The Use of a Locking Plate for the Treatment of Femoral Diaphyseal Fracture in Giant Anteaters (Myrmecophaga tridactyla)

Background: The giant anteater is considered a species vulnerable to trauma due to being slow and, therefore, vulnerable to long bone fractures, such as femoral fracture. Locking plates have the potential to restore and maintain fractured bone stability, as well as reduce damage to the vascular supply. This study aims at reporting cases of two giant anteaters subjected to femoral osteosynthesis using locking plates. Cases:Two giant anteaters presenting non-weight bearing lameness on the right pelvic limbs were evaluated, diagnosed with femoral fracture of unknown etiology and submitted to osteosynthesis. A clinical evaluation was performed under chemical restraint for the adult animal and physical restraint for the young one. Crepitation and swelling in the right femur topography led to a radiographic examination, which showed a complete and transverse diaphyseal fracture of the right femur in both cases. The first one was an adult male and was subjected to osteosynthesis of the right femur using a locking plate. Once anesthetized, the animal was placed in left lateral recumbency, and the right pelvic limb was clipped and sterilized. A craniolateral incision was made to expose the femoral diaphysis. A large amount of fibrous-looking tissue was found and removed. Subsequently, the fracture was reduced and the locking plate system was positioned on the craniolateral side of the femur. An osteotomy of the femoral trochanteric crest was required to position the implant. The overlying fascia lata was closed using monofilament suture in a simple continuous pattern. The closure of the subcutaneous tissue and skin was performed using a Cushing pattern and simple interrupted pattern, respectively. Immediate postoperative radiographic examinations showed fracture reduction and bone axis alignment, with a properly positioned implant. The surgical wound was cleaned daily with 0.5% aqueous chlorhexidine solution. Seven days after surgery, the animal had a partial dehiscence at the suture site, with bone and plate exposure. Wound healing by second intention was initiated. At 127 days after surgery, a radiographic examination showed periosteal bone proliferation in the middle third of the right femur and that the bone implants were well-positioned. The second case was of a young 3.68 kg female anteater. The surgery was performed as described for the adult one, but there was no fibrosis at the fracture site and the osteotomy of the femoral trochanteric crest was not required. Closure of the fascia lata, subcutaneous tissue, and skin was performed as in Case 1. An immediate postoperative radiographic examination showed fracture reduction, bone axis alignment, and a properly positioned implant. The surgical wound was cleaned daily with 0.5% aqueous chlorhexidine solution. On the day of the surgery, the animal could already bear weight on its right pelvic limb, presenting discrete lameness with gradual improvement. Twenty-three days after surgery, a radiographic examination showed moderate periosteal bone proliferation in the middle third of the right femur. The bone implant was still well-positioned and bone healing was achieved around the 40th post-operative day.Discussion:The cases are very similar, but the younger anteater's femoral trochanteric crest didn't prevent positioning the plate. The fibrosis observed on the adult specimen is indicative of a chronic fracture, which may explain, in conjunction with the post-surgical complications, the longer time required for bone healing in the adult animal. Even so, both animals recovered fully and it's safe to deduce that the locking plate is an adequate option for internal fixation in transverse diaphyseal femoral fractures in both adult and young giant anteaters.

Craniomandibular Osteopathy in Mixed Breed Dogs

Background: Craniomandibular osteopathy (CMO) is a degenerative, osteopetrotic, and self-limiting bone disease that is rare in the canine species. The most affected bones and joints are the branches of the mandible, tympanic bulla, and temporomandibular joint (TMJ) with generalized thickening of the bone trabeculae, increased lines of bone cementation, and bone proliferation. The aim of the present study was to evaluate 2 cases of CMO in mixed-breed dogs belonging to the same litter sent to the Laboratório Regional de Diagnóstico, Faculdade de Veterinária, Universidade Federal de Pelotas (LRD / FV / UFPel).Cases: Three canines (mixed-breed, 2 female and 1 male) belonging to the same litter presented at eight months of age with increases in volume and pain in the face, difficulties in moving the jaw, anorexia, and sialorrhea. The 2 female dogs were euthanized and sent to LRD / FV / UFPel for necropsy. The animals underwent radiography of the left and right lateral and dorsoventral lateral projections in the imaging sector of the Hospital de Clínicas Veterinária (HCV) at UFPel. During the necropsy, fragments of organs from the abdominal and thoracic cavities, as well as the central nervous system and head bones, were collected and fixed in 10% buffered formalin. The tissue samples were cleaved, processed routinely, embedded in paraffin, cut into sections of 3 µm thickness, and stained using hematoxylin and eosin (HE). The bone fragments were decalcified in a 50/50 solution of 8% hydrochloric acid and 8% formic acid and subsequently cleaved and stained with HE. The head and jaw of one of the animals was dissected and subjected to maceration in water at room temperature. Radiographic examination of the two remaining animals showed irregular and exuberant bone proliferation in the mandible and temporomandibular region. In the tympanic bullae, occipital bone, and zygomatic process, thickening of the structures was observed with increased opacity. On necropsy, the animals were cachectic with marked muscle atrophy and increased volume of the mandibular branches and head bones, in addition to marked edema in the adjacent subcutaneous tissue. The regional lymph nodes were enlarged, and in one of the animals, bilateral lesions in the femurs were also observed. In the head subjected to biological maceration, areas of bone proliferation and rarefaction were observed, with increased volume and destruction of the TMJ. On histopathological evaluation of the ventral portion of the mandibular bodies, a network of bony trabeculae was observed, composed of a chondroid matrix with different degrees of mineralization. The cortical portion of the bones exhibited loss of lamellar compactness, with greater spread of the bone trabeculae. The bone trabeculae were perpendicular to the long axis of the cortical of the mandible and were distributed in the medullary spaces, presenting some dense foci of inflammatory infiltrates composed predominantly of neutrophils, lymphocytes, and plasma cells.Discussion: The breeds most predisposed to developing CMO are the West Highland White Terrier and Scottish Terrier; however, the disease has also been described in other non-Terriers. Nevertheless, there are no descriptions in the literature of mixed-breed animals (SRD), with this report being the first of CMO in SRD dogs. The bones most frequently affected in CMO are those of the head. In Terrier dogs, the TMJ is also affected. In the cases of this study, severe CMO occurred, affecting both the head bones and TMJ, and in 1 of the animals, it also affected the femurs. Although CMO has not previously been reported in SRD dogs, the condition can seriously affect these animals, and differential diagnosis should always be made.Keywords: degenerative bone disease, bone proliferation, lion jaw, TMJ.Título: Osteopatia craniomandibular em cães sem raça definidaDescritores: doença óssea degenerativa, proliferação óssea, mandíbula de leão, ATM.

Enterococcus faecalis causes osteitis deformans in a Golden Lancehead snake (Bothrops insularis): a case report

Osteitis deformans (Paget’s disease) is a chronic bone disorder characterized by excessive osteoclast-mediated bone resorption followed by new bone formation. The present paper reports this condition in an 18-year-old captive golden lancehead (Bothrops insularis) from Brazil. This patient initially exhibited anorexia and swelling in the middle third of the spine associated with locomotor disability. For diagnosis, radiography, ultrasound, computed tomography, cytology, and microbiological culture were performed. Diagnostic imaging showed bone changes, vertebral fusion, and bone proliferation. Cytology revealed blood cells how toxic heterophiles, reactive monocytes, young red blood cells, and polychromasia compatible with an infectious process. A bacterial culture identified an ampicillin-susceptible strain of Enterococcus faecalis. Antibiotic treatment was promptly started, but the snake died 25 days later. Histopathologically, the bone tissue showed a generalized thickening of the vertebral trabeculae. For the first time, the presence of E. faecalis associated with the development of osteitis deformans in snakes was presented.

Description of a novel distribution and subsequent resolution of severe, bilateral thoracic limb and cervical vertebral abnormalities in a dog with craniomandibular osteopathy

A 6-month-old female entire, mixed breed dog was presented for evaluation of a 3-week history of neck stiffness and pain on opening the mouth. Radiographs and subsequent CT were performed, as well as a further CT at a 3-month follow-up. The images revealed multiple osseous abnormalities characterised by severe periosteal reactions affecting the head, cervical vertebrae and the proximal thoracic limbs. Histopathological analysis was compatible with a severe case of extensive craniomandibular osteopathy (CMO). To the authors’ knowledge, a diffuse periosteal reaction effecting the cervical vertebrae, associated with CMO, has not been previously reported. Furthermore, it demonstrates that despite the novel distribution of the disease, clinical improvement is possible with conservative management, with partial resolution of excessive bone proliferation, improvement in the ability to flex and extend the neck, as well as a marked improvement in temporomandibular function.

Validation of the ReXSPA (Reductive X-ray Score for Psoriatic Arthritis) index in patients with Psoriatic Arthritis of the RAPSODIA cohort

There are many scores available to measure radiographic joint damage in patients with Psoriatic Arthritis (PsA), but most of them were developed for Rheumatoid Arhtritis and then modified for PsA. These scores do not evaluate juxtaarticular bone proliferation. The aim of our study was to validate the Reductive X-Ray Score for Psoriatic Arthritis (ReXSPA), which was recently developed to be used in observational cohorts. Methods: A cross-sectional study was carried out. Consecutive patients ≥18 years old with sA according to CASPAR criteria were included. All patients underwent X-rays of the hands and feet in an anteroposterior view. Two blind readers for the clinical characteristics of the patients and previously trained, scored them by Sharp van der Heijde modified for PsA (PsA-SvdH) and ReXSPA indexes. Time to read and calculate both scores were measured. Results: A total of 66 patients were included, half of them were female, median (m) disease duration of 8 years (IQR: 4-14.3). 132 X-Rays were scored according to PsA-SvdH [m 35 (IQR: 16.3-72.5)] and ReXSPA [m 22 (IQR: 7-46.3)]. Time to read was significantly shorter for ReXSPA than PsA-SvdH [mean 5.8±2.1 vs mean 7.5±2.5 minutes, p<0.0001], as well as, time to calculate them [mean 26.5±14.7 vs mean 55.3±38.3 seconds, p<0.0001]. The correlation between both indexes was excellent (Rho: 0.93). In the multivariate analysis, using both radiographic scores as dependent variable, association of each of the indices with disease duration was observed, and ReXSPA also had association with age. Conclusion: The ReXSPA index has shown validity and a very good correlation with PsA-SvdH. It is quicker to read and to calculate than PsA-SvdH. Subsequent longitudinal evalua-tions will allow demonstrating the validity of these findings.

Combined Surgical, Radiation, and Medical Therapies for Osteochondrodysplasia in a Scottish Fold Cat

ABSTRACT Osteochondrodysplasia affects both homozygous and heterozygous Scottish Fold cats, and various treatments have been attempted to control chronic pain and improve mobility in these animals. However, to date, there is no single effective treatment that can be used to treat all cats with Scottish Fold osteochondrodysplasia (SFOCD). A 4 yr old castrated Scottish Fold cat presented with plantar exostoses in the right hindlimb, the largest of which was caudal to the tarsometatarsal joint and had stretched the overlying skin, causing ulceration and bleeding. There was right hindlimb lameness. The cat was diagnosed with SFOCD, and the skin lesions were treated by excision of the exostoses, removal of the damaged skin, and wound closure. All extremities were treated with radiotherapy and subcutaneous pentosan polysulfate for chronic pain. The cat’s gait improved after surgery, and increased activity was noted after radiotherapy. There were no signs of excessive bone proliferation or adverse effects at 80 wk postoperatively. In conclusion, a combination of surgical, radiation, and medical therapies could be an effective treatment strategy for SFOCD with skin ulceration.

Chronic osteomyelitis in canine penile bone: case report

ABSTRACT A 10-year-old male mixed-breed dog was admitted for recurrent signs of urinary tract infection (UTI). Urinary bladder ultrasonography revealed decreased thickness of its wall with floating hyperopic particles within its lumen. Ultrasonography revealed a structure invading the dorsal wall of the penile urethral lumen, located in a segment distal to the bladder. Radiographies showed bone resorption with proliferation at the caudal aspect of the penile bone, stricture of the final aspect of the penile urethra, and no radiopaque images compatible with a urethrolith. Computed tomography showed bone proliferation causing stricture of the urethral lumen at two different sites. Presumptive diagnosis of penile neoplasia was considered more likely and the dog underwent penectomy along with orchiectomy and scrotal urethrostomy. Enterobacter spp. was cultured from the urine sample and antibiotic sensitivity tests revealed that the bacterium was susceptible to amikacin, imipenem, and meropenem. Histopathology revealed severe suppurative urethritis, bone resorption, and hyperostosis, suggestive of osteomyelitis of the penile bone. Neoplastic cells were not observed at any part of the examined tissue. The findings in the present case suggest that osteomyelitis of the penile bone should be included in differential diagnosis for partial and complete urethral obstruction in dogs with recurrent UTI.

Ex-Vivo Equine Cartilage Explant Osteoarthritis Model - A Metabolomics and Proteomics Study

Osteoarthritis (OA) is an age-related degenerative musculoskeletal disease characterised by loss of articular cartilage, synovitis, abnormal bone proliferation and subchondral bone sclerosis. Underlying OA pathogenesis is yet to be fully elucidated with no OA specific biomarkers in clinical use. Ex-vivo equine cartilage explants (n=5) were incubated in TNF-α/IL-1β supplemented culture media for 8 days, with media removed and replaced at 2, 5 and 8 days. Acetonitrile metabolite extractions of 8 day cartilage explants and media samples at all time points underwent 1D 1H nuclear magnetic resonance metabolomic analysis with media samples also undergoing mass spectrometry proteomic analysis. Within the cartilage, metabolites glucose and lysine were elevated following TNF-α/IL-1β treatment whilst adenosine, alanine, betaine, creatine, myo-inositol and uridine levels decreased. Within the culture media, four, four and six differentially abundant metabolites and 154, 138 and 72 differentially abundant proteins, with > 2 fold change, were identified for 1-2 day, 3-5 day and 6-8 day time points respectively. Nine potential novel OA neopeptides were elevated in treated media. Our innovative study has identified differentially abundant metabolites, proteins and extracellular matrix derived neopeptides, providing insightful information on OA pathogenesis, enabling potential translation for clinical markers and possible new therapeutic targets.

Hypertrophic osteoarthropathy in a sheep

ABSTRACT: This research described the radiological, clinical and pathological aspects of hypertrophic osteoarthropathy in a seven-year-old Santa Inês ram. The main clinical features were lameness of the thoracic and pelvic limbs, rigid, cracking and enlarged of the humeroradial, humeroulnar and tibiofemoral joints, cervical spine stiffness, and severe lordosis of the thoracolumbar vertebrae. Dyspnea, nasal discharge and abdominal breathing were also observed. On radiographic examination of the thoracic and pelvic limbs, osteoarthrosis with the formation of osteophyte bridging, intra-articular calcification and periosteum reaction were observed. At necropsy were reported bilateral osteophytosis in the humeroradial, humeroulnar, tibiofemoral and interphalangeal joints, and fusion of the bodies of thoracic vertebrae T5-13 T6 and T12-T13. Microscopically, extensive areas of fibrosis were observed in the lungs and the affected joints were thickened by well demarcated and perpendicular orientated woven and trabecular bone proliferation in the epiphysis. The periosteum was also expanded by fibrous connective tissue that extended into and between the new proliferated bone. Based on these findings, hypertrophic osteoarthropathy, which is an unusual condition in sheep, was diagnosed.

Osteochondrodysplasia in a 9-Year-Old Scottish Fold Cat

Objective The aim of this study was to share clinical and radiological findings of extremely advanced osteochondrodysplasia.A 9-year-old Scottish Fold cat was presented with the complaint of difficulty in urination, defecation, respiration, standing and walking. Physical findings such as kyphosis, hyperflexion of joints and thick tail and, radiological findings including periosteal bone proliferation in distal extremities, ankylosing changes in spine and tail and, calcification of triceps brachii insertion were consistent with the most advanced osteochondrodysplasia ever documented. Antibiotic medications, anti-inflammatory drugs, vitamin C and enema were administered considering difficulty of urination, defecation and respiration. Then, glycosaminoglycans and prednisolone were administered for osteochondrodysplasia and increase in the movement of the cat was observed in a few days. Conclusion By sharing clinical and radiological findings of severe osteochondrodysplasia in advanced age, the importance of informing breeders and owners about uncontrolled breeding of these cats was emphasized.