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.

PATIENT SUMMARY:
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.

PATIENT SUMMARY:
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.

PATIENT SUMMARY:
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.

PATIENT SUMMARY:
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.

PATIENT SUMMARY:
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.