Introduction
Definitions
Epidemiology - Surgical Site Infection Incidence
SSI Definitions
Common Pathogens Recovered from Canine Surgical Site Infections
Challenges and Risks
Compliance as a Risk Factor
Tibial Plateau Leveling Osteotomy
Bacterial Biofilms
Biofilm Lifecycle
Diagnosis
Treatment
Novel Therapies
Prevention
Evidence-Based and Preventive Measures with High Efficacy
Antimicrobial Prophylaxis
Postponing elective surgeries in case of remote infection or systemic disease
Active and postdischarge surveillance programs
Low Evidence-Based but Commonly Accepted Measures for Prevention of Surgical Site Infections\
Promising Avenues in Prevention and Future Research
SUMMARY: MULTIMODAL INTERVENTIONS 5 CONVERTING THEORY INTO PRACTICE
Since 1999, when the author first described the research and potential applications of minimally invasive gastrointestinal surgery in animals, veterinarians have begun to apply some of these techniques in treating client owned animals. Minimally invasive surgery is advocated with diagnostic, prophylactic, and therapeutic intent. There has been a transition from a minimally invasive caseload toward the expansion of diagnostic procedures, adoption of prophylactic procedures (such as lap-assisted gastropexy), and performing more difficult therapeutic procedures. Small animal patients benefit from reduced tissue trauma and experience a rapid recovery. In this article, current research and minimally invasive gastrointestinal procedures in animals are discussed.
Article Outline
Chapter Outline
Musculoskeletal Development
Orthopedic Examination
Congenital Musculoskeletal Diseases
Acquired Musculoskeletal Diseases
Traumatic Injuries (Fractures)
Limb Deformities with Primary Skeletal Abnormalities
Nutritional Diseases
Developmental Orthopedic Bone Diseases
Miscellaneous
Inflammatory Arthropathies
Noninflammatory Arthropathies
Shoulder
Elbow
Hip
Stifle
Tarsus
Acquired Musculotendinous Diseases
Suggested Readings
Article Outline
Preoperative Considerations
Intraoperative Considerations
Postoperative Considerations
Parathyroid Surgery
Preoperative Considerations - Chronic kidney disease, Adenoma versus hyperplasia, Pretreatment with calcitriol (prevent hypocalcemia), Pretreatment with bisphosphonate (prevent “hungry bone syndrome”)
Urolithiasis and Urinary Tract Infections
Postoperative Considerations - Persistent or recurrent hypercalcemia; Management of hypocalcemia: acute and subacute / chronic
Adrenal Surgery
Adrenal-dependent hyperadrenocorticism
Pheochromocytoma
Preoperative Considerations
Arrhythmias and Hypertension
Risks of Surgery - Hemorrhage; Caval invasion (tumor, thrombi); Thromboembolism
Postoperative Considerations - Thromboembolism; Hypoadrenocorticism
Summary
References
Most surgical conditions of the feline stifle joint are caused by ligament injuries. Rupture of the cranial cruciate ligament is the most commonly encountered surgical condition of the stifle joint. Stifle joint disruption or luxation is also common, and is seen more frequently in cats than in dogs. Isolated ruptures of the caudal cruciate ligament and the medial collateral ligament occur rarely.
Other differential diagnoses to be considered in a cat with a stifle joint problem include articular fractures, patellar luxation, patellar fractures, meniscal calcification, degenerative joint disease, osteochondrosis, and patellar tendon injury. Degenerative joint disease is mostly found in older cats, and may be secondary to cranial cruciate ligament tears or other injuries. Patellar fractures can occur spontaneously and cause an acute lameness. Diagnosis and treatment of the most frequent stifle joint disorders are described in the following sections.
The field of feline rehabilitation has been slow to take hold due to the perceived idea that the cat will not cooperate with the physical therapy modalities or perform therapeutic exercises. However, physical rehabilitation is a very effective modality in cats, provided that feline behavior and personality are taken into account. Specific orthopedic conditions that benefit from physical therapy include postoperative fracture repair, postoperative joint repair, and osteoarthritis management.
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