bluuebunny/crossref_metadata_2025 huggingface dataset:
Schizophrenia costs and treatment cost‐effectiveness
Authors: Knapp Martin
Published: October 2010

Objective: The paper sets out to summarize evidence on the costs of schizophrenia and on the cost‐effectiveness of three broad treatment areas.

Method: Evidence from a number of countries was examined, both published and unpublished, and systematic reviews and meta‐analyses were consulted.

Results: The costs of schizophrenia are high and wide‐ranging. They fall not only to health‐care agencies but also to other parts of the public sector, to families, to sufferers themselves and to the wider society. However, there are interventions — a counselling intervention to address non‐compliance with medication, family interventions to reduce levels of expressed emotion, and atypical antipsychotic drugs — that have been found to be not only effective (improving patient outcomes) but also appear to be cost‐effective.

Conclusion: Resource constraints and policy pressures make it increasingly common for economic as well as clinical questions to be asked about new modes of treatment. This is the new reality of mental health practice. Reliable evidence is now available to address these economic questions and can be factored into decision‐making processes.
A Radiographic Stress Technique for Evaluation of Coxofemoral Joint Laxity in Dogs
Authors: Flüaduckiger Mark A. , Friedrich G. Anne , Binder Heinrich
Published: October 2010

Objective—To develop a radiographic stress technique to quantify hip joint laxity in dogs.

Study Design—Prospective study on client‐owned dogs presented for hip dysplasia screening.

Animal Population—302 nonselected dogs (63 breeds).

Methods—Dogs were sedated and placed in dorsal recumbency. During pelvic radiography, the femoral heads were displaced manually in a craniodorsal direction. On these stress radiographs, the degree of lateral displacement of the femoral heads was assessed in terms of a subluxation index (SI) and compared with the degree of femoral head subluxation and the severity of hip dysplasia found on conventional extended hindlimb radiographs.

Results—The degree of subluxation on stress radiographs was significantly greater than on conventional radiographs. Correlation between the severity of canine hip dysplasia (CHD), graded according to conventional techniques, and the degree of subluxation, induced by radiographic stress technique, was positive (r= .57; P < .0001). Two critical SI values were noted. Of the dogs with an SI value of 0.3 or less, 99% were classified as CHD grade normal, borderline, or mildly dysplastic. In dogs with an SI value between 0.3 and 0.5, CHD grading ranged from normal to severely dysplastic. Of the dogs with an SI value greater than 0.5, 95% had dysplastic hip joints.

Conclusions—Hip joint laxity cannot be quantified precisely on standard position radiographs. The proposed stress technique yields significantly higher degrees of femoral head subluxation than the standard position.
The Effect of a Surgically Created Shunt Between the Corpus Cavernosum Penis and Corpus Spongiosum Penis of Stallions on Erectile and Ejaculatory Function
Authors: Schumacher Jim , Varner Dickson D. , Crabill Mark R. , Blanchard Terry L.
Published: October 2010

Objective—To evaluate the effect of a shunt created between the corpus cavernosum penis (CCP) and corpus spongiosum penis (CSP) on erectile and ejaculatory function of normal stallions and to verify persistence of the shunt.

Study Design—The capability of stallions to develop an erection and to ejaculate was evaluated before and after creation of a corporeal shunt. Persistence of the shunt was determined by dye injection into the CCP at necropsy.

Animals—Six stallions.

Methods—A CCP‐CSP shunt was created in five stallions. Semen was collected before and 4 to 14 weeks after surgery, before the horses were euthanatized. Dye was injected into the CCP to determine persistence of the shunt. Dye was also injected into the CCP of a control stallion.

Results—All stallions had normal erectile and ejaculatory function before and after surgery. Dye, injected into the CCP, entered the CSP in three of five treated stallions, demonstrating persistence of the shunt, whereas in two stallions, dye was found only in the CCP, indicating closure of the shunt. No dye was detected in the CSP of the control stallion.

Conclusions—Creation of a corporeal shunt does not interfere with normal erection and ejaculation of stallions. Shunt closure is not necessary for stallions to retain normal erectile and ejaculatory function.

Clinical Relevance—Failure of a stallion affected by priapism to achieve normal erection or to ejaculate after creation of a corporeal shunt would likely be because of damage to corporeal tissue than from an effect of the shunt.
Metacarpal Fractures Associated with Pancarpal Arthrodesis in Dogs
Authors: Whitelock Richard G. , Dyce Jonathan , Houlton John E. F.
Published: October 2010

Objective— To report the prevalence of third metacarpal bone fractures after dorsal plating for pancarpal arthrodeses in dogs and to identify predisposing factors.

Study Design— Retrospective clinical study.

Animals— Fifty‐four client‐owned dogs.

Methods— Pancarpal arthrodesis was performed using dorsally applied 2.7‐ or 3.5‐mm bone plates. Medical records and radiographs were retrospectively evaluated to identify those dogs with metacarpal bone fractures after pancarpal arthrodesis and to determine the angle of arthrodesis, the percentage of the third metacarpal bone covered by the bone plate, and the percentage width of the bone occupied by the screw. Radiological evidence of arthrodesis at follow‐up examination 6 weeks postoperatively was recorded. Long‐term results were obtained by telephone follow‐up with the owners. All lame dogs were evaluated clinically and radiographically.

Results— Metacarpal fractures occurred in 6 of 54 dogs. One of these dogs had a stress fracture of the third metacarpal 10 months after implant removal and was not included in the statistical analysis. Fractures occurred through the distal screw hole in four dogs and involved two metacarpal bones (III and IV) in two dogs. The median ratio of bone screw diameter‐to‐metacarpal bone diameter was the same for dogs with metacarpal bone fractures and those with no fractures (44%), and the median angles of arthrodesis were 8° and 7°. These values were not statistically significant. The percentage length of the metacarpal bone covered by the plate was 53% (no fracture) compared with 46% (fracture), and this difference was statistically significant (P= .035).

Conclusions— Screw diameter was not implicated as a predisposing factor for metacarpal bone fracture in dogs undergoing pancarpal arthrodesis using a dorsally applied dynamic compression plate. The length of the metacarpal bone covered by the bone plate did affect the frequency of metacarpal fracture, with fewer fractures occurring when greater than 53% of the bone length was covered by the dynamic compression plate.

Clinical Relevance— When performing pancarpal arthrodesis with a dorsally applied bone plate, it is recommended that at least 50% of the length of the third metacarpal bone should be covered by the plate.
Ionized and Total Serum Magnesium Concentrations in Feline Renal Transplant Recipients
Authors: Wooldridge John D. , Gregory Clare R.
Published: October 2010

Objective—To measure the blood concentrations of total and ionized serum magnesium in feline renal transplant recipients and to determine if there was a correlation between these concentrations and the development of neurological disorders after renal transplantation.

Study Design—Prospective clinical study.

Animals—Fourteen client‐owned cats undergoing renal transplantation as a treatment for renal failure. Ten healthy adult cats were used to establish normal electrolyte concentrations.

Methods—Total and ionized serum magnesium as well as potassium and ionized calcium concentrations were measured in 14 renal transplant recipients at five intervals: preoperatively; immediately postoperatively; and 24, 48, and 120 hours postoperatively. The mean values from all 14 cats over each time interval were compared with the normal range. The serum concentration of these electrolytes, particularly magnesium, was evaluated in relation to the occurrence of neurological complications.

Results—Ninety‐four percent of all ionized serum magnesium concentrations measured in clinical patients were below normal. Ninety percent of all total serum magnesium concentrations were within the normal range, and no cats had abnormally low total serum magnesium concentrations at any time. All clinical patients were hypocalcemic at all intervals. Sixty‐six percent of all serum potassium concentrations were below normal. One cat in the study group experienced neurological problems, including seizures, in the immediate postoperative period. The signs appeared to be related to hypertension and responded to appropriate therapy. All electrolyte concentrations in this cat, including ionized magnesium, were within the same range of values as other clinical patients.

Conclusions—Ionized serum magnesium concentrations are decreased in feline renal transplant recipients in the perioperative period; however, hypomagnesemia would not appear to be directly related to the development of neurological disorders. None of the study patients were hypomagnesemic when total serum magnesium concentrations were measured over the same intervals. In addition, ionized serum calcium concentrations and serum potassium concentrations are below normal in the perioperative period.

Clinical Significance—The specific clinical significance of these abnormalities is unknown. It is possible that the profound weakness and depression that is commonly seen in feline renal transplant recipients in the immediate postoperative period may be improved by supplementation with these electrolytes. Further work is needed to understand the implications of these abnormalities.
Experimental Evaluation of Four Methods of Progressive Venous Attenuation in Dogs
Authors: Youmans K. Ruth , Hunt Geraldine B.
Published: October 2010

Objective—To determine the most effective and reliable method for progressive attenuation of single extrahepatic portosystemic shunts in dogs.

Study Design—The effects of the four treatments on femoral vein diameter and histology were compared with controls.

Animals—Fourteen healthy adult dogs.

Methods—Twenty‐eight canine femoral veins were subjected to sham surgery (4), partial attenuation using silk (5), cellophane banding (6), ameroid constrictor implantation (5), and intravascular thrombogenic coils (8). Changes in vein diameter were evaluated at weekly intervals using venography. After 6 weeks, the dogs were humanely euthanatized, and histopathology was performed on the femoral veins.

Results—Only cellophane and ameroid constrictors produced progressive and permanent vein attenuation. Ameroid constrictors produced complete occlusion within 14 days in four of five veins and by 21 days in the fifth vein. Cellophane banding produced slow progressive (but not complete) attenuation in five of six veins. Complete occlusion was demonstrated in four of eight veins after thrombogenic coil implantation; however, recanalization occurred in all but one dog. Perivascular silk did not produce significant progressive attenuation.

Conclusions—Ameroid constrictors produced rapid occlusion of femoral veins. Cellophane banding resulted in slower attenuation. Thrombogenic coils produced attenuation, but this was not sustained in many cases. Silk did not promote ongoing attenuation.

Clinical Relevance—Both ameroid constrictor implantation and cellophane banding show promise for progressive attenuation of single extrahepatic portosystemic shunts in dogs. Because rapid occlusion was seen with ameroid constrictors, however, cellophane banding maybe a safer technique in animals with increased hepatic vascular resistance. Further evaluation of both treatments in clinical cases is warranted.
Complete Biceps Brachii Tenotomy to Facilitate Internal Fixation of Supraglenoid Tubercle Fractures in Three Horses
Authors: Bleyaert Helga F. , Madison John B.
Published: October 2010

Objective—To describe a method for internal fixation of supraglenoid tubercle fractures in conjunction with complete tenotomy of the biceps brachii tendon.

Animals—Three horses, ranging in age from 8 months to 2 years and weighing from 300 to 400 kg.

Methods—Fractures were repaired by open reduction‐internal fixation using bone screws placed in lag fashion and complete tenotomy of the biceps brachii tendon.

Outcome—All three horses were sound for their intended use with a good cosmetic result 6 months after surgery.

Conclusions—Complete transection of the biceps brachii tendon facilitates supraglenoid tubercle fracture repair by reducing tensile forces exerted on the supraglenoid tubercle. Complete tenotomy does not appear to preclude return to a successful athletic career.
Osteosarcoma at the Site of Bone Infarction Associated with Total Hip Arthroplasty in a Dog
Authors: Marcellin‐Little Denis J. , DeYoung David J. , Thrall Donald E. , Merrill Christine L.
Published: October 2010

Objective—To report the occurrence of medullary bone infarction in both femoral canals after bilateral total hip arthroplasty (THA) and the subsequent unilateral development of an osteosarcoma at the site of bone infarction.

Study Design—Clinical report.

Animal Population—An 8‐month‐old neutered male Samoyed dog.

Methods—Serial physical and radiographic examinations performed at 1, 2, 3, and 5 years after THA. Bone biopsy specimens of the right distal femoral metaphysis were taken 5 years after THA, and a complete necropsy was performed at the time of euthanasia.

Results—Bilateral medullary bone infarction was visible in the femoral canals 1 year after THA and remained visible on subsequent evaluations. An osteosarcoma developed in the right distal femoral metaphysis at the site of infarction, 5 years after THA, and was found to have metastasized widely throughout the body.

Conclusion—Bone infarction may occur in the femoral canal after canine THA.

Clinical Relevance—Bone infarction may be a predisposing factor for the development of osteosarcoma in the femora of dogs with THAs.
Evaluation of a Technique to Occlude the Internal Carotid Artery of Horses
Authors: Cheramie Hoyt S. , Pleasant R. Scott , Robertson John L. , Moll H. David , Carrig Colin B. , Freeman David E. , Jensen Mary E.
Published: October 2010

Objective—To evaluate an occlusion technique for the internal carotid artery of horses using an intravascular, detachable, self‐sealing, latex balloon distally and ligatures proximally.

Study Design—Experimental study.

Animals—Six healthy adult horses.

Methods—In each horse, the left internal carotid artery was occluded by placement of an intravascular, detachable, self‐sealing, latex balloon distally and two ligatures proximally. Radiographs were taken on days 2, 5, 10, and 30 after surgery to evaluate balloon inflation and position. Endoscopic examination of the left guttural pouch was performed 10 days after surgery to evaluate the integrity of the internal carotid artery and surrounding tissues. At 30 days, the left and right, common, internal, and external carotid arteries were examined grossly and then processed for histologic evaluation.

Results—Immediate and long‐term occlusion of the left internal carotid artery was achieved in all horses. The surgical procedure was technically straightforward and no intraoperative or postoperative complications were encountered. The balloons remained inflated and in their original position throughout the study. Maturing to mature, organized thrombi were present in the left internal carotid artery in all horses at 30 days. The cerebral arterial circle and common carotid artery were patent at their junctions with the internal carotid artery in all horses.

Conclusions—Use of an intravascular, detachable, self‐sealing, latex balloon distally and ligatures proximally is an effective technique for occluding the internal carotid artery of horses.

Clinical Relevance—This technique may be useful for prevention of fatal hemorrhage in horses with lesions of the internal carotid artery.
Surgical Treatment of Degenerative Lumbosacral Stenosis in Dogs
Authors: Danielsson Fredrik , Sjöström Lennart
Published: October 2010

Objective—To study the epidemiology, clinical findings, and long‐term outcome of surgical treatment of degenerative lumbosacral stenosis (DLSS) in dogs.

Study Design—Retrospective study.

Sample Population—131 client‐owned dogs with DLSS.

Methods—The medical records of dogs with DLSS treated by dorsal laminectomy and dorsal fenestration were reviewed. The clinical diagnosis had been verified by diskography, epidurography or myelography, or a combination thereof.

Results—The German shepherd breed was over‐represented (56.5%), and males were more often affected than females (2:1). Historically, reluctance or pain when jumping, rising from a prone position, or climbing stairs (92.4%) and signs of pain or stiffness during extensive physical activity (85.5%) were the most frequent concerns. The most common physical and neurologic examination findings were pain in the lumbosacral area during hyperextension (97.7%) and on direct digital palpation (84.7%). A total of 93.2% of the dogs were improved clinically within the follow‐up period (mean 26 ± 17 months). Recurrence of clinical signs resembling DLSS was reported by the owner or diagnosed by clinical examination in 17.6% of the dogs with a mean onset of signs at 18 ± 13 months postoperatively.

Conclusions—Surgical treatment of DLSS with dorsal laminectomy and fenestration generally resulted in good to excellent clinical outcome.
Desmotomy of the Accessory Ligament of the Superficial Digital Flexor Tendon in the Horse with Use of a Tenoscopic Approach to the Carpal Sheath
Authors: Southwood Louise L. , Stashak Ted S. , Kainer Robert A. , Wrigley Robert H.
Published: October 2010

Objective—To describe a tenoscopic approach to the carpal sheath for desmotomy of the accessory ligament of the superficial digital flexor tendon.

Study Design—The surgical procedure was developed with use of normal forelimbs from equine cadavers and experimental horses.

Animals or Sample Population—Twelve equine cadaveric forelimbs, 4 forelimbs from 2 horses anesthetized for terminal surgical laboratories, and 10 forelimbs from five experimental horses were used.

Methods—The limbs were positioned lateral side up with the carpus slightly flexed. After distention of the carpal sheath, a portal was made approximately 2 cm proximal to the distal radial physis for arthroscope insertion. An instrument portal was made approximately 0.2 cm proximal to the distal radial physis. After flexion of the limb to 90°, the accessory ligament of the superficial digital flexor tendon was palpated and desmotomy was performed. Cadaveric limbs were dissected to confirm complete desmotomy. Experimental horses were monitored for short‐ (perioperative) and long‐ (4 weeks) term postoperative complications.

Results—A tenoscopic approach to the carpal sheath provided adequate surgical access to the accessory ligament of the superficial digital flexor tendon for desmotomy. Most of the accessory ligament of the superficial digital flexor tendon could be easily seen within the sheath, except for the proximal 2 cm that could be readily palpated and subsequently transected. Important technical considerations were location of the arthroscope portal, adequate sheath distention, limb flexion to 90°, and desmotomy location. It was beneficial, but apparently not essential, to avoid the proximal perforating vessel. Postoperatively, some horses had swelling but were not lame and had normal range of motion of the carpus.

Conclusions—Desmotomy of the accessory ligament of the superficial digital flexor tendon could be performed by using a lateral tenoscopic approach to the carpal sheath.

Clinical Relevance—Desmotomy of the accessory ligament of the superficial digital flexor tendon by using a tenoscopic approach to the carpal sheath is an alternative technique to the medial incisional approach.
Bilateral Laparoscopic Ovariectomy in Standing Mares: 22 Cases
Authors: Hanson Christopher A. , Galuppo Larry D.
Published: October 2010

Objective—To describe a technique for laparoscopic bilateral ovariectomy in standing mares and report the outcome of 22 clinical cases.

Study Design—Prospective study.

Animals or Sample Population—A total of 22 mares between 4 and 23 years of age, weighing between 360 and 600 kg.

Methods—Mares with normal ovaries, as determined by palpation per rectum, were restrained in standing stocks and sedated with detomidine (0.01 to 0.02 mg/kg intravenously [IV]) and butorphanol (0.01 to 0.02 mg/kg IV). The laparoscope and instrument insertion sites were infiltrated with 2% lidocaine before incision. One laparoscope portal and two instrument portals were located in each paralumbar fossa. Ovariectomy was accomplished by intracorporeal dissection and ligation of the ovarian pedicles. The two instrument portals in each flank were ultimately connected resulting in a 4 to 5 cm laparotomy to facilitate ovarian removal.

Results—No major operative or postoperative complications occurred. Minor complications included incomplete hemostasis of an ovarian pedicle with a single ligature (three mares), transient inappetence, pyrexia and incisional infection. Owner satisfaction and cosmetic results were considered excellent.

Conclusions—Standing laparoscopic ovariectomy appears to eliminate many of the potential complications associated with traditional surgical methods for ovariectomy and avoids the risk of general anesthesia.

Clinical Relevance—This technique requires minimal laparoscopic instrumentation and will provide surgeons with an alternative approach for bilateral ovariectomy in mares.
Biomechanical Comparison of Two Plating Techniques for Fixation of Acetabular Osteotomies in Dogs
Authors: Hardie R. J. , Bertram J. E. A. , Todhunter R. J. , Trotter E. J.
Published: October 2010

Objective—To compare the failure properties of a 5‐hole, 2.7‐mm curved acetabular plate (AP) to a 5‐hole, 3.5‐mm reconstruction plate (RP) when applied to acetabular osteotomies.

Study Design—Cadaver study.

Animals or Sample Population—Pelves of 8 mature, large‐breed dogs.

Methods—A 5‐hole, 2.7‐mm AP and a 5‐hole, 3.5‐mm RP were contoured and applied to the dorsal acetabulum of each pelvis. A central acetabular fracture was simulated after plate application by a transverse osteotomy with a fine saw. Each acetabulum was loaded in a weight‐bearing direction. A load‐deformation curve was produced for each construct, and biomechanical properties of the AP and RP were compared with the Student's pairedt‐test. APvalue of < .05 was considered significant.

Results—For the AP and RP composite respectively, the mean ± SD maximum load to failure was 2,721 ± 632 N and 2,488 ± 800 N, the stiffness was 4.8 ± 1.8 N/m and 5.3 ± 1.9 N/m, and the energy absorbed was 15.1 ± 5.2 Nm and 16.3 ± 8.3 Nm. None of these differences was statistically significant.

Conclusions—Both fixation techniques provided comparable strength, stiffness, and energy absorbed under the loading conditions of this study.

Clinical Relevance—Because of the relative ease of application, the 2.7‐mm curved AP may be the practical choice for acetabular fracture repair in large dogs.
Effect of Disk Fenestration on Sagittal Kinematics of the Canine C5‐C6 Intervertebral Space
Authors: Macy Nicholas B. , Les Clifford M. , Stover Susan M. , Kass Philip H.
Published: October 2010

Objective—To determine the effect that ventral intervertebral disk fenestration has on the sagittal range of motion about the C5‐C6 intervertebral space.

Study Design—A repeated measures in vitro mechanical study of spinal range of motion under controlled loading conditions before and after fenestration.

Sample Population—A total of 10 canine cervical vertebral specimens (C4‐C7) collected from clinically normal animals within 12 hours of euthanasia.

Methods—Specimens were loaded as cantilever beams fixed at C7. Weights (1 to 5 kg) were progressively applied to C4 to produce flexion or extension in the sagittal plane. Radiographs were taken at each load, 3 times before and 3 times after fenestration of the C5‐C6 disk. The positions of radiodense markers embedded in the vertebrae were used to calculate flexion and extension angles and range of motion.

Results—Range of motion (difference between flexion and extension) and flexion and extension angles (individually) significantly increased after fenestration (P< .0001).

Conclusion—Ventral fenestration produces sagittal instability of the C5‐C6 disk space.

Clinical Relevance—In surgical fusion of caudal cervical intervertebral spaces in dogs, radiographically normal disks adjacent to the affected space are often fenestrated to facilitate distraction before surgical stabilization. This study shows that ventral fenestration produces instability of a caudal cervical intervertebral space in the model used. Such instability may contribute to the development of the secondary instability (“domino lesions”) seen in some surgically treated dogs.
Effect of Ischemia and Reperfusion on Neutrophil Accumulation in Equine Microvascular Tissue Flaps
Authors: Scott W. Michael , Fowler J. David , Matte Gilbert , Allen Andrew L. , Wilkinson A. A. , Bailey Jeremy V. , Fretz Peter B.
Published: October 2010

Objective—To investigate neutrophil accumulation after ischemia and reperfusion (IR) in microvascular tissue flaps in horses.

Study Design—Randomized controlled experiment.

Sample Population—A total of 8 horses between 1 and 10 years of age, 4 of each sex.

Methods—Control and experimental myocutaneous island flaps based on the superficial branch of the deep circumflex iliac vessels were dissected on each horse. Atraumatic vascular clamps were applied to the pedicle of the experimental flap for 90 minutes and then removed to allow reperfusion. Based on the assumption that rapid infiltration of neutrophils into affected tissues is a hallmark of IR injury, radiolabeled autogenous leukocytes were used to indirectly quantify neutrophil accumulation in flap tissues. Labeled leukocytes were administered through a jugular catheter 30 minutes before flap reperfusion. Biopsies were collected from each flap over a 6 hour postischemia time period; in group 1 (n = 4) from 0 to 6 hours postischemia, and in group 2 (n = 4) from 24 to 30 hours postischemia. Biopsies were examined scintigraphically and histologically for evidence of neutrophil infiltration.

Results—All control flaps survived and 6 of 8 experimental flaps survived. There was no significant evidence of acute neutrophil infiltration into flap tissues after reperfusion in either group.

Conclusions—The results of this study suggest that equine myocutaneous flap tissues can survive a 90‐minute ischemic period and reperfusion. No significant evidence of the occurrence of IR injury in flap tissues was found.

Clinical Relevance—The reasons for the previously reported failures of equine free tissue transfer remain uncertain, but they do not appear to be caused by neutrophil mediated injury associated with ischemia and reperfusion.
Letter to the Editor
Authors: Leighton Robert L.
Published: October 2010

To the editor:
During the preparation of an article on the repair of rupture of the cranial cruciate ligament in dogs, I made a survey of the members of the American College of Veterinary Surgery in active practice with a special interest in orthopedics. They were asked to specify their preferences for treatment of this condition in small (under 16 kg) and large dogs.

A total of 111 replies were obtained. Repair in small dogs was to a great extent achieved by lateral suture stabilization by using a variety of materials such as fishing line, multifilament nonabsorbable suture, and stainless steel wire. Lateral extracapsular techniques were also used in large dogs; however, the tibial plateau leveling osteotomy was also used frequently. The data are summarized as follows:
Use of Electrocautery Probes in Arthroscopic Removal of Apical Sesamoid Fracture Fragments in 18 Standardbred Horses
Authors: Bouré Ludovic , Marcoux Marcel , Laverty Sheila , Lepage Olivier M.
Published: October 2010

Objective—To develop a technique for arthroscopic excision of apical sesamoid fracture fragments using electrocautery probes.

Animals or Sample Population—A total of 18 Standardbred horses.

Methods—Arthroscopic removal of apical sesamoid fracture fragments using both hook and loop electrocautery probes was performed on 18 Standardbred horses. The fracture fragments were approached using either an ipsilateral (3) or contralateral (15) arthroscopic triangulation technique. Distension of the metacarpo‐ (metatarso)‐phalangeal joints was achieved using a 1.5% glycine solution. Under arthroscopic guidance, both the suspensory and intersesamoidean ligament attachments to the abaxial and the axial margins of the apical fragment were transected using a hook electrocautery probe. Subsequently, the palmar (plantar) soft tissue attachments to the apical fragment were transected with a loop electrocautery probe. Once freed of soft tissue attachments, the apical fragment was removed with Ferris‐Smith intervertebral disc rongeur. The arthroscopic portals were closed in a routine manner.

Results—Horse ages ranged from 2 to 8 years (median, 2.5 years). Eighteen apical sesamoid fracture fragments were removed from the left (8) and right (8) hind limbs and the left (1) and right (1) forelimbs. Apical fragments occured in 15 lateral and 3 medial proximal sesamoid bones. No major complications occurred during or after surgery. The electrocautery probes permitted an easy and precise dissection of all soft tissue attachments to the apical sesamoid fracture fragments in all horses. Follow‐up time was 7 to 44 months (median, 26 months); 10 of 14 horses returned to racing. Seven of nine horses that raced before surgery raced again and three of five that had not raced before surgery, raced afterwards.

Conclusion—Arthroscopic excision of apical sesamoid fracture fragments can be accomplished arthroscopically using electrocautery probes.

Clinical Relevance—Arthroscopic electrosurgery is an efficient and safe alternative for intra‐articular dissection in horses.
Biodegradable Drug Delivery Systems for Gentamicin Release and Treatment of Synovial Membrane Infection
Authors: Cook V.L. , Bertone A.L. , Kowalski J.J. , Schwendeman S.P. , Ruggles A.J. , Weisbrode S.E.
Published: October 2010

Objective—This study investigated two biodegradable drug delivery systems (BDDS) for elution of gentamicin and elimination of synovial membrane infection.

Study Design—The effect of BDDS on control and infected synovial explants was determined.

Animals or Sample Population—Synovial explants from four adult equine cadavers.

Methods—First, BDDS were placed in phosphate buffered saline for 14 days. Eluent was tested for gentamicin concentration (G) and bioactivity. Second, synovial explants were divided into four groups (n = 14/group): Group 1 (control); Group 2 (infected control) 405 cfuStaphylococcus aureusadded at 6 hours; Group 3 (antibiotic BDDS [Ab‐BDDS]) Ab‐BDDS added at 24 hours; Group 4 (infected Ab‐BDDS) 405 cfuS. aureusadded at 6 hours, Ab‐BDDS added at 24 hours. Both types of Ab‐BDDS were used (n = 7/type/group). Explants were incubated in standard medium for 4 days. Medium was cultured and analyzed for (G) and hyaluronic acid concentration (HA). Explants were analyzed for viability and morphologic changes.

Results—The Ab‐BDDS released >500 μg/mL of active gentamicin for 10 days. In Group 3, infection was eliminated within 24 hours, but histologic scores did not return to normal. Viability was significantly reduced by infection, but if eliminated, viability tended to return to normal. In Group 3, the Ab‐BDDS had no significant effect on viability or (HA). Histopathologic scores were significantly higher for infected synovium. Infection, even if treated, significantly reduced (HA).

Conclusions—Both Ab‐BDDS eliminated infection within 24 hours. However, synovial morphology, viability and function did not return to normal.

Clinical Relevance—The Ab‐BDDS may be useful for treatment of synovial membrane infection.
Arthroscopic Subchondral Bone Plate Microfracture Technique Augments Healing of Large Chondral Defects in the Radial Carpal Bone and Medial Femoral Condyle of Horses
Authors: Frisbie D.D. , Trotter G.W. , Powers B.E. , Rodkey W.G. , Steadman J.R. , Howard R.D. , Park R.D. , McIlwraith C.W.
Published: October 2010

Objective—To evaluate the effect of arthroscopic subchondral bone microfracture on healing of large chondral defects in horses.

Study Design—Short‐ (4 months) and long‐term (12 months) in vivo experimental chondral defect model.

Animals—10 horses, aged 2 to 5 years.

Methods—Each horse had a 1 cm2full‐thickness chondral defect created in both radial carpal bones and both medial femoral condyles. One carpus and one femoral condyle of each horse had the subchondral bone plate under the defect perforated using an orthopedic awl. All horses were exercised, five horses were evaluated after 4 months and five horses after 12 months. Gross, histologic, and histomorphometric examination of defect sites and repair tissues was performed, as was collagen typing of the repair tissue.

Results—On gross observation a greater volume of repair tissue filled treated defects (74%) compared with control defects (45%). Histomorphometry confirmed more repair tissue filling treated defects, but no difference in the relative amounts of different tissue types was observed. There was an increased percentage of type II collagen in treated defects compared with control defects and evidence of earlier bone remodeling as documented by changes in porosity.

Conclusions—In full‐thickness chondral defects in exercised horses, treatment with subchondral bone microfracture increased the tissue volume in the defects and the percentage of type II collagen in the tissue filling the defects when compared to nontreated defects.

Clinical Relevance—No negative effects of the microfracture technique were observed and some of the beneficial effects are the basis for recommending its use in patients cases with exposed subchondral bone.
The Effect of Knotting Method on the Structural Properties of Large Diameter Nonabsorbable Monofilament Sutures
Authors: Huber Douglas J. , Egger Erick L. , James Susan P.
Published: October 2010

Objective— To evaluate the effect of knotting method on the mechanical properties of large diameter nonabsorbable monofilament suture materials.

Study Design— In vitro mechanical evaluation.

Methods— A conventional square knot was compared with the surgeon's knot, sliding half‐hitch, and clamped square knot. Knotted suture loops were created in a uniform manner and acutely tensioned to failure (20 mm/min loading rate; n = 20 per knot type for each material). Stiffness, yield, and failure characteristics of USP #2 nylon, #2 polybutester, #2 polypropylene, 27 kg test monofilament nylon fishing line, and 27 kg nylon leader material were evaluated.

Results— Compared with a conventional square knot, a surgeon's knot decreased stiffness for #2 polypropylene, 27 kg fishing line, and 27 kg leader (P < .05). A sliding half‐hitch weakened all materials except 27 kg leader (P < .05). Clamping the first throw of a square knot increased the stiffness of 27 kg leader loops (P < .05).

Conclusions— Based on clinically relevant parameters (stiffness and yield), knotting method had no effect on #2 nylon and #2 polybutester. The surgeon's knot is not recommended for #2 polypropylene and 27 kg fishing line and leader material. A sliding half‐hitch decreased the yield of leader material. Clamping the first throw of a square knot had no adverse effects on acute properties of tested materials; it increased the stiffness for leader material.

Clinical Relevance— Knotting method does influence the structural properties of suture materials and should be considered when tying knots under tension.
In VitroEffects of Epidermal Growth Factor or Insulin‐Like Growth Factor on Tenoblast Migration on Absorbable Suture Material
Authors: Jann H.W. , Stein Larry E. , Slater Donna A.
Published: October 2010

Objective—To determine the effects of epidermal growth factor (EGF) or insulin‐like growth factor (IGF) on tenoblast migration on absorbable suture material using anin vitromodel.

Study Design—Anin vitroevaluation of tenoblast migration.

Animal or Sample Population—Segments of the long digital flexor tendon were obtained from Cobb chickens (9–11 weeks old) immediately after the birds were euthanatized.

Methods—Tissue culture explants of tendons containing absorbable suture material were treated with either EGF or IGF. Tenoblast migration was assessed daily using an inverted microscope equipped with bright field and phase optics. Tenoblast migration was assessed according to the following criteria: time of first cell appearance, percent of explant interfaces producing cells, migration distance, and terminal migration index at 120 and 168 hours.

Results—EGF had a stimulatory effect on tenoblast migration for cells originating from the endotenon interfaces. No significant effect was noted on migration distance for cells originating from epitenon interfaces. A stimulatory effect on the percentage of interfaces producing cells and a significant decrease in time of first cell appearance were also observed after EGF treatment. IGF‐stimulated cell migration distance for epitenon interfaces but this stimulatory effect did not occur at a higher concentration. IGF was inhibitory to percent of epitenon and endotenon interfaces producing cells but decreased time of first cell appearance at low concentration.

Conclusions—Using anin vitromodel, EGF had a stimulatory effect on tenoblast migration. IGF was stimulatory at low concentration levels but inhibitory at a higher concentration. Increased migration distance was observed for endotenon interfaces after EGF treatment and for epitenon interfaces after IGF treatment.

Clinical Relevance—EGF or IGF might enhance tendon repair if they could be delivered to the repair site. Incorporation of EGF or IGF into suture material would allow slow release and prolonged exposure of migrating tenoblasts to growth factors.
AnIn VitroComparison of Hollow Ground and Trocar Points on Threaded Positive‐Profile External Skeletal Fixation Pins in Canine Cadaveric Bone
Authors: Marti Juan M. , Roe Simon C.
Published: October 2010

Objective—To compare the microstructural damage created in bone by pins with lathe‐cut and rolled‐on threads, and to determine the peak tip temperature and damage created by positive‐profile external fixator pins with either hollow ground (HG) or trocar (T) tips during insertion.

Study Design—An acute, in vitro biomechanical evaluation.

Sample Population—Twenty‐seven canine tibiae.

Methods—Lathe‐cut thread design with T point (LT‐T), rolled‐on thread design with T point (RT‐T), and rolled‐on thread design with HG point (RT‐HG) pins were evaluated. Twenty pins of each type were inserted under constant drilling pressure into 12 canine tibiae (12 diaphyseal and 8 metaphyseal sites per pin type). Peak pin tip temperature, drilling energy, end‐insertional pin torque, and pullout force were measured for each pin. For the histologic study, five pins of each type were inserted into cortical and cancellous sites in 15 additional tibiae. Entry and exit damage, and thread quality were assessed from 100 micron histologic sections by using computer‐interfaced videomicroscopy.

Results—T‐tipped pins reached higher tip temperature in both diaphyseal and metaphyseal bone compared with HG‐tipped pins. RT‐T pins had higher pullout strength (diaphyseal) and end‐insertional torque compared with other combinations. No differences in drilling energy or insertional bone damage was found between the three pin types (P< .05).

Conclusions—T‐tipped pins mechanically outperformed HG‐tipped pins. Pin tip and thread design did not significantly influence the degree of insertional bone damage.

Clinical Relevance—T‐tipped pins may provide the best compromise between thermal damage and interface friction for maximizing performance of threaded external fixator pins.
Low‐Intensity Laser Light‐Induced Closure of a Chronic Wound in a Dog
Authors: Lucroy Michael D. , Edwards Benjamin F. , Madewell Bruce R.
Published: October 2010

Objective— To describe the application of low‐intensity laser light for treatment of a chronic, full‐thickness skin wound in a dog.

Study Design— Case report.

Animals— An 8‐year old, castrated Whippet.

Methods— The wound was irradiated on the awake patient with 630 nM wavelength, nonthermal red light once daily for 4 consecutive days. Changes in wound surface area were measured by computer analysis of digital images of the wound.

Results— The wound diminished in size during the course of laser treatments and was completely healed by day 21. No post‐treatment complications occurred.

Conclusions— Low‐intensity laser light may be useful for treatment of chronic skin wounds in dogs.
Warming With a Forced Air Warming Blanket Minimizes Anesthetic‐Induced Hypothermia in Cats
Authors: Machon Roslyn G. , Raffe Marc R. , Robinson Elaine P.
Published: October 2010

Objective—To evaluate the effectiveness of a forced‐air warming blanket (FAWB) in minimizing anesthetic‐induced hypothermia in cats, and to examine the relationship between esophageal and other estimates of body temperature during skin surface warming.

Study Design—Prospective, randomized cross‐over trial.

Animals—Eight adult domestic shorthair cats (four males and four females) weighing 2.3 to 4.5 kg.

Methods—Each cat was anesthetized with halothane in oxygen on four occasions and covered with a modified FAWB. Air delivered to the cats by the FAWB was warmed to approximately 43°C. Each trial lasted 90 minutes and was divided into two consecutive 45‐minute periods, during which the FAWB was activated or inactivated thus creating four treatment trials: off/off, on/off, on/on, off/on. Measurements of body temperature from the caudal esophagus, deep rectum, toe‐web, and tympanic membrane were recorded at regular intervals throughout each trial and compared.

Results—A steady decline in body temperature was observed throughout each trial. Mean body temperature in the cats receiving continual skin surface warming (on/on) was significantly higher than in those receiving no active warming (off/off) and those receiving delayed warming (off/on), from 45 minutes onwards. By 90 minutes, the mean body temperature of cats warmed continuously was 0.9°C higher than in those with no active warming. Notable differences in body temperature were detected between all measurement sites, with the exception of esophagus versus rectum. Rectal and esophageal temperatures did not differ at any time point. Tympanic membrane temperatures measured with either device were lower than esophageal temperatures.

Conclusions—The modified FAWB was effective in minimizing the degree of hypothermia experienced in cats anesthetized with halothane for 90 minutes. Deep rectal temperature was an accurate reflection of esophageal temperature in these cats.

Clinical Relevance—Forced air warming blankets may prove successful in minimizing anesthetic‐induced hypothermia in cats.
Nd:YAG Laser–Assisted Modified Forssell's Procedure for Treatment of Cribbing (Crib‐Biting) in Horses
Authors: Delacalle Jorge , Burba Daniel J. , Tetens Joanne , Moore Rustin M.
Published: October 2010

Objective—To report an neodymium:yttrium‐aluminum garnet (Nd:YAG) laser‐assisted modified Forssell's surgical technique and outcome for treatment of cribbing (crib‐biting) in horses.

Study design—Retrospective clinical study.

Animals—Ten adult horses with stereotypic cribbing behavior.

Methods—Data were obtained from medical records and telephone conversations with owners, trainers, and veterinarians. Surgical technique involved an approximately 34‐cm ventral median skin incision starting rostral to the larynx and extending caudally. A 10‐cm section of the ventral branch of the spinal accessory nerve was removed, using an Nd:YAG laser at 25 W and continuous pulse with a contact, sculpted‐fiber tip. After neurectomy, approximately 34‐cm sections of the paired omohyoideus and sternothyrohyoideus muscles were removed starting 2 cm rostral to the ventral aspect of the larynx, at the basihyoid bone, using the Nd:YAG laser.

Results—Median horse age was 7 years (range, 1 to 11 years). Median surgical time was 90 minutes (range, 75 to 130 minutes). Long‐term outcome (range, 7 to 72 months) was available for all horses. None of the horses had cribbing behavior after surgery, and all returned to their previous use. Four horses had complications (two of which were unrelated to the surgical site), but all recovered fully.

Conclusion—The successful outcome we obtained is better than reported previously using a modified Forssell's technique.

Clinical relevance—Surgical treatment for cribbing by Nd: YAG laser‐assisted myectomy and neurectomy resulted in an excellent prognosis for resolution of the stereotypical behavior with minimal complications.
Changes in the Local Regulation of Insulin‐Like Growth Factors I and II and Insulin‐Like Growth Factor‐Binding Proteins in Osteoarthritis of the Canine Stifle Joint Secondary to Cruciate Ligament Rupture
Authors: Fernihough Janet K. , Innes John F. , Billingham Michael E. J. , Holly Jeff M. P.
Published: October 2010

Objectives—To investigate changes in concentrations of insulin‐like growth factors I (IGF‐I) and II (IGF‐II) and the expression of IGF‐binding proteins (IGFBP) in synovial fluids from dogs with naturally occurring osteoarthritis (OA) of the canine stifle joint secondary to cranial cruciate ligament (CCL) rupture.

Study Design—Prospective study with synovial fluid sampling from diseased and contralateral unaffected joints at 0, 1.5, and 5 months.

Sample Population—Eleven dogs with unilateral CCL deficiency, with unaffected contralateral joints.

Methods—IGF‐I and IGF‐II concentrations in synovial fluids were estimated by radioimmunoassay at 0, 1.5, and 5 months; Western ligand blotting was performed for intact IGFBPs at 0, 1.5, 5, and 9 months. Both stifle joints were radiographed at 0, 7, and 13 months.

Results—The IGF system is altered after CCL rupture and during development of early OA. Mean IGF‐I and IGF‐II concentrations in index stifle joints at study entry were 201.6 μg/mL and 345.7 μg/mL, respectively, compared with 57.7 μg/mL and 79.4 μg/mL, respectively, for contralateral joints. Index joint IGF concentrations increased after surgical treatment and then declined, although they remained higher than contralateral joints. Index joints had increases in IGFBP‐3 and –4, and a decrease in IGFBP‐2 expression compared with contralateral joints.

Conclusions—Although IGF concentrations are increased in canine OA, alterations in IGFBP profiles may limit the tissue availability of IGF.

Clinical Relevance—Manipulation of the IGF system may provide an opportunity for novel treatments of OA in dogs.