Dedicated Orthopaedic Services
Lameness work ups
Here at Jubilee we regular encounter animals that are lame. We are fortunate to have experienced clinicians who with accurate history taking, clinical exam and in house equipment like digital X-rays, ultrasound and our fantastic in house CT machine can get to the bottom of these problems.
Oftentimes the problem is straightforward and animals get better with rest and painkillers .
For longer term problems like developmental joint disease, ligament/tendon disruption and arthritis we have many modalities to treat these conditions from modern pain killing drugs, new monoclonal antibody injection for pain relief, joint supplement injections and food supplements and nurse led clinics for K Laser therapy. We have also started to do some stem cell injections into joints to try and rejuvinate them.
Trauma
We also have experience with trauma and are able to fix broken longbones with intramedullary pins, plates and external fixators. We can replace and secure dislocated joints (Hips and elbows) with prosthetic ligaments.
This was a farm dog with a proximal fracture to the tibia and fibula. It was repaired with an intramedullary pin and an external fixator bar. After 6 weeks, the dog was sedated again, xrays confirmed adequate healing. the external fixator bars were removed and the intramedullary pin was left in situ. The dog recovered well.
Fractured radius and ulna in a collie
Radius and ulna fractured with a surgical plate and screws. This plate was left in, the dog recovered well after surgery.
Luxating patella in a labrador
In this instance this patient had a history of intermittent left hind lameness where he could not stand on his back leg. The lameness came and went. The muscle on the leg was beginning to waste and the dog and his owners weren’t able to enjoy the walks hey used to do together. On examination the patella (Knee cap) was loose and able to dislocate medially to the inside of the leg causing pain. We had our diagnosis. Medial patellar luxation is a disease we would see in small to medium breed dogs and its not so common in bigger ones. We did x-rays to rule out anything else and confirm our suspicions and for surgical planning. The surgery was carried out at the start of the week and has 3 basic steps. 1 we want to deepen the groove the knee cap glides in, secondly we want to realign the quadriceps muscle alignment to the tibia- this is done by cutting this attachment and securing it with a pin and circlage wire. Finally we want to tighten the capsule on the outside to stop it sliding medially. The operation went very well. the post op x-rays and some surgical photos are below for you to see. Recovery will take 6-8 weeks and physio will be important to build the muscle back up and retrain walking to a degree. We will be involving Josie at vet rehab NI in this process.
Surgical repair for Incomplete Ossification of the Humeral Condyle (I.O.H.C) in spaniels at Jubilee vet centre
Case Study
A 5 year old male English springer spaniel presented with a grumbling right forelimb lamaness that had been going on for a few weeks. Traditional pain relief and rest afforded some relief of symptoms but it wasnt long lasting. The dog resented extension of the elbow.
The spaniel breed is predisposed to a hereditary condition where in the development of their bones , sometimes a retained cartilaginous fissure in the bottom of the humerus in the elbow results in a weakness that predisposed to elbow fractures with minimal trauma. Due to the breed and age of dog, I was concerned this could be the cause. We did conventional x-rays which are enclosed and you can see no fissure is evident. It can only rarely be seen on xrays if you get the exact projection where this tiny crack a mm wide is parallel to the beam. In years gone by we would have missed these.
Thankfully our CT machine allows us to look at bones through many small slices in 4 different planes so its easier to see.
Thankfully our CT machine allows us to look at bones through many small slices in 4 different planes so its easier to see.
Interestingly a ct image of the other elbow also showed a fissure. The significance of this is uncertain.
Under general anaesthesia i made an incision on the ouside of the elbow and drilled a 3.5mm pilot hole from the lateral to medial aspect while cooling the drill bit with sterile water. The hole was then tapped with a 4.5mm cortical drill tap, the distance was measured, compression was applied with a clamp across the elbow and finally a 4.5mm cortical screw was advanced across the space to reinforce the fissure. Unlike a conventional fracture, I don’t expect the fissure to heal but the screw will add additional support. There was some serous discharge from the surgical site we believe due to drilling such thick bone but thankfully it has subsised and the lameness has reduced.
We’ve agreed that if the dog starts limping on the other side we will repeat the operation on the other side.
