Our Week in Review "Patient of the Week" contest is now located
on our newly rennovated/remodeled website.
on our newly rennovated/remodeled website.
Monday, July 12, 2010
Tuesday, July 6, 2010
POTW June 21st thru June 25th, 2010
Our Patient of the Week for last week's voting contest was:
Willie with 308 votes!
Who will be our winner for this week's voting contest? Vote now!
Monday, June 28, 2010
Monday, June 21, 2010
POTW June 7 thru June 11, 2010
The winner of our Patient of the Week poll last week
Boogie with 104 votes!
Monday, June 14, 2010
POTW May 31st thru June 4th, 2010
The winner of our Patient of the Week poll last week was
Maddie with 349 Votes!
PATIENT SUMMARY:Lindsey is a Terrier Mix weighing 40# and is 2yrs old. Her referring veterinarian is Dr. J.K. Montgomery of Fox Ridge Animal Hospital. Lindsey had Bilateral TTT surgeries 1 year ago. She returned to our facility to have her Left cruciate corrected by EFS.
TREATMENT:Dr. Dew used a lateral approach with lateral arthrotomy. He explored, debrided, lavaged, and imbricated joint EFS using medial buttress suture #0-PDS. Lindsey’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function.
Winchester is a 55# 13yr old Labrador Retriever. Dr. Keith Johnson of Yale Road Animal Clinic referred her to us. Winchester has had a progressive onset of stridor and exercise intolerance over the past 6 months. Upon examination, stridor and tongue cyanosis were consistent with laryngeal paralysis. Dr. Dew discussed laryngeal paralysis and tumor as potential etiologies, as well as arytenoid tie-back procedure, recovery and prognosis. Her owner decided to proceed with surgery.
TREATMENT:
Dr. Dew performed a tracheoscopy to confirm his diagnosis. He used a left lateral approach for Winchester’s arytenoid tie-back. He identified muscular process, and cricothyroid disarticulation. He used two 0-nylon suture for the tie-back. Winchester has a good prognosis for an uncomplicated recovery and improved quality of life. For the first 24 hours, the chance of airway edema is present, therefore it is recommended that she be watched at a 24-hour facility. Dogs with an arytenoid tie-back will experience an occasional bout of aspiration pneumonia. When this occurs, Winchester will become lethargic and stop eating. Dr, Johnson can confirm the diagnosis with a chest radiograph and antibiotics should resolved the problem.
Chotka is a 85# 10yr old Doberman Pinscher. She was referred to us by Dr. Doug Kenney of Frayser-Raleigh Animal Hospital. Chotka was having more difficulty rising and was showing reluctance to walk. Upon exam, Dr. Dew noted positive anterior drawer and medial buttress of the right stifle, as well as loss of muscle mass on right rear. He discussed the likelihood of multiple joint issues, hips, stifles, lumbar spine, but TTA (tibial tuberosity advancement) on the right stifle should benefit overall function. Her owner decided to proceed with a right TTA.
TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. Hardware from Kyon used were as follows: 12x22mm basket, 6 hole plate & fork, and 4 titanium screws. A bone graft was also placed along with the hardware to promote positive bone growth and healing. Chotka’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function. With the TTA procedure, it is not uncommon to see some bruising and edema around the hock (ankle) and on the inside of the leg below the incision. These changes are not painful and will resolve without treatment in 3-10 days.
Amy is a 4yr old 45# Bassett Hound. She was referred to us by Dr. Michael Drennan of Hillcrest Animal Hospital. Amy is a rescue baby with TMJ subluxation. Her mandible had luxated out of place and been closed-reduced several times. Dr. Dew discussed suture imbrication, tape muzzle and gruel diet, with a good prognosis for healing and return to normal function. An agent from Bartlett Animal Shelter consented for Amy’s surgery.
TREATMENT:
Dr. Dew used a lateral approach for the suture imbrication. He used 2-0 PDS, lavaged, assessed range of motion, and placed a tape muzzle. Amy’s prognosis is good for soft tissue healing and return to normal function.
Buster is a Siamese mix. He weighs 11.11# and is 14yrs old. He was referred to us by Dr. Barbara Larsen of All Cats Clinic. At the time of referral, he was being treated for intestinal lymphoma. His owner had noticed a change in his vocalization in the previous month. Dr. Larsen identified peri-laryngeal changes and an oral mass. Cytology at that time was suggestive of but not diagnostic for lymphoma. Dr. Dew discussed mass removal if possible, with a good prognosis for healing from excision. Also, valuable information will be gained which should be beneficial for future decision making. Buster’s owner wished to proceed with the procedure.
TREATMENT:
Dr. Dew used an oral approach for the oropharynx mass excision. The mass was 2mm in diameter, raised, and red. It’s location was immediately rostral to left tonsil. The peri-arytenoid tissues appear edematous with pebbled mucosa. The arytenoid function appears normal. The mass and a peri-arytenoid mucosa biopsy were both submitted to the AR-State laboratory. Buster’s prognosis is good for healing from the surgical procedure, the long term prognosis will be dictated by the biopsy results.
Boogie is an Exotic Geoffroys Cat. She is 5 months old and weighs 3#. Her referring veterinarian was Dr. Teresa Durham from All For Pets. Boogie jumped from her owner’s head, and is now acutely non-weight bearing lame on left forelimb. Dr. Durham identified a comminuted fracture of the distal humerus. Dr. Dew discussed internal pin/wire fixation, and gave a good prognosis for healing, with the need for activity restrictions. Boogie’s owner wished to proceed with surgery.
TREATMENT:
Dr. Dew used a lateral approach with olecranon osteotomy. The small comminutions did not allow for a complete reduction; obliquity was short allowing only single cerclage. There was good ROM post stabilization. The fracture was stabilized using divergent 0.045 wires and a 20 gauge cerclage. The olecranon was stabilized with 0.045 IM wire and periosteal/fascial sutures. Boogie’s prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.
Monday, June 7, 2010
POTW May 24th thru May 28th, 2010
Our winner for last week's POTW Poll was Lola!
Yay, Lola!
This week's candidates are below:
Tuesday, June 1, 2010
POTW 5/17/10 through 5/21/10
Lucy won last week's contest with 20 votes.
Congrats, Lucy!
Below are the candidates for this week:
Monday, May 24, 2010
POTW May 10, 2010 thru May 14, 2010
Jethro and Gator were in a VERY close race last week, but Jethro finally won 66 to 62.
Great race, boys!!
Monday, May 17, 2010
Your Candidates for POTW for the week of May 3 through May 7:
Last week, Abbigale won POTW...
Congrats, Abbi!!
Who will win this week? See below for the eligible patients:
Monday, May 10, 2010
Candidates for week of 4/26 - 4/30 for Patient of the Week
Grace won our last week's vote with 8 votes :)
Congrats, Grace!
Here are the candidates for this week's Patient of the Week:
Monday, May 3, 2010
Patient of the Week candidates for 4/19 - 4/23
Your winner for last week's voting was Max with 21 votes.
Way to go, Max!
Monday, April 26, 2010
Your Patient of the Week candidates for the week of April 12th - 16th:
Last week's POTW winner was Sophie with 8 votes. Congrats, Sophie!
Lets see if we can get it going with this week's Patient of the Week poll. Vote Here~~~~>>>
CASE STUDY:TREATMENT:
Diagnostics: The radiographs of Max’s lumbar spine were normal; he had very minor degenerative joint disease in his hips. The changes in his Left stifle were consistent with partial CCL tear.
Dr. Dew used a medial approach with medial arthrotomy. The Kyon hardware used to stabilize Max’s stifle were a 12x22 basket, 6 hole plate & fork, and 4 titanium screws. His prognosis good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function. With the TTA procedure, it is not uncommon to see some bruising and edema around the hock (ankle) and on the inside of the leg below the incision. These changes are not painful and will resolve without treatment in 3-10 days.
Mercy is a 5# 2yr old Chihuahua. Her RDVM is now Dr. Carondelet Nollner with Greene Animal Hospital. She was a rescue baby who was HBC 10 days previous to appointment with us. She was diagnosed with a Right femur fracture, and also received an OHE (spay).
TREATMENT:
Dr. Dew used a ventral to abdomen approach for Mercy’s OHE. He then used a lateral approach to repair her fracture. To stabilize her fracture, he used a single IM 5/64 pin and 2 –f 5/64 threaded transcortial pins as well as a 5/8 sidebar. Mercy’s prognosis is for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.
Sophie is a Bichon Frise and Shih Tzu cross. She is 3yrs and 3mo old and weighs 11#. She was referred to us by Dr. J. Gregg Melancon with West Fork Veterinary Clinic. Sophie had jumped from moving vehicle and had acute onset non-weight bearing lameness right rear. She was treated treated at AEC, and her radiographs demonstrated a right coxofemoral luxation as well as a distal femoral fracture. Upon exam by Dr. Dew, she was BAR and able to support weight on her left rear limb. The degenerative changes in her acetabulum and femoral head suggest chronic subluxation. Dr. Dew discussed open reduction of the femoral fracture and FHO (femoral head osteotomy) on the right. Her owner decided to proceed with surgery.
TREATMENT:
Dr. Dew used a medial to stifle approach for her femur fracture repair and a lateral to hip approach for her FHO. Hardware used in these surgeries were 0.062 wires. Sophie’s prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing. Physical therapy will need to be completed to maintain the range of motion in both the stifle and hips.
Bella is a 3yr old Pug who weighs 15.2#. She was referred to us by Dr. Shane Parker of Parker Animal Clinic. She has had a history of difficulty breathing, sleep apnea and exercise intolerance. Medical therapy has allowed her to function on a limited basis. Upon exam by Dr. Dew, she exhibited stenotic nares and stridor consistent with elongated soft palate. He discussed brachycephalic upper airway syndrome, and the benefits and risks of surgical correction. Her owner decided to proceed with rhinoplasty, soft palate reduction and excision of saccules if required.
TREATMENT:
Dr. Dew used a lateral approach for the stenotic nares and an oral approach for elongated soft palate. He significantly improved Bella’s nasal opening, and her soft palate was reduced to the level of tonsilar crypts. There was significant redundant tissue dorsal to soft palate, and the saccules were normal. Her prognosis is good for healing and significant improvement in airway function. It would not be unusual for Bella to have some blood tinged saliva or nasal discharge for the next 3-5 days. Airway sounds should be significantly reduced but will remain raspy and louder than a dog with a normal length nose. Some coughing when eating or drinking for then next 7-10 days is to be expected.
Valentina is a 2yr old 22# Pug. Her referring veterinarian was Dr. Randy Ashley of Briarwood Animal Hospital. She has had a chronic history of exercise intolerance, snoring and coughing. She was partially responsive to medical therapy, but has been crate confined for the past 2 weeks previous. Upon examination by Dr. Dew she was BAR. The stenotic nares were evident, and her stridor was consistent with an elongated soft palate. Dr. Dew discussed brachycephalic upper airway syndrome, correction and prognosis. Her owner wished to proceed with rhinoplasty, soft palate reduction and saccule excision if required.
TREATMENT:
Dr. Dew used a lateral approach for the stenotic nares and an oral approach for elongated soft palate. He significantly improved Valentina’s nasal appeture, and her soft palate was reduced to the level of tonsilar crypts. There was significant redundant tissue dorsal to soft palate, and the saccules were normal. Valentina’s prognosis is good for healing and significant improvement in airway function. It would not be unusual for her to have some blood tinged saliva or nasal discharge for the next 3-5 days. Airway sounds should be significantly reduced but will remain raspy and louder than a dog with a normal length nose. Some coughing when eating or drinking for then next 7-10 days is to be expected.
Monday, April 19, 2010
Your Patient of the Week Candidates for April 5th through April 9th:
J.R. wins Patient of the Week for last week with 103 votes.
Way to go, J.R.!
Who will be the next POTW??
Sunday, April 18, 2010
Your candidates for the week of March 29 through April 2nd:
The winner for last week's Patient of the Week vote was Lola with 71 votes.
Congratulations LOLA!
Above is Lola playing with her ball.
Who will be next? Vote Here ~~~~>>>
J.R. is an 8yr old 23# Jack Russell Terrier referred to us by Dr. Blair Willman of North Hills Animal Clinic. 2 weeks previous, he became acutely lame on his left rear after chasing an opossum. Dr. Willman identified a CCL injury. Upon exam by Dr. Dew, J.R. is weight –bearing , but lame He discussed the EFS (external fascial strip) procedure, recovery and prognosis. J.R.’s owners decided to proceed with surgery.
TREATMENT:
Dr. Dew used a lateral approach with lateral arthrotomy. He observed that the meniscus was intact. He performed the fascial surgery and used a medial buttress suture #1-maxo, advanced biceps, lavaged, and closed the site. J.R.’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function.
Duke is a Doberman; he weighs 112# and is 3yrs old. He was referred to us by Dr. Beth Stropes at Crossover Veterinary Clinic. 6 months ago, Duke became acutely lame on right rear, had a suture/anchor technique completed, revised for osteophytes and cold laser therapy. However; he never returned to to more than toe-touching use. Last month he became acutely lame on left rear and began to use his right rear. Dr. Stropes had identified a left CCL rupture. Upon Dr. Dew’s exam, Duke was lame in both rear limbs and was placing more weight on right than left. Both stifles were thickened and there was + anterior drawer on left, but Dr. Dew was not able to assess the right while Duke was awake. He discussed TTA (Tibial Tuberosity Advancement), recovery and prognosis for unilateral and bilateral surgery. He also suggested assessing the right stifle while under anesthesia, if significant drawer is present then proceed with bilateral TTA. Duke’s owner wished to proceed with the above plan.
TREATMENT:
Dr. Dew did identify CCL rupture on the Right while Duke was under anesthesia. He used a medial with medial arthrotomy-left, medial with lateral arthrotomy-right. All of Duke’s previous implanted hardware was explanted. The Kyon hardware used in Duke’s corrective surger were a 12x25 basket on the Left, a 12x28 basket on the Right, 7 hole plate & fork combo on both Left and Right as well as 4 titanium screws in each side. Cancellous graft placed to promote bone growth. Duke’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function. With the TTA procedure, it is not uncommon to see some bruising and edema around the hock (ankle) and on the inside of the leg below the incision. These changes are not painful and will resolve without treatment in 3-10 days. Due to having both knees corrected simultaneously, Duke may require some assistance rising and walking for the next 3-14 days, the harness (Help ‘Em Up Harness) should be helpful for this care.
Amy is a 10yr old 64.8# Bassett Hound. Her RDVM, Dr. Kim Miller of Chenal Valley Animal Hospital referred her to us because she had identified a mass at 7 O'clock in the wall of the rectum. Upon Dr. Dew’s examination, the mass was 2cm in diameter and firmly affixed to rectal wall with no ulceration noted. Dr. Dew discussed the likelihood of an anal gland tumor, and suggested local excision with good prognosis for recovery and continence. Her owner wished to proceed with surgery today and asked that any suspicious sub-Q masses be aspirated for cytology.
TREATMENT:
Dr. Dew used a caudolateral-left approach to remove Amy’s mass. It was 2cm in diameter, irregular is circumference, and firmly adhered to rectal wall. There was no evidence of deep involvement, and it was contained within pseudocapsule. The mass was excised and submitted for histologic assessment. A Fine Needle Aspirate was also performed on Left cervical area, right thoracic area, and sternal area. All slides were also submitted to the Arkansas State Lab. Amy’s prognosis is good for healing; the long term prognosis will be more clearly defined by the histology results.
Mellee is a 38# 6yr and 4mo Cocker Spaniel. She came to us from Dr. Leath Harper of Village Pet Hospital for a Lateral Condylar fracture of the Left Humerus, caused by running through a ditch. Dr. Dew discussed an open reduction, the prognosis and restrictions, and Mellee’s owner decided to proceed with surgical stabilization.
TREATMENT:
Dr. Dew used an anconeal myotomy approach for Mellee’s surgery. The fracture was stabilized using a 2.7mm transcondylar screw placed in lag fashion, along with a 0.062 antirotational wire. Her prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.
Reese’s is a Mix Breed who is 66# and 3yrs old. Dr. Todd Kollasch referred her to us for a previous diagnosis of Bilateral Medial Patellar Luxation, and her owners decided on Tibial Tuberosity Transposition surgery for correction.
TREATMENT:
Dr. Dew used a medial approach with medial release. The tibial tuberosity were stabilized with divergent pins, 5/64 in size. Reese’s prognosis is for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function. Due to having bilateral correction today, Reese’s may require some assistance rising and walking for the next 3-10 days.
Chopper is an 80# 2yr old English Bulldog. He was referred to us by Dr. Joe Rohlman with Rohlman Animal Hospital. Chopper had rear limb dysfunction, and had unilateral lameness recently until it progressed into bilateral to the point that he no longer attempted to stand. Radiographs demonstrated bilateral degenerative changes consistent with dysplasia/chondrodystrophic anatomy. Bilateral cranial drawer and medial buttress is present. Dr. Dew discussed mechanical issues with CCL rupture and pain due to hip dysplasia. He suggested bilateral TTA surgery, and his owners wished to proceed.
TREATMENT:
Dr. Dew used a medial approach with medial with medial arthrotomy. Kyon implants consist of 9x19 mm baskets on both sides, 4 hole plate & fork combination for both left and right, as well as 4 titanium screws in each side. A cancellous bone graft was used to promote bone growth and healing. Chopper’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function. With the TTA procedure, it is not uncommon to see some bruising and edema around the hock (ankle) and on the inside of the leg below the incision. These changes are not painful and will resolve without treatment in 3-10 days. Due to having both legs corrected simultaneously, Chopper may require some assistance rising and walking for the next 1-14 days. This can be done with a harness or by placing a towel under his abdomen.
Zoe is a Pomeranian. She is 1yr and 7mo old and weighs 3.8#. Her referring veterinarian is Dr. Alan Thompson of Farmington Veterinary Clinic. Zoe had previous bilateral MPL correction in Feb 2009, and has done well since that time and is participating in agility. The left patella continued to luxate when the limb is relaxed and this may be limiting her ability to compete. Upon Dr. Dew’s exam, he notes a grade II MPL which stayed reduced with normal muscle tension. He discussed a revision surgery with good prognosis for return to athletic function. Her owner decided to proceed.
TREATMENT:
Dr. Dew used a medial approach with medial release for Zoe’s revision. Post-surgically, Dr. Dew observed trochleoplasty of adequate depth and well healed, also, he was unable to luxate post correction. Zoe’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function.
Lucy is an 80# 8mo old Lab. She was referred to us by Dr. William Pitchford of Pitchford Animal Clinc. She fell off of a 4-wheeler and became acutely non-weight bearing on her left rear. Dr. Pitchford identified a Salter Type IV fracture of the distal femur. Dr. Dew discussed an open reduction and IM pin stabilization. Her owners wished to proceed with surgery.
TREATMENT:
Dr. Dew used a lateral approach for Lucy’s fracture repair. Her femur was stabilized using 2 size 7/64 divergent pins. Her prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.
Dusty is a Mix Breed 10yr 8mo old and weighs 24#. This baby was referred to us also by Dr. William Pitchford of Pitchford Animal Clinic. Dusty had previously undergone a Right EFS (external fascial strip) surgery on his Left cruciate ligament, and had come back to our office because he was acutely lame on his Right rear limb. Dr. Pitchford identified a Right CCL Rupture. His owners opt for surgery for correction.
TREATMENT:
Dr. Dew used a lateral approach with lateral arthrotomy for Dusty’s Right EFS. He used #0 size suture for medial buttress, advanced biceps, lavaged, and closed his incision. Dusty’s prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function.
Monday, April 5, 2010
Patient of the Week candidates for March 22 through March 26:
Last week was a close one for awhile, but Belle ended up POTW with 48 votes, Congratulations! The week of the 22nd through the 26th was a short week, but the babies in question are below.
Vote to the right, to the right ~~~>>
CASE STUDY:Lola is an English Bulldog. She weighs 10# and is 2mo old. Dr. Bob Mills with North Arkansas Veterinary Clinic referred her to us for Upper Airway issues. Dr. Mills identified stenotic nares and elongated soft palate. Lola had previously responded well to steroid and antibiotic therapy. Upon Dr. Dew's examination, she exhibited moderate stridor at rest, and her nares collapsed. Radiographs demonstrate mildly hypoplastic trachea. Dr. Dew discussed hypoplastic trachea, stenotic nares and elongated soft palate with her owner. He decided to proceed with nares revision and soft palate reduction.
TREATMENT:Dr. Dew used an oral approach for Lola's surgery. Her soft palate was reduced to the level of tonsilar crypts, and on her nares he performed wedge reduction naroplasty. Lola's prognosis is good for recovery from the procedure, uncomplicated healing and improved respiratory function. Exercise restriction will help facilitate an uncomplicated recovery.
Duncan is a 42# 7yr old West Highland White Terrier. Dr. Scott Hollensworth of Springhill Animal Clinic sent him to us for a hemi maxillectomy. Radiographs taken previously did not demonstrate any evidence of pulmonary metastasis. Osteolysis/osteoproductive changes were noted on maxilla and rostral zygomatic arch. Duncan's owners wished proceed with partial hemi maxillectomy.
TREATMENT:
Dr. Dew used an intra-oral approach for this surgery. The tumor tissue extended full thickness through hard palate and lateral maxilla, and there were periosteal changes on the zygomatic arch. Tumor tissue also extends to medial canthus. The tumor was excised en block with 1mm margins obtained at ventral border of eye and medial canthus; otherwise 3-10mm margins soft tissue and bone. The maxillectomy was from the canine root to the rostral border of the zygomatic arch. All tissue was submitted for histologic assessment to the Arkansas State lab. Duncan's prognosis is good for soft tissue healing from the sugery. Due to the aggressive nature of the tumor, size, and location there is little doubt that recurrence will be seen. However Duncan should be much more comfortable during this time.
Ginger is an 11# 3yr old Dachschund. Dr. Susan Belt at Benton Veterinary Hospital is her referring veterinarian. Six weeks previous, Ginger had an acute onset of left rear paresis, and responded well to prednisone and rest. 3-4 days previous to referral to Dr. Dew, she exhibited bilateral rear limb weakness. Prednisone was re-instituted with no response, and her ambulatory function continued to decline. Upon examination by Dr. Dew, she was unable to move her back limbs at all. She is at Grade V rear limb paresis, panniculus localizes lesion to T9. Dr. Dew discussed the severity of Ginger's clinical presentation. Surgery would be of benefit to decompress the cord, prognosis for improvement 30-65%. Her owner decided to proceed with myelogram and hemilaminectomy.
TREATMENT:
Myelogram: Dr. Dew administered 2 lumber injections, each of 2.5ml iohexol, and loss of columns at T11-12 and T8-9 were observed. He then called and discussed these findings with Ginger's owner. It was advised that surgery would be beneficial, but due to multiple lesions and clinical signs, prognosis is poor to guarded for return of ambulation until improvement is noted, she wishes to proceed with hemilaminectomy.
Hemilaminectomy: Dr. Dew used a Left dorsolateral approach. He observed cord swelling and chronic disc protrusions at each site. There was also a loss of epidural fat in the affected areas. Disc material was removed, the canals explored. Ginger's prognosis is good for healing and improved neurologic function. A transient worsening of neurologic function can be noted after a myelogram and surgery. This condition will usually resolve to the pre-operative state in 3-10 days. The nervous system is very slow to heal. Improvement can be expected for up to 5 months. Nursing care, physical therapy and exercise restriction all play critical roles in avoiding complications and aiding recovery.
Cosmo is a Brussells Griffon. He is 4yrs and 3mo old and weighs 24#. Dr. Allison Patchell of Patchell Veterinary Clinic referred him to us with a history of recurrent urethral calculi, and at the time of his exam was only able to dribble urine. Dr. Dew discussed a scrotal urethrostomy, cystotomy and stone analysis, recovery and prognosis. Cosmo's owners wished to proceed with surgery.
TREATMENT:
Dr. Dew used a ventral celiotomy approach for Cosmo's surgery. He observed that the stones were spiculated, urethra adequate lumen at level of urethrostomy. The urethrostomy was at 1.5cm in length, Dr. Dew lavaged the bladder and urethra, and submitted the stones for analysis to the Arkansas State Lab. Cosmo's prognosis is good for healing and recovery from the surgical procedure. Cosmo should have a significantly easier time urinating as a result of the surgery. Uncomplicated healing will be facilitated with exercise restriction and the use of the e-collar.
Chugalug is a 137# 1yr old St. Bernard. Dr. Claire Kelly at Edwards Veterinary Clinic referred him to us for a hygroma on right elbow. It had been drained repeatedly but still recurs. Upon examination, it is a fluid filled mass over the right calcaneous,a nd is 6cm in diameter. Dr. Dew explained the nature of hygromas in young dogs, suggested surgical excision and closure of joint capsule. His owner decieded to proceed with removal.
TREATMENT:
Dr. Dew used a lateral approach for Chugalug's surgery. Also identified a defect in his joint capsule. The hygroma capsule was excised and the joint capsule defect was closed. The prognosis for Chug is good for normal soft tissue healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.
Sunday, April 4, 2010
Who will be Patient of the week for week 3/15 through 3/19??
OUR WINNER FOR LAST WEEK'S VOTE WAS, DRUM ROLL PLEASE........LOUIE!! WITH 931 VOTES!!!!!
Belle is a Bernese Mountain Dog and is 2yrs and 6mos old. She weighs 60#. Dr. Kristy of Austin Osage Veterinary Clinic is her referring physician. Back in July of 2008, Belle had a THR. Between then and now, she has had a previous diagnosis of a loose acetabular cup. She now has come in for a Total Hip Replacement revison. Dr. Dew discussed prognosis and recovery. Belle's owners decide to proceed with surgery.
TREATMENT: Dr. Dew observed moderate wear debris associated with loose cup and cup screw. After he implanted a new cup and proceeded to replace the femoral head, a loose femoral component was identified. Following conversations with Dr. Tepic of Switzerland, Dr. Dew elected to explant all components. There appeared to be no crepitus post implant removal and calcar reduction. Dr. Dew discovered also from his conversations that most femoral stem loosening has been associated with low grade osteomyelitis. Cultures were sent to Arkansas State Lab for further examination. Dr. Dew noted adequate femoral neck resection and soft tissue interposition between femur and acetabulum Belle's prognosis is good for healing and resolution of the arthritic pain. Physical therapy will play a critical role in assuring that she has a good return of post-operative function.
Poo is a 7yr old, 10# Poodle sent to us by Dr. Heath Stump of Russellville Animal Clinic. She had been HBC several weeks ago. The left hock had been splinted, but had not stabilized. Dr. Dew discussed primary ligament repair and splint augmentation or stabilization of avulsion fragment. Her owner wished to proceed with surgery.
TREATMENT:
Dr. Dew used a medial approach for Poo's medial collateral ligament reconstruction in her right hock. Radiographs suggested medial collateral disruption, but no fractures were noted. Good stability was achieved by debriding the ligament/joint capsule attachments, and also by drilling a 0.045 hole through medial malleolus and placing multiple SI 2-0 maxon sutures in differing orientations, whereby good stability was achieved. Poo's prognosis is good for normal soft tissue healing. Exercise restrictions and bandage care instructions must be followed to maximize the prognosis for uncomplicated healing.
Diesel is a 1.5yr old 85# Labrador referred to us by Dr. James Hoffman with Westside Veterinary Clinic. He was HBC 4 days previous, and Dr. Hoffman had identified a sagittal fracture of the olecranon that involved the aconeous and articular surface. Dr. Dew discussed internal fixation with lag screws, and gave a good prognosis for return to hunting function. His owner wished to proceed with stabilization.
TREATMENT:
Dr. Dew used a lateral approach with anconeal myotomy for this procedure. He observed good reduction and compression of fragments. He stabilized the fracture with two 2.7mm screws placed in lag fashion. Post-surgically, good reduction and hardware placement was noted. Diesel's prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing. Diesel's leg has been repaired using a combination of wires and/or pins. These implants have been designed to maximize the opportunity for successful bone healing and return to function. HOWEVER, they are initially not as strong as normal bone or tissue! Therefore, exercise restriction is mandatory to prevent catastrophic failure of the fixation hardware.
Dixie is a Labrador who is 6yrs old and weighs 67.9#. She came to us from Dr. Sandra Reynolds with Little Rock Veterinary Clinic. Dixie became acutely lame on the Right Rear 3-4 days previous. Dr. Reynolds identified a right CCL, and upon examination there was + anterior drawer consistent with that diagnosis. The owners have had experience with the TTA (tibial tuberosity advancement) procedure, as Dr. Dew had previously operated on one of their other family members, and had no further questions.
TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. The Kyon implants used for the Tibial Tuberosity Advancement were a 9x19mm basket, 6 hole plate & fork, and 4 titanium screws. Good hardware placement was observed; tibial plateau was perpendicular to straight patellar ligament. Dixie's prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Nursing care, physical therapy, exercise restriction and the use of Glycoflex will play critical roles in an uncomplicated recovery and optimization of long term function. With the TTA procedure, it is not uncommon to see some bruising and edema around the hock (ankle) and on the inside of the leg below the incision. These changes are not painful and will resolve without treatment in 3-10 days.
Haley is a 10 yr and 6mo old, 113# Golden Retriever. She was referred to us by Dr. Scott Hollensworth of Springhill Animal Clinic. Her owner had noted a soft tissue tumor on the caudal aspect of the left mandible. The mass is 2x1.5cm on the buccal side of the 4th premolar. Dr. Dew discussed resection with margins including partial mandibulectomy. Haley's owner wished to proceed with surgery. Presurgical radiographs did not demonstrate any evidence of pulmonary metastasis.
TREATMENT:
Dr. Dew used an oral approach to excise Haley's tumor and perform her left partial mandibulectomy. The removed segment includes the last premolar and 2 molars. There was no evidence of tumor at bone or soft tissue margins. The removed tissue was submitted to Akansas State lab. Haley's prognosis is good for healing; the biopsy results will help define the expected outcome
Coletrane is a Dachschund weighing 12.4# and is 4yrs old. He was referred to us by Dr. Mark Sharp of South County Animal Hospital. Coletrane had had previous rear limb weakness treated conservatively and resolved. However; 48 hours prior to presentation to us, Coletrane became weak bilaterally, and was unable to support weight. He was given tramadol, buprenorphine and robaxin at Dr. Sharp's clinic. Upon examination by Dr. Dew, he had Grade IV paresis in his left hind limb, and Grade V in the right. Dr. Sharp's radiographs were suggestive of T11-12 disc rupture. Dr. Dew discussed the confounding clinical signs that may have been drug influenced. Coletrane's owner decided to proceed with myelogram and hemilaminectomy surgery.
TREATMENT:
Myelogram: Coletrane was given a lumber injection of 4ml iohexol. This allowed Dr. Dew to view the loss of all columns throughout T12, with column attenuation greater on the right side. T11-2 rupture, left sided lesion.
Hemilaminectomy: Dr. Dew used a left dorsolateral approch. There was a large amount of acute and fibrous disc material removed ventral to the spinal cord, decompression extended to level of normal epidural fat. Cord appeared normal. The disrupted disc material from T-11 through T-12 was removed. Coletrane's prognosis is good for healing and guarded for improved neurologic function. A transient worsening of neurologic function can be noted after a myelogram and surgery. This condition will usually resolve to the pre-operative state in 3-10 days. The nervous system is very slow to heal. Improvement can be expected for up to 5 months. Nursing care, physical therapy and exercise restriction all play critical roles in avoiding complications and aiding recovery.
Tuesday, March 30, 2010
Monday, March 22, 2010
Your Patient of the Week candidates for the week of 3/8 -- 3/12:
The winner for last week's vote was Charlie, with 11 votes. Have a picture of your pet getting his/her prize pack in the mail? Email it to info [at] azzore.com and we'll add it to the photo album on our website: You've Got Mail!
Who will be next? ~~~~~>>>
Angel is an Italian Greyhound who is 15yrs old and weighs 8#. She was sent to us by Dr. Doug Leach of Stanton Animal Hospital for acute onset of right rear lameness 2-3 weeks previous. Dr. Leach identified a LPL which was manually reduced.
Monday, March 15, 2010
Your Patient of the Week candidates for Week 3/1 through 3/5
The winner of last week's poll was Olive with 45 votes. Awesome, Olive! Have a picture of your pet getting his/her prize pack in the mail? Email it to info [at] azzore.com and we'll add it to the photo album on our website: You've Got Mail!
CASE HISTORY:
Gracie is a Mix Breed at 57# and 2yr 4mo. Her referring veterinarian is Dr Tammy Smith of Animal Medical Clinic. Gracie had been to us before for Bilateral Cruciate surgery, now she had presented with Bilateral Luxating patellas.
CASE HISTORY:
Sunday, March 14, 2010
Patient of the Week poll for week February 22 thru February 26
Last week's voting was fun to watch! Brie closed up the win with 156 votes. Congratulations, Brie!!
Vote over to the right for this week's babies~~>>>
CASE STUDY:
Olive is a Boston Terrier weighing 32# and is 2yrs old. She was sent to us by Dr. Amy Hawley of North Hills Animal Clinic. She had a history of intermittent left rear lameness. Dr. Hawley identified bilateral MPL (medial patellar luxation).
Vote over to the right for this week's babies~~>>>
Olive is a Boston Terrier weighing 32# and is 2yrs old. She was sent to us by Dr. Amy Hawley of North Hills Animal Clinic. She had a history of intermittent left rear lameness. Dr. Hawley identified bilateral MPL (medial patellar luxation).
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