Veterinary Conditions: Pectus Excavatum & Injuries

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Questions and Answers

What is the most important factor influencing the success of treatment for an avulsed tooth?

Proper storage of the tooth

Patient age

Quick reattachment of the tooth

Periodontal ligament vitality (correct)

Which type of teeth are usually associated with familial delayed eruption in certain breeds?

Third molars (correct)

Maxillary incisors

Mandibular 1st premolars (correct)

Brachycephalic teeth

What characterizes a supernumerary tooth?

An additional tooth that may cause crowding (correct)

A tooth split due to germ division

An absence of teeth

The formation of two complete teeth from one tooth bud

What dental condition involves the fusion of tooth germs along the entire length of the tooth?

Fusion Signup and view all the answers

What is a significant risk of impacted teeth?

Cyst formation Signup and view all the answers

What is the most common breed or condition associated with Pectus Excavatum?

Bengal dogs Signup and view all the answers

Which of the following tools is used for diagnosing Pectus Excavatum?

Frontosagittal index Signup and view all the answers

What is a recommended treatment for Achilles Tendon Injury?

Avoiding caloric excess and bandaging Signup and view all the answers

Which breed is commonly associated with Fibrotic Myopathy?

German Shepherd Signup and view all the answers

What condition may lead a young adult dog to experience cat-like tail flaccidity?

Caudal Myopathy Signup and view all the answers

What is a characteristic symptom of the Knees and Teeth Syndrome in cats?

Patellar luxation Signup and view all the answers

Which option indicates a clinical sign related to Carpal Hyperflexion?

Limb adduction Signup and view all the answers

Which treatment is often NOT indicated for Fibrotic Myopathy due to its non-painful nature?

Surgical intervention Signup and view all the answers

What is a common consequence of persistent deciduous teeth?

Malocclusion due to altered position of permanent teeth Signup and view all the answers

Which breed is most associated with gingival hyperplasia?

Great Dane Signup and view all the answers

What surgical technique is typically recommended for treating an oronasal fistula?

Full thickness flap or double reposition flap Signup and view all the answers

Which of the following conditions can lead to a pathological fracture?

Dentigerous cyst Signup and view all the answers

Which of the following teeth is most commonly associated with a tooth root abscess?

Maxillary 4th PM Signup and view all the answers

What is the primary cause of feline alveolar osteitis?

Secondary to periodontal inflammation Signup and view all the answers

For a traumatic dentoalveolar injury, what is the main risk if pulpal exposure is untreated?

Pulpitis leading to necrosis and periapical pathology Signup and view all the answers

Which factor is essential in the management of temporomandibular joint disorder in dogs?

Manual reduction Signup and view all the answers

Which symptom is indicative of possible nerve dysfunction in the dog?

Urinary or fecal incontinence Signup and view all the answers

What is a non-surgical treatment option listed for the dog's condition?

Pain medication Signup and view all the answers

Which condition is NOT mentioned as a cause of the dog's health issues?

Arthritis of the hips Signup and view all the answers

What is one of the observed symptoms that directly affects the dog's mobility?

Pelvic limb lameness Signup and view all the answers

What surgical procedure may be necessary for treating severe cases?

Lateral foraminotomy Signup and view all the answers

What is a key symptom associated with dysautonomia in dogs?

Photophobia Signup and view all the answers

Which type of paralysis is associated with an immune-mediated response and often follows a raccoon bite?

Coonhound paralysis Signup and view all the answers

Which diagnostic tool is essential for confirming coonhound paralysis?

Electromyography (EMG) Signup and view all the answers

What symptom differentiates the early phase of canine degenerative myelopathy (DM) from typical signs of paralysis?

Loss of paraspinal hyperesthesia Signup and view all the answers

What is the expected prognosis timeline for recovery from coonhound paralysis?

3-6 weeks Signup and view all the answers

Which symptom is NOT typically observed in a case of botulism?

Increased muscle tone Signup and view all the answers

Which treatment is considered ineffective for dogs diagnosed with canine DM?

Prednisone Signup and view all the answers

What is a common initial clinical sign in cases of botulism?

Stiff short stride gait Signup and view all the answers

Which of the following is a diagnostic finding expected in early canine DM?

Asymmetric GP ataxia Signup and view all the answers

What is the main purpose of administering 0.05% pilocarpine in a case of dysautonomia?

To produce miosis Signup and view all the answers

What are common symptoms of tick bite paralysis in dogs?

Hindlimb weakness and respiratory depression Signup and view all the answers

Which diagnostic method is crucial for identifying SRMA?

CSF analysis Signup and view all the answers

What is a common outcome for dogs with brachial plexus avulsion?

Marked weakness with muscle atrophy Signup and view all the answers

What distinguishes caudal avulsion from other types of spinal injuries?

Inability to bear weight Signup and view all the answers

Which treatment method is recommended for severe tick bite paralysis cases?

Fipronil application and tick antitoxin Signup and view all the answers

Spondylosis deformans is primarily characterized by which condition?

Degenerative noninflammatory changes Signup and view all the answers

What is a significant risk if tick paralysis is not treated promptly?

Respiratory paralysis and potential death Signup and view all the answers

Which breed is more commonly associated with congenital lumbosacral stenosis?

Border Collies Signup and view all the answers

What symptom may indicate spondylosis deformans in dogs?

Asymptomatic findings during routine exams Signup and view all the answers

Which treatment might be used in the long-term for SRMA if pleocytosis persists?

Prednisone and other immune drugs Signup and view all the answers

Study Notes

Pectus Excavatum

More common in brachycephalic breeds and Bengal dogs
Commonly seen in males
The condition appears between 4 weeks and 3 months of age
Sternum and coastal cartilage deformity leading to chest narrowing
Secondary respiratory and cardiovascular issues
Some patients may exhibit "swimmer syndrome" with limb adduction issues and sternal recumbency
Diagnosis can be made using the frontosagittal index and vertebral index
Treatments include external coaptation, partial or total sternectomy, or a combination of both

Carpal Hyperflexion

Non-clinical cases may become clinical later in life
More common in medium and large breeds, notably Doberman and Shar-Pei
Often occurs between 6-16 weeks of age

Achilles Tendon Injury

Often self-limiting
Bandaging and caloric restriction are recommended

Gastrocnemius and Other Tendon Injuries

Includes injuries to the combined tendon of biceps femoris, semitendinosus, and gracilis
SDF tendon injury common in Labradors and Dobermans
Can lead to dropped hock, plantigrade stance, and tarsal hyperflexion
Treatment may involve casting, splinting, or calcaneotibial screws (often with ESF without calcaneal avulsion)
Avulsed midsubstance tears may require wire or suture repair, different techniques like 3-loop pulley or locking loop can also be applied
Platelet-rich plasma injections can be used for chronic cases

Fibrotic Myopathy of Caudal Thigh Muscle

Fibrosis of the semitendinosus or gracilis muscle in German Shepherds
Unknown cause, potential prior muscle trauma may play a role
Limb abnormalities include distal hindlimb adduction and tibial/metatarsal inward rotation
Band resection may be needed, but fibrosis often recurs
Surgery may not be indicated as the condition often isn't painful

Caudal Myopathy

Flaccid paralysis or paresis of the tail due to ischemic injury of coccygeal muscles in young adult dogs
Acute phase: tail is flaccid and straight down
Recovery phase: tail may hang to one side
Supportive care is required

Knees and Teeth Syndrome

Cats become lame at 2 years of age
Persistent deciduous teeth and non-traumatic bilateral patellar luxation or fracture are common symptoms
Osteosclerotic disorder
Surgical repairs often fail, conservative treatments are often recommended

Persistent Deciduous Teeth

Genetic component
Risk of bacterial invasion and plague accumulation
Permanent teeth can be malpositioned due to altered natural positioning
Removal is necessary as there is no resorption process
Removal timeframes vary: incisors - 3 months, canines and molars - 5-7 months

Dentigerous Cyst

Can lead to pathological fracture
Most common in the mandibular 1st PM, followed by the canine tooth
Surgical removal of unerupted teeth and the cyst lining is required
Common in brachycephalic breeds

Feline Alveolar Osteitis

Commonly found over maxillary canine roots in middle-aged cats
Secondary to periodontal inflammation
Differentiation from benign alveolar bone expansion is important (no inflammation in the case of benign expansion)
Thickening or bulging over maxillary canine roots, usually bilateral

Gingival Hyperplasia

Common in Boxer and Great Dane (genetic in Boxers)
Thickening and increase in height of attached gingiva and gingival margin
Pseudopockets often form, increasing pocket depth but not due to attachment loss
Chronic and recurring problem requiring repeated therapy
Gingivectomy and gingivoplasty are common treatments
Caused by chronic inflammatory response to bacteria in plaque, often associated with periodontal disease

Oronasal Fistula

Maxillary canines are the most commonly affected, followed by the palatal root of the maxillary 4th PM
More frequent in dolichocephalic breeds, especially Dachshunds
Advanced periodontitis, trauma, and neoplasia are common causes
Probing is used for diagnosis
Full thickness flap or double reposition flap are common surgical approaches
Bone grafts and ear cartilage may be considered

Temporomandibular Joint Disorder

Retroarticular process helps prevent caudal luxation of the mandible
Most luxations occur rostrodorsal
Common in Basset Hounds
Manual reduction can be attempted
Open-mouth mandible locking requires immediate attention
Surgical excision of the ventral portion of the zygo arch and/or the dorsal portion of the coronoid process may be necessary

Tooth Root Abscess

Maxillary 4th PM, canine, and mandibular 1st M are most commonly affected
"Phoenix abscess" refers to acute worsening of chronic periapical abscess
Can arise without bacteria involvement

Traumatic Dentoalveolar Injury

Includes dental fractures or luxations
Untreated pulpal exposure can lead to pulpitis, necrosis, and periapical pathology

Avulsion

The most important factor for determining treatment outcome is periodontal ligament vitality
Good prognosis if replanted within 30-60 minutes
Place tooth in saline water
Vital pulpotomy is reserved for young patients within 48 hours of injury

Unerupted Teeth

Embedded/Impacted:
- Teeth form naturally but fail to erupt properly
- Increased risk of cyst formation
- Familial delayed eruption is seen in Tibetan and Weather terriers
- Toy breeds have slower eruption times
- Brachycephalic and toy breeds are predisposed to impacted teeth due to crowding
- Embedded teeth are unerupted teeth in bone
- Impacted teeth are partially or unerupted teeth prevented from eruption by a physical barrier
- Most common unerupted teeth: mandibular 1st premolar and 3rd molar

Abnormal Tooth Formation

Supernumerary:
- If causes crowding, extraction is recommended
- Reduced tooth number
- Anodontia: no teeth develop at all
- Hypodontia: failure to develop few teeth
- Oligodontia: failure to develop several teeth
- Radiographs are needed to assess
Germination:
- A single germ may divide, causing a split in the crown (bifid crown)
- Radiographs can confirm, only one root present
- Twinning:
- Two complete teeth form from one tooth bud
- Concresence:
- Tooth germs fuse via cementum alone
- Fusion:
- Tooth germs fuse completely along the entire length of the tooth
- Dens invaginatus/carnassial tooth malformation:
- Tooth invaginates on itself at crown or root level
- Invagination can lead to bacterial entry into the pulp and endodontic complications

Dysautonomia

Failure of autonomic function in multiple organs with minimal motor or sensory involvement
Young adults, rural dogs, are most commonly affected
Common gastrointestinal signs include vomiting, regurgitation, or diarrhea
Other symptoms involve photophobia, third eyelid elevation, dyspnea, urine dribbling, lack of tears and gut sounds, and aspiration pneumonia
Cause is unknown
Pupil involvement is key for diagnosis:
- 0.05% pilocarpine in one eye should produce miosis within 60 minutes, ruling out anticholinergic toxicity
- Atropine may not produce expected heart rate rise, suggesting loss of vagal tone
- Intradermal histamine may produce no response or a wheal but no flare
- Treatment is supportive; guarded prognosis; some cats may be managed supportively and stay well

Coonhound Paralysis

Etiology is unknown, potentially immune-mediated
Inflammation is delayed, developing 7-14 days later
Toxoplasma gondii titres are often positive in affected dogs
May occur following raccoon bites, systemic illness, or vaccination
Idiopathic type: may have a recent respiratory or GI infection; clinical signs identical to coonhound paralysis but without raccoon bite
Peripheral nervous system (PNS) most severely affected, particularly ventral nerve roots; lumbosacral roots most affected
Central nervous system (CNS): nerve 7 often affected, 9 and 10 occasionally
Respiratory failure is a risk
Initial presentation: stiff, stilted gait in all limbs, starting in pelvic limbs and progressing to forelimbs
Rapid progression to flaccid LMN tetraparesis or plegia within 2-4 days
Loss or change of voice is common
Diagnosis: Electromyography (EMG) - fibrillation potentials and positive sharp waves are consistent with denervation. May be normal in the first 4-5 days.
Treatment: Supportive; no specific treatment exists. IV immunoglobulin may be helpful. Prednisone is not effective.
Stabilize once progressive phase subsides; full recovery in 3-6 weeks, some require months

Canine Degenerative Myelopathy (DM)

Progressive adult-onset fatal disease
SOD1 mutation plays a role
Homozygotes are at the highest risk, particularly Bernese Mountain Dogs
Genetic testing is available
Diagnosis:
- Early phase: UMN paraplegia, insidious progression, asymmetric gait ataxia, long stride spastic paraparesis. Key feature - loss of paraspinal hyperesthesia, spinal reflexes are present or increased.
- Later phase: pelvic limb paresis leads to tetraparesis. Muscle mass loss.
- End stage: flaccid tetraparesis; absence of spinal reflexes in all limbs, urinary and fecal incontinence
Treatment: Supportive
Non-ambulatory paraplegia occurs within 9-12 months of onset
Tetraparesis may develop within 3 years (long-term poor prognosis)

Botulism

Preformed neurotoxin type C is found in uncooked carrier and raw food
Interferes with acetylcholine release at the junction
LMN paresis/paralysis starts in pelvic limbs, progressing to quadriplegia
Muscle tone is reduced in all limbs
Normal mentation, sluggish pupillary light reflex, palpebral reflexes, reduced jaw tone, gag reflex, saliva, and dysphonia
Initial stiff short stride gait without ataxia is often seen
Diagnosis: Definitive diagnosis relies on detection of botulinum toxin in serum, feces, vomitus, or ingested food samples. Anti-C botulinum neurotoxin antibodies can be helpful.
Treatment: Recent developments include gastric lavage, enemas. Supportive treatment is crucial. Type C antitoxin may cause anaphylaxis.
Ineffective for bound toxins

Tick Bite Paralysis

Symptoms include hindlimb weakness progressing to stiff forelimb gait and flaccid paralysis.
Rapidly ascending flaccid generalized LMN paralysis is common.
Symptoms include: more severe neurological issues within hours (ascending motor weakness, depressed gag reflex, dysphonia, megaesophagus, vomiting/regurgitation, mydriasis, tachyarrhythmia, pulmonary edema, and respiratory depression).
Diagnosis: tick identification and neurotoxin interference testing. North American tick species can have more pronounced symptoms at higher temperatures.
Treatment: Supportive care, including applying fipronil and using a tick antitoxin hyperimmune serum. Pre-medication with atropine is necessary in severe cases. Death from respiratory paralysis is a risk if untreated within 1-2 days.

Brachial Plexus Avulsion

Complete avulsion involves C5-T2 nerve roots (most common).
Symptoms include: marked weakness due to supraspinatus and infraspinatus muscle atrophy, dropped elbow, and possibly diaphragm hemiplegia.
Diagnosis: Neurological examination, often showing less damage to dorsal sensory nerves; ventral motor nerve roots are more susceptible.
Treatment: Supportive care; protective wrap or boot. Cranial avulsions generally have a better prognosis than complete avulsions.

Spinal Cord Injuries

Caudal Avulsion (C7-T2): Inability to bear weight, knuckling over dorsum of paw, and abnormal limb positions with analgesia distal to elbows.
Treatment: May require amputation due to potential carpal fusion and transposition of the biceps muscle tendon. Supportive care is essential.

SRMA (Acute or Protracted)

Symptoms: Lesions in the CNS, meninges, or genetic factors (e.g., beagles); acute hyperesthesia, cervical rigidity, stiff gait, and fever may be indicative.
Diagnosis: Complete diagnostic assessments, including CSF analysis (pleocytosis) will be needed.
Treatment: Initial therapy includes fluid therapy, ice packs for acute symptoms, and NSAIDs. Long-term treatment may necessitate switching to Prednisone depending on continued pleocytosis results and severity. Adding other immune drugs may also be beneficial or necessary.

Spondylosis Deformans

Description: Degenerative noninflammatory condition of the vertebral column, possibly arising from IVDD degeneration. Osteophyte production along the ventral, lateral, and dorsolateral aspects of vertebral endplates is common.
Prevalence: Most common in the thoracic-lumbar spine areas of anticlinal vertebrae and upper lumbar vertebrae. More common in females, larger breeds (e.g., German Shepherds), and older animals. Brachycephalic breeds like Boxers may also be predisposed. Cats may also display symptoms, though less commonly.
Symptoms: Often asymptomatic, making it an incidental finding in routine exams.
Treatment: No specific treatment. Symptomatic management may include pain control, depending on severity.

Lumbosacral Stenosis and Cauda Equina Syndrome

Description: Narrowing of the LS vertebral canal and L7-sacral intervertebral foramina can compress L7, sacral, or caudal nerves.
Etiology: May be congenital or acquired. Congenital cases are more prevalent in smaller to medium-sized dogs (e.g., Border Collies).
Treatment: Depends on the diagnosis and severity.

Dog's Health Information

Dog's breed: Medium to large German Shepherd, possibly a Border Collie
Symptoms: Lumbosacral pain, pelvic limb lameness; urinary or fecal incontinence (if S1-3 nerve dysfunction); abnormal tail carriage.
Cause: IVDD type 1 and 2, congenital, hypertrophy of the interarcuate ligament
Treatment: Non-surgical: Pain medication (carprofen, gabapentin); Epidural steroid. Surgical (if needed): Dorsal laminectomy; lateral foraminotomy; Fixation-fusion.
Post-Surgical Restrictions: Restrict activity for 6-12 weeks after surgery

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Explore various veterinary conditions, including Pectus Excavatum, Carpal Hyperflexion, and Achilles Tendon Injuries, often seen in specific dog breeds. Learn about diagnosis, treatments, and the implications of these conditions on young dogs. This quiz is tailored for veterinary students and professionals.