1. Central Texas Veterinary Sports Medicine
Orthopedic Injuries and Diseases in Immature Patients Stephen J. Kerpsack, DVM, MS
Diplomate ACVS
Central Texas Veterinary Specialty and Emergency Hospital
tpitaland Emergency
Central Texas Veterinary Sports Medicine

5. Infectious Diseases
Neospora caninum Parasite similar to Toxoplasma Transplacental transmission Eating Intermediate Host

7. Infectious Diseases Neospora caninum -Clinical signs in dogs
-rear limb stiffness
-primarily quadriceps
-differential diagnosis for hip dysplasia
-rear limb paralysis

9. Infectious Diseases Neospora caninum Diagnosis – serum titer
Treatment - 4 – 8 weeks
- clindamycin
- smz – tmp
- physical/water treadmill therapy
- seek out littermates when possible

10. Infectious Diseases
Hepatozoon - canis - americanum - gulf coast - Tick borne/transplacental transmission - Clincal Signs - rear limb stiffness/lameness - long bone pain - hip pain Diagnosis - high white blood cell count - radiographs - PCR - blood

11. Hepatozoon

12. Infectious Diseases Hepatozoan Treatment 4-8 weeks + - clindamycin
- smz – tmp
- decoquinate (americanum)
-doxycycline/imidacarb?

13. Carpal Hyperflexion

14. Carpal Hypoflexion

15. Retained Cartilagenous Cores

16. Retained Cartilagneous Cores
Treatment
Treat pain
Monitor for growth plate closure
Diet Change
Less calories

17. Retained Cartilagenous Cores

18. Hypertrophic Osteodystrophy
 -decreased blood flow to the metaphysis
-failure of ossification
-necrosis and inflammation of cancellous bone --usually bilateral in the long bones
distal radius, ulna, tibia
Cause – excessive calcium intake, genetic in Weimaraners

19. Hypertrophic Osteodystrophy -

20. Hypertrophic Osteodystrophy

21. Hypertrophic Osteodystrophy
Diagnosis
Fever
Radiographs
CBC
Neutropenia
Treatment
Corticosteroids
Supportive care
Monitor for growth plate closure

22. Septic Arthritis
Stifle
Elbow
Usually Hematogenous

23. Septic Arthritis Diagnosis Joint tap
Cytology – suppurative inflammation
Culture – negative culture does not rule out infection

24. Septic Arthritis Treatment Joint Lavage – needle ingress/egress, LRS
Antibiotic therapy
Anti-staph
Avoid flouroquinalones
Based on culture or response to treatment
6 week minimum

25. Septic Arthritis Treatment Joint Lavage – needle ingress/egress
LRS liters

26. Matacarpal/Metatarsal Fractures
-Closed reduction/Splint Application -Approximately 1 week of healing for every month of age up to 9 months. - Fracture can remodel if not anatomic.

27. Matacarpal/Metatarsal Fractures
-Heavy Sedation or Anesthesia
-Linear Traction during splint placement.
Spoon splint
Extend to the calcaneus or just above the carpus
Weekly to biweekly splint change

28. Tibial Tuberosity Fracture
Indications for surgery
Significant displacement
Palpable instability
Patella luxation

29. Tibial Tuberosity Fracture
Coaptation - bandage that extends as high up the thigh as possible for 4 – 6 weeks
Surgery – two parallel pins in young dogs
Avoids growth plate
closure
Flouroscopic guided
closed reduction is
preferable

30. Tibia Fracture

31. Tibia Fracture

32. Capital Physis Fracture
Shear force – repair with two parallel pins
Flouroscopic guided closed reduction prevents femoral head collapse or apple core remodeling
Delay in repair can lead to poor outcome

33. Lateral Humeral Condyle Fracture
Often missed if two view/straight radiographs not obtained
Low energy fracture
Flouroscopic guided closed repair
Delay in repair (weeks) can lead to poor outcome

34. Patella Luxation Repair is not indicated in asypmtomatic patients
Younger is better in symptomatic patients
Avoid a tension band

35. Distal Ulna Growth Plate Closure
Early Detection and early treatment is key to a good outcome.
Treatment – Distal ulnar ostectomy

36. Distal Ulna Growth Plate Closure

37. Radius Growth Plate Closure

38. Elbow Dysplasia

39. Elbow Dysplasia
Goal of treatment is to reduce signs. No change in approximately 20% of dogs.
Questionable value in operating older patients with chronic lameness

40. Osteochondritis dissecans

41. Osteochondritis dissecans

42. Hip Dysplasia
Juvenile Pubic Symphysiodesis  - puppies less than 4 months of age
Triple pelvic osteotomy
less than 9 months of age
at least 10% coverage of
the femoral head
no osteoarthritis
symptomatic.

44. Early Intervention is often the key to success