vet-tech-animal-diseases-2-musculoskeletal-diseases-part-3

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darlene.m.nelson
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137734
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vet-tech-animal-diseases-2-musculoskeletal-diseases-part-3
Updated:
2012-02-25 22:41:27
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vet tech animal diseases musculoskeletal part set
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vet tech animal diseases 2 musculoskeletal diseases part 3 set
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  1. Arthritis
    • general term, no specific organism
    • inflammation of the joint
    • many causes:
    • - old age/wear
    • -- #1
    • -- cells slow down, wear
    • -- osteoarthritis
    • - immune mediated - attacking self
    • -- rheumatiod
    • - septic
    • -- trauma - penetrating wound into joint can cause sepsis
    • - infectious
    • -- Lymes
  2. Osteoarthritis
    • most common form of arthritis in animals
    • affects dogs and cats
    • - more common in dogs than cats as we have different expectations
    • old age
    • injury resulting in joint instability
    • congenital instability of joints
    • - dysplasia
    • - luxating patellas
  3. Osteoarthritis clinical signs
    • decreased activity
    • - lay in one position too long and get stiff
    • restlessness
    • pain on motion
    • - resistance = pain
    • crepitus
    • muscle atrophy
    • - measure circumference of thigh in animal
    • obesity - secondary to reluctance to move (less activity)
    • changes in normal behavior - as pain increases
    • - reluctance to jump #1 sign in cats
    • stiffness in cold
  4. Osteoarthritis diagnosis
    • age (breed)
    • clinical signs - subtle changes
    • imaging
    • - radiographs REQUIRED for definitive diagnosis
    • -- narrow joint space
    • -- osteophytes (bone spurs)
  5. Osteoarthritis treatment
    • joint support
    • - some animals respond, some don't
    • - adequan injections
    • -- helps synovial fluid
    • -- weekly for 4 weeks then monthly
    • -- stimulates hyaluronic acid
    • - glucosamine chondroitin
    • -- some people start this early
    • - herbal
    • NSAIDs
    • - rimadyl
    • - metacam (blindness in cats)
    • - zubrin
    • - deramaxx
    • narcotic pain relief can be prescribed
    • - issues of abuse of the drug by humans
    • - may give them 6-8 months
    • - eg Tramadol
    • we don't have the capability to make whole again
    • - manage pain
    • - arrest disease
    • diet
    • - joint support diets - eg Hills J/D
    • - weight reduction - slentrol - pill - fen fen for dogs
    • exercise
    • - moderate, regular exercise is good for the joints
    • - swimming - aquatherapy
  6. Osteoarthritis prognosis
    • this is a chronic, progressive disease
    • arthritis is not fatal
    • problems associated with decreased mobility may lead to euthanasia
  7. Spondylosis
    • degenerative arthritis of the spine
    • symptoms may resemble disc disease, Wobblers, myelopathy
    • spurs that form a bony bridge
    • - won't bend very well
    • - microfractures in bony bridge
    • occurs in dogs and cats
    • hypersensitivity in back, especially cats
    • diagnosed with imaging
    • - bridging of the vertebral bodies
    • - treated as other arthritic conditions
    • not a synovial joint, so manage pain
    • - no frisbee
    • - modify your behavior
  8. Anterior Cruciate Rupture
    • ACL or cranial cruciate ligament rupture
    • most common ligamentous injury in dogs
    • rotational injury - rotate so far that other (external) ligaments can't support joint
    • luxating patellas predispose them to this
    • 10 years ago rare - middle-aged/older female obese dogs - was known as quarterback injury
    • now common - all weights, ages, genders
    • signalment - that part of the veterinary medical history dealing with the animal's age, sex and breed
    • ACUTE INJURY?
    • - presents that way from owner's perspective
    • - likely degenerative changes lead to rupture
    • sudden onset of significant lameness - 3 legged lame
    • little or no pain on palpation
    • - there is swelling, reluctance to move
    • toe touching behavior - rest leg on toe
    • partial or total rupture may occur
    • - partial tear will improve in 7-10 days
    • - will not be 100%
    • - can feel crepitus
    • - leg will be thinner as it is less used
    • buttressing
    • - collateral ligament will thicken to stabilize joint
    • - bone also gets thicker
  9. Anterior Cruciate Rupture clinical signs
    • toe touching lameness
    • - won't toe touch with broken leg
    • no improvement with rest
    • little pain on palpation
    • - more pain can mean damage to meniscus or wimpy dog
    • buttressing if chronic
    • femur slips forward on tibia sometimes
  10. Anterior Cruciate Rupture diagnosis
    • history
    • physical exam
    • - larger dog may need to sedate as muscles are stronger and will tense
    • - drawer sign
    • -- femur sliding over tibia
    • -- subtle movement where there shouldn't be any
    • imaging
    • - rules out other causes - osteosarcoma
    • - may also have damage to meniscus - no space on x-ray means meniscus is gone
    • - orthopedic dept will do MRI
  11. Anterior Cruciate Rupture treatment options
    • rest and PT - can get 80% of use back
    • imbrication
    • - The operative overlapping of layers of tissue in the closure of wounds or the repair of defects
    • - take all of connective tissue and make it tight
    • - good for sm & not too active dogs
    • - kind of like ace bandage on the outside
    • figure 8 wire
    • tightrope
    • TPLO - Tibial Plateau Leveling Osteotomy
    • - patented like PENN hip
    • - pay to learn & pay every time you do this surgery
    • - surgery of choice for large active dogs
    • - cut bone to move tibial plateau down, leaving a lip of bone in front to stop femur sliding off
    • post-surgery study
    • - 1 year - TPLO most stable
    • - 5 year - amount of arthritis the same regardless of which surgery was done
  12. Anterior Cruciate Rupture post-operative care
    • regardless of which surgery it was
    • exercise restriction for 3-6 weeks - need to be crated
    • gradual increase in activity 4-8 weeks post-op
    • - good time for PT - eg underwater treadmill or swimming
    • full return to use 12 weeks post-op
    • - will have residual lameness
    • weight management is important if patient obese
    • - most surgeons will not operate until lose weight
    • most of the time these go really well
    • - TPLO - regain 90% of use
    • - do nothing - regain 70% of use
    • when they go bad, they go really bad
  13. Anterior Cruciate Rupture prognosis
    • arthritis of knee within 3-5 years regardless of repair method
    • common for other knee to be affected within one year in dogs (as they are now using it more)
    • post-op PT is highly beneficial
  14. Intervertebral Disc Disease (IVD)
    • did this with nervous system, so brief overview
    • cervical or lumbar
    • thoracic uncommon (ribs stabilize them)
    • may be acute or chronic
    • long backed dogs susceptible
    • - lhasas
    • - bassett hounds
    • - dachshunds
    • - poodles
  15. Intervertebral Disc Disease clinical signs
    • depends on:
    • - location of disc
    • -- cervical
    • -- lumbar
    • - rate of progression
    • -- acute
    • -- chronic
  16. Intervertebral Disc Disease clinical signs - cervical
    • neck pain
    • reluctance to eat
    • weakness in hind end
    • if sudden, whole body paralysis
  17. Intervertebral Disc Disease diagnosis - cervical
    • breed
    • clinical signs
    • imaging
    • - x-ray
    • - myelogram - x-ray of the spinal cord after injection of air or a radiopaque substance into the subarachnoid space
    • - MRI
    • - CT
  18. Intervertebral Disc Disease clinical signs - thoraco-lumbar
    • reluctance to climb stairs
    • reluctance to jump
    • back pain
    • decreased CP (concious proprioception - placing reflex)
    • sudden hind limb paralysis
  19. Intervertebral Disc Disease diagnosis - thoraco-lumbar
    • breed
    • clinical signs
    • imaging
    • - x-ray
    • - MRI
    • - CT
  20. Intervertebral Disc Disease treatment
    • medical
    • - strict confinement
    • - corticosteroids
    • - intensive nursing
    • -- bladder
    • surgical
    • - fenestration
    • -- cervical
    • -- go in ventral, slide everything out of way, make window, pull out part of vertebrae
    • - hemilaminectomy
    • -- lumbar
    • -- remove half of lamina, hole in bone to get to herniated disc
  21. Intervertebral Disc Disease prognosis
    • guarded
    • - frequently multiple discs are involved
    • - surgical intervention can further destabilize spine
    • - pain management
    • - carts
  22. Myopathies
    • figure out if bone, ligament, or muscle
    • diseases of muscles - on the rise
    • inflammatory
    • - rare
    • - bacterial - protozoal - toxoplasmosis in cats
    • immune-mediated
    • - most frequently seen
    • - body not recognizing self
    • - polymyositis
    • -- dogs and cats
    • -- fairly common
    • acquired
    • - feline polymyopathy
    • -- associated with hypokalemia
    • --- not enough potassium in diet
    • --- see most often in renal failure
    • --- usually give Tumil K - potassium gluconate is most bioavailable
  23. Atrophic Myositis
    • less common in cats
    • must check potassium levels
    • eosinophilic myositis - eosinophils attack muscles
    • muscles of mastication in dogs
    • - can appear in other muscles, but not usually
    • reluctance to open mouth
    • - even under sedation, can't open it
    • swelling & pain
    • atrophy & fibrosis
    • - if not treated aggressively
    • - after fibrosis, there's no more function & never will be
    • CPK (creatinine phosphokinase) - check levels; elevated when muscle dying
    • eosinophil count also elevated
    • muscle biopsy for definitive dx - often don't do this
    • glucocorticosteroids
    • - immune suppressor
    • - very aggressive early on
    • - high doses (1 mg/lb) prednisone in office
    • - usually respond well, can sometimes gradually wean off
    • can look like retrobulbar abcess
    • primarily seen in goldens
    • rapid onset

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