Relationship between Tibial conformation, cage size and advancement achieved in TTA procedure

Previous studies have suggested that there is a theoretical discrepancy between the cage size and the resultant tibial tuberosity advancement, with the cage size consistently providing less tibial tuberosity advancement than predicted. The purpose of this study was to test and quantify this in clinical cases. The hypothesis was that the advancement of the tibial tuberosity as measured by the widening of the proximal tibia at the tibial tuberosity level after a standard TTA, will be less than the cage sized used, with no particular cage size providing a relative smaller or higher under-advancement, and that the conformation of the proximal tibia will have an influence on the amount of advancement achieved

Metronidazole-induced encephalopathy in a patient with infectious colitis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Encephalopathy is a rare disease caused by adverse effects of antibiotic drugs such as metronidazole. The incidence of metronidazole-induced encephalopathy is unknown, although several previous studies have addressed metronidazole neurotoxicity. Here, we report the case of a patient with reversible cerebellar dysfunction on magnetic resonance imaging, induced by prolonged administration of metronidazole for the treatment of infectious colitis.</p> <p>Case presentation</p> <p>A 71-year-old Asian man, admitted to our hospital with hematochezia, underwent Hartmann's operation for the treatment of colorectal cancer three years ago. He was diagnosed with an infectious colitis by colonoscopy. After taking metronidazole, he showed drowsiness and slow response to verbal commands. Brain magnetic resonance imaging showed obvious bilateral symmetric hyperintensities within his dentate nucleus, tectal region of the cerebellum, and splenium of corpus callosum in T2-weighted images and fluid attenuated inversion recovery images. Our patient's clinical presentation and magnetic resonance images were thought to be most consistent with metronidazole toxicity. Therefore, we discontinued metronidazole, and his cerebellar syndrome resolved. Follow-up magnetic resonance imaging examinations showed complete resolution of previously noted signal changes.</p> <p>Conclusion</p> <p>Metronidazole may produce neurologic side effects such as cerebellar syndrome, and encephalopathy in rare cases. We show that metronidazole-induced encephalopathy can be reversed after cessation of the drug. Consequently, careful consideration should be given to patients presenting with complaints of neurologic disorder after the initiation of metronidazole therapy.</p

Polycythemia vera in a cat and management with hydroxyurea

Polycythemia vera (PV) was diagnosed in a four-year-old domestic shorthair evaluated for hind-limb ataxia, extension of all claws, and difficulty in jumping to elevated surfaces. Mild cardiac hypertrophy also was diagnosed. Initial laboratory evaluation revealed polycythemia (packed cell volume [PCV], 75%) and normal serum total protein (7.5 g/dl). Definitive diagnosis of PV was reached by excluding causes of relative and secondary absolute polycythemia using radiography, ultrasonography, and blood gases, and by measuring serum erythropoietin concentration by radioimmunoassay (13 mU/ml) and an enzyme-linked immunosorbent assay (ELISA) method (8.0 mU/ml). Bone-marrow biopsy revealed relative erythroid hyperplasia characteristic of myeloproliferative disease. Clinical signs were controlled with hydroxyurea (12.2 mg/kg body weight) and occasional phlebotomy. Polycythemia vera is an uncommon feline disease, and clinical reports on the use of hydroxyurea to manage the condition in the cat are lacking.</jats:p

Metronidazole neurotoxicosis in two cats

Two cats were presented for neurological dysfunction from suspected metronidazole toxicity. One cat was receiving 111 mg/kg body weight per day of metronidazole for 9 weeks. After 9 weeks, the dose was increased to 222 mg/kg body weight per day, and 2 days later the cat began to experience progressive neurological signs that culminated in generalized seizures. The second cat was receiving metronidazole at a total dose of 58 mg/kg body weight per day for 6 months. This cat experienced acute onset of ataxia and alteration in mentation. Laboratory evaluations in both cases were without significant findings. The neurological signs in both cats resolved within days of initiating supportive therapy and withdrawal of the drug. This report describes the two cases and discusses the etiology of metronidazole neurotoxicosis.</jats:p

Intra- and interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs

Measurement of the tibial plateau slope from lateral hind-limb radiographs is a preoperative requirement when performing tibial plateau leveling osteotomy (TPLO) for repair of the cruciate-deficient stifle in dogs. Two measurements of the tibial plateau slope in 312 stifles of 156 dogs were taken from lateral radiographs by each of three observers with varying degrees of experience in the measurement method. Intraobserver variability was +/-3.4 degrees, and interobserver variability was +/-4.8 degrees. No significant differences were identified for the intraobserver measurements; however, in evaluating interobserver variability, a significant difference was found between the inexperienced observer and the two experienced observers.</jats:p