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Suwankanit K, Shimizu M. Effects of Neuromuscular Electrical Stimulation and Therapeutic Ultrasound on Quadriceps Contracture of Immobilized Rats. Vet Sci 2024; 11:158. [PMID: 38668425 PMCID: PMC11054819 DOI: 10.3390/vetsci11040158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/29/2024] Open
Abstract
Quadriceps contracture is a condition where the muscle-tendon unit is abnormally shortened. The treatment prognosis is guarded to poor depending on the progress of the disease. To improve the prognosis, we investigated the effectiveness of therapeutic ultrasound and NMES in treating quadriceps contracture in an immobilized rat model. Thirty-six Wistar rats were randomized into control, immobilization alone, immobilization and spontaneous recovery, immobilization and therapeutic ultrasound, immobilization and NMES, and immobilization and therapeutic ultrasound and NMES combination groups. The continuous therapeutic ultrasound (frequency, 3 MHz, intensity 1 W/cm2) and NMES (TENS mode, frequency 50 Hz; intensity 5.0 ± 0.8 mA) were performed on the quadriceps muscle. On Day 15, immobilization-induced quadriceps contracture resulted in a decreased ROM of the stifle joint, reduction in the sarcomere length, muscle atrophy, and muscle fibrosis. On Day 43, therapeutic ultrasound, NMES, and combining both methods improved muscle atrophy and shortening and decreased collagen type I and III and α-SMA protein. The combination of therapeutic ultrasound and NMES significantly reduced the mRNA expression of IL-1β, TGF-β1, and HIF-1α and increased TGF-β3. Therefore, the combination of therapeutic ultrasound and NMES is the most potent rehabilitation program for treating quadriceps contracture.
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Affiliation(s)
- Kanokwan Suwankanit
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu 183-0054, Tokyo, Japan;
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Miki Shimizu
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu 183-0054, Tokyo, Japan;
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Tsai FC, Alvarez LX. Outcome of eight working dogs with fibrotic myopathy following extracorporeal shockwave and rehabilitation therapy: a case series. Front Vet Sci 2024; 10:1258319. [PMID: 38260195 PMCID: PMC10800511 DOI: 10.3389/fvets.2023.1258319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Fibrotic myopathy of the gracilis, semitendinosus, and semimembranosus is described primarily in working German Shepherd dogs. The purpose of this case series is to describe the rehabilitation modalities and treatments utilized in working dogs with fibrotic myopathy and the time frame they were able to continue working. Methods Medical records of patients with hindlimb lameness that were presented to the Schwarzman Animal Medical Center in New York City from 2012 to 2023 were retrospectively searched. Signalment, history, clinical evaluation, gait analysis, goniometry of stifles, and follow-up evaluation were compared among patients. Ten male working dogs met inclusion criteria. Extracorporeal Shockwave Therapy (ECSWT) was administered under sedation or general anesthesia. Rehabilitation therapy (RT), including massage, hamstring stretch, photobiomodulation, pulsed electromagnetic field therapy, warm compress, therapeutic ultrasound, underwater treadmill, and therapeutic exercises, were performed once every one to 3 weeks with varying protocols according to patient assessments. Follow-up phone calls and emails were conducted to determine long-term outcome. Results On average, dogs were able to work full-time for 32.1 months (range 6-82; SD 23.6) from the time of diagnosis. No activity limitation was reported by the owners/handlers. Discussion This report is the first to describe non-invasive medical treatments that may extend the working ability of dogs diagnosed with fibrotic myopathy. Further prospective randomized controlled studies are needed to demonstrate the efficacy of ECSWT and RT for treating fibrotic myopathy. Conclusion The results of this retrospective study suggest that the combination of ECSWT and RT may allow working dogs with fibrotic myopathy to continue their working capacity for an extended period of time.
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Affiliation(s)
- Frank C. Tsai
- Department of Integrative and Rehabilitative Medicine, Schwarzman Animal Medical Center, New York, NY, United States
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Suwankanit K, Shimizu M, Suzuki K, Kaneda M. Usefulness of Ultrasound Shear Wave Elastography for Detection of Quadriceps Contracture in Immobilized Rats. Animals (Basel) 2023; 14:76. [PMID: 38200807 PMCID: PMC10778017 DOI: 10.3390/ani14010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Quadriceps contracture is an abnormal pathological shortening of the muscle-tendon unit. To improve the prognosis of quadriceps contracture, improvement of its diagnostic method is needed. In this study, we evaluated the diagnostic utility of ultrasound shear wave elastography in a rat model of quadriceps contracture induced by immobilization. Fifty Wistar rats were randomly divided into control and immobilization groups. During up to 4 weeks of joint immobilization, the quadriceps elastic modulus, muscle hardness, creatinine phosphokinase levels, joint range of motion, histopathologic parameters, and levels of fibrosis-associated mRNA expression were measured every week in the immobilization and control groups and compared. In the immobilization group, the elastic modulus gradually but significantly increased (p < 0.05) throughout the immobilization period. However, muscle hardness and serum creatinine phosphokinase levels only increased at 1 and 2 weeks after the start of immobilization, respectively. Muscle atrophy and shortening progressed throughout the immobilization group. Collagen type I and III, α-SMA protein, and mRNA expression of IL-1β and TGF-β1 significantly increased (p < 0.05) throughout in the immobilization group. Ultrasound shear wave elastography is the most useful method for clinical assessment of muscle contracture.
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Affiliation(s)
- Kanokwan Suwankanit
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-0054, Japan;
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Miki Shimizu
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-0054, Japan;
| | - Kazuhiko Suzuki
- Laboratory of Veterinary Toxicology, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-0054, Japan;
| | - Masahiro Kaneda
- Laboratory of Veterinary Anatomy, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-8509, Japan;
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Millis D, Janas K. Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis. Vet Clin North Am Small Anim Pract 2021; 51:235-251. [PMID: 33446365 DOI: 10.1016/j.cvsm.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Darryl Millis
- University of Tennessee College of Veterinary Medicine, 2407 River Drive, Knoxville, TN 37996, USA.
| | - Krysta Janas
- University of Tennessee College of Veterinary Medicine, 2407 River Drive, Knoxville, TN 37996, USA
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Mestieri MLDA, dos Santos BG, da Silva MNG, Pascon JPDE, Carneiro LZ. Ultrasonographic diagnosis of bilateral partial rupture of the infraspinatus muscle in a racing greyhound. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2021; 43:e003120. [PMID: 35749086 PMCID: PMC9179189 DOI: 10.29374/2527-2179.bjvm003120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/03/2021] [Indexed: 12/02/2022] Open
Abstract
Athletic dogs are more susceptible to musculoskeletal disorders, especially in the muscles or tendons surrounding the shoulder joint. In this report, we describe a case of partial bilateral rupture of the infraspinatus muscle, an unusual injury. Clinical signs included lameness of the left thoracic limb after training. On physical examination, there was discomfort on bilateral palpation in the infraspinatus fossa region. The main clinical suspicion was partial rupture or myositis of the infraspinatus muscle (IF). Ultrasound examination of the region revealed the presence of hypoechoic areas intermingling the muscle fibers in a deeper and distal region of the infraspinatus muscle, compatible with edema or bilateral intramuscular hematoma (left +++, right ++) and integrity of the fascia. The findings were characterized as a partial rupture of the musculature. A detailed physical examination associated with ultrasound examination is essential for early diagnosis and therapeutic management. Although no other reports of partial rupture of the IF have been found, partial or complete rupture of muscle fibers in sport dogs is frequent. Early diagnosis prevents the development of contractures due to the institution of therapy before the fibrous process is established and improves prognosis.
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Affiliation(s)
- Maria Ligia de Arruda Mestieri
- Veterinarian, Programa de Pós-Graduação em Ciência Animal, Universidade Federal do Pampa (UNIPAMPA), Uruguaiana, RS, Brazil.
| | - Bruna Gonzalez dos Santos
- Veterinarian, Programa de Pós-Graduação em Ciência Animal, Universidade Federal do Pampa (UNIPAMPA), Uruguaiana, RS, Brazil.
- Correspondence Bruna Gonzalez dos Santos Programa de Pós-graduação em Ciência Animal, Universidade Federal do Pampa - UNIPAMPA BR 472, Km 585, CP 118 CEP 97501-970 - Uruguaiana (RS), Brasil E-mail:
| | | | - João Paulo da Exaltação Pascon
- Veterinarian, Programa de Pós-Graduação em Ciência Animal, Universidade Federal do Pampa (UNIPAMPA), Uruguaiana, RS, Brazil.
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McGeachan RI, Schwarz T, Gunn-Moore DA, Marioni-Henry K. Botulinum toxin type A for the treatment of muscle contractures secondary to acute spinal cord injury in a young cat. JFMS Open Rep 2020; 6:2055116920922648. [PMID: 35145724 PMCID: PMC8822334 DOI: 10.1177/2055116920922648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 4-month-old male entire domestic shorthair cat presented for sudden onset of right thoracic monoparesis following a fall; within 18 h, the clinical signs progressed to non-ambulatory right hemiplegia with absent sensation in the distal right thoracic limb and left hemiparesis. MRI revealed changes consistent with a C6-C7 acute non-compressive nucleus pulposus extrusion with suspected secondary C5-C7 spinal cord haemorrhage. Rehabilitation exercises were started immediately after the diagnosis of acute spinal cord trauma. Sensation in the right thoracic limb improved and, with the help of a splint applied to that limb, the cat was ambulatory on all four limbs. Unfortunately, clinical signs started to progress over the course of 10 days. The cat developed progressive discomfort on manipulation of the right elbow and carpus, and a hyperflexion of the right carpus. Radiographs revealed no skeletal abnormalities. Muscle contractures were suspected. Under general anaesthesia the triceps and flexor muscles of the carpus and digits were injected with a total of 100 U of botulinum toxin type A (BTX-A). No complications were associated with the procedure and 24 h after the injection the carpal hyperflexion resolved. Relevance and novel information The use of BTX-A to treat muscle contractures in human medicine is an established and increasingly used technique. For example, in subacute stroke patients with a non-functional arm, BTX-A forearm injection appears to prevent disabling finger stiffness, likely by minimising the development of contractures. Here, we demonstrate that intramuscular BTX-A is an effective treatment for acquired muscle contractures in a cat.
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Affiliation(s)
- Robert I McGeachan
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, UK
| | - Tobias Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, UK
| | - Danièlle A Gunn-Moore
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, UK
| | - Katia Marioni-Henry
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, UK
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Tisdall PL, Rogowski CP. Use of adjunctive prednisolone in the management of a cat with bilateral quadriceps contracture following trauma. JFMS Open Rep 2017; 3:2055116917695876. [PMID: 28491455 PMCID: PMC5415297 DOI: 10.1177/2055116917695876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Case summary A 6-month-old cat was successfully treated for bilateral quadriceps contracture. Conventional treatments including surgery, dynamic flexion apparatus and physical therapy along with analgesics and non-steroidal anti-inflammatory drugs resulted in temporary clinical improvement that was relapsing. The initiation of supplementary corticosteroid treatment with prednisolone coincided with an immediate and sustained clinical improvement and long-term resolution. Relevance and novel information Successful treatment of bilateral quadriceps contracture has not previously been reported in a cat. Quadriceps contracture remains a challenging condition to treat with some cases unresponsive to therapy. Systemic prednisolone treatment appeared to be of benefit in the management of this case and may have a role in some cats where muscle contracture appears relapsing in nature. Further prospective investigations in cats with muscle contracture, including muscle biopsies of affected cats, are warranted.
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Affiliation(s)
- Penelope Lc Tisdall
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Roseworthy, Australia
| | - Cameron P Rogowski
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Roseworthy, Australia
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Thom LK, Pool RR, Malik R. Digital flexor musculotendinous contracture in two Devon Rex cats. J Feline Med Surg 2017; 19:304-310. [PMID: 28245736 DOI: 10.1177/1098612x17693503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Clinical summary: A 13-year-old, spayed Devon Rex with unilateral digital flexor musculotendinous contracture of the forelimb was treated by surgical tenotomy. The condition improved transiently, but recurred rapidly and became bilateral. Histopathologic analysis of necropsy tissues resulted in a morphologic diagnosis of fibromyositis of the antebrachial muscles causing contracture and flexural deformity of the carpi and phalanges of both thoracic limbs. A search for similar cases yielded the clinical notes of a second cat, a 10-year-old, spayed Devon Rex, also with bilateral disease. This second case responded well to surgical tenotomy but tissue biopsies were not obtained to permit microscopic assessment of the underlying pathologic process. Relevance and novel information: Acquired and permanent contracture of the digital flexor muscles and/or tendons of the forelimbs is a rare and poorly described condition of cats. The very limited number of documented cases describing disease affecting one or more digits (but not the carpus) infers a causal link with onychectomy, but reported histopathologic changes have been limited to the tendons. The two cases described in this report suffered contracture of the carpus and all digits bilaterally, one without previous onychectomy and the other 9 years after onychectomy. There were novel histopathologic findings in the muscles of the one case for which biopsy material was available. Information gained from these two cases provides a new perspective for the investigation and treatment of future cases. Specifically, consideration should be given to an underlying immune-mediated myopathic process and a possible genetic predisposition in the Devon Rex breed. Currently, the poorly understood etiopathogenesis hinders our ability to definitively recommend treatment options, which might include corticosteroids and other forms of immunosuppressive therapy.
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Affiliation(s)
| | - Roy R Pool
- 2 Osteopathology and Dental Services, Texas A&M University, College Station, Texas, USA
| | - Richard Malik
- 3 Centre for Veterinary Education, University of Sydney, New South Wales, Australia
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Cabon Q, Plante J, Gatineau M. Digital flexor tendon contracture treated by tenectomy: different clinical presentations in three cats. JFMS Open Rep 2015; 1:2055116915597237. [PMID: 28491376 PMCID: PMC5362020 DOI: 10.1177/2055116915597237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 11/21/2022] Open
Abstract
Case series summary Three cats, Siamese or Siamese cross, were presented with a chronic thoracic limb weightbearing lameness. Previous anti-inflammatory administrations were unable to improve lameness consistently in the three cats. Two of the three cats had undergone onychectomy several years before presentation. A permanent flexion of the proximal interphalangeal joint of one or more digits, associated with a difficult and painful extension of the proximal interphalangeal joint, was noticed during orthopedic examination. A digital flexor tendon contracture was suspected and confirmed with radiographic examination. Surgical exploration was then performed. For all cats, treatment consisted of a tenectomy or tenotomy of the superficial and deep digital flexor tendons in order to release the contracture. The three cats responded well to the surgical treatment and became sound around 2–4 weeks after surgery. Relevance and novel information Digital flexor tendon contracture is rarely reported as a cause of lameness in cats. It should be considered in a differential diagnosis of feline lameness whenever onychectomy has been performed in the past. The precise etiology that explains this tendon contracture is unknown, but trauma or breed predisposition could represent potential causes.
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Affiliation(s)
- Quentin Cabon
- Surgery Department, VetAgroSup, Veterinary Campus of Lyon, Marcy l'Etoile, France
| | - Jérôme Plante
- DMV Veterinary Centre, Montréal (Lachine), Québec, Canada
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Nielsen LK, Whelan M. Compartment syndrome: pathophysiology, clinical presentations, treatment, and prevention in human and veterinary medicine. J Vet Emerg Crit Care (San Antonio) 2012; 22:291-302. [PMID: 22554185 DOI: 10.1111/j.1476-4431.2012.00750.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/11/2011] [Accepted: 03/25/2012] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To review the human and veterinary literature pertaining to all forms of compartment syndrome (CS). DATA SOURCES Data sources included scientific reviews and original research publications from the human and veterinary literature. HUMAN DATA SYNTHESIS While CS affecting the extremities has been recognized in people for decades, other forms of CS in the abdominal and thoracic cavities are recently gaining more attention. The role of CS in critically ill people is a rapidly growing area of interest. More research on prevention and treatment of CS is being conducted in people because some studies have found mortality rates as high as 80% for those suffering from these conditions. VETERINARY DATA SYNTHESIS While a significant amount of experimental studies of CS have been performed on small animals, there is a marked lack of primary veterinary studies. The majority of the veterinary literature includes case reports and series, and many of these studies were published over a decade ago. However, the increased recognition of CS in people has sparked an interest in veterinary critical care medicine and this has been demonstrated by the recent increased evaluation of compartment pressures in veterinary patients. CONCLUSIONS CS is a complex clinical condition where increased pressure within a compartment can cause significant adverse effects within the compartment as well as throughout the body. Systemic inflammatory responses and local ischemia-reperfusion elements can contribute to the detrimental effects seen in CS. This cascade of events results in increased mortality rates and contributes to the development of CS elsewhere. A better understanding of CS will help veterinarians improve patient care and outcome. Future studies on incidence, prevention, and treatment of CSs in the critical care patient are needed in veterinary medicine.
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