A 7-year-old neutered female Golden Retriever was referred to the Veterinary Teaching Hospital of the University of Teramo with a diagnosis of cranial cruciate ligament rupture on the right hindlimb. The dog underwent a TPLO procedure and was discharged the day after surgery with standard recommendations. Five days after surgery acute onset lameness developed with severe swelling around the right stifle joint. At re-examination the dog was bright, alert and responsive. Radiographs did not show complications relatable to the implant. Ultrasonographic assessment revealed diffuse subcutaneous edema. Fine needle aspirate of the swelling yielded only blood. Bacteriological culture was negative. The haematologic profile was within the normal limits. A Robert Jones bandage was applied, and anti-inflammatory drugs and antibiotics were given. Two days later, evidence of profuse blood effusion was observed during the bandage change, as well as pallor with a HCT of 18%. Coagulation profile was still within normal limits. Repeated cytology from the stifle swelling yielded now abundant red blood cells suggestive of an hematoma from a local hemorrhage. During immediate revision surgery under blood transfusion the cranial tibial artery (CTA) was found ruptured and was ligated. Bacteriological culture yielded now Escherichia Coli. Three days after the revision surgery, the wound dehiscence occurred with the TPLO-plate exposed. The dog underwent two different surgeries to treat the infection. The culture swab confirmed Escherichia Coli. 5 days after the last surgery a new wound dehiscence was observed. The patient was treated with local medication and administration of Amikacin at dose of 20 mg/kg SID for 20 days in order to achieve second intention healing. Urine and hematologic assessments were performed every 7 days to check renal function. One month thereafter the wound had healed and the osteotomy gap was closing. There was no lameness and implants were left in place.
Life-threatening cranial tibial artery hemorrhage developing five days after tibial plateau levelling osteotomy in a dog
Collivignarelli F;
2023-01-01
Abstract
A 7-year-old neutered female Golden Retriever was referred to the Veterinary Teaching Hospital of the University of Teramo with a diagnosis of cranial cruciate ligament rupture on the right hindlimb. The dog underwent a TPLO procedure and was discharged the day after surgery with standard recommendations. Five days after surgery acute onset lameness developed with severe swelling around the right stifle joint. At re-examination the dog was bright, alert and responsive. Radiographs did not show complications relatable to the implant. Ultrasonographic assessment revealed diffuse subcutaneous edema. Fine needle aspirate of the swelling yielded only blood. Bacteriological culture was negative. The haematologic profile was within the normal limits. A Robert Jones bandage was applied, and anti-inflammatory drugs and antibiotics were given. Two days later, evidence of profuse blood effusion was observed during the bandage change, as well as pallor with a HCT of 18%. Coagulation profile was still within normal limits. Repeated cytology from the stifle swelling yielded now abundant red blood cells suggestive of an hematoma from a local hemorrhage. During immediate revision surgery under blood transfusion the cranial tibial artery (CTA) was found ruptured and was ligated. Bacteriological culture yielded now Escherichia Coli. Three days after the revision surgery, the wound dehiscence occurred with the TPLO-plate exposed. The dog underwent two different surgeries to treat the infection. The culture swab confirmed Escherichia Coli. 5 days after the last surgery a new wound dehiscence was observed. The patient was treated with local medication and administration of Amikacin at dose of 20 mg/kg SID for 20 days in order to achieve second intention healing. Urine and hematologic assessments were performed every 7 days to check renal function. One month thereafter the wound had healed and the osteotomy gap was closing. There was no lameness and implants were left in place.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
