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Compendium October 2006 (Vol 28, No 10)

Abstract Thoughts (October 2006)

by Joseph Harari, MS, DVM, DACVS

    Loughin CA, Kerwin SC, Hosgood G: Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002). JAVMA 228(9):1370-1375, 2006.

    Abstract: In this retrospective case series from two veterinary teaching hospitals and a private referral center, the clinical signs and response to treatment were described in 42 cats with patellar luxation. The mean age of the cats was 3.3 years, and the mean body weight was 9.4 lb (4.3 kg). Domestic shorthairs accounted for 62% of the cases. Most (83%) cases had no history of trauma. Medial patellar luxation was diagnosed in 95% of the joints, and 34 cats had bilateral lesions. Lameness grades were assigned to 73 joints, and grade 1 (i.e., mild, intermittent lameness) was the most common. Luxation grades were assigned to 65 joints, and grade 2 (i.e., spontaneous luxation and reduction) was the most common. Radiographs suitable for scoring were available for 44 joints, and mild osteoarthritis was the most common feature. Nearly half (37 joints) were treated with rest, whereas 39 had surgery (the most frequently performed surgeries were retinaculum imbrication and tuberosity transposition).

    The outcome was excellent in eight of 17 joints treated with rest and 23 of 35 joints treated with surgery. Surgical complications were recorded in eight cats. The authors noted that surgery was usually performed on joints with higher grades of luxation, lameness was similar across all luxation grades, and both treatment strategies provided favorable outcomes.

    Commentary: Although common in the canine population, patellar luxation is infrequently described in the veterinary literature. Most often, congenital bilateral medial luxation has been reported. The results of this multicenter study involve a large number of cases with some interesting clinical features: Limb lameness may not be directly correlated with severity of the luxation, and conservative or surgical treatments provide satisfactory resolution of lameness. Furthermore, the authors describe several practical trends: In cats with bilateral luxation, the joint with a higher luxation grade was operated on, and in some cats with progressively worsening lameness, surgery was eventually performed. Common complications of surgery, such as iatrogenic lateral patellar luxation and pin migration, appear to be easily corrected. As the feline pet population continues to increase, especially in urban centers with expanding surgical referral centers, prospective clinical reports will be useful in elucidating guidelines for surgical intervention.

    Effect Of Vaccination With Recombinant Canine Distemper Virus Vaccine Immediately Before Exposure Under Shelter-Like Conditions

    Larson L, Schultz RD: Effect of vaccination with recombinant canine distemper virus vaccine immediately before exposure under shelter-like conditions. Vet Ther 7(2):113-118, 2006.

    Vaccination with modified-live virus (MLV) canine distemper virus (CDV) vaccine has historically been recommended for animals in high-risk environments because of the rapid onset of immunity following vaccination. Recombinant CDV (rCDV) vaccine was deemed a suitable alternative to MLV-CDV vaccination in pet dogs, but insufficient data precluded its use where CDV was a serious threat to puppies, such as in shelters, kennels, and pet stores. In this study, dogs experimentally challenged hours after a single dose of rCDV or MLV-CDV vaccine became sick but recovered, whereas unvaccinated dogs became sick and died. Dogs vaccinated with a single dose of rCDV or MLV-CDV vaccine 1 week before being experimentally challenged remained healthy and showed no clinical signs. Dogs given one dose of rCDV vaccine hours before being placed in a CDV-contaminated environment did not become sick.

    Key Finding:

    • The study results support the hypothesis that rCDV vaccine has a similar time to immunity as MLV-CDV vaccines and can likewise protect dogs in high-risk environments after one dose.

    Comparison Of Radiography And Computed Tomography For Diagnosis Of Middle Ear Disease In Dogs

    Rohleder JJ, Jones JC, Duncan RB, et al: Comparative performance of radiography and computed tomography in the diagnosis of middle ear disease in 31 dogs. Vet Radiol Ultrasound 47:45-52, 2006.

    Difficulties in diagnosing otitis media prompted a prospective comparison of radiographic and computed tomographic (CT) findings with surgical and his­to­pathologic results in 31 dogs with chronic, severe otitis externa and no previous ear surgery. One person performed (radiographic) or supervised (CT) imaging; a randomized, blinded study design was applied for analyzing imaging and histopathologic results. Analysis involved scoring via visual analog scales for the presence and severity of otitis media.

    Fifteen dogs had bilateral surgery (total ear canal ablation and bulla oste­otomy); 16 had unilateral surgery. Surgical diagnosis was made for 29 of 47 ears; disease was absent in 18 ears. Both imaging findings agreed more with the surgical than histopathologic findings for right-sided disease; both modalities were more accurate in predicting disease severity than presence. CT was more sensitive than and as specific as radiography in predicting disease presence and severity but was better for diagnosis only for severe disease.

    Key Findings:

    • Bilateral disease may be more prevalent than reported.
    • The side of involvement affected the diagnosis and severity scores.
    • The surgical findings were not as definite as expected.
    • Observer consistency was greater for CT than for radiography (left-sided disease).
    • The surgical and histopathologic findings differed.

    Both imaging modalities may underestimate the presence of mild disease.

    NEXT: Cricopharyngeal Dysphagia in Dogs: The Lateral Approach for Surgical Management

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