Mature lame animal 2 Flashcards
What is the most common primary bone tumour
osteosarcoma
List the osteosarcoma predilection sites
proximal humerus
distal radius
proximal tibia
Distal femur
where do osteosarcomas tend to metastasise to
lungs- they will have done this by the time of diagnosis
which breeds are predisposed to osteosarcomas
Giant and large breeds with average ages of 5-8 years
List the cliical signs of bone neoplasia
marked pain with poor response to analgesia
muscle atrophy
moderate swelling
pathological fractures
‘older dog has fractured a limb with no or little history of trauma’ what should you consider
could be osteosarcoma
what do we see on radiography with osteosarcomas
this may show both a proliferative and destructive pattern
inital changes occur on the endosteal surface
always radiograph the chest
How can we diagnose bone neoplasia
usually radiographical signs are enough but we can do core biopsies for definitive diagnosis
Describe treatment of bone neoplasia
unlikely to be curative
Limb amputation - provides immediate pain relief
Limb sparing procedures
surgical therapy need to be followed by chemotherapy e.g. carboplatin
what is the prognosis of osteosarcoma in dogs
poor
without treatment < 1 month
limb amputation <4-5 months
limb amputation + chemo - 9-10 months
Describe prognosis of osteosarcoma in cats
If there is no evidence of metastatic disease then no follow up chemotherapy is advised and median survival times range from 24-44 months
what do you see with nerve root tumours
Marked muscle atrophy usually in one limb (a monoparesis) as there is neurogenic as well as disuse atrophy
Painful
How can you detect a nerve root tumour
palpation of the axilla and rectal exam- sometimes detect their presence
If not MRI
where can nerve root tumours occur
brachial and lumbosacral plexuses
Describe how to treat a never root tumour
Surgical resection but this can be difficult and limb amputation is often employed to remove the tumour
what is the prognosis of a nerve root tumour
guarded and recurrence within 1 year likely
rarely spread to other sites though
Describe cruciate rupture in the cat
usually obese, minimal trauma
Extra articular stabilisation but generally improve with rest only
What is PADS
Patella fracture and dental anomaly syndrome
describe PADS
Patella fractures in the cat
Associated with retained deciduous teeth and a variety of other typical fractures
They rarely heal
How to treat PADS
conservative management
circumferential wire, tension bands without pins, pin and tension bands, circumferential wire and pin and tension band
when does Capital physis separation occur in cats normally
Usually the cat is 6-7 months old
List 6 clinical signs of joint disease in the dog and cat
walking stiffly
lameness in one or several limbs
swollen joints
pain on manipulation
reduced range of motion
muscle atrophy
List 6 possible causes of secondary arthritis
developmental conditions
degenerative conditions
inflammatory arthropathies
trauma
sepsis
crystal induced - RARE
Describe the pathophysiology of osteoarthritis
Weight bearing areas of the joint undergo fibrillation (fraying) of the articular cartilage
causes exposure of subchondral bone to synovial fluid–> sclerosis and osteophytes produced –> joint re-modelling
List some examples of drugs used to treat/ manage osteoarthritis
Analgesia - e.g.
1. NSAIDs (really just want it to affect COX-2)
2. Opiates- for acute flare ups
3. Paracetamol - useful adjunct to NSAID- only in dog
3. Monoclonal antibosies
4. Disease modifying osteoarthritic drugs- e.g. cartrophen
List 2 options for management of oestoarthritis
weight loss
physio/ hydrotherapy
How to treat cruciate rupture in cats
they generally just improve with just rest but TTA and TPLO can be attempted
clinical signs of capital physis separation in cats
obvious hip pain and difficulty jumping
How to repair capital physis separation
stabilise with wires or a lag screw
How do we diagnose joint disease
clinical exam
manipulation
radiography
CT
joint taps
arthroscopy
ultrasound
