CASE HISTORY:
Meet Max. Max is a 3 month old, 5 pound Chihuahua who apparently thought he was superdog and could fly! Max jumped from a place that was just a little too high off the ground. The result? A fracture of his left humerus, lateral condyle. Dr. Stephanie Kessler with Lake Hamilton Animal Hospital referred Max and his humans to Azzore Veterinary Specialists for a fracture repair.TREATMENT:
Dr. Dew performed an open reduction/fixation to repair Max's fracture with pins and wire. We got several adorable pictures of Max while he was here in our surgery center. This is one of our favorites! These front leg fractures are actually fairly common in tiny dogs. They just don't realize how fragile those little bones are when jumping down from a high place. Max will have to be exercise restricted to leash activity only for the next 12 weeks. We'll see him back in about 8 weeks for x-rays to see how his bone is healing.
C.J. is a 1 1/2 year old, 92 pound German Shepherd. C.J. had been experiencing right rear lameness for about 3-4 weeks, which had recently become worse to the point that C.J. was no longer weight bearing on that leg. Xrays taken by C.J.'s veterinarian, Dr. Richard Hittner with Arkansas Veterinary Clinic, suggest a bone tumor. C.J. was referred to Dr. Dew for further diagnostics and treatment.
TREATMENT:
Xrays showed osteolytic/osteoproductive changes (destruction of bone) in the proximal tibia (the part closest to the body), but no evidence of metastatic disease in thorax (in layman's terms, it doesn't look like the cancer has spread to his chest). After discussion of osteosarcoma and possible treatment methods, C.J.'s humans give the go ahead to proceed with limb amputation and labwork. As you can see from the picture, C.J. is doing great following surgery! Labwork will show what we are dealing with and will dictate future treatment and prognosis.
Gus is a 5 year old, 51 pound Blue Heeler mix. Gus was referred to Azzore by Dr. Bonnie McLaughlin of Wedington Animal Hospital. Gus suffered a right femur fracture, proximal (or the end closest to the body) involving the femoral neck and calcar, from a gunshot wound. Xrays also show that Gus suffers from bi-lateral hip dysplasia. His humans want Dr. Dew to take care of the fracture today, and may consider total hip replacment for Gus in the future.
TREATMENT:
Gus had a pretty nasty fracture. Dr. Dew was able to reconstruct the majority of calcar area, but there was minimal bone available for implant seating. He reduced the fracture, stabilized the bone with transcortical wires, pins, and tension band wires, and then placed an external fixator on Gus's leg to hold his stifle in flexion while the bones heal. Dr. Dew co-designed the acrylic sidebar external fixator method used to repair Gus's fracture.
Baby Girl is is a 2 year old, 7 1/2 pound, Tortoiseshell kitty. She also happens to be my fur neice, but don't let that influence your voting! I received a phone call Sunday morning letting me know that Baby Girl had been hit by a car. I met her humans at our surgery center after church and made Baby Girl as comfortable as I could in a cage for Dr. Dew to examine her in the morning. Baby Girl used up at least one of her 9 lives. She suffered diaphragmatic hernia, right tarsal lateral collateral rupture and right sacroiliac luxation.
TREATMENT:
It was no wonder Baby Girl's breathing was labored! Her liver, stomach, spleen and small intestines were in the hernia. Dr. Dew repaired Baby Girl's diaphragmatic hernia and stabilized her right tarsus-collateral ligament. Now comes the tough part. Kitties are probably the most difficult pets to keep exercise restricted, and she'll need to be restricted for the next 8 weeks -- no jumping, running around, or playing with her family members. We often recommend a playpen to provide enough space to move around in, but not so much that they can injure themselves. When I visited with Baby Girl's family over the weekend, I saw that my brother-in-law had constructed a large enclosed cage for Baby Girl in their bedroom so that they could keep her confined.
Henry is a 1 1/2 year old, 15 pound Lhasa Apso. Dr. Craig Boyd of Boyd Veterinary Clinic referred Henry to Dr. Dew for correction of bi-lateral medial patella luxation (MPL), sometimes called "trick knee". Basically, Henry's knee caps weren't staying in place, but moving medially, or inwardly.
TREATMENT:
Henry's trochlear grooves were adequate, so Dr. Dew performed tibial tuberosity transpostion (TTT) without trochleoplasty on both of his knees. Since he had both knees fixed at once, he may be a little awkward for a few days post surgery, but he's light enough to be able to recover nicely from bilateral surgery. Again, exercise restriction for three months will be a key component to his recovery.
Quick update: Henry was here for his 2-week recheck today, walking as if he never even had a knee problem! We'll see Henry back in eight weeks for a recheck with xrays.
Peanut is a 1 year old, 13 pound Miniature Dachshund. Her veterinarian, Dr. Blair Willman of North Hills Animal Clinic referred Peanut and her family to us after diagnosing Peanut with a Grade III left medial patellar luxation. The severity of this condition is graded I-IV, so Peanut's was fairly severe. We were just happy to see a Dachshund that wasn't here for a back issue!
TREATMENT:
Dr. Dew corrected Peanut's MPL by performing a left tibial tuberosity transposition (TTT) with block recession trochleoplasty, due to the trochlear groove being shallow. The trochlear groove is a groove in the end of the femur that allows the patella (knee cap) to glide up and down when the knee joint is bent back and forth. When this groove is too shallow, the patella can jump out of this grove and move sideways instead of up and down. After three months of exercise restriction, Peanut's knee should work just fine.
Anna Claire is an 8 year old, 18 1/2 pound Feist. Anna Claire has been battling cancer. She had a sub-cutaneous tumor located ventral to the right ischium removed 8 weeks ago, but it had come back and increased in overall size. Anna Claire was referred to us by Dr. Kathy Mitchener of Angel Care Cancer Clinic for Animals for surgery.
TREATMENT:
Due to the to size, location and tumor type (neurofibrosarcoma), Dr. Dew performed a limb amputation and partial hemipelvectomy in order to have the best chance of effecting a cure or long disease-free interval. Anna Claire was transported from Memphis, TN to our center in Russellville, AR for surgery. We have a recheck appointment at the Animal Emergency Center in Memphis with Anna Claire this week to see how she is doing.
Rounding up our surgery cases for the week is Izzy -- our best-dressed patient of the year! Izzy is a 11 month old, 10 pound, Yorkshire Terrier. She was referred to us by her veterinarian, Dr. David Oates of Russellville Animal Clinic, who had previously identified bilateral MPL and left cruciate issues. Izzy's people ask Dr. Dew to take care of both knees.
TREATMENT:
Izzy's left cruciate had a partial tear, but the meniscus was intact. Dr. Dew performed a tibial tuberosity advancement (TTA) procedure using titanium implants to decrease patellar-femoral pressure and femoral-tibial pressure. Izzy had Grade I medial patellar luxation (MPL) with shallow trochlear grooves and required tibial tuberosity transposition with bilateral block recession trochleoplasty to correct this condition. Since she had surgery on both knees at the same time, Izzy may need help getting up and walking for a few days. But, with time and exercise restriction, our fashionable little patient will be strutting her stuff down the runway in a few months.
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So, there you have it. Another Dew Week in Review. Vote for your favorite Patient of the Week, and be sure to have your friends and family vote too!
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