Small Animal Orthopedics, Rheumatology and Musculoskeletal Disorders: Self-Assessment Color Review 2nd Edition PDF
Preview Small Animal Orthopedics, Rheumatology and Musculoskeletal Disorders: Self-Assessment Color Review 2nd Edition
S S Ce e The practice of small animal orthopedics has advanced considerably in olor Relf-Asses Cololf-Ass LEARN • REVISE • REINFORCE the 15 years since the publication of the first edition of Self-Assessment viesm r e Small Animal Color Review of Small Animal Orthopedics. Diagnostic procedures, instrumentation, implant we Rs systems, and surgical techniques have evolved and progressed considerably. nt esm v This second edition of a trusted text keeps pace with the rapidly expanding practice of small animal iee Orthopedics, orthopedics while embracing the developing fields of canine sports medicine and rehabilitative wn t medicine. The newly titled Small Animal Orthopedics, Rheumatology, & Musculoskeletal Disorders: Self-Assessment Color Review, 2nd Edition is designed to facilitate active learning &S Rheumatology, & through a new selection of clinical case scenarios along with integrated questions and answers Mm that help readers develop sound decision-making skills. ua l sl Musculoskeletal This illustrative, self-directed educational tool disseminates essential information to veterinary c A students, interns, and residents in training as well as small animal practitioners with specific un interests in orthopedics, canine sports medicine, and rehabilitative medicine. In response to feedback loim s Disorders provided by readers of the original text, references have been provided for each question, allowing ka readers the opportunity to delve more deeply into the topic of focus. el lO e The book includes contributions from an international group of clinicians and investigators. Orthopedic tr at 2nd Edition surgeons, radiologists, internists, pathologists, neurologists, and anesthetists as well as veterinarians lh engaged in rehabilitative medicine have provided their diverse expertise and experience to make Do p this text a comprehensive review of the expanding fields relating to small animal orthopedics. ise od Also available in the Self-Assessment Color Review series: rdic Brown & Rosenthal: Small Mammals Moriello: Small Animal Dermatology es Edited by r, Elsheikha & Patterson: Veterinary Parasitology Moriello & Diesel: Small Animal Dermatology, s R Forbes & Altman: Avian Medicine Advanced Cases |h Daniel D. Lewis Freeman: Veterinary Cytology Pycock: Equine Reproduction and Stud Medicine 2e Frye & Williams: Reptiles and Amphibians Samuelson & Brooks: Small Animal Ophthalmology ndum Sorrel J. Langley-Hobbs Hartmann & Levy: Feline Infectious Diseases Scott: Cattle and Sheep Medicine E Keeble & Meredith: Rabbit Medicine and Surgery Sparkes & Caney: Feline Medicine dat Kirby, Rudloff & Linklater: Small Animal Emergency Tennant: Small Animal Abdominal and Metabolic ito and Critical Care Medicine 2nd Edition Disorders iolo Lewbart: Ornamental Fish Thieman-Mankin: Small Animal Soft Tissue Surgery ng y Mair & Divers: Equine Internal Medicine 2nd Edition , May & McIlwraith: Equine Orthopaedics and Verstraete: Veterinary Dentistry Rheumatology Ware: Small Animal Cardiopulmonary Medicine L e Meredith & Keeble: Wildlife Medicine and Rehabilitation w is • L Clinical cases a n g Problem based le y -H Fully illustrated o b b s K22396 Veterinary Medicine ISBN-13: 978-1-4822-2492-4 90000 9 781482 224924 K22396_Cover_mech.indd All Pages 5/13/14 11:46 AM Self-Assessment Color Review Small Animal Orthopedics, Rheumatology, & Musculoskeletal Disorders Second Edition Daniel D. Lewis DVM, DACVS Professor Small Animal Surgery Jerry & Lola Collins Eminent Scholar Canine Sports Medicine and Comparative Orthopedics Department of Small Animal Clinical Sciences College of Veterinary Medicine, University of Florida Gainesville, Florida, USA Sorrel J. Langley-Hobbs MA, BVetMed, DSAS(Orth), DECVS, FHEA, MRCVS European Specialist in Small Animal Surgery Professor in Small Animal Orthopaedic Surgery University of Bristol School of Veterinary Sciences Langford, Bristol, UK CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2015 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20140606 International Standard Book Number-13: 978-1-4822-2494-8 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urge to consult the relevant national drug formulary and the drug companies’ printed instructions, and their websites, before administering any of the drugs recommended in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any elec- tronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Preface The original version of the Self-Assessment Color Review of Small Animal Orthopedics was published in 1998. The practice of small animal orthopedics has advanced consider ably in the 15 years that have transpired since that initial volume went to press. Advanced diagnostic imaging and minimally invasive orthopedic surgery were in their infancy and formal development of the disciplines of canine sports medicine and rehabilita tive therapy were only taking root. Diagnostic procedures, instrumentation, implant systems, and surgical techniques for the treatment of orthopedic disorders in the dog and cat have changed and advanced considerably in the new millennium. Building on the precedent established in the late 20th century, continued experimental and clinical research has expanded our understanding of bone and fracture biology, musculoskeletal tumor development and treatment, and the pathophysiology and management of arthropathies, and new interests were founded with regard to non- surgical rehabilitative therapies. This new expanded text has been designed to keep pace with the rapidly expanding practice of small animal orthopedics while embracing the developing fields of canine sports medicine and rehabilitative medicine. As with the original version, this book is not intended to be an all-encompassing, comprehensive text reviewing every facet of small animal orthopedics. This book is one in a series of self-assessment guides designed to facilitate active learning by presenting selected clinical case scenarios or applied research material. The clinical practice of all aspects of veterinary medicine is a balance of science, art, experience, and judgement. The reader may give a different answer to individual questions to those provided in this text. The contributors and editors have made a conscientious effort to make the information in this book as current and accurate as possible; however, the reader should be cognizant that appropriate alternative answers to many questions, particularly clinical case scenarios, exist. Our intent was to provide an illustrative, self-directed educational tool containing current information of value to veterinary students, interns and residents in training, and general and specialist small animal practitioners with specific interests in orthopedics, canine sports medicine, and rehabilitative medicine. In response to feedback relating to the original version, references have been provided for each question to allow the reader the opportunity to delve more into the topic by reading the referenced journal articles if they so desire. An international group of 46 clinicians and investigators have contributed to this publication. Orthopedic surgeons, radiologists, internists, neurologists, and anesthesiologists, as well as veterinarians engaged in rehabilitative medicine, have provided their diverse expertise and experience to make this text a comprehensive review of the expanding fields relating to small animal orthopedics. Finally, we would be remiss if we did not acknowledge the passing of Robert Bennett Parker, one of the co-editors of the original Self-Assessment Color Review of Small Animal Orthopedics. Rob’s tragic demise, like that of Mark Bloomberg, who was also a contributing editor to the original volume, came much too early, but his memory and legacy serve as a source of inspiration for those of us who had the privilege of working with Rob. Daniel D. Lewis Sorrel J. Langley-Hobbs iii Broad classification of cases Agility 31, 84, 220 Analgesia/anesthesia 49, 61, 102, 106, 143, 166, 172, 248 Anatomy 122, 126, 129 Arthrodesis 12, 104, 107, 134, 216, 255 Arthroscopy 190, 241 Bone disease 2, 8, 76, 101, 119, 125, 148, 152, 198, 215, 244 Cranial cruciate ligament disease 27, 57, 68, 81, 193, 194, 196, 217, 221, 233, 254 Diagnostics 11, 23, 29, 39, 73, 88, 96, 108, 125, 132, 196, 236, 242, 246 Fracture classification 10, 38, 43, 75, 83, 85, 95, 97, 114, 129, 138, 169, 197, 199, 201 Fracture complications 51, 94, 95, 164, 179, 180, 200, 202, 227 Fracture management 19, 25, 34, 35, 40, 43, 51, 56, 67, 77, 78, 81, 83, 85, 86, 99, 112, 114, 115, 118, 123, 128, 129, 131, 133, 138, 139, 145, 163, 203, 215, 229, 230 Gait analysis 4, 210 Hip dysplasia 5, 18, 74, 75, 127, 153, 155, 253 Imaging 5, 33, 110, 113, 127, 137, 167, 168, 207, 225 Implants and instruments 3, 16, 26, 28, 52, 54, 63, 66, 68, 77, 89, 98, 103, 109, 114, 136, 140, 142, 146, 151, 154, 159, 162, 170, 176, 184, 185, 189, 191, 195, 209, 244, 239, 255 Joint disease 11, 14, 20, 39, 42, 45, 55, 58, 70, 80, 84, 107, 108, 121, 159, 168, 186, 190, 191, 192, 207, 223, 228, 236, 241 Limb deformity 101, 119, 141, 144, 165, 183, 211, 213, 238, 240 Luxations 22, 24, 47, 64, 65, 72, 79, 110, 120, 133, 134, 135, 149, 157, 177, 181, 183, 188, 204, 205, 208, 218, 234, 238, 243 Miscellaneous 62, 105, 150, 156, 158, 171, 174, 186, 187, 226 Musculotendinous 17, 21, 30, 31, 32, 33, 50, 60, 88, 96, 178, 206, 231, 232, 242, 246, 249, 250, 251 Neoplasia 6, 15, 23, 41, 59, 76, 90, 117, 124, 130, 137, 147, 175, 182, 214, 225, 235 Neurology 13, 37, 48, 82, 91, 100, 111, 25, 160 Osteochondritis/osteochondrosis 1, 7, 9, 53, 71, 119, 161, 252 Rehabilitation and therapeutics 36, 44, 46, 58, 69, 87, 92, 102, 173, 212, 219, 222, 237, 245 Surgical approaches 35, 40, 53, 116, 247 iv Contributors A. Rick Alleman, DVM, PhD, DABVP, Eithne J. Comerford, MVB, PhD, CertVR, DACVP CertSAS, PGCertHE, DECVS, MRCVS Professor Clinical Pathology School of Veterinary Science Department of Physiological Sciences University of Liverpool College of Veterinary Medicine Neston, Cheshire, UK University of Florida Gainesville, Florida, USA Alan R. Cross, DVM, DACVS Staff Surgeon Nicholas J. Bacon, MA, VetMB, DECVS, Georgia Veterinary Specialists DACVS, MRCVS Atlanta, Georgia, USA ACVS Founding Fellow Surgical Oncology Imparoto Associate Clinical Professor of Small Laura C. Cuddy, MVB, MS, DACVS Animal Surgical Oncology Lecturer Small Animal Surgery Department of Small Animal Clinical Sciences School of Veterinary Medicine College of Veterinary Medicine University College Dublin University of Florida Dublin, Ireland Gainesville, Florida, USA Nicole Erhart, VMD, MS, DACVS Clifford Berry, DVM, DACR ACVS Founding Fellow Surgical Oncology Professor Diagnostic Imaging Professor Surgical Oncology Department of Small Animal Clinical Sciences Director Laboratory of Comparative College of Veterinary Medicine Musculoskeletal Oncology and Traumatology University of Florida Flint Animal Cancer Center Gainesville, Florida, USA College of Veterinary Medicine & Biomedical Sciences Sherman O. Canapp Jr., DVM, MS, CCRT, Colorado State University DACVS, DACVSMR Fort Collins, Colorado, USA Director and Staff Surgeon Veterinary Orthopedic & Sports Medicine Group James P. Farese DVM, DACVS Annapolis Junction, Maryland, USA ACVS Founding Fellow Surgical Oncology Staff Surgeon Christina J. Choate, DVM VCA Animal Care Center of Sonoma County Small Animal Orthopedic Research Fellow Rohnert Park, California, USA Collaborative Orthopedics and Biomechanics Laboratory Cassio R. Ferringo, DVM, MS, PhD University of Florida Professor Small Animal Surgery Gainesville, Florida, USA Department of Surgery College of Veterinary Medicine Christi R. Cook, DVM, MS, DACR University of São Paulo Teaching Assistant Professor Radiology University City, São Paulo, Brazil Veterinary Medical Teaching Hospital College of Veterinary Medicine Noel M. Fitzpatrick, MVB, CertVR, University of Missouri DSAS(Orth), DACVSMR, MRCVS Columbia, Missouri, USA Professor of Veterinary Orthopaedics University of Surrey Veterinary School James L. Cook, DVM, PhD, DACVS, Director, Fitzpatrick Referrals DACVSMR Godalming, Surrey, UK William & Kathryn Allen Distinguished Professor in Orthopaedic Surgery Steven M. Fox, MS, DVM, MBA, PhD Director Comparative Orthopedic Laboratory President, Securos – A Division of MWI Comparative Orthopedic Laboratory Fiskdale, Massachusetts, USA University of Missouri Columbia, Missouri, USA v Krista-Britt Halling DVM, CCRT, DACVS Sorrel J. Langley-Hobbs, MA, BVetMed, Staff Surgeon DSAS(Orth), DECVS, FHEA, MRCVS Mississauga-Oakville Veterinary Emergency & European Specialist in Small Animal Surgery Referral Hospital Professor in Small Animal Orthopaedic Surgery Oakville, Ontario, Canada University of Bristol School of Veterinary Sciences Graham M. Hayes, VetMB, MA, CertSAS, Langford, Bristol, UK DECVS, MRCVS Department of Veterinary Medicine Daniel D. Lewis, DVM, DACVS University of Cambridge Professor Small Animal Surgery, Cambridge, UK Jerry & Lola Collins Eminent Scholar Canine Sports Medicine and Comparative Caleb C. Hudson, DVM, MS, DACVS Orthopedics Staff Surgeon Department of Small Animal Clinical Sciences Gulf Coast Veterinary Specialists College of Veterinary Medicine Houston, Texas, USA University of Florida Gainesville, Florida, USA Kenneth A. Johnson, MVSc, PhD, FACVSc, DACVS, DECVS Ron M. McLaughlin, DVM, DVSc, DACVS Director of Orthopaedics, Associate Dean Professor and Chief Small Animal Surgery University Veterinary Teaching Hospital Department Head Small Animal Sciences University of Sydney Department of Clinical Sciences Sydney, New South Wales, Australia College of Veterinary Medicine Mississippi State University Amy S. Kapatkin, BS, DVM, MS Mississippi State, Mississippi, USA Associate Professor Surgical and Radiological Sciences Andy Moores, BVSc, DSAS(Orth), DECVS, School of Veterinary Medicine MRCVS University of California Davis Anderson Sturgess Veterinary Specialists Davis, California, USA Winchester, Hampshire, UK Sharon C. Kerwin, DVM, MS, DACVS Martin Owen, BVSc, BSc, PhD, DSAS(Orth), Professor Small Animal Surgery DECVS, MRCVS Department of Small Animal Clinical Sciences Dick White Referrals College of Veterinary Medicine Six Mile Bottom Veterinary Specialist Centre Texas A&M University Six Mile Bottom, Suffolk, UK College Station, Texas, USA Stanley E. Kim, BVSc, MS, DACVS Ross H. Palmer, DVM, MS, DACVS Assistant Professor Small Animal Surgery Professor Small Animal Surgery Department of Small Animal Clinical Sciences Department of Clinical Sciences College of Veterinary Medicine College of Veterinary Medicine & Biomedical University of Florida Sciences Gainesville, Florida, USA Colorado State University Fort Collins, Colorado, USA Kristin A. Kirkby Shaw, DVM, MS, CCRT, DACVS, DACVSMR Alessandro Piras, DVM, ISVS, MRCVS Senior Professional Services Veterinarian Oakland Small Animal Veterinary Clinic Northwest District Banbridge, Northern Ireland, UK Novartis Animal Health Seattle, Washington, USA vi Simon R. Platt, BVM&S, G. Diana Shelton, DVM, PhD, DACVIM DACVIM(Neurology), DECVN, MRCVS Professor, Department of Pathology Department of Small Animal Medicine & Surgery Comparative Neuromuscular Laboratory College of Veterinary Medicine University of California – San Diego University of Georgia La Jolla, California, USA Athens, Georgia, USA Thomas Sissner, MS, DVM, CertSAS, Antonio Pozzi, DMV, MS, DACVS, DECVS, MRCVS DACVSMR Staff Surgeon Associate Professor Small Animal Surgery Calgary Animal Referral and Emergency Center Department of Small Animal Clinical Sciences Calgary, Alberta, Canada College of Veterinary Medicine University of Florida Jane E. Sykes, BVSc, PhD, DACVIM Gainesville, Florida, USA Professor Medicine and Epidemiology School of Veterinary Medicine Robert M. Radaasch, DVM, MS, DACVS University of California Davis Staff Surgeon Davis, California, USA Dallas Veterinary Surgical Center Dallas, Texas, USA Kelley M. Thieman DVM, MS, DACVS Clinical Assistant Professor, Small Animal Heidi Radke, Dr. Med. Vet., DECVS, MRCVS Surgery Surgery Lecturer Department of Small Animal Clinical Sciences Department of Veterinary Medicine College of Veterinary Medicine University of Cambridge Texas A&M University Cambridge, UK College Station, Texas, USA Rick A. Read, BVSc, PhD, FACVSc, FNZCVSc Ricco Vannini, Dr. Med. Vet., DECVS Adjunct Professor Small Animal Surgery Bessy’s Kleintierklinik School of Veterinary & Life Sciences Watt, Switzerland College of Veterinary Medicine Murdoch University Aldo Vezzoni, Med. Vet., SCMPA, DECVS Murdoch, Western Australia, Australia Clinica Veterinaria Vezzoni Cremona, Italy David J. Reece, DVM, DACVR Senior Lecturer Diagnostic Imaging Katja Voss, Dr. Med. Vet., DECVS School of Veterinary & Life Sciences Small Animal Surgery Specialist College of Veterinary Medicine Head of Small Animal Surgery Murdoch University University Veterinary Teaching Hospital Murdoch, Western Australia, Australia University of Sydney Sydney, New South Wales, Australia Colin W. Sereda, DVM, MS, DACVS Staff Surgeon Matthew D. Winter, DVM, DACVR Guardian Veterinary Center Assistant Professor Diagnostic Imaging Edmonton, Alberta, Canada Department of Small Animal Clinical Sciences College of Veterinary Medicine Chris Seymour, MA, VetMB, DVA, DECVAA, University of Florida MRCVS Gainesville, Florida, USA Lecturer in Veterinary Anaesthesia Department of Veterinary Clinical Sciences Royal Veterinary College Hatfield, Hertfordshire, UK vii Abbreviations CaCL caudal cruciate ligament MRI magnetic resonance imaging CBC complete blood count NSAID non-steroidal anti-inflammatory CrCL cranial cruciate ligament drug CT computed tomography PMMA polymethylmethacrylate FNA fine needle aspirate/aspiration Image acknowledgements 31b Reproduced with permission from Clean Run Magazine, March 2007, Non-responsive hindlimb lameness in agility dogs – iliopsoas strain. 39a, b From Cook JL, Renfro DC, Tomlinson JL et al. (2005) Measurement of angles of abduction for diagnosis of shoulder instability in dogs using goniometry and digital image analysis. Vet Surg 34:463–468, with permission. 53a, b, 74a, 116 Courtesy Anne Raines 71a, b Courtesy Dr. Natasha Arzi 73 Courtesy Dr. Natasha Arzi 88 Courtesy Dr. Rebecca Parker© 96a, b Courtesy Dr. Mike Targett 108 Courtesy Dr. Heather Wamsley 125 Reproduced with permission from the BSAVA Manual of Canine and Feline Musculoskeletal Disorders. © BSAVA. 126a, b From Voss K, Geyer H, Montavon PM (2003) Antebrachiocarpal luxation in a cat. A case report and anatomical study of the medial collateral ligament. Vet Comp Orthop Traumatol 16:266–70, with permission. 134b, c Courtesy Dr. Gordon Brown 148 Courtesy Dr. George Papadopoulos 206a, b Courtesy Dr. Joy Archer We would like to acknowledge the contribution of Ms. Debby Sundstrom and her expertise in helping to prepare many of the images for this book. viii Questions: 1, 2 1 Two radiographic 1a 1b views of the left elbow of a 33 kg, 6-month-old male Dogue De Bor- deaux that had bilateral forelimb lame ness are shown (1a, b). On physi- cal examination there was a palpable effu sion of the dog’s left elbow, while pain was elicited on extension of both elbows. i. What is the diagnosis? ii. Describe the two radio- graphic views shown and discuss the value of these two views relat ive to establ ishing a diagnosis of the condition affecting this dog. 2 An 11-month-old male cat was referred for 2 treatment after it sustained a right tibial fracture after jumping off a bed. The cat had previously sustained a left tibial fracture, which had been managed with external coaptation. The owner was unaware of any prior trauma or lameness. A ventrodorsal radiograph of the pelvis and hind- limbs, obtained at the time of this most recent presen tation, is shown (2). i. Give a list of differential diagnoses for potential underlying causes of the fractures observed in this cat. ii. What diagnostic tests can be done to further investigate the etiologies of those fractures? 1 K22396 Lewis final.indd 1 9/5/14 4:40 PM
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