Surgery

While considered a very common problem in small animal medicine, osteoarthritis is very likely the most under diagnosed, and misunderstood rheumatic disease in dogs and cats. Part of the problem veterinarians face with OA is that it is a slow, progressive and often insidious problem.

It is important to understand that when a dog presents with a dog with hip laxity (hip dysplasia) with or without secondary degenerative changes, that there is not one single way to manage every patient. Initially, one must decide if a particular patient is better suited for medical or surgical options.

Current treatment options for osteoarthritis are extensive and can be categorized into medical/ conservative or surgical therapies. Medical therapies may consist of weight control, exercise modification, rehabilitation therapy, pain management medications, oral joint protective compounds, and intra-articular treatments.

The most common hind limb orthopedic/sports medicine conditions afflicting active dogs are iliopsoas strains, cranial cruciate ligament (CCL) insuffiency and gracilis and semitendinosus contracture. Of the hind limb muscular injuries iliopsoas strain is, by a considerable margin, seen more frequently than gracilis and semitendinosus contracture.

There are numerous studies indicating the positive benefits of rehabilitation therapy following CCL surgery. In summary, rehabilitation therapy has been shown to improve muscle mass and attenuate muscle atrophy that occurs in the post-operative period, increase stifle joint ROM, especially extension, improve weight-bearing as measured by force plate analysis, and reduce the progression of osteoarthritis.

Soft tissue injuries and osteoarthritis are common conditions afflicting active dogs due to the repetitive forces placed on the joints. Microtrauma to the tendons, ligaments, and the articular surfaces of joints can occur, creating an environment for osteoarthritic development.

Megacolon occurs more frequently in cats than dogs and is usually seen in middle-aged to geriatric cats. The ascending, transverse, and descending colon are chronically large in diameter and filled with dry stool. A congenital form of the disease has been seen especially in Manx cats with rectal/anal atresia and a sacral spinal deformity.

Metallic implants placed in the body should be corrosion-resistant, biocompatible, and must have adequate strength to withstand functional stress. Corrosion of metal occurs because of the electrochemical ions in body fluid. Most metal implants currently used in veterinary surgery are of 316L stainless steel.

Similar to dogs, joint disorders of the cat are common. Despite this fact, the reported treatment options for cats with joint disease are limited. The object of this presentation is to describe the clinical findings, surgical / arthroscopic findings and post-operative management of cats with joint disorders including elbow osteoarthritis and medial compartment disease, shoulder osteoarthritis and medial shoulder instability, and cranial cruciate ligament insufficiency.

Careful consideration of preoperative, intraoperative, and postoperative management techniques will assist in preventing complications related to anesthesia and surgery in patients with urinary tract surgical disease. Hospital acquired renal insufficiency is common in humans, seemingly less so in animals but caution is advised. Hypotension of any cause is a potential predisposing cause to renal failure.

Diagnosing and treating forelimb conditions in dogs can be very challenging. Many dogs present with a similar history including minimal responsive to rest and non-steroidal anti-inflammatory drugs and increased lameness following exercise and heavy activity. It can be difficult to localize the lesion on palpation as many dogs may show increased sensitivity in the shoulder and elbow from referred pain and compensation.

A working definition of antimicrobial prophylaxis in surgery is the administration of an antimicrobial drug to a patient, in the absence of infection, prior to surgery. The history of the use of these agents during surgery is interesting and reveals many of the problems which occur with their use.

A systematic approach can help ensure safety.

Four studies on treating joint disease.

A roundtable discussion of joint health and disease in dogs and cats.

Owners and veterinarians often seek additional therapies for dogs with osteoarthritis that are safe and effective.

Tube drainage of the thorax is indicated to drain free air or fluid in the pleural space. This is not an absolute indication as small amounts of air within the thorax do not require a thoracostomy tube. Similarly, the presence of blood within the pleural space is not usually an indication for thoracic drainage.

Surgical fenestration of the intervertebral space provides a means of prophylaxis on disk disease. If protrusion exists, surgical removal of the nucleus remaining in the intervertebral area will eliminate the pressure causing the protrusion.

The advantages of the tightrope repair technique.

When we use a circulating warm-water blanket under a surgical patient, we lay a clean towel under the blanket.

When suturing after a wedge resection from an eyelid margin, it can be challenging to keep the suture ends from irritating the eye.

The primary advantage staples provide over sutures is rapid closure.

Important interventions to help you improve a patient's chances of survival.

In this presentation, Dr. Theresa J. Fossum discusses what's new regarding risk factors for this deadly disease, what to tell your clients who have high risk pets, whether prophylactic gastropexy is indicated, what you can do to reduce mortality, how quickly you need to operate and the best gastropexy techniques to use. (1 CE credit)

Dr. Allyson Berent of New York's Animal Medical Center takes a look at the indications for interventional radiology in veterinary patients.

Dr. Chick Weisse discusses using interventional radiology to administer chemotherapeutic drugs and other oncology treatments.

A word of caution about maxillectomies.

What are the signs of this condition in puppies and kittens?

When assisting with anesthesia and surgery, our technician sets her cell phone, which is in her pocket, to vibrate every five minutes.

A reader tip for catching the drainage that results from ear hematoma surgery.