force (PVF), vertical impulse (VI), and stance time (ST) in healthy dolichomorph and mesomorph dogs and their combined effect on and interactions with V, PVF, VI, and ST in the same morphological types. Fifty dogs were enrolled in the current study, and specific morphometric measurements were recorded for each dog. A force platform was used to record the ground reaction forces (GFRs), including PVF and VI. Multiple linear regression models were used for the study purposes. According to our results, GFRs are influenced by morphometric measures (body weight, withers height, and speed) not so much as a single contribution, but by the interaction between them. It is not possible to compare GFRs in dogs that do not belong to the same breed. However, the subjective variabilities make this comparison difficult and poorly reliable. According to the author, the comparison should be made between canine morphological types rather than breeds.

DEVELOPMENT OF A MOBILITY ASSESSMENT SCORE FOR EVALUATION OF THE EFFECTS OF ORAL HYALURONIC ACID ON CLINICAL LAMENESS IN ASIAN SMALL-CLAWED OTTERS (AONYX CINEREA) AND AFRICAN SPOT-NECKED OTTERS (HYDRICTIS MACULICOLIS) UNDER HUMAN CARE

Oral hyaluronic acid has been shown to reduce inflammation and pain in humans with osteoarthritis. Eight Asian small-clawed otters (Aonyx cinerea) and two African spot-necked otters (Hydrictis maculicolis) with varying degrees of osteoarthritic changes identified on radiographs were selected for a randomized, double-blinded, placebo-controlled clinical trial. Animal husbandry staff completed otter mobility assessment (OMA) questionnaires for each animal prior to study commencement and following either oral hyaluronic acid at a loading dose of 4 mg/kg PO SID for 10 d followed by a maintenance dose of 2 mg/kg PO SID for 20 d, or placebo for 30 d. Four veterinarians with experience assessing otters watched randomized videos of otter gaits and assigned a clinical lameness score. Two additional evaluators watched the videos: an experienced veterinarian in small animal practice and a final-year veterinary student. All evaluators for OMA and clinical lameness score were blinded to treatment group. Radiographs performed prior to, and following, the study were assessed by a board-certified radiologist (Dennison). The OMA questionnaire had high reliability coefficients and correlated strongly with clinical gait scores and radiographic assessment. Although hyaluronic acid appears to be safe for use in otters at the dose described, there was no observed significant effect of hyaluronic acid on clinical lameness scores, OMA scores, or radiographic assessment of the limbs. The development of the OMA questionnaire is a promising tool for evaluating lameness in managed-care otters and may be further validated in future studies investigating therapeutics or incorporated as a component of animal welfare assessment.

Canine Comprehensive Mobility Assessment

A comprehensive mobility assessment goes beyond the orthopedic or neurologic examination for the localization of pathology. This assessment involves attention to the dog's posture and stance, a hands-on examination with special attention to soft tissue structures, and the performance of functional assessments. A comprehensive mobility assessment can guide advanced diagnostic testing as well as providing a foundation in the formulation of a successful treatment plan.

Best practices for measuring and reporting ground reaction forces in dogs

Kinetic gait analysis and ground reaction forces (GRFs) have been used in hundreds of scientific manuscripts. Specific methodology, interpretation of results, and translation to clinical veterinary medicine have been inconsistent. This impedes the advance of veterinary medicine and poses a risk to patients. The objective of this report was to address methodological variations and share our consensus on a recommended approach with viable alternatives to data collection methods, analysis, reporting, and interpretation for GRFs in the dog. Investigators with experience performing kinetic gait analysis reviewed the literature and discussed the topics that most influenced GRF data collection, reporting, and interpretation. Methodological variations were reported and a consensus from the group was devised. There are several reasonable alternatives to collect, report, and interpret GRFs in dogs appropriately. Attention to detail is required in several areas to collect and report them. This review and consensus report should assist future investigations and interpretations of studies, optimize comparison between publications, minimize use of animals, and limit the investment in cost and time.

Evidence-based evaluation of owner-reported outcome measures for canine orthopedic care - a COSMIN evaluation of 6 instruments

OBJECTIVE

To systematically review the currently available validated owner-reported outcome measures (OROMs) for assessing pain and function in dogs with osteoarthritis and other joint diseases.

STUDY DESIGN

Systematic review.

METHODS

A systematic literature search of PubMed and Web of Science was performed in December, 2019, using search terms relevant to OROMs for pain and function in dogs with osteoarthritis and other joint diseases. The measurement properties of the resulting outcome instruments and validation studies were evaluated with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN).

RESULTS

Seventeen publications describing the validation of 6 OROMs were selected and evaluated with the COSMIN. The Canine Brief Pain Inventory (CBPI), Canine Orthopedic Index (COI), and Liverpool Osteoarthritis in Dogs (LOAD) provided evidence of sufficient content validity. Internal consistency, reliability, construct validity, and responsiveness were the most frequently validated other properties. Both CBPI and COI had sufficient internal consistency; LOAD, being formative in construct, need not be assessed for internal consistency. No instruments provided information on measurement errors.

CONCLUSION

The CBPI, COI, and LOAD can be recommended for use in dogs with osteoarthritis. Further evidence is necessary to increase the interpretability of these instruments or expand their application into other canine orthopedic conditions. Further evidence is also needed before the other 3 instruments can be recommended.

CLINICAL SIGNIFICANCE

This systematic evaluation of 6 OROMs provides clinicians and researchers with a tool that facilitates and improves evidence-based selection of outcome measures for evaluating canine osteoarthritis and other joint disease treatments.

Combined internal fixation and transarticular external skeletal fixation to treat traumatic patellar fractures in five dogs

CASE HISTORY

Medical records of dogs (n = 5) that had been treated for patellar fracture with transarticular external skeletal fixation (TA-ESF) to augment internal fixation, at a single referral hospital in the United Kingdom between 2015 and 2017, were reviewed.

CLINICAL FINDINGS AND TREATMENT

At presentation, two dogs had polar patellar fractures, two had comminuted fractures and one dog had a transverse fracture. The median age at the time of the surgery was 21 (min 8, max 132) months and the median body weight was 19.0 (min 8.3, max 28.6) kg. In all cases, TA-ESF (Type IA lateral triangulated or modified Type II) was used in combination with internal fixation with pins and/or orthopaedic wire, supported by nylon leader line (patella-to-tibia mattress suture) and/or absorbable suture in a locking loop and/or circum-patellar pattern. All cases had short-term (6-12 weeks) post-operative radiographic follow-up, which showed evidence of fracture healing in 2/5 cases. All TA-ESF were removed 6 or 7 weeks post-operatively and four dogs had minor complications related to TA-ESF. More than 2 years post-operatively, the owners of all dogs were contacted and questioned using the Liverpool Osteoarthritis in Dogs questionnaire regarding the mobility of their pet. Four of the five cases were re-examined to evaluate their long-term outcomes. Based on the results of goniometric measurement of stifle range of motion, subjective gait assessment and objective gait analysis with a pressure-sensitive walkway, all dogs showed a satisfactory outcome at the final follow-up.

CLINICAL RELEVANCE

A combination of internal fixation and TA-ESF for stabilisation of traumatic patellar fractures is a valid treatment option. Further investigations with larger case numbers are necessary to evaluate success and complication rates.

Post-operative analgesia following TPLO surgery: A comparison between cimicoxib and tramadol

OBJECTIVE

To compare the analgesic effects of oral administration of cimicoxib and tramadol over a 30 day period following Tibial Plateau Leveling Osteotomy and partial menisectomy in dogs.

DESIGN

Randomized, double blinded, prospective clinical trial.

ANIMALS

42 adult client-owned dogs with unilateral cranial cruciate ligament disease and partial meniscal tears.

METHODS

Dogs were allocated into 2 treatment groups (cimicoxib or tramadol). Weight bearing while standing, thigh circumference, flexion and extension range of motions, wound classification, adverse effects, Visual Analogue Scale (VAS), Glasgow Composite Measure Pain Scale (CMPS-SF) and Helsinki Chronic Pain Index (HCPI) questionnaire and limb function by means of pressure platform gait analysis were recorded before surgery and at several time points after surgery for 30 days. Outcome measures were compared at each time point among groups.

RESULTS

A significant improvement in two objective measures of gait of the cimicoxib group: the vertical impulse on day 1 and day 20 and the peak vertical force on day 20 were significantly improved when compared to the tramadol group. However, no difference was seen for the VI or PVF of dogs on the other days compared. In addiction there was no difference in the weight bearing while standing, thigh circumference, wound classification, adverse effects, VAS, CMPS-SF and HCPI. We did not observe a difference in the number of adverse effects measured in this study with the exception of hock edaema.

CONCLUSIONS AND CLINICAL RELEVANCE

A significant difference was not found in long-term postoperative analgesia provided by cimicoxib or tramadol in dogs undergoing TPLO when subjective parameters (with the exception of knee joint range of motion) were evaluated, but use of the force plate analysis revealed a significant difference between groups at T20 for both PVF and VI. The use of cimicoxib improved the limb function and ROM and reduced the occurrence of hock edema, in the first 20 days after surgery, without any additional side effects, compared to tramadol. Thus, the use of cimicoxib should be preferred to tramadol alone in clinical cases similar to the ones included in this study.

Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis

This article contains a guide for small animal practitioners to use when confronted with the challenge of diagnosing a forelimb lameness. The examination begins by monitoring the dog at a stance and a visual gait assessment. A hands-on evaluation includes the initial examination, checking for asymmetry and muscle atrophy while the dog is standing, and step-by-step instructions for a thorough forelimb examination.

Kinetic gait analysis in healthy dogs and dogs with osteoarthritis: An evaluation of precision and overlap performance of a pressure-sensitive walkway and the use of symmetry indices

In veterinary practice, a thorough gait examination is essential in the clinical workup of any orthopedic patient, including the large population of dogs with chronic pain as a result of osteoarthritis. The traditional visual gait examination is, however, a subjective discipline, and systems for kinetic gait analysis may potentially offer an objective alternative for gait assessment by the measurement of ground reaction forces. In order to avoid unnecessary testing of patients, a thorough, stepwise evaluation of the diagnostic performance of each system is recommended before clinical use for diagnostic purposes. The aim of the study was to evaluate the Tekscan pressure-sensitive walkway system by assessing precision (agreement between repetitive measurements in individual dogs) and overlap performance (the ability to distinguish dogs with lameness due to osteoarthritis from clinically healthy dogs). Direction of travel over the walkway was investigated as a possible bias. Symmetry indices are commonly used to assess lameness by comparing ground reaction forces across different combinations of limbs in each dog. However, SIs can be calculated in several different ways and specific recommendations for optimal use of individual indices are currently lacking. Therefore the present study also compared indices in order to recommend a specific index preferable for future studies of canine osteoarthritis. Forty-one clinically healthy dogs and 21 dogs with osteoarthritis were included in the study. High precision was demonstrated. The direction of travel over the walkway was excluded as a possible bias. A significant overlap was observed when comparing ground reaction forces measured in dogs with osteoarthritis compared to clinically healthy dogs. In some affected dogs, symmetry indices comparing contralateral limbs differed from clinically healthy dogs, but in general, the overlap performance was insufficient and, consequently, general use of this method for diagnostic purposes in dogs with osteoarthritis cannot be recommended.

Evaluation of the repeatability of kinetic and temporospatial gait variables measured with a pressure-sensitive treadmill for dogs

OBJECTIVE

To evaluate intrasession and intersession repeatability of measurements for temporospatial and kinetic variables obtained with a pressure-sensitive treadmill designed for gait analysis of dogs.

ANIMALS

16 client-owned dogs.

PROCEDURES

The influence of treadmill speed on accuracy of ground reaction force (GRF) measurements was assessed by simulated gait analysis at 0 to 7.5 km/h with a custom test device. A similar test was performed with 1 client-owned dog ambulating on the treadmill at 5 speeds (3 to 7 km/h) for GRF calculations. Fifteen client-owned dogs were then walked on the treadmill at 3 km/h for collection of temporospatial and kinetic data. Intrasession repeatability was determined by comparing 2 sets of measurements obtained ≤ 2 hours apart. Intersession repeatability was determined by comparing the first set of these measurements with those for a second session ≥ 4 days later. Intraclass correlation coefficients (ICCs; consistency test) and difference ratios were calculated to assess repeatability.

RESULTS

Increases in treadmill speed yielded a mean 9.1% decrease in weight-normalized force data at belt speeds of up to 7.5 km/h for the test device, compared with the value when the treadmill belt was stationary. Results were similar for the dog at increasing treadmill speeds (mean decrease, 12.4%). For temporospatial data, intrasession ICCs were > 0.9 and intersession ICCs ranged from 0.75 to 0.9; for GRFs, intrasession and intersession ICCs ranged from 0.68 to 0.97 and from 0.35 to 0.78, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Repeatability of temporospatial data for healthy dogs was good to excellent; results for kinetic data varied. Further research is needed to investigate use of this system for gait analysis with larger samples of dogs and dogs with lameness.

Long-Term Prognosis of Quality of Life in Dogs Diagnosed With Mild to Moderate Elbow Dysplasia in Sweden

Objective: The objective of this study was to increase knowledge regarding long-term prognosis of mild to moderate elbow dysplasia (ED) using a canine orthopedic index.

Study Design: Cross-sectional observational study.

Sample Population: Sixty dogs randomly selected from each of five different breeds and three ED groups: ED0 (control), ED1, and ED2, based on the Kennel Club's screening results. The total number of selected dogs was 900 (60^*5^*3).

Methods: Questionnaires were administered to owners by telephone interview. Bayesian network modeling was used to assess the relation between ED grade, treatment options, dog demographics, and quality-of-life indicators.

Results: Seven hundred sixty-five questionnaires were collected (85% response rate), of which 61 concerned dogs euthanized due to osteoarthritis. There was no direct association between ED grade and owner's perceived quality of life, but ED1 and ED2 dogs were more likely to receive veterinary care and subsequent NSAID treatment compared to ED0 dogs. A significant association was found between the occurrence of euthanasia due to orthopedic disease and ED scores 1 and 2 in the sample (p < 0.001).

Conclusion: The degree of osteoarthritis was not directly associated with the canine orthopedic index, except for ED2 and lameness score. It can be speculated that owners who paid closer attention to orthopedic symptoms and perceived them as impairing their dogs' lives were also more likely to seek veterinary care and get treatment, irrespective of the ED grading.

Impact: ED1-graded dogs had a lower risk than might be expected to develop visible clinical symptoms and showed a similar quality of life as dogs with ED0. ED2-graded dogs were more likely than ED0-graded dogs to have their lives impaired by lameness, according to the owners' perception.

Use of Physical Self-Experience for Teaching Lameness Evaluation: Short-Term Effects on Lameness Evaluation of Horses with Mild Forelimb Lameness by Novice Veterinary Students

Lameness evaluation (LE) is an important veterinary skill, but it can be a challenging task to teach. Acoustic and visual input in conjunction with acting are the three major learning channels for acquiring new information. Acting (e.g., physical self-experience) has not been reported as a didactic tool for LE; therefore, we investigated two physical self-experience techniques, imitation of lameness during LE instruction and head nod during LE. Undergraduate veterinary students (N = 78) who had not yet received any instructions for LE underwent standard instruction for LE, followed by instructions to head nod, instructions to imitate lameness, or neither. Students' subjective LE skills were then tested against those of senior clinicians on two horses that were either sound or mildly forelimb lame. In more than 80%, there was agreement on the presence or absence of lameness independent of instruction, and we found no significant evaluation differences between didactic strategies. Specific instructions for head nodding did not significantly influence the quality of LE, possibly because head nodding was widespread even when no specific instructions had been given. Veterinary students who had been taught to imitate lameness without instructions to head nod were consistently closest to the assessment of the senior clinicians, and in walk these students were significantly better at LE than students additionally instructed to head nod. This finding indicates that imitation of lameness, but not necessarily head nodding, may be beneficial for understanding body movement such as mild equine forelimb lameness.

Influence of orthopedic examination on lameness scores and interobserver and intraobserver agreement in dogs with naturally occurring elbow osteoarthritis

OBJECTIVE

To determine the influence of orthopedic examination on numerical rating score (NRS) and visual analog score (VAS) when scoring lameness in dogs with elbow osteoarthritis (OA) and to evaluate interobserver and intraobserver agreement in NRS and VAS on the basis of video-graphic gait analysis.

DESIGN

Prospective blinded study.

ANIMALS

Eighteen client-owned dogs with radiographically confirmed elbow OA.

METHODS

Videos were obtained for all dogs at a walk and at a trot both prior to and immediately after orthopedic examination. All videos were randomly sequenced. Six observers, unaware of the timing of the video, independently assigned both NRS and VAS twice, with at least a 2-week interval. Scores were evaluated with mixed analysis of variance, and the agreement among observers was accessed by intraclass correlation coefficient (ICC).

RESULTS

No difference was detected between NRS and VAS at walk or at trot before and after orthopedic examination. Numeric rating score and VAS at walk were lower than those at trot before an orthopedic examination by scores of 0.17 (P = .0018) and 3.54 (P = .0019), respectively. The ICC for both scores for all observers was >0.9.

CONCLUSION

An orthopedic examination did not exacerbate the NRS and the VAS for dogs with elbow OA. Interobserver and intraobserver agreement was high for both lameness scores.

CLINICAL SIGNIFICANCE

Lameness may be scored after gait evaluation in dogs with elbow OA irrespective of the timing of a comprehensive orthopedic examination.

Long-term arthroscopic assessment of intra-articular allografts for treatment of spontaneous cranial cruciate ligament rupture in the dog

OBJECTIVE

To assess the 12-month survival of intra-articular, decellularized allografts for the treatment of cranial cruciate ligament disease (CCLD) in dogs.

STUDY DESIGN

Prospective case series.

ANIMALS

Twenty client-owned dogs with spontaneous CCL rupture.

METHODS

Affected stifles were treated solely by implantation of an intra-articular, decellularized, deep digital flexor tendon allograft. Functional outcome was evaluated at baseline and at 6 and 12 months after surgery with the Liverpool Osteoarthritis for Dogs questionnaire and force platform gait analysis. At 12 months after surgery, dogs underwent arthroscopy to visually assess the allografts.

RESULTS

Scores on owner questionnaires (improved 62.5%; P = .005) and ground reaction forces (improved 34.4%; P = .017) were improved in all dogs 12 months after surgery. Dogs with an intact graft (IG) were more likely to have a successful outcome compared with dogs with a torn graft (P = .011). According to arthroscopy, 45% of grafts seemed to survive at 12 months after surgery.

CONCLUSION

About half of intra-articular allografts survived 12 months after implantation in CCL-deficient stifles. Dogs with IG had successful outcomes at 12 months after surgery according to assessment by force platform gait analysis.

CLINICAL SIGNIFICANCE

These results preclude immediate clinical application but provide evidence to justify further investigation of intra-articular grafts as a repair option for CLLD.

Measurement of chronic pain in companion animals: Discussions from the Pain in Animals Workshop (PAW) 2017

In the face of increasing recognition and interest in treating chronic pain in companion animals, we struggle with a lack of therapeutic options. A significant barrier to the development of new therapeutics, or the critical evaluation of current therapies, is our inability to accurately measure chronic pain and its impact on companion animals. Over the last 20 years, much progress has been made in developing methods to measure chronic pain via subjective and objective methods - particularly in owner assessment tools and measurements of limb use and activity. Most work has been focused on chronic joint pain conditions, but there has been relatively little work in other areas of chronic pain, such as neuropathic and cancer pain. Although progress has been made, there is a considerable interest in improving our assessment of chronic pain, as evidenced by the multiple disciplines across industry, academia, and clinical practice from the veterinary and human medical fields that participated in the Pain in Animals Workshop held at the National Institutes of Health in 2017. This review is one product of that meeting and summarizes the current state of knowledge surrounding the measurement of chronic pain (musculoskeletal, cancer, neuropathic), and its impact, in cats and dogs.

A Monosodium Iodoacetate Osteoarthritis Lameness Model in Growing Pigs

Lameness is a common problem in pigs, causing welfare issues in affected pigs and economic losses for farmers. It is often caused by osteoarthrosis (OA) in its acute or chronic form. We assessed face and construct validity of a potential model for naturally-occurring OA and its progression to chronic OA. Such a model would allow the assessment of possible interventions. Monosodium-iodoacetate (MIA) or isotonic saline was deposited in the intercarpal joint of 20 growing pigs. Functional effects were assessed using subjective (visual lameness scoring) and objective (kinetic gait analysis) techniques at several timepoints. Structural effects were assessed by histopathology at 68 days. Eight out of 10 MIA treated animals had histopathological OA lesions confirmed in the target joint, while for all saline treated animals the target joint was judged to be normal. Pressure mat analysis revealed increased asymmetric weight bearing in these animals compared to the control group on day 3, 14, 28 and 56. Visual scoring only showed a difference between groups on day 1. MIA did not cause prolonged visible lameness, thus face validity for OA under field conditions was not entirely met. Since objective gait parameters showed decreased weightbearing as a behavioral expression of pain, it may be used as a general model for movement-induced pain in pigs.

Evaluation of recovery of limb function by use of force plate gait analysis after tibial plateau leveling osteotomy for management of dogs with unilateral cranial cruciate ligament rupture

OBJECTIVE

To evaluate recovery of limb function by use of gait force analysis after tibial plateau leveling osteotomy (TPLO) in dogs with unilateral cranial cruciate ligament (CrCL) rupture.

ANIMALS

19 dogs with unilateral CrCL rupture treated with TPLO.

PROCEDURES

Force plate gait analysis was performed before and 1, 2, 4, and 7 months after TPLO. Ground reaction forces (GRFs; which comprised peak vertical force [PVF], vertical impulse [VI], peak braking force, braking impulse, peak propulsion force [PPF], and propulsion impulse), time to switching from braking to propulsion, and vector magnitude at PVF in the forelimbs and hind limbs were evaluated.

RESULTS

GRFs in the affected hind limb were significantly lower than in the contralateral hind limb before TPLO. These variables, except for PPF, were not significantly different 7 months after TPLO. Time to the switching point in the affected hind limb was significantly less from before to 2 months after TPLO. Vector magnitude at PVF had a similar pattern as PVF and VI during the recovery process. The PVF in the ipsilateral forelimb was significantly higher than in the contralateral forelimb before TPLO.

CONCLUSIONS AND CLINICAL RELEVANCE

A similar pattern was detected between PVF or VI and craniocaudal force during recovery of dogs that underwent TPLO. Rupture of he CrCl resulted in a decrease in GRFs in the affected hind limb as well as in the switching point and PVF of limbs. However, weight distribution for the craniocaudal force was normalized before PVF or VI. Vector magnitude at PVF might be effectively evaluated by combining vertical force and craniocaudal force.

Pedobarography: a novel approach to test the efficacy of treatments for lameness; an experience with mavacoxib in dogs with elbow osteoarthritis

Background

Pedobarographic analyses detect pressure redistribution among limbs and within limbs in humans, equids and dogs. The main objective of this study was to assess the usefulness of a set of pedobarographic parameters for the detection of lameness, as well as for its suitability for assessing the effects of therapies against osteoarthritis in dogs. With this purpose, eleven large-breed lame dogs with unilateral osteoarthritis due to elbow dysplasia were evaluated using a pressure platform prior to (D0) and after 3 months (D90) of treatment with mavacoxib, a COX-2 selective NSAID. The obtained parameters were: pressure distribution between lame and sound limbs, as well as paw area, mean pressure, and peak pressure of both lame and sound limbs.

Results

The results showed statistical differences in all these parameters between lame and sound limbs at D0; however, at D90, differences were significantly decreased as result of the treatment, indicating a substantial functional recovery under the study design conditions.

Conclusions

The provided data prove the suitability of this novel technique in canine models for the quantitative and objective assessment of lameness, but also for the evaluation of treatments for lameness caused by articular pain.

Electronic supplementary material

The online version of this article (10.1186/s12917-019-1946-1) contains supplementary material, which is available to authorized users.

Relationship Between Gait Mechanics and the Speed of the Trot in the Weimaraner Dog Breed

While the size of the Weimaraner may assist in the breed performing the tasks of a sporting dog, the large size coupled with these tasks may also make the breed more susceptible to orthopedic issues. The understanding of the normal gait mechanics of the Weimaraner can be a useful tool in examining for gait abnormalities associated with these orthopedic issues, and yet, research concerning breed-specific gaits in the canine is limited. Therefore, study objectives were to define the normal Weimaraner trotting kinematics and determine the influence of speed on these parameters. Markers were attached to palpation points on the limbs and head of American Kennel Club registered Weimaraners. Dogs were tracked while performing a slow (1.2-1.7 m/s) and fast (1.9-2.3 m/s) trotting speed. Frame-by-frame analysis was performed. Paw ground contact and lift-off was documented and marker displacement was tracked. At both speeds, the trot had a diagonal footfall sequence with diagonal limb pairing alternating between diagonal bipedal support and suspension. The faster speed was achieved with significant increases in stride length and displacements of the head, withers, and fore and hind paws (P < .05). Range of motion of the elbow and hip significantly increased as the dog transitioned from a slow to fast speed (P < .05). Through gait analysis, the Weimaraner trot was defined as a 2-beat diagonal rhythm gait with suspension. Speed did not change these characteristics, but did influence stride length and linear and angular displacements, and thus, should be a consideration in clinical examination.

Comparative kinematic gait analysis in young and old Beagle dogs

Age-related involution in dogs involves loss of muscle mass and changes in connective tissue and articular cartilage. The aim of this study was to examine whether an age-related influence on joint mobility can be detected in the absence of disease. Five young (mean age 2.0 years) and five old (mean age 10.4 years) healthy and sound Beagle dogs underwent computer-assisted gait analysis during locomotion on a treadmill. Shoulder, elbow, carpal, hip, stifle, and tarsal joint angles including joint angle progression curves, minimum and maximum joint angles, and range of motion (ROM) in degrees were analyzed. The old group had a smaller maximum joint angle (p = 0.037) and ROM (p = 0.037) of the carpal joint; there were similar tendencies in the shoulder, elbow, and carpal joints. Descriptive analysis of the progression curves revealed less flexion and extension of the forelimb joints. The results indicate restricted joint mobility of the forelimb in old dogs, primarily of the carpal joint. Results in the joints of the hindlimb were inconsistent, and the contrasting alterations may be due to a compensatory mechanism. As most alterations were found in the distal joints, these should receive particular attention when examining elderly dogs.

Posturography and dynamic pedobarography in lame dogs with elbow dysplasia and cranial cruciate ligament rupture

BACKGROUND

The usefulness of studying posture and its modifications due to locomotor deficiencies of multiple origins has been widely proven in humans. To assess its suitability in the canine species, static posturography and dynamic pedobarography were performed on lame dogs affected with unilateral elbow dysplasia and cranial cruciate ligament rupture by using a pressure platform. With this objective, statokinesiograms and stabilograms, the percentage of pressure distribution between limbs, paw area, mean pressure, and peak pressure, were obtained from lame and sound dogs. These data were compared with Peak Vertical Force values originated from a force platform in the same recording sessions.

RESULTS

Significant differences were found in the parameters mentioned above between sound and lame dogs and limbs.

CONCLUSIONS

Posturography and pedobarography are useful and reliable for the monitoring of fore and hindlimb lameness in dogs, providing a new set of parameters for lameness detection.

Management of cranial cruciate ligament rupture in small dogs: A questionnaire study

Objectives: To survey the current management of cranial cruciate ligament rupture in small dogs (<15 kg) by veterinarians.

Methods: A questionnaire was distributed to veterinarians attending the British Veterinary Orthopaedic Association Spring meeting and British Small Animal Veterinary Association Annual Congress which took place in April 2010. Respondents were surveyed on their management of small dogs with cranial cruciate ligament rupture

Results: Immediate surgical management was chosen by 15.5% of the respondents. Following that, 77.6% of respondents suggested that case management would depend on severity of lameness (81%), age (72.6%), bodyweight (70.4%), degree of instability (64.8%), and duration of lameness (64.0%). Conservative management included non- steroidal antiinflammatory drugs (91.1%), short leash walks (91.1%), weight loss (89.0%), hydrotherapy (53.6%), physiotherapy (41.9%), and cage rest (24.2%). Where surgical management was chosen, 71.4% would perform the procedure rather than refer it to another practice. Surgical techniques included extra-capsular stabilisation (63.4%), corrective osteotomies (32.9%), and intra-articular stabilisation (6.8%). The demographic characteristics of the responding veterinarians had no effect on their initial management of the case. General practice veterinarians were less likely to perform a corrective osteotomy than to refer the case, but were no less likely to perform an extracapsular technique.

Clinical significance: Conservative management is still widely used for treatment of cranial cruciate ligament rupture in dogs weighing less than 15 kg; this is in agreement with previous publications on the management of this condition in small dogs.

Computer-assisted gait analysis of the dog: Comparison of two surgical techniques for the ruptured cranial cruciate ligament

Objectives: To compare the improvement in degree of lameness following surgical repair of cranial cruciate ligament rupture in dogs using computer-assisted gait analysis.

Methods: Two groups of 14 dogs were used. One group was treated by a capsular-fascial imbrication method, and the other group by tibial plateau levelling osteotomy (TPLO). All dogs underwent gait analysis prior to surgery, as well as at four days, four weeks, and four months after surgery. Symmetry indices of vertical ground reaction forces as well as vertical ground reaction forces in % body weight, joint angles and certain gait cycle parameters were evaluated.

Results: Four months after surgery, the degree of lameness expressed as symmetry index for peak vertical force for the TPLO group (5.83%) was not significantly different to the capsular-fascial imbrication group (19.05%). Within the TPLO group, there was a significantly increased ability to extend the stifle joint four months after surgery. The stifle motion pattern of the capsular-fascial imbrication group as well as the range-of-motion in both groups showed very little change at the time of the last gait analysis. The complication rate was greater in the TPLO group than in the capsular-fascial group.

Clinical significance: In conclusion the results suggest that the TPLO method leads to a faster recovery and improved limb function in comparison to the capsular-fascial imbrication method four months after surgery. Further analyses are needed to determine if the TPLO method is superior concerning long-term joint stability.

Online supplementary material: A video of the three-dimensional kinematic model is available online at: http://www.vcot-online.com

Retrospective study of 476 tibial plateau levelling osteotomy procedures

Objective: To determine the rate of subsequent ‘pivot shift’, meniscal tear and risk factors associated with complications of tibial plateau levelling osteotomy (TPLO) and to assess clinical and owner perception outcome.

Study design: Retrospective study.

Sample population: Three hundred and forty-eight dogs that had undergone TPLO surgical procedures (n = 476 stifles).

Methods: Medical records were reviewed for the retrieval of information on breed, sex, age, body weight, clinical history, radiograph findings, pre- and postoperative tibial plateau angle, limb alignment, unilateral versus bilateral disease, condition of cranial cruciate ligament (CCL) and menisci, implant material, healing time and complications. Clinical and owner-assessed questionnaire outcomes were also recorded.

Results: Forty-six (9.7%) postoperative complications were reported. Twenty (4.2%) were classified as major complications requiring an additional surgical intervention, and 26 (5.5%) as minor complications. No risk factors associated with postoperative complications were identified. Ten (2.1%) subsequent meniscal injuries in the stifles with normal unaltered menisci at time of TPLO were reported with a median postoperative time of 9.5 months. Signs of postoperative ‘pivot shift’ were reported in 15 (3.1%) stifles. All stifles with a ‘pivot shift’ had a complete CCL rupture or a debrided partial CCL rupture a medial menisectomy was identified as a risk factor for a ‘pivot shift’ (p = 0.02). Dogs with intact medial meniscus had a significantly higher activity level (p <0.0001) and a shorter time to peak function (p = 0.02) than dogs that underwent menisectomy according to an owner questionnaire.

Conclusions: Dogs with TPLO and intact meniscus seemed to have a better and faster recovery than dogs with TPLO and menisectomy based on owner questionnaires. ‘Pivot shift’ was infrequent after TPLO surgery. All dogs with a ‘pivot shift’ had a complete CCL rupture or a debrided partial CCL rupture and menisectomy was identified as a risk factor for its occurrence.

Clinical relevance: Considering the relatively low rate of subsequent meniscal injury after TPLO, systematic medial meniscal release with TPLO may be unnecessary. The ‘pivot shift’ deserved further investigation to completely understand its mechanism, to identify its anatomic components and potential consequences on the stifle joint.

An investigation of mechanical nociceptive thresholds in dogs with hind limb joint pain compared to healthy control dogs

This study investigated the effects of osteoarthritis (OA) on somatosensory processing in dogs using mechanical threshold testing. A pressure algometer was used to measure mechanical thresholds in 27 dogs with presumed hind limb osteoarthritis and 28 healthy dogs. Mechanical thresholds were measured at the stifles, radii and sternum, and were correlated with scores from an owner questionnaire and a clinical checklist, a scoring system that quantified clinical signs of osteoarthritis. The effects of age and bodyweight on mechanical thresholds were also investigated. Multiple regression models indicated that, when bodyweight was taken into account, dogs with presumed osteoarthritis had lower mechanical thresholds at the stifles than control dogs, but not at other sites. Non-parametric correlations showed that clinical checklist scores and questionnaire scores were negatively correlated with mechanical thresholds at the stifles. The results suggest that mechanical threshold testing using a pressure algometer can detect primary, and possibly secondary, hyperalgesia in dogs with presumed osteoarthritis. This suggests that the mechanical threshold testing protocol used in this study might facilitate assessment of somatosensory changes associated with disease progression or response to treatment.

Inertial sensor-based system for lameness detection in trotting dogs with induced lameness

Lameness detection can be challenging in dogs, as reflected in the reported low inter-rater agreement when visually assessing lameness. The aim of this study was to use an inertial sensor-based system to detect and quantify induced distal and proximal limb disturbances mimicking supporting and swinging limb lameness in dogs trotting on a treadmill by measuring vertical head and pelvic movement symmetry. Ten clinically sound dogs were equipped with inertial measurement units that were attached to the head, pelvis and right distal forelimb. Vertical head and pelvic movement symmetry were measured while dogs trotted on a treadmill, before and after the induction of moderate support or swinging fore- and hindlimb lameness. Four symmetry variables were calculated: the differences in displacement between the two lowest and between the two highest values of the head and pelvis per stride, respectively. These variables were defined as minimum head difference (HDmin), maximum head difference (HDmax), minimum pelvic difference (PDmin) and maximum pelvic difference (PDmax). Induction of supporting forelimb and hindlimb lameness produced significant changes in HDmin and PDmin, respectively. Swinging forelimb and hindlimb lameness produced significant changes in HDmax and PDmax, respectively. Additional compensatory ipsilateral forelimb and contralateral hindlimb movements were detected. Based on our findings, inertial sensor-based systems can be used to detect and quantify induced moderate lameness and differentiate between supporting and swinging limb lameness in dogs trotting on a treadmill. Further studies are needed to evaluate this method in dogs presented for clinical lameness evaluation and in overground locomotion.

Quantitative assessment of two methods of tiludronate administration for the treatment of lameness caused by navicular syndrome in horses

OBJECTIVE

To determine effects of 2 tiludronate administration protocols on measures of lameness in horses with navicular syndrome (NS).

ANIMALS

12 horses with bilateral forelimb NS.

PROCEDURES

Horses were randomly assigned to receive tiludronate (1 mg/kg), diluted in 5 L of isotonic electrolyte solution and delivered through a jugular vein catheter (systemic treatment group; n = 6), or tiludronate (0.1 mg/kg), diluted with saline (0.9% NaCl) solution to a total volume of 35 mL and delivered into the lateral digital vein of each forelimb with an IV regional limb perfusion (IVRLP) technique (IVRLP group; 6). Mean peak vertical ground reaction force (pVGRF) measured with a stationary force plate and subjective lameness scores (SLSs) were recorded before (day -1) and at predetermined time points after tiludronate administration on day 0. Mean pVGRFs (standardized as percentage body weight of force) and mean SLSs for the most lame forelimb and for both forelimbs of horses in each group were compared with day -1 values to determine treatment effect.

RESULTS

Mean pVGRF for both forelimbs and for the most lame forelimbs of systemically treated horses were significantly increased on days 120 and 200, compared with day -1 results. No significant difference in mean pVGRF was observed for IVRLP-treated horses. The SLSs were not improved at any time point following systemic treatment and were improved only on day 120 following IVRLP.

CONCLUSIONS AND CLINICAL RELEVANCE

Tiludronate (1 mg/kg, IV) as a single systemic treatment appeared to be beneficial for horses with NS, but no horses were judged as sound during the study period. Additional research on IVRLP with tiludronate is needed before this method can be recommended.

Effects of denervation of the hip joint on results of clinical observations and instrumented gait analysis in dogs with sodium urate crystal-induced synovitis

OBJECTIVE To evaluate the effects of selective hip joint denervation on gait abnormalities and signs of hip joint pain in dogs. ANIMALS 6 healthy adult hound-type dogs. PROCEDURES Minimally invasive denervation was performed on the right hip joint of each dog. Two weeks later, sodium urate was injected into the right hip joint to induce synovitis. Dogs were evaluated clinically and by use of instrumented gait analysis before and 2 weeks after minimally invasive denervation and 4, 8, and 24 hours after induction of synovitis. Dogs were euthanized, and necropsy and histologic examination were performed. RESULTS No kinetic or kinematic gait modifications were detected 2 weeks after minimally invasive denervation. Denervation did not eliminate signs of pain and lameness associated with sodium urate-induced synovitis. Results of histologic examination confirmed that denervation was an effective method for transecting the innervation of the craniolateral and caudolateral aspects of the hip joint capsule. CONCLUSIONS AND CLINICAL RELEVANCE In this study, minimally invasive denervation did not result in gait modifications in dogs. Denervation did not abolish the signs of pain and lameness associated with generalized induced synovitis of the hip joint. Further studies are required before conclusions can be drawn regarding the clinical usefulness of hip joint denervation for dogs with hip dysplasia.

Evaluation of inertial measurement units as a novel method for kinematic gait evaluation in dogs

OBJECTIVE

To evaluate the use of inertial measurement units (IMU) for quantification of canine limb kinematics.

METHODS

Sixteen clinically healthy, medium-sized dogs were enrolled. Baseline kinematic data were acquired using an optical motion capture system. Following this baseline data acquisition, a harness system was used for attachment of IMU to the animals. Optical kinematic data of dogs with and without the harness were compared to evaluate the influence of the harness on gait parameters. Sagittal plane joint kinematics acquired simultaneously with IMU and the optical system were compared for the carpal, tarsal, stifle and hip joints. Comparisons of data were made using the concordance correlation coefficient (CCC) test and evaluation of root mean squared errors (RMSE).

RESULTS

No significant differences were demonstrated in stance duration, swing duration or stride length between dogs instrumented with or without the harness, however, mean RMSE values ranged from 4.90° to 14.10° across the various joints. When comparing simultaneously acquired optical and IMU kinematic data, strong correlations were found for all four joints evaluated (CCC: carpus = 0.98, hock = 0.95, stifle = 0.98, hip = 0.96) and median RMSE values were similar across the joints ranging from 2.51° to 3.52°.

CONCLUSIONS AND CLINICAL RELEVANCE

Canine sagittal plane motion data acquisition with IMU is feasible, and optically acquired and IMU acquired sagittal plane kinematics had good correlation. This technology allows data acquisition outside the gait laboratory and may provide an alternative to optical kinematic gait analysis for the carpal, tarsal, stifle, and hip joints in the dog. Further investigation into this technology is indicated.