Your Candidates for POTW for the week of May 3 through May 7:

Last week, Abbigale won POTW...

Congrats, Abbi!!

Who will win this week?  See below for the eligible patients:

Your candidates for the week of March 29 through April 2nd:

The winner for last week's Patient of the Week vote was Lola with 71 votes.

Congratulations LOLA!

Above is Lola playing with her ball.

Who will be next?  Vote Here ~~~~>>>

CASE STUDY:
J.R. is an 8yr old 23# Jack Russell Terrier referred to us by Dr. Blair Willman of North Hills Animal Clinic. 2 weeks previous, he became acutely lame on his left rear after chasing an opossum. Dr. Willman identified a CCL injury. Upon exam by Dr. Dew, J.R. is weight –bearing , but lame He discussed the EFS (external fascial strip) procedure, recovery and prognosis. J.R.’s owners decided to proceed with surgery.
TREATMENT:
Dr. Dew used a lateral approach with lateral arthrotomy. He observed that the meniscus was intact. He performed the fascial surgery and used a medial buttress suture #1-maxo, advanced biceps, lavaged, and closed the site. J.R.’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:
Duke is a Doberman; he weighs 112# and is 3yrs old. He was referred to us by Dr. Beth Stropes at Crossover Veterinary Clinic. 6 months ago, Duke became acutely lame on right rear, had a suture/anchor technique completed, revised for osteophytes and cold laser therapy. However; he never returned to to more than toe-touching use. Last month he became acutely lame on left rear and began to use his right rear. Dr. Stropes had identified a left CCL rupture. Upon Dr. Dew’s exam, Duke was lame in both rear limbs and was placing more weight on right than left. Both stifles were thickened and there was + anterior drawer on left, but Dr. Dew was not able to assess the right while Duke was awake. He discussed TTA (Tibial Tuberosity Advancement), recovery and prognosis for unilateral and bilateral surgery. He also suggested assessing the right stifle while under anesthesia, if significant drawer is present then proceed with bilateral TTA. Duke’s owner wished to proceed with the above plan.
TREATMENT:
Dr. Dew did identify CCL rupture on the Right while Duke was under anesthesia. He used a medial with medial arthrotomy-left, medial with lateral arthrotomy-right. All of Duke’s previous implanted hardware was explanted. The Kyon hardware used in Duke’s corrective surger were a 12x25 basket on the Left, a 12x28 basket on the Right, 7 hole plate & fork combo on both Left and Right as well as 4 titanium screws in each side. Cancellous graft placed to promote bone growth. Duke’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. Due to having both knees corrected simultaneously, Duke may require some assistance rising and walking for the next 3-14 days, the harness (Help ‘Em Up Harness) should be helpful for this care.

CASE STUDY:
Amy is a 10yr old 64.8# Bassett Hound. Her RDVM, Dr. Kim Miller of Chenal Valley Animal Hospital referred her to us because she had identified a mass at 7 O'clock in the wall of the rectum. Upon Dr. Dew’s examination, the mass was 2cm in diameter and firmly affixed to rectal wall with no ulceration noted. Dr. Dew discussed the likelihood of an anal gland tumor, and suggested local excision with good prognosis for recovery and continence. Her owner wished to proceed with surgery today and asked that any suspicious sub-Q masses be aspirated for cytology.
TREATMENT:
Dr. Dew used a caudolateral-left approach to remove Amy’s mass. It was 2cm in diameter, irregular is circumference, and firmly adhered to rectal wall. There was no evidence of deep involvement, and it was contained within pseudocapsule. The mass was excised and submitted for histologic assessment. A Fine Needle Aspirate was also performed on Left cervical area, right thoracic area, and sternal area. All slides were also submitted to the Arkansas State Lab. Amy’s prognosis is good for healing; the long term prognosis will be more clearly defined by the histology results.

CASE STUDY:
Mellee is a 38# 6yr and 4mo Cocker Spaniel. She came to us from Dr. Leath Harper of Village Pet Hospital for a Lateral Condylar fracture of the Left Humerus, caused by running through a ditch. Dr. Dew discussed an open reduction, the prognosis and restrictions, and Mellee’s owner decided to proceed with surgical stabilization.
TREATMENT:
Dr. Dew used an anconeal myotomy approach for Mellee’s surgery. The fracture was stabilized using a 2.7mm transcondylar screw placed in lag fashion, along with a 0.062 antirotational wire. Her prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.

CASE STUDY:
Reese’s is a Mix Breed who is 66# and 3yrs old. Dr. Todd Kollasch referred her to us for a previous diagnosis of Bilateral Medial Patellar Luxation, and her owners decided on Tibial Tuberosity Transposition surgery for correction.
TREATMENT:
Dr. Dew used a medial approach with medial release. The tibial tuberosity were stabilized with divergent pins, 5/64 in size. Reese’s prognosis is 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. Due to having bilateral correction today, Reese’s may require some assistance rising and walking for the next 3-10 days.

CASE STUDY:
Chopper is an 80# 2yr old English Bulldog. He was referred to us by Dr. Joe Rohlman with Rohlman Animal Hospital. Chopper had rear limb dysfunction, and had unilateral lameness recently until it progressed into bilateral to the point that he no longer attempted to stand. Radiographs demonstrated bilateral degenerative changes consistent with dysplasia/chondrodystrophic anatomy. Bilateral cranial drawer and medial buttress is present. Dr. Dew discussed mechanical issues with CCL rupture and pain due to hip dysplasia. He suggested bilateral TTA surgery, and his owners wished to proceed.
TREATMENT:
Dr. Dew used a medial approach with medial with medial arthrotomy. Kyon implants consist of 9x19 mm baskets on both sides, 4 hole plate & fork combination for both left and right, as well as 4 titanium screws in each side. A cancellous bone graft was used to promote bone growth and healing. Chopper’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. Due to having both legs corrected simultaneously, Chopper may require some assistance rising and walking for the next 1-14 days. This can be done with a harness or by placing a towel under his abdomen.

CASE STUDY:
Zoe is a Pomeranian. She is 1yr and 7mo old and weighs 3.8#. Her referring veterinarian is Dr. Alan Thompson of Farmington Veterinary Clinic. Zoe had previous bilateral MPL correction in Feb 2009, and has done well since that time and is participating in agility. The left patella continued to luxate when the limb is relaxed and this may be limiting her ability to compete. Upon Dr. Dew’s exam, he notes a grade II MPL which stayed reduced with normal muscle tension. He discussed a revision surgery with good prognosis for return to athletic function. Her owner decided to proceed.
TREATMENT:
Dr. Dew used a medial approach with medial release for Zoe’s revision. Post-surgically, Dr. Dew observed trochleoplasty of adequate depth and well healed, also, he was unable to luxate post correction. Zoe’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:
Lucy is an 80# 8mo old Lab. She was referred to us by Dr. William Pitchford of Pitchford Animal Clinc. She fell off of a 4-wheeler and became acutely non-weight bearing on her left rear. Dr. Pitchford identified a Salter Type IV fracture of the distal femur. Dr. Dew discussed an open reduction and IM pin stabilization. Her owners wished to proceed with surgery.
TREATMENT:
Dr. Dew used a lateral approach for Lucy’s fracture repair. Her femur was stabilized using 2 size 7/64 divergent pins. Her prognosis is good for normal osseous healing. Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.

CASE STUDY:
Dusty is a Mix Breed 10yr 8mo old and weighs 24#. This baby was referred to us also by Dr. William Pitchford of Pitchford Animal Clinic. Dusty had previously undergone a Right EFS (external fascial strip) surgery on his Left cruciate ligament, and had come back to our office because he was acutely lame on his Right rear limb. Dr. Pitchford identified a Right CCL Rupture. His owners opt for surgery for correction.
TREATMENT:
Dr. Dew used a lateral approach with lateral arthrotomy for Dusty’s Right EFS. He used #0 size suture for medial buttress, advanced biceps, lavaged, and closed his incision. Dusty’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.

Your Patient of the Week candidates for the week of 3/8 -- 3/12:

The winner for last week's vote was Charlie, with 11 votes. Have a picture of your pet getting his/her prize pack in the mail? Email it to info [at] azzore.com and we'll add it to the photo album on our website: You've Got Mail!

Who will be next?  ~~~~~>>>

CASE HISTORY:
Angel is an Italian Greyhound who is 15yrs old and weighs 8#.  She was sent to us by Dr. Doug Leach of Stanton Animal Hospital for acute onset of right rear lameness 2-3 weeks previous.  Dr. Leach identified a LPL which was manually reduced.  

Patient of the Week poll for week February 22 thru February 26

Last week's voting was fun to watch!  Brie closed up the win with 156 votes.  Congratulations, Brie!!
Vote over to the right for this week's babies~~>>>

CASE STUDY:
Olive is a Boston Terrier weighing 32# and is 2yrs old. She was sent to us by Dr. Amy Hawley of North Hills Animal Clinic. She had a history of intermittent left rear lameness. Dr. Hawley identified bilateral MPL (medial patellar luxation).