Treatment of hemorrhagic hepatic cysts with omentalization in a serval

A 2 year old, spayed female African serval was evaluated for a history of abdominal distention. Physical examination findings were consistent with cranial abdominal masses and anemia. Abdominal imaging revealed soft tissue opacity masses in the cranial abdomen and hypoechoic cysts arising from the liver parenchyma. Conservative management failed to improve clinical signs, and a midline exploratory laparotomy was performed. Three large hemorrhagic cysts were visualized occupying a significant amount of the liver parenchyma. The cysts were drained, omentalized and partially closed with a surgical stapler and suture. Histopatological evaluation of the resected tissue was consistent with a chronic hepatic hematoma. The patient recovered well and was discharged 3 days postoperatively. Two years later, the patient was readmitted with the same clinical signs and large multiple hepatic cysts involving most of the liver lobes. These were surgically omentalized similarly to the previous surgery and the patient recovered well postoperatively. Two years later, return to normal life and no recurrence of the cysts was reported.

Chronology of hip dysplasia development in a cohort of 48 Labrador retrievers followed for life

OBJECTIVE

To determine the chronology of radiographic signs of canine hip dysplasia (CHD), specifically joint laxity and secondary osteoarthritis (OA).

STUDY DESIGN

Longitudinal cohort study.

ANIMALS

Paired littermates, 48 Labrador retrievers.

METHODS

Conventional, ventrodorsal, hip-extended (HE) radiographs were evaluated yearly for CHD according to the subjective criteria of the Orthopedic Foundation for Animals (OFA). PennHIP screening was performed at 2 years of age to assess joint laxity by distraction index (DI). Histopathologic evaluation of coxofemoral joints was performed at the dogs' natural end of life.

RESULTS

Coxofemoral subluxation, as identified on the HE radiograph occurred by 2 years of age and not thereafter. Accuracy of OFA-criteria scoring was poor: 55% of dogs scored "normal" at 2 years of age became radiographically dysplastic by the end of life (45% negative predictive value, NPV); 92% of the dogs scored as normal at 2 years of age had histopathologic OA of CHD (8% NPV). The DI predicted all 48 dogs to be susceptible to OA of CHD and 98% had radiographic or histopathologic OA by the end of life.

CONCLUSION

OFA-criteria score was profoundly influenced by environmental factors, such as diet restriction and age, reducing its value as a selection criterion. DI measurements were not influenced by dietary treatment suggesting higher trait heritability.

Evaluation of the relationship between Orthopedic Foundation for Animals' hip joint scores and PennHIP distraction index values in dogs

OBJECTIVE

To compare 2 screening methods for detecting evidence of hip dysplasia (Orthopedic Foundation for Animals [OFA] and PennHIP) in dogs.

DESIGN

Diagnostic test evaluation study. Animals-439 dogs >or= 24 months of age that received routine hip joint screening from June 1987 through July 2008.

PROCEDURES

Dogs were sedated, and PennHIP radiography was performed (hip joint- extended [HE], compression, and distraction radiographic views). The HE radiographic view was submitted for OFA evaluation. A copy of the HE radiographic view plus the compression and distraction radiographic views were submitted for routine PennHIP evaluation, including quantification of hip joint laxity via the distraction index (DI).

RESULTS

14% (60/439) of dogs had hip joints scored as excellent by OFA standards; however, 52% (31/60) of those had a DI >or= 0.30 (range, 0.14 to 0.61). Eighty-two percent of (183/223) dogs with OFA-rated good hip joints had a DI >or= 0.30 (range, 0.10 to 0.77), and 94% (79/84) of dogs with OFA-rated fair hip joints had a DI >or= 0.30 (range, 0.14 to 0.77). Of all dogs with fair to excellent hip joints by OFA standards, 80% (293/367) had a DI >or= 0.30. All dogs with OFA-rated borderline hip joints or mild, moderate, or severe hip dysplasia had a DI >or= 0.30 (range, 0.30 to 0.83).

CONCLUSION AND CLINICAL RELEVANCE

Dogs judged as phenotypically normal by the OFA harbored clinically important passive hip joint laxity as determined via distraction radiography. Results suggested that OFA scoring of HE radiographs underestimated susceptibility to osteoarthritis in dogs, which may impede progress in reducing or eliminating hip dysplasia through breeding.

Porcine Small Intestinal Submucosa Augmentation Urethroplasty and Balloon Dilatation of a Urethral Stricture Secondary to Inadvertent Prostatectomy in a Dog

A 10-month-old, male German shepherd dog experienced inadvertent prostatectomy during cryptorchidectomy. Cystourethral anastomosis was performed 1 day later. The dog developed stranguria and incontinence. A proximal urethral stricture was diagnosed with a contrast urethrogram 5 weeks later. Urethral augmentation with an onlay graft of porcine small intestinal submucosa was performed. Urinary diversion was accomplished with a urethral catheter followed by a cystostomy tube. The stricture recurred over the next 6 weeks. Three urethral balloon dilatations were performed 3 days apart, with the third attempt resulting in expansion of the stricture. Twenty-two months postdilatation, the dog intermittently urinated with a steady stream and had mild to moderate urinary incontinence.

Preputial damage and lateral penile displacement during castration in a degu

CASE DESCRIPTION

A 2-month-old male degu was treated for preputial damage and lateral penile displacement that occurred during attempted castration.

CLINICAL FINDINGS

Bruising and swelling of the prepuce and severe edema to the left of the prepuce were evident. The penis could not be extruded from the prepuce. Radiography revealed a large bladder. Contrast medium injected into the prepuce filled the peripreputial subcutaneous tissues.

TREATMENT AND OUTCOME

During surgical exploration through a peripreputial approach, the penis was found to be completely separated from the prepuce and located in the adjacent subcutaneous tissue. The penis was repositioned in the prepuce and anchored with a suture at its base. The following day, the preputial orifice was crusted over, urine was leaking from the incision, and the penis could not be extruded from the prepuce. The anchoring suture was removed, and the tip of the penis was sutured to the preputial orifice so that the penis protruded slightly from the prepuce. Urination was normal after the second surgery. Two years later, the preputial orifice remained adhered to the distal portion of the penis and the exposed penile tissue was healthy.

CLINICAL RELEVANCE

Penile displacement from the prepuce is an unusual complication of castration in degus. The surgical technique used in this animal may be an effective means of repair. Permanent exposure of the tip of the penis may be well-tolerated in degus.

Evaluation of a circumferential femoral head osteophyte as an early indicator of osteoarthritis characteristic of canine hip dysplasia in dogs

OBJECTIVE

To determine the relationship between a circumferential femoral head osteophyte (CFHO) and osteoarthritis characteristic of canine hip dysplasia, and to ascertain whether CFHO, like osteoarthritis, varies between diet-restricted and control-fed dogs.

DESIGN

Longitudinal cohort study.

ANIMALS

48 Labrador Retrievers.

PROCEDURES

Dogs were paired by size, sex, and litter and assigned to 1 of 2 equal groups at 2 months of age. The control-fed group was fed ad libitum, and the diet-restricted group was fed 25% less on a pairwise basis of the same diet for life. The dogs' hip joints were radiographed yearly for life. Each radiograph was evaluated for radiographic signs of osteoarthritis characteristic of hip dysplasia and for the presence and severity of a CFHO.

RESULTS

41 of the 48 (85.4%) dogs had a CFHO, which was detected at a median age of 5.4 years, and 33 of those 41 (80.5%) developed radiographic evidence of osteoarthritis. Nineteen (79.2%) dogs in the diet-restricted group and 22 (91.7%) in the control-fed group had a CFHO at a median age of 9 and 3 years, respectively. Of the dogs with a CFHO, 12 (63.2%) in the diet-restricted group and 20 (90.0%) in the control-fed group developed radiographic evidence of osteoarthritis characteristic of hip dysplasia at a median age of 11 and 6.5 years, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated a relationship between the CFHO and subsequent development of radiographic signs of osteoarthritis. If a CFHO is present in Labrador Retrievers, it might be considered an early indicator of osteoarthritis.

Lifelong diet restriction and radiographic evidence of osteoarthritis of the hip joint in dogs

OBJECTIVE

To evaluate the effects of diet restriction on development of radiographic evidence of hip joint osteoarthritis in dogs.

DESIGN

Longitudinal cohort study.

ANIMALS

48 Labrador Retrievers from 7 litters.

PROCEDURES

Forty-eight 6-week-old puppies from 7 litters were paired with littermates by sex and weight, and each pairmate was randomly assigned to 1 of 2 groups of 24 dogs each. Starting at 8 weeks of age, 1 group was fed ad libitum (control fed) and the other was fed 25% less (restricted fed) of the same diet for life on a pairwise basis. The dogs' hip joints were radiographed in the standard ventrodorsal hip-extended view at multiple intervals prior to 1 year of age and at annual intervals thereafter on the basis of birth anniversary. A board-certified radiologist unaware of group assignment scored the radiographs for evidence of osteoarthritis.

RESULTS

Prevalence of radiographic evidence of hip joint osteoarthritis in all dogs increased linearly throughout the study, from an overall prevalence of 15% at 2 years to 67% by 14 years. Restricted-fed dogs had lower prevalence and later onset of hip joint osteoarthritis. Median age at first identification of radiographic evidence of hip joint osteoarthritis was significantly lower in the control-fed group (6 years), compared with the restricted-fed group (12 years).

CONCLUSIONS AND CLINICAL RELEVANCE

Restricted feeding delayed or prevented development of radiographic signs of hip joint osteoarthritis in this cohort of Labrador Retrievers. Lifetime maintenance of 25% diet restriction delayed onset and reduced severity of hip joint osteoarthritis, thus favorably affecting both duration and quality of life. In addition, the data indicated that development of hip joint osteoarthritis was not bimodal in these dogs but occurred as a continuum throughout life.

Evaluation of the Norberg Angle Threshold: A Comparison of Norberg Angle and Distraction Index as Measures of Coxofemoral Degenerative Joint Disease Susceptibility in Seven Breeds of Dogs

OBJECTIVE

To evaluate the thresholds of 2 radiographic methods used to determine coxofemoral joint laxity in 7 breeds of dogs.

ANIMALS

Three hundred and fifty clinically normal dogs.

STUDY DESIGN

Retrospective study.

METHODS

Hip radiographs from 7 breeds of dogs were randomly selected from a database. None of the dogs had radiographic evidence of degenerative joint disease (DJD). Distraction index (DI) and Norberg angle (NA) were measured on these radiographs and compared with DI and NA thresholds for diagnosing DJD susceptibility derived from the literature and from evaluated Borzois. Dogs with a NA<105 degrees and a DI of < or =0.32 were considered false-positives and dogs with a NA> or =105 degrees and a DI of >0.32 were considered false-negatives.

RESULTS

Mean age of all dogs was 22.9 months. Mean NA for all dogs was 99.37 degrees, and mean DI for all dogs was 0.44. Borzoi mean DI of was significantly less than the mean DI of the other 6 breeds. The highest (most hip laxity) Borzoi DI was 0.32, and the lowest (most hip laxity) Borzoi NA was 99 degrees. False-positive and false-negative diagnoses were identified in 6 of the 7 breeds.

CONCLUSIONS

Using the NA threshold of 105 degrees (literature established threshold of susceptibility to DJD) resulted in a high percentage of false-negative and false-positive diagnoses. Breeds like the Labrador Retriever and Rottweiler would have large numbers of hip dysplasia susceptible dogs remain in the breeding population based on this NA threshold. False-positive diagnoses were common in breeds like the Australian Shepherd, Borzoi, and German Shepherd effectively eliminating hip dysplasia nonsusceptible dogs from the breeding population.

CLINICAL RELEVANCE

The NA was not an accurate predictor of DJD susceptibility in these 7 breeds of dogs when using a NA threshold of 105 degrees.

Effects of electrostimulated acupuncture on ground reaction forces and pain scores in dogs with chronic elbow joint arthritis

OBJECTIVE

To determine whether use of electrostimuluated acupuncture (ESA) would result in significant improvements in ground reaction forces and lameness scores in dogs with chronic elbow joint osteoarthritis secondary to elbow joint dysplasia.

DESIGN

Randomized, controlled, crossover clinical trial.

ANIMALS

9 dogs with chronic forelimb lameness and radiographic evidence of elbow joint osteoarthritis.

PROCEDURES

All dogs had a 3-week control acclimation period during which gait analysis was performed weekly. Dogs then received ESA once weekly for 3 weeks followed by a sham treatment once weekly for 3 weeks or received the sham treatment followed by ESA. Gait analysis was repeated prior to each treatment, and owners were asked to provide pain scores by use of a visual analog scale method.

RESULTS

Treatment (control, acupuncture, or sham) did not have a significant effect on ground reaction forces for any limb. Owners of 8 of the 9 dogs were able to correctly guess the time period when ESA was delivered.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that ESA did not have any significant effects on severity of lameness, as determined by measurement of ground reaction forces, or severity of pain, as determined by visual analog scale pain scores, in dogs with chronic elbow joint osteoarthritis secondary to elbow joint dysplasia.

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

OBJECTIVE

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

DESIGN

Retrospective study.

ANIMALS

369 client-owned dogs.

PROCEDURES

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

RESULTS

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

CONCLUSIONS AND CLINICAL RELEVANCE

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

Use of the caudolateral curvilinear osteophyte as an early marker for future development of osteoarthritis associated with hip dysplasia in dogs

OBJECTIVE

To determine the relationship between the caudolateral curvilinear osteophyte (CCO) and osteoarthritis associated with hip dysplasia in dogs.

DESIGN

Longitudinal cohort study.

ANIMALS

48 Labrador Retrievers from 7 litters.

PROCEDURE

In each of 24 sex- and size-matched pairs fed the same diet, a restricted-fed dog was fed 25% less than a control dog for life. The dogs' hips were evaluated in the standard ventrodorsal hip-extended radiographic projection at 16, 30, and 52 weeks of age and then yearly for life. Histologic examination of hip joint tissues was performed on 45 dogs.

RESULTS

Median age at death was 11.2 years. Adjusting for feeding group, dogs with a CCO were 3.7 times as likely to develop radiographic signs of osteoarthritis than those without a CCO. Stratified by diet, 100% of the control dogs with a CCO developed radiographic signs of osteoarthritis and 55% of restricted-fed dogs with a CCO developed radiographic signs of osteoarthritis. The CCO was the first radiographic change seen in 22 of 29 (76%) dogs with osteoarthritis. Overall, 35 of 37 (95%) dogs with a CCO had histopathologic lesions of osteoarthritis.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicate a relationship between a CCO on the femoral neck and subsequent development of radiographic signs of osteoarthritis in Labrador Retrievers evaluated over their life span. A CCO is an important early radiographic indication of osteoarthritis associated with canine hip dysplasia.