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:

Max is a 122# 5yr old Golden Retriever. He was referred to us by Dr. Greg Hartman with Hartman Animal Hospital. Max has had Left rear lameness for the past 4-5 months which gets worse after activity. He had improved on Previcox. Dr. Hartman's radiographs were not suggestive of hip dysplasia as a cause. There was Left stifle thickening and medial buttress suggestive of partial CCL tear, but no pain on hock manipulation or hip extension. Max exhibited delayed proprioception with normal foot placement, and no pain on dorsal spinal palpation. Dr. Dew discussed EFS (external fascial strip) and TTA (tibial tuberosity advancement) augmentation, and also suggested prior to surgery some survey lumbar films to rule out discospondylitis. The owners wished to pursue radiographs and a TTA if recommended.
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.

CASE STUDY:
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.

CASE STUDY:
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.

CASE STUDY:
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.

CASE STUDY:
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.