Interesting Cases
Intussusception in a Springer Spaniel Pup
Teal is an adorable 5 month old Springer spaniel that presented to us this week with a stomach upset. Both of the family dogs had been suffering from sickness and diarrhoea in the previous week but the older dog had gotten over it. Poor Teal “was still not just right”. He had lost some weight and could keep nothing down.
On examining him, Gareth Torney could feel a doughy mass inside Teals belly which was hurting him and x rays were recommended.
This is the x-ray. The intestines look very doughy and there is retention of gas which is a sign of a blockage. When teal was anaesthetised Gareth confirmed the presence of a blockage and recommended exploratory surgery.
This is a picture during surgery of the blockage. A piece of Teals small intestine had invaginated into the large bowel on the right hand side of the picture and in essence had become blocked. Without surgery this piece of bowel would have ruptured and that would be the end of Teal. This is called an INTUSSUSCEPTION and is more common in young dogs and in children. Thanks to the owners prompt recognition that Teals condition had become more serious Gareth was able to tease the intussecption apart without having to cut out any diseased bowel. He then layed the intestines out and put small tacking sutures between the loops to stop this happening again. It is believed that in young dogs when the guts are affected by a bug, virus or worms that they become hyperactive and that this predisposes to the condition.
The small intestines layed out before tacking sutures placed to stop the condition recurring.
Thankfully Teal has recovered uneventfully and is back enjoying his food again.
Bilateral Cruciate Ligament Rupture in a 2 year old Labrador
Exciting new procedure for torn cruciate ligaments in athletic dogs over 25kgs
MODIFIED MAQUET PROCEDURE
Bouncer presented to Jubilee veterinary centre 2 weeks ago and could hardly stand on his hind legs. He had gone lame on one back leg 4 months before and a strain had been diagnosed. In the following months however both knees had gotten progressively worse to the point that he was struggling to get up and down at all. Bouncer is a big dog weighing 44kgs.
On examining him, Gareth Torney found that both of his knees were unstable and that he had a ruptured anterior cruciate ligament in both knees. No wonder he was so sore.
Traditionally we have repaired this condition by removing the diseased ligaments and creating new ones using 100lb breaking strain surgical nylon drilled through holes in the tibia and the fabellar bones at the back of the knee. This procedure has served us very well over the years. Recently new procedures have been developed for large active breeds with plenty of energy. They are supposed to return the patient back to better soundness long term.
The Modified Maquet Procedure was developed 50 years ago by a Belgian human surgeon to reduce the pain associated with arthritis of the knee. It went out of favour for controlling knee arthritis in people with the introduction of knee replacements. An interesting strength of this procedure was noted that if you advance the attachment of the patellar tendon so that it is perpendicular to the tibial plateau angle of the knee, you no longer need your cruciate ligament. This theory has encouraged its use in our canine patients over the last few years.
This is Bouncers right Knee before the surgery. You can see a lot of arthritis around the joint which will cause pain. You can’t see the ruptured ligament because it is soft tissue.
During the operation, an oscillating saw is used to make a cut in the bone of the tibia behind the tendon of the kneecap. This fragment of bone is carefully advanced with pre measured sterile wedges.
When the advancement is fully made we insert a very advanced sterile titanium wedge called orthofoam into the space and secure it down with a pin and orthopaedic wire. The wedge is specially designed to be very inert and eventually becomes a part of the bone itself.
The orthofoam wedge in place secured with a kirschener wire and 2 titanium staples.
Hopefully you can see how the implant sits in place and how it pushes the kneecap forward. Bouncer continues to do very well. Dogs having this procedure are xrayed again at 4 weeks and need controlled physiotherapy plans while the bone heals. When the first knee is adequately healed we can then go about fixing the other one. We expect Bouncer to be 100% sound and back to a good level of exercise in this knee by 12 weeks.
If you have any questions about cruciate disease in your dog or would like to discuss the M.M.P procedure, please feel free to make an appointment and come and see Gareth Torney at the surgery.
Lateral condylar fracture in an English springer spaniel
Bobby is a 2 year old springer spaniel that presented acutely lame on his front right leg this week. He was in pain in his elbow and it felt unstable.
I was worried about a break as he was so lame and also springers are very prone to breaking their lateral condyle.
X rays confirmed a broken elbow (lateral condyle)
You cannot easily put a dogs leg in a cast as they fall off easily and with this type of fracture it is really important to reduce the fracture well and we had to use a mixture of screws and plates. This fracture involved the elbow joint itself so a degree of arthritis will be inevitable.
Surgery involved opening into the elbow and drilling a hole in the broken condyle from inside to out
It was then reduced back in place and a 4.5mm screw was drilled across the broken condyles and a plate and screws to reattach it back to the rest of the humerus.
The elbow is fixed in place with screws and plate.
X rays showing good internal fixation. Bobby will need to be kept strictly rested to give his bones time to heal and hopefully we will not need to take the implants out. Lucky dog!
