CASE HISTORY:Lola is a 4yr old Pekapoo who came to us from Dr. Hollensworth at Springhill Animal Clinic in Bryant. She had an acute onset of bilateral rear limb paresis (paralysis) three days prior. She was
treated at an emergency facility with steroids; there was no improvement noted. On the day of her surgery, she presented to Dr. Dew with grade IV rear limb paresis. Dr. Dew discussed IVDD (invertebral disc disease), GME (Granulomatous Meningoencephalitis), and tumor. He suggested cerebrospinal centesis, myelogram and hemilaminectomy if indicated.
treated at an emergency facility with steroids; there was no improvement noted. On the day of her surgery, she presented to Dr. Dew with grade IV rear limb paresis. Dr. Dew discussed IVDD (invertebral disc disease), GME (Granulomatous Meningoencephalitis), and tumor. He suggested cerebrospinal centesis, myelogram and hemilaminectomy if indicated.
TREATMENT:
Myelogram: Dr. Dew injected 3ml iohexol (contract medium). X-rays showed column thinning from T11-12 with aslight deviation of cord toward the left side at the T11-12 vertebrae. Dr Dew then contacted Lola's family and they gave consent to go ahead with the Hemilaminectomy.
Hemilaminectomy: Dr Dew used a right dorsolateral approach to T11-12. He was able to remove a large amount of acute disc material. He gave Lola a good prognosis for improved neurologic function over the next 6 months.
Olive
CASE HISTORY:Olive is a 4 month old Labrador Retriever who jumped from a chair the previous week. She was visiting her grandparents, and was taken to Dr. David Oates here locally at Russellville Animal Clinic. (Her veterinarian at home is Dr. Teresa Durham at All For Pets in Cabot.) Dr. Oates examined Olive, after she presented with acute non-weight bearing lame on her right forelimb. Dr. Oates identified a right lateral condylar fracture. He then referred her to Dr. Dew. During consult, he discussed the intra-articular nature of fracture, progression of DJD (degenerative joint disease), healing and recovery. Ms. Humphrey wished to proceed with internal fixation today to correct the fracture.
TREATMENT:
Dr. Dew used a lateral approach with anconeal myotomy. He observed good reduction, alignment of the fracture, and stabilized with 1/8 enhanced thread pin and 5/64 IM pin. After stabilization of the fracture, Dr. Dew observed good ROM (range of motion), and verified hardware placement with x-ray. This picture of Olive is during her recovery.
Annie
Annie is a 4 year old Brussels Griffon with Bilateral Medial Patellar Luxation. She was sent to us by Dr. Brian Kohler of Bowman Road Animal Clinic in Little Rock. Upon examination, Dr. Dew identified Grade III patellar luxation on the Left, and Grade IV patellar luxation on the Right. Dr. Dew discussed correcting both knees with the TTT (Tibial Tuberosity Transposition), as well as recovery and prognosis with Annie's mom, and it was decided to proceed.
TREATMENT:
Both of Annie's knees were corrected with the TTT with Trochleoplasty. Her patellas are held in place, one with a .045 wire and the other with a .032 wire. Due to having both legs corrected simultaneously, Annie would require some assistance rising and walking for the following 1-5 days. She could also be a bit awkward and fall to the side; this will not hurt her nor harm the surgery.
Abby
CASE HISTORY:Abby is a 10 year old Miniature Poodle sent to us by Dr. David Oates of Russellville Animal Clinic. She had acute onset of right rear paresis and was diagnosed with a Cranial Cruciate Ligament rupture as well as Grade III MPL (Medial Patellar Luxation). Abby was in need of corrective surgery. Dr. Dew discussed the options of TTA sugery with her owner, and they elected to proceed with the TTA (Tibial Tuberosity Advancement), as it would not only correct the Cruciate Ligament injury, Dr. Dew could also simultaneously correct her Patellar Luxation.
TREATMENT:
A medial approach was used in the corrective surgeries. Abby's meniscus was still intact, which was good. Hardware used in her knee were a 3x9mm basket, 2 hole plate/fork, and 4 titanium screws. A bone graft was also placed to enhance growth of bone in the area where the cage was placed. 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 should be resolved without treatment in 3-10 days. Her prognosis is a good one.
Katie
Katie is a 9yr Dachshund that was referred to us by Dr. Ken Smith of Parkway Animal Hospital here locally for IVDD (invertebral disc disease) on Tuesday. She was treated with 125mg of solu medrol, but her clinical presentation remained the same on Wednesday morning when she returned, and Dr. Dew suggested a CSF, Myelogram and Hemilaminectomy surgery if indicated.
TREATMENT:
Cerebrospinal centesis: Dr. Dew obtained 2ml clear CSF collected from cisterna magna.
Myelogram: Into the lumber region, Dr. Dew injected 3ml iohexol, and after examining x-rays, he noted column thinning from T10-12 vertebrae. Also, there was a slight deviation of the spinal cord to the left. He then called and discussed findings with Katie's owner; he wished to proceed with surgery.
Hemilaminectomy: With a dorsolateral approach to the T10-12 vertebrae, Dr. Dew removed a large amount of disc material that was pressing on the spinal cord and noted that the cord was swollen.
Surgery will be beneficial, but due to cord swelling prognosis is guarded until improvement is noted.
Sophie
Sophie is a Miniature Schnauzer who is 3 months old. She comes to us by way of Dr. Donna Hunter with Interstate Animal Clinic in Little Rock. Sophie had a history of constantly dribbling urine and inability to void posture normally. Dr. Dew discussed the likelihood of an ectopic ureter, IVP and/or exploratory surgery. Her owner decided to proceed with exploratory surgery, correction of urinary abnormality and OHE (ovarahysterectomy or "spay"). She understands that even with correction dogs with ectopic ureters may still have some degree of incontinence.
TREATMENT:
With a ventral approach, Dr. Dew noted that Sophie's right ureter continued on past the bladder, and her left ureter's opening into the bladder was unable to be identified. Dr. Dew explored the abdomen and transplanted (dropped in) the Right ureter into the bladder. The bladder was then closed. He then proceeded with Sophie's spay. Although Sophie's ectopic ureter was corrected, her owner understands that even with correction, dogs with ectopic ureters may still have some degree of incontinence.
Dutchess
CASE HISTORY:
Dutchess the 5 year old Labrador Retriever came to us all the way from Mississippi, sent by Dr. Earnest Harland of Lafayette Animal Clinic. She had an acute onset of Right rear lameness 2 months ago, and has had minimal improvement with rest. She was difinitively diagnosed today with a partial CCL rupture. Have discussed EFS (External Fascial Strip) and TTA procedures with Dr. Jordan, he wishes to proceed with the EFS today.
TREATMENT:
A lateral approach was used to perform the TTA in Dutchess' Right knee. Her meniscus was intact. There was no hardware used in her knee, as the EFS uses her own soft tissue. Her prognosis is good for healing, improved function and decreased progression of degenerative joint disease (arthritis). Dr. Dew recommends physical therapy, exercise restriction and the use of Glycoflex III, as these will play critical roles in an uncomplicated recovery and optimization of long term function.
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