Patient of the Week

May 10th thru May 14th, 2010

PATIENT SUMMARY:

Lucy is a Golden Retriever. She is 9yrs old and weighs 78#. Dr. Greg Hartman of Hartman Animal Hospital was her referring veterinarian. Lucy had acute onset of right rear lameness 2 weeks previous. Dr. Hartman identified a right CCL injury. Upon exam by Dr. Dew, there was positive anterior drawer consistent with right CCL rupture, and two soft tissue masses: one left of midline at the level of the last mammary gland and one on the left scapula. Both were 2cm in diameter, which upon palpitation were the consistency of a lipoma. Dr. Dew discussed the TTA (tibial tuberosity advancement) procedure, recovery and prognosis as well as mass excision and histologic assessment. Lucy’s owner decided to proceed with a TTA and mass removal.

TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. He advanced the tuberosity and stabilized with Kyon 12x22mm basket, 6 hole plate & fork, and 4 titanium screws. The lipomas were removed from ventral midline and left scapula. They were submitted to AR-state lab. Lucy’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. The masses removed appeared to be lipoma’s the laboratory will confirm this diagnosis.

Congratulations Lucy!

Patient of the Week Candidates

for the week of May 10 thru 14th, 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:

Lucy is a Golden Retriever. She is 9yrs old and weighs 78#. Dr. Greg Hartman of Hartman Animal Hospital was her referring veterinarian. Lucy had acute onset of right rear lameness 2 weeks previous. Dr. Hartman identified a right CCL injury. Upon exam by Dr. Dew, there was positive anterior drawer consistent with right CCL rupture, and two soft tissue masses: one left of midline at the level of the last mammary gland and one on the left scapula. Both were 2cm in diameter, which upon palpitation were the consistency of a lipoma. Dr. Dew discussed the TTA (tibial tuberosity advancement) procedure, recovery and prognosis as well as mass excision and histologic assessment. Lucy’s owner decided to proceed with a TTA and mass removal.

TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy. He advanced the tuberosity and stabilized with Kyon 12x22mm basket, 6 hole plate & fork, and 4 titanium screws. The lipomas were removed from ventral midline and left scapula. They were submitted to AR-state lab. Lucy’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. The masses removed appeared to be lipoma’s the laboratory will confirm this diagnosis.

(more…)

Patient of the Month

April 2010

With 21 votes,
Max’s people pulled out a win for the
April Patient of the Month Title!

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.

 Congratulations Max!

The surgery – Arytenoid Tie-Back

Laryngeal Paralysis Part Three

Marcie’s mom brought her to our Russellville surgery center on May 5th. Marcie underwent arytenoid tieback on the left side. Typically, only one side needs to be operated on, as a unilateral tieback procedure will provide sufficient increase in the airway for comfortable breathing.

Marcie did well during surgery, and has a good prognosis for an uncomplicated recovery and improved quality of life.

With this procedure, there is a significant chance of airway edema for the first 24 hours, so we recommended that Marcie be watched at a 24-hour facility.

Dogs with an arytenoid tie-back will experience an occasional bout of aspiration pneumonia.  Symptoms to watch for are lethargy and not eating. Marcie’s mom is cautioned to take her to her regular veterinarian if this occurs for chest x-rays. If that is the cause, a round of antibiotics should take care of the problem.

After surgery, Marcie looks and sounds much better!

Patient of the Week

May 3rd thru 7th, 2010

PATIENT SUMMARY:
Jethro is a 55# 3yr old Mix Breed. His referring veterinarian was Dr. John Miller of Otter Creek Animal Hospital.  Jethro had been hit by a car (HBC) on 05/03, and treated at an Animal Emergency Clinic (AEC).

Radiographs demonstrated a right coxofemoral luxation (craniodorsal) and a right femoral fracture, transverse condylar. Dr. Dew discussed the need for an open reduction and stabilization of both fractures. He also discussed the articular nature of trauma, and progression of degenerative joint disease (DJD), and the need for physical therapy (PT) due to joint capsule contracture.

Jethro’s owner has experienced a significant stifle surgery himself and acknowledges issues associated with stabilization, recovery and function. He wished to proceed with reduction/stabilization.

TREATMENT:
Dr. Dew used a Lateral to stifle approach, a craniolateral approach to the hip, with trochanteric osteotomy. He reduced the fracture and luxation trochanteric transposition. Stabilized with divergent 3/32 IM pins and 20ga tension band, cranioventral imbrication suture 0-maxon. The longitudinal fracture in the condyle was stabilized with 2-0.062 enhanced thread pins, condyle stabilized with 2-3/32 divergent pins and 2-1/8″ divergent pins.

Jethro’s prognosis was good for normal bone healing and return to weight bearing function. Exercise restriction, nursing care and physical therapy instructions must be followed to maximize the prognosis for uncomplicated healing.

“LarPar” patient

Laryngeal Paralysis Part Two

Meet Marcie.

Marcie came to us with a history of breathing problems. Over the past five to six months, her respiration had gradually worsened and become more and more of a struggle.

At her exam, she displayed stridor and cyanosis consistent with laryngeal paralysis.

Dr. Dew discussed arytenoid tie-back procedure, the recovery process and prognosis for patients undergoing this procedure.

Marcie’s mom decided to go ahead and bring Marcie to Russellville for surgery.

Wondering what a laryngeal paralysis dog sounds like?  Click here:  

Larpar Audio Clip

You can learn more about laryngeal paralysis and see videos of the larynx of a dog before and after this procedure on our Laryngeal Paralysis page.

Patient of the Week Candidates

for the week of May 3 thru 7th, 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:

Gator is a Jack Russell Terrier. He is 10yrs old and weighs 24#. He was referred to us by Dr. Amy Hawley of North Hills Animal Clinic. Gator had an acute onset of right rear lameness. Dr. Hawley identified a right CCL injury. Upon examination by Dr. Dew, there was positive anterior drawer and medial buttress identified. He discussed the EFS (external fascial strip) procedure, recovery and prognosis. His owner decided to proceed with a right EFS procedure.

TREATMENT:
Dr. Dew used a lateral approach with lateral arthrotomy. He observed that the meniscus was intact. He imbricated the joint EFS, used medial buttress suture #1-Maxon, and advanced the biceps. Gator’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.

(more…)

Patient of the Week

April 26th thru 30th, 2010

and the winner,
with 5 votes, is. . .

PATIENT SUMMARY:

Abbigale is a 1yr and 6mo old Min Pin, and she weighs 13.3#. She was referred to us by Dr. Carol Entricken with Benton Veterinary Hospital. Abbigale has had intermittent rear limb lameness, and Dr. Entricken identified bilateral Medial Patella Luxation (MPL). Upon examination by Dr. Dew, she did have grade III MPL. Dr. Dew discussed MPL correction, recovery and prognosis. Her owner wished to proceed with bilateral MPL correction by TTT (tibial tuberosity transposition).

TREATMENT:
Dr. Dew used a medial approach for Abbigale’s TTT surgeries. He used 0.045 divergent pins to stabilized her patellas. Abbigale’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 Abbigale!!

Patient of the Week Candidates

for the week of April 26th thru 30th, 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:

Tucker is a Labrador Retriever weighing 98# and is 8yrs old. Dr. Greg Hartman with Hartman Animal Clinic was his referring veterinarian. He had chronic right forelimb weight bearing lameness, and the signs were only partially palliated with NSAID’s. Radiographs from Dr. Hartman did not demonstrate lesions of any significance in Tucker’s elbow or shoulder. Upon Dr. Dew’s examination, he was weight bearing lame on the right forelimb, and there was moderate atrophy of suprascapular muscles. Tucker had pain on palpation of his biceps tendon. His elbow and carpus palpate normally. Dr. Dew discussed the taking of radiographs to rule out changes in the proximal humerus consistent with a tumor, and then if indicated he would perform a biceps tenotomy. Tucker’s owner wished to proceed with the above treatment plan.
TREATMENT:
A radiograph of the right shoulder demonstrated only a small osteophyte at the caudal aspect of the humeral head. Dr. Dew used a craniolateral approach for Tucker’s biceps tenotomy. The osteophytes lined the biceps groove, but Dr. Dew was able to perform a complete biceps release. Tucker’s prognosis is good for reduction of lameness.

(more…)

Patient of the Week

for April 19th thru 23rd, 2010

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

PATIENT SUMMARY:
Grace is a Golden Retriever. She is 4yrs and 10mos old, and weighs 72.2#. She was referred to us by Dr. Bob Hale of Briarwood Animal Hospital. Previously, Grace had seen us for right Tibail Tuberosity Advancement (TTA), right lateral luxating patella (LPL correction), and Grace continues to have intermittent LPL on the right. Dr. Dew discussed trochleoplasty procedures. Her owner decided to proceed with right trochleoplasty today.
TREATMENT:
Dr. Dew used a medial approach with medial arthrotomy for Grace’s revision. The patella was easily reduced, and unable to be luxated post surgery. There was also a 1.5cm in diameter mass sub –Q on her right mid-thigh. This was removed and submitted to the AR State Lab. Grace’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 Grace!