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ThesisItem Open Access COMPARISON OF EXCISION ARTHROPLASTY, DENERVATION AND TRANS-FEMOROARTICULAR WIRING FOR HIP DYSPLASIA IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517502. (A.P.) INDIA, 2019-09) NAGARAJU, N; SREENU, MAKKENA(MAJOR); VASANTH, M.S.; SRINIVAS, MANDA; RAJU, N.K.B.The present study was conducted on clinical cases of dogs with hip disorders viz, dysplastic hip, subluxated and luxated hips. Incidence of hip disorders was 13.31% of orthopedic cases and higher incidence of hip disorders was found in male dogs (62.12%) than in female dogs (37.87%) and breed wise higher incidence was noticed in Labrador retriever breed (28.28%) followed by Non-descriptive dogs (17.68%) whereas, the lowest incidence was observed in Chihuahua and Saint Bernard (1.01%) breeds of dogs. Higher incidence of hip disorders was observed in dogs aged above five years (47.47%) followed by dogs of age 0-1 year and between above one year to five years.Hip extended venterodorsal views of radiographs confirmed the dysplastic, osteoarthritic, subluxated and luxated hips. Dogs with hip disorders under the study were grouped into three groupsgroup I,group II and group III. Excision arthroplasty was done in group I dogs where femoral head and neck was excised and joint capsule was sutured to prevent bone contact between femur and acetabulum. Denervation done in group II dogs wherein craniodorsal gluteal nerves on acetabular rim were destroyed using bone curette. Trans-femoroarticular wiring was done in group III dogs for subluxated and luxated hips using nylon wiring. The dogs were followed up to 60 days. Hematobiochemical changes during the study period in all the three groups were non significant. Physiological parameters were non significant in all the three groups. All the dogs in group I were evidenced by grade I lameness by end of 60 days of study period, five dogs showed grade I lameness in group II and two dogs showed grade I lameness in group III dogs. Radiological evaluation in group I revealed clear gap between acetabulum and excised femoral part. In group II dogs, apparently no change in radiographs were observed during study period. In group III, dogs four dogs showed good apposition of acetabulum and head of femur and reluxation in two dogs. Operation procedures were very simple and less time consuming in group II followed by group I and group III dogs. Functional assessment of dogs by getting the owners feed back over period of six months revealed better results in group I and group II dog than group III dog owners.ThesisItem Open Access EVALUATION OF ANTIBIOTIC IMPREGNATED IMPLANTS AND BEADS FOR STABILIZATION OF LONG BONE DIAPHYSEAL COMPOUND FRACTURES IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2017-11) PHANEENDRA, M.S.S.V.; DHANA LAKSHMI, N(MAJOR); RAGHUNATH, M; RAJU, N.K.B.; ADILAXMAMMA, KABSTRACT: The study was undertaken in 30 dogs with compound long bone diaphyseal fractures presented to Veterinary Clinical complex, Department of Veterinary Surgery and Radiology, Tirupati. The detailed history and signalment including sex, breed, age, weight, time since injury and limb involved were collected from the owner and incidence was analyzed. The cases were divided into two groups, in which 24 dogs with various compound long bone diaphyseal fractures were stabilized by Locking compression plates or intramedullary pins along with local antibiotic (gentamicin) + biodegradable bone cement (hydroxyapatite or Poly D,L lactide) (Group I) and 6 dogs with various compound long bone diaphyseal fractures were stabilized by Locking Compression Plates or intramedullary pins without local antibiotic therapy as control group (Group II). The outcome was evaluated by clinical, radiographical and biochemical analysis in both the groups. In Group I, 18 dogs out of 24 cases were stabilized by using antibiotic bone cement impregnated Locking Compression Plates and 6 dogs of humerus and femur fractures were stabilized using intramedullary pinning with local application of antibiotic bone cement beads. Post-operatively, the operated limb was supported by Robert- jones bandaging and systemic antibiotics were given in both the groups. Clinical evaluation was routinely carried out at periodical intervals for the signs of swelling, exudation, weight bearing and stability of the fixation in all the dogs. Post-operative swelling was not much in Group I compared to Group II. The degree of lameness was graded from I to V on 1st, 7th, 14th, 28th, 45th and 60th day of the surgery in all the cases and thereafter every two weeks until implant removal in case of plating. All the dogs showed grade V lameness preoperatively. In Group I, all dogs with radius-ulna and tibia compound fractures stabilized by antibiotic impregnated Locking Compression Plating (LCP) technique showed grade I lameness by 14th post-operative day except for two cases in which grade I lameness was seen by 19th and 21st post-operative day whereas all dogs in control group (Group II) stabilized with LCP showed complete weight bearing only after 45th post-operative day. In case of humerus and femur compound fractures in Group I, which were stabilized with intramedullary pinning with placement of a local antibiotic bead, full weight bearing with paw touching on the ground associated with normal gait was observed on 25th postoperative day. On 45th day, all the cases showed no lameness (grade I) whereas all dogs in control group (Group II) showed grade I lameness by 60th post-operative day. Medio-lateral and anterio-posterior radiographs of the operated bones were obtained immediately after surgery and on 3rd, 5th, 7th and 9th week postoperatively and whenever needed on later dates in all the cases for assessing alignment of fragments and implant position to assess the progress of bone healing. Radiographs showed progressive healing of the fractures. In case of plating in Group I, obliteration of the fracture line with the bony callus bridging the fracture area was observed on 7th post-operative week and by 11th post-operative week in all cases of Group II. In case of Intramedullary Pinning in Group I, on 6th post-operative week remodeling of the callus with obliteration of the fracture line was observed in all the cases whereas in the same Intramedullary Pinning cases of Group II postoperative healing was observed by 9th postoperative week. Physiotherapy of the limb was advised after two weeks of surgery for 10-15 minutes thrice a day to retain normal joint movement for 6- 8 weeks. Haematological studies showed neutrophilia, leucocytosis and high erythrocyte sedimentation rates persisted for upto 14th post-operative day and 28th post-operative day in Group I and Group II (control group) respectively. Blood biochemistry showed serum alkaline phosphatase values significantly increased from preoperative day to 14th day and there after the levels decreased reaching normal by 60thday in both the groups. CRP values in Group II were higher compared to Group I, owing to prolonged post-operative inflammation in Group II. Swab samples were taken from the wound at fracture site on the preoperative day and on 12th postoperative day, which were assessed for microbial load. The microbial load values in Group I on 12th day was in the range of 3.73±0.84×102 to 3.92±1.27×103 CFU/ml and in Group II was ranging from 4.97±0.97×106 to 3.52±0.86×107 CFU/ml. The use of poly-(D,L)-lactide bone cement was limited to three cases as it turned about to be less cost effective, which was replaced by the use of another high efficiency biodegradable hydroxyapatite bone cement. The implants were well tolerated in all the cases except in one case of intramedullary pinning in Group II, which showed slight pin migration resulting in seroma formation. In the present clinical study, the technique of improvised use of antibiotic impregnated implants and beads along with biodegradable bone cement for stabilization of long bone diaphyseal compound fractures in dogs resulted in favorable functional limb outcome and bone healing. The infection was controlled by adding gentamicin and the bone healing was facilitated by the use of biodegradable bone cements like hydroxyapatite and poly-(D,L)-lactide. Unnecessary long term systemic antibiotic usage for open and infected fractures in dogs may be avoided by using antibiotic biodegradable impregnated implants in future.ThesisItem Open Access MANAGEMENT OF LONG BONE DIAPHYSEAL FRACTURES WITH MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS TECHNIQUE USING LOCKING COMPRESSION PLATES IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2016-08) RAVI, RAIDURG; DHANA LAKSHMI, N(MAJOR); VASANTH, M.S; SRILATHA, Ch.; RAJU, N.K.BABSTRACT: Twenty four dogs presented to the college hospital (SVVU/KVAFSU) with unstable long bone diaphyseal fractures which were diagnosed by clinical signs, orthopaedic examination and survey radiography were taken as clinical material for the study. The breed, age, sex wise incidence, etiology and type of fracture were studied. The dogs were equally divided into four groups viz; Group I (humerus), Group II (radius and ulna), Group III (femur) and Group IV (tibia and fibula) and the fractures were stabilized with minimally innasive plate osteosynthesis (MIPO) using locking compression plate following standard AO/ASIF procedures. Preoperative plan was prepared using Fracture Patient Assessment Score (FPAS) and following the AO/ASIF procedures. The minimally invasive surgical approach for long bones was successfully implemented in radial and tibial diaphyseal fractures. MIPO was not successful in humeral and femoral diaphyseal fractures and hence alternate Open reduction and internal fixation (ORIF) was used for fracture repair. The outcome of fracture stabilization and healing was evaluated with postoperative lameness grading, radiography, ultrasonography and biochemical analysis. All the animals showed grade V lameness i.e. no weight bearing on limb at rest or while walking before surgery. Animals in group II (Radius Ulna) & group IV (Tibia) which underwent MIPO exhibited early limb usage (grade II lameness by 7th day and grade I lameness by 45th day) as compared to group I (Humerus) and group III (Femur) in which MIPO was unsuccessful (grade III lameness by 28th day and grade II lameness by 60th day). Radiographic healing (grade 1) was noticed in all the cases treated by MIPO of group II (Radius Ulna) and IV (Tibia) with obliterated fracture line and homogenous bone structure (callus) within 7 weeks, where as, group I (Humerus) and group III (Femur) where MIPO was unsuccessful showed grade 2 radiographic healing with barely discernible fracture line and massive bone trabeculae crossing fracture line (callus) by 7th week indicating slower fracture repair than MIPO. Ultrasonographic healing (grade 4 – Increasingly homogeneous, hyperechoic image of the tissue at the fracture site (acoustic shadow returns) was noticed in all the cases treated by MIPO of group II (Radius Ulna) and IV (Tibia) ,where as, group I (Humerus) and group III (Femur) where MIPO was unsuccessful showed (grade 3 - Evidence of bridging of the fracture gap with inhomogeneous tissue (mix of hypoechoic and hyperechoic areas) by 5th week. Vascularization was not detectable by use of power Doppler ultrasonography by 9th week in all the group. No major intraoperative complications like implant instability or loosening of screws were seen in MIPO group (Radius Ulna and Tibia), however, Dog no 1(Radius Ulna) and Dog no 3 (Tibia) showed lateral angulation of distal limb. Statistical analysis revealed increase (P<0.05) in the serum alkaline phosphatase values significantly from 0 day to 7th day in all the groups and there after the levels decreased reaching normal at 45th day. Serum Calcium values were also increased significantly from 0 day to 14th day in all the groups. Serum phosphorus level showed significant difference on the day 0, 7, 14 and 28 days in all the groups. Based on present study, it was concluded that successful MIPO technique for long bone fracture repair can be done clinically for faster healing in radial and tibial fractures, whereas for Femoral and Humeral long bone fractures, it was difficult due to more instability and unsuccessful alignment due to strong musculature and bone configuration. As the MIPO technique has a “learning curve”, it can be successful once the surgeon gains dexterity in MIPO and can be attempted for complex fracture where alignment may be possible due to loss of bone.ThesisItem Open Access A CLINICAL STUDY ON THE DISEASES OF ESOPHAGUS AND STOMACH WITH SPECIAL REFERENCE TO ENDOSCOPY IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2010-07) RAVIRAJ VINAYAK, SURYAWANSHI; RAGHAVENDER, K.B.P(MAJOR); GIREESH KUMAR, V; PURUSHOTHAM, G; SHANTHI LAKSHMI, MABSTRACT: The present study was undertaken in 42 cases out of the 120 clinical cases of dogs presented with diseases of esophagus and stomach with the history of persistent vomiting or regurgitation. A total of 120 dogs were presented with the chief complaint of recurrent vomiting or regurgitation. Out of the total of 120 cases selected for closer examination, 78 dogs (65%) responded to routine medical treatment with antiemetics, antibiotics and fluid therapy and hence, they were excluded from the purview of the present clinical study. The remaining 42 dogs (35%), which continued to vomit or regurgitate for more than one week and showed signs consistent with the primary diseases of the esophagus and stomach formed the patient material for the present clinical study. All the 42 clinical cases of dogs underwent routine physical, clinical, haematological and biochemical examinations as well as plain and contrast radiographic, Ultrasonographic and endoscopic assessment to rule out the concurrent diseases prior to the consideration in the present study. The results of the present study revealed that out of the total 42 cases selected for the present study, 31dogs (73.81%) had diseases of the esophagus while the rest (11dogs; 26.19%) had diseases of the stomach. During the present study, megaesophagus was diagnosed in 18 (42.86%) dogs, reflux esophagitis in 2 dogs (4.76%), vascular ring anomalies in 2 dogs (4.76%), esophageal diverticula and esophageal nodule in one dog each (2.38% each), esophageal foreign bodies in 5 dogs (11.90%), esophageal erosion or ulcers in 2 dogs (4.76%), chronic gastritis in 3 dogs (7.14%), gastric foreign bodies in 4 dogs (9.52% ), gastric erosion/ ulcer in 2 dogs (4.76%) and gastric dilatation and Volvulus in 2 dogs (4.76%). The results also showed that the occurrences of these diseases were seen in dogs ranging from two and a half months to thirteen years of age. No sex wise occurrence of the esophageal or stomach diseases was reported. All the dogs afflicted with the various diseases exhibited similar symptoms like emaciation, shrunken abdomen, chronic weight loss, prominent rib cage, regurgitation, vomiting or both. In the present clinical study, 18 clinical cases of megaesophagus were recorded. The disease was encountered in Labrador (2 dogs), Golden Retriever (2 Dogs), German Shepherd (5 Dogs), Doberman (2 Dogs), Mongrel (3 Dogs), Pomeranian (2 Dogs), Cocker Spaniel (1 Dog) and Boxer (1 Dog) breeds of dogs. The mean age of occurrence was found to be 6.25 ± 0.88 years. Out of these 18 dogs, 11were found to be males (61.12 %) and the rest were females (7 dogs; 38.88%). All these 18 dogs showed the signs of regurgitation of the food soon after food consumption. The haematological and biochemical studies showed that all the parameters studied were with in the normal range, except for haemoglobin. Ultrasonography did not reveal any sort of esophageal pathology. Radiographic features of megaesophagus in the seven dogs were air filled dilated esophagus and tracheoesophageal stripe sign. Esophagography clearly revealed generalized distention of esophagus in all the 18 dogs. While endoscopy revealed markedly dilated, flaccid esophagus and pooling of retained fluid, in the most dependent segment of the esophagus. The results of the present study indicated that among the three treatment regimens tested, Metoclopramide combined with feeding the dogs in an upright position from an elevated platform improved the esophageal function to the maximum extent. Post mortem examination of the seven dogs died or euthanized showed severe dilatation and thinning of the esophageal wall, while histopathological examination showed scanty muscle bundles, infiltration of polymorphonuclear cells with submucosal congestion and enlargement of submucosal glandular pattern with epithelial irregularity. Scanning electron microscopy revealed destruction of blood vessels, loss of normal architecture and direction of inner circular as well as outer longitudinal muscle fibers while, transmission electron microscopic examination showed complete loss of cellular architecture, mitochondrial destruction and complete loss of architecture of myoneuronal plate at the neuromuscular junction suggestive of neuromuscular disorder. Two clinical cases of dogs were tentatively diagnosed to be suffering from reflux esophagitis. Endoscopic examination characterized by mucosal erythema, haemorrhage, mucosal irregularity, erosion with thickened mucosal folds especially at the lower esophageal area confirmed reflux esophagitis. Endoscopic examination showed the evidence of reflux esophagitis in these two dogs. Both the dogs recovered uneventfully following the treatment adopted. Esophagoscopy of a nine year old male Pomeranian dog with sings of recurrent cough and retching revealed a lemon sized nodular growth appearing as broad based protuberance with nipple like orifice located just caudal to the base of the heart suggestive of Spirocerca lupi infestation. No surgical exploration was conducted as the dog was not available for further investigation. Plain radiography of five cases out of 42 cases (11.90%) revealed osseous foreign bodies in the esophagus of four dogs and radiolucent foreign bodies (socks) in an other dog. In three dogs, osseous foreign bodies located in the thoracic esophagus were pushed in to the stomach successfully by endoscope itself. In dog, osseous foreign bodies located in the post pharyngeal was retrieved by cheatle forceps under the endoscopic illumination. The dog with socks in the cervical esophagus vomited the socks out due to emetic effects of xylazine prior to endoscopic manoeuvre. All dogs recovered uneventfully. Barium swallow of the dogs revealed stricture of esophagus over the base of heart and cranial distention of esophagus suggestive of vascular ring anomalies. Despite of giving supportive therapy, both the dogs died. Necropsy revealed distention of esophagus cranial to the constructive vascular band confirmed vascular ring anomalies. Histopathological examination further confirmed presence of concurrent gastritis. Plain radiography of three year old female German shepherd dog with post prandial regurgitation, revealed saclike out pouching of cranial thoracic esophageal wall that rested on floor of sternum which was further confirmed by endoscopy. No treatment was initiated in this case on the owner was reluctant for surgery. The two dogs with vomiting of about three weeks duration that did not respond to routine medication were diagnosed to be suffering from esophageal erosions/ulcers, both by endoscopy and by positive contrast radiography. The dogs responded well to the treatment adopted. Gastroscopy of all three dogs revealed generalized congestion as well as petechial hemorrhagic spots on gastric mucosa with minor areas of mucosal erosions suggestive of chronic gastritis. Cytological examination of stomach fluid collected during endoscopy further confirmed chronic gastritis. No Helicobacter Like Organisms (HLO) was encountered. These three dogs responded well to the treatment protocol adopted i.e. combination of amoxicillin, clarithromycin, Metronidazole and ranitidine. In the present study, gastroscopy of two dogs revealed gastric ulcerative patches with marked thickening and irregular edges confirmed gastric erosion or ulcers. Both the dogs treated with sucralfate and omperazole responded well to complete recovery. In present clinical study, four dogs were diagnosed to be affected with gastric foreign bodies. Out of four cases, two dogs that underwent plain radiographic examination revealed presence of sewing needle in the stomach of one dog and a pair of metal caps of cool drink bottle and a safety pin in another dog. The metallic foreign bodies whose removal was considered to be too risky by endoscope were removed by standard gastrotomy. In the remaining two dogs that swallowed dog nylon belt, plain radiograph did not confirm their presence. Endoscopic examination revealed presence of dog collar made up of nylon in the stomach. Endoscopic retrieval of the nylon belt in the stomach of one dog was successfully done while, in the second case, the radiolucent foreign body (another nylon belt), which turned out later on to be a linear foreign body, was removed successfully by standard gastrotomy and enterotomy operation. All the dogs recovered uneventfully. In the two dogs with gastric dilatation and volvulus (GD-V) in the present study, the clinical and radiographic signs helped in confirmation of the disease and the clinical out come of their treatment with surgical derotation and gastropexy was uneventful. From the results of the present clinical study, it was concluded that about 35% of dogs (42 out of 120 dogs) that were refractory to general medical treatment for vomiting or regurgitation were appeared to be affected with primary diseases of esophagus and stomach. The most common malady affecting the esophagus in dogs was found to be megaesophagus (18), and this can be reasonably well managed by using metoclopramide and feeding the dogs in an upright position from an elevated platform. The disease is considered to be a neuromuscular disease as seen during scanning and transmission electron microscopy. The neuromuscular junctions as seen by transmission electron microscopy appeared to be destroyed in cases of megaesophagus. Esophagography was found to be more useful procedure in confirming the cases of megaesophagus than endoscopy. This is because it is sometimes difficult in mild cases to be sure whether the esophagus was really dilated or it appeared so due to insufflation during endoscopy. On endoscopy examination, a large cavernous lumen extending the length of the esophagus is vividly suggestive of megaesophagus. But a normal esophagus can also appear flaccid and distended under anaesthesia. The other diseases encountered in the present study in their order frequency of occurrence are esophageal foreign bodies (5), gastric foreign bodies (4), chronic gastritis (3), reflux esophagitis (2), esophageal erosion/ulcer (2), gastric erosion/ ulcer (2), vascular ring anomalies (2), gastric dilatation and volvulus (2), esophageal nodule (1) and esophageal diverticulum (1). Endoscopy is not always useful in treatment of esophageal or gastric foreign bodies in dogs for the shape and size of foreign body, duration of obstruction and nature and location of foreign body in the esophagus and stomach determine the use and success of endoscopy for therapeutic purpose. Endoscopy proved to be a valuable and useful aid in the diagnosis of esophageal and gastric ulcers/ erosions, esophageal nodule and esophageal diverticulum. Albeit veterinarians are still in the early phase of adoption of minimally invasive procedures, endoscopy proves to be vital diagnostic and therapeutic tool of the future veterinarians armamentarium.ThesisItem Open Access Experimental Studies On Ischaemia-Reperfusion Injury Of Intestines And Its Attenuation In Dogs(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2000-10) Gireesh Kumar, V; Haragopal, V(MAJOR); Raghavender, K.B.P.; Gopinath, S; Rafiq Ahmed