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??

CASE STUDY:

Filo is an 8yr old 5# Pomeranian referred to us by Dr. Robert Prescott of Pet Tracks Veterinary Hospital. He had been dragging right rear limb past several weeks. Upon Dr. Dew’s examination, there were proprioceptive deficits in the right rear; the left was normal. Reflexes in the right rear at +. Panniculus absent on both sides past T10. There was bilateral grade III patella luxation noted. Radiographs demonstrate narrowed disc spaces through the spine; spondylosis L1-2. Dr. Dew discussed neurologic versus orthopedic disease. He suggested cerebrospinal centesis, myelogram +/- decompressive surgery. Filo’s owner decided to proceed with diagnostic/surgical plan.

TREATMENT:
Cerebrospinal centesis: Dr. Dew extracted 1/2ml clear CSF from cisterna magna.
Myelogram: He administered 2 lumber injections of 1.5ml iohexol. The central canal filling demonstrated multiple sites of cord deviation, but the only area of loss of column was T13/L1. This suggested a right sided lesion at T13/L1.
Hemilaminectomy: Dr. Dew used a right dorsolateral approach. He removed the excess disc material at T13/L1. Filo'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.

CASE STUDY:
Lil Daschl Do Ya is Dachschund weighing 8.7# and is 1yr and 3mo old. Dr. Karen Sherman of Oak View Animal Clinic was the referring veterinarian. Daschl was hit by a car the previous Sunday, and was treated at NWAEC. The radiographs demonstrated a right ilial body fracture. Daschl was able to support weight on the left rear limb, and was urinating on own, according to the record. Dr. Dew discussed an open reduction and plate stabilization.
TREATMENT:
Dr. Dew used a lateral approach for the surgery. He observed good reduction and hardware placement. The stabilization consisted of a 5 hole, 6.5mm plate and 5 ./7mm screws. He replaced one of the 2.7mm screw with a short 3.5mm due to impingement on femoral head. Daschl'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.

CASE STUDY:
Sophie is a 2yr old 158# Mastiff. Dr. Thomas McCain of Greenbrook Companion Animal Hospital was the referring veterinarian as well as Sophie’s owner. Sophie had an acute onset of right rear lameness. Dr. McCain had identified a right CCL injury and wished to augment the stifle with a TTA (tibial tuberosity advancement). Radiographic changes and positive anterior drawer were consistent with a partial CCL rupture.
TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. The Kyon hardware used for the TTA were a 15x25mm basket, 7 hole plate & fork, and 4 titanium screws. Sophie'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.

CASE STUDY:
Ellie is an 83# 2yr and 10mo old Labrador Retriever. She was referred to us by Dr. Doug Parker at Sugar Creek Animal Hospital. Ellie had come to us back in August of 2009 for a Right TTA, and was doing great with it. She was presently lame on her Left. Positive anterior drawer and medial buttress were consistent with partial CCL rupture on the Left. Her owners wished to proceed with TTA augmentation.
TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. The Kyon hardware used on her TTA were a 12x22mm basket, 6 hole plate & fork, and 4 titanium screws. Ellie'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.

CASE STUDY:
Darth is a Great Dane who weighs 147# and is 4yrs and 6mo old. He was referred to us by Dr. David Oates of Russellville Animal Clinic. Darth had a 4 month history of right rear lameness that got worse after activity. Radiographs from Dr. Oates were suggestive of CCL disease. Upon examination by Dr. Dew, there was positive anterior drawer and medial buttress consistent with partial CCL rupture. He discussed EFS (external fascial strip) and TTA augmentation procedures. His owner wished to proceed with a right TTA.
TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. The implants from Kyon consisted of a 15x28mm basket, 8 hole plate & fork, and 4 titanium screws. Darth'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.