Patient of the Week

April 12th thru 16th, 2010

 and the winner,
with 21 votes, is. . .

PATIENT SUMMARY:

Max is a 122# 5yr old Golden Retriever. He was referred to us by Dr. Greg Hartman with Hartman Animal Hospital. Max has had Left rear lameness for the past 4-5 months which gets worse after activity. He had improved on Previcox. Dr. Hartman’s radiographs were not suggestive of hip dysplasia as a cause. There was Left stifle thickening and medial buttress suggestive of partial CCL tear, but no pain on hock manipulation or hip extension. Max exhibited delayed proprioception with normal foot placement, and no pain on dorsal spinal palpation. Dr. Dew discussed EFS (external fascial strip) and TTA (tibial tuberosity advancement) augmentation, and also suggested prior to surgery some survey lumbar films to rule out discospondylitis. The owners wished to pursue radiographs and a TTA if recommended.
 

TREATMENT:
Diagnostics: The radiographs of Max’s lumbar spine were normal; he had very minor degenerative joint disease in his hips. The changes in his Left stifle were consistent with partial CCL tear.Dr. Dew used a medial approach with medial arthrotomy. The Kyon hardware used to stabilize Max’s stifle were a 12×22 basket, 6 hole plate & fork, and 4 titanium screws. His prognosis 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.

Pet of the Week Candidates

for the week of April 12th thru 16th, 2010

CASE STUDY:

Max is a 122# 5yr old Golden Retriever. He was referred to us by Dr. Greg Hartman with Hartman Animal Hospital. Max has had Left rear lameness for the past 4-5 months which gets worse after activity. He had improved on Previcox. Dr. Hartman’s radiographs were not suggestive of hip dysplasia as a cause. There was Left stifle thickening and medial buttress suggestive of partial CCL tear, but no pain on hock manipulation or hip extension. Max exhibited delayed proprioception with normal foot placement, and no pain on dorsal spinal palpation. Dr. Dew discussed EFS (external fascial strip) and TTA (tibial tuberosity advancement) augmentation, and also suggested prior to surgery some survey lumbar films to rule out discospondylitis. The owners wished to pursue radiographs and a TTA if recommended.
TREATMENT:
Diagnostics: The radiographs of Max’s lumbar spine were normal; he had very minor degenerative joint disease in his hips. The changes in his Left stifle were consistent with partial CCL tear.
Dr. Dew used a medial approach with medial arthrotomy. The Kyon hardware used to stabilize Max’s stifle were a 12×22 basket, 6 hole plate & fork, and 4 titanium screws. His prognosis 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.

(more…)

Patient of the Week

April 5th thru 9th, 2010

 and the winner,
with 8 votes, is. . . .

PATIENT SUMMARY:
Sophie is a 2yr old 158# Mastiff. Dr. Thomas McCain of Greenbrook Companion Animal Hospital was the referring veterinarian as well as Sophie’s owner. Sophie had an acute onset of right rear lameness. Dr. McCain had identified a right CCL injury and wished to augment the stifle with a TTA (tibial tuberosity advancement). Radiographic changes and positive anterior drawer were consistent with a partial CCL rupture.
 

TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. The Kyon hardware used for the TTA were a 15x25mm basket, 7 hole plate & fork, and 4 titanium screws. Sophie’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.

Congratulations Sophie!

Patient of the Week Candidates

for the week of April 5th thru 9th, 2010

Review the patient summaries below 
then  vote for your favorite patient.
The patient with the most votes wins the “Patient of the Week” title.

Then the POTW with the most votes in a month will
be dubbed Azzore’s Patient of the Month and will receive
an extra special prize package from Dr. Dew and the Dew Crew.

PATIENT SUMMARY:

Filo is an 8yr old 5# Pomeranian referred to us by Dr. Robert Prescott of Pet Tracks Veterinary Hospital. He had been dragging right rear limb past several weeks. Upon Dr. Dew’s examination, there were proprioceptive deficits in the right rear; the left was normal. Reflexes in the right rear at +. Panniculus absent on both sides past T10. There was bilateral grade III patella luxation noted. Radiographs demonstrate narrowed disc spaces through the spine; spondylosis L1-2. Dr. Dew discussed neurologic versus orthopedic disease. He suggested cerebrospinal centesis, myelogram +/- decompressive surgery. Filo’s owner decided to proceed with diagnostic/surgical plan. 

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PATIENT HISTORY:
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.

Congratulations JR!

Pet of the Week Candidates

for the week of March 29th thru April 2nd, 2010

Review the patient summaries below 
then  vote for your favorite patient.
The patient with the most votes wins the “Patient of the Week” title.

Then the POTW with the most votes in a month will
be dubbed Azzore’s Patient of the Month and will receive
an extra special prize package from Dr. Dew and the Dew Crew.

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.

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Patient of the Month

March 2010

This may end up going down in Azzore History!

With 961 votes

Louie wins!

PATIENT SUMMARY:
Louie is a Boxer who weighs 34# and is 4mos old.  Dr. Kendra Kaufman with All For Pets has referred him to us.  Unknown trauma had resulted in right forelimb lameness.  Dr. Kaufman’s radiographs demonstrate transverse mid-diaphysis fracture of metacarpal bone II-V.  Dr. Dew discussed IM pin stabilization, need for bandage care post surgery, and good prognosis for healing and return to normal function.
TREATMENT: 
Dr. Dew used an anterior approach for Louie’s surgery.  He used 0.045 IM wires to stabilize the fracture, and left the wire exposed distally with shepherds crook.  The prognosis is good for normal osseous healing.  Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.

Congratulations Landslide Louie!

Patient of the Week

March 22nd thru 26th, 2010

LOLA wins with 71 votes!

Congrats!

PATIENT SUMMARY:

TREATMENT:
Dr. Dew used an oral approach for Lola’s surgery.  Her soft palate was reduced to the level of tonsilar crypts, and on her nares he performed wedge reduction naroplasty.  Lola’s prognosis is good for recovery from the procedure, uncomplicated healing and improved respiratory function.  Exercise restriction will help facilitate an uncomplicated recovery.

Patient of the Week Candidates

for the week of March 22nd thru 26th, 2010

Review the patient summaries below 
then  vote for your favorite patient.
The patient with the most votes wins the “Patient of the Week” title.

Then the POTW with the most votes in a month will
be dubbed Azzore’s Patient of the Month and will receive
an extra special prize package from Dr. Dew and the Dew Crew.

Congratulations!  

PATIENT SUMMARY:

TREATMENT:
Dr. Dew used an oral approach for Lola’s surgery.  Her soft palate was reduced to the level of tonsilar crypts, and on her nares he performed wedge reduction naroplasty.  Lola’s prognosis is good for recovery from the procedure, uncomplicated healing and improved respiratory function.  Exercise restriction will help facilitate an uncomplicated recovery.

(more…)

Patient of the Week

March 15th thru 19th, 2010

Belle wins with 48 votes! 

Congratulations!

 

PATIENT SUMMARY:
Belle is a Bernese Mountain Dog and is 2yrs and 6mos old.  She weighs 60#.  Dr. Kristy Austin of Osage Veterinary Clinic is her referring physician.  Back in July of 2008, Belle had a THR.  Between then and now, she has had a previous diagnosis of a loose acetabular cup.  She now has come in for a Total Hip Replacement revison.  Dr. Dew discussed prognosis and recovery.  Belle’s owners decide to proceed with surgery.
TREATMENT:  Dr. Dew observed moderate wear debris associated with loose cup and cup screw.  After he implanted a new cup and proceeded to replace the femoral head, a loose femoral component was identified.  Following conversations with Dr. Tepic of Switzerland, Dr. Dew elected to explant all components.  There appeared to be no crepitus post implant removal and calcar reduction.  Dr. Dew discovered also from his conversations that most femoral stem loosening has been associated with low grade osteomyelitis.  Cultures were sent to Arkansas State Lab for further examination.  Dr. Dew noted adequate femoral neck resection and soft tissue interposition between femur and acetabulum  Belle’s prognosis is good for healing and resolution of the arthritic pain.  Physical therapy will play a critical role in assuring that she has a good return of post-operative function.