1
|
Franco-Gonçalo P, Pereira AI, Loureiro C, Alves-Pimenta S, Filipe V, Gonçalves L, Colaço B, Leite P, McEvoy F, Ginja M. Femoral Neck Thickness Index as an Indicator of Proximal Femur Bone Modeling. Vet Sci 2023; 10:371. [PMID: 37368757 DOI: 10.3390/vetsci10060371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
The alteration in the shape of the femoral neck is an important radiographic sign for scoring canine hip dysplasia (CHD). Previous studies have reported that the femoral neck thickness (FNT) is greater in dogs with hip joint dysplasia, becoming progressively thicker with disease severity. The main objective of this work was to describe a femoral neck thickness index (FNTi) to quantify FNT and to study its association with the degree of CHD using the Fédération Cynologique Internationale (FCI) scheme. A total of 53 dogs (106 hips) were randomly selected for this study. Two examiners performed FNTi estimation to study intra- and inter-examiner reliability and agreement. The paired t-test, the Bland-Altman plots, and the intraclass correlation coefficient showed excellent agreement and reliability between the measurements of the two examiners and the examiners' sessions. All joints were scored in five categories by an experienced examiner according to FCI criteria. The results from examiner 1 were compared between FCI categories. Hips that were assigned an FCI grade of A (n = 19), B (n = 23), C (n = 24), D (n = 24), and E (n = 16) had a mean ± standard deviation FNTi of 0.809 ± 0.024, 0.835 ± 0.044, 0.868 ± 0.022, 0.903 ± 0.033, and 0.923 ± 0.068, respectively (ANOVA, p < 0.05). Therefore, these results show that FNTi is a parameter capable of evaluating proximal femur bone modeling and that it has the potential to enrich conventional CHD scoring criteria if incorporated into a computer-aided diagnosis capable of detecting CHD.
Collapse
Affiliation(s)
- Pedro Franco-Gonçalo
- Department of Veterinary Science, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Ana Inês Pereira
- Department of Veterinary Science, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Animal Science, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Cátia Loureiro
- Department of Engineering, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Sofia Alves-Pimenta
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Animal Science, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Vítor Filipe
- Department of Engineering, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Institute for Systems and Computer Engineering (INESC-TEC), Technology and Science, 4200-465 Porto, Portugal
| | - Lio Gonçalves
- Department of Engineering, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Institute for Systems and Computer Engineering (INESC-TEC), Technology and Science, 4200-465 Porto, Portugal
| | - Bruno Colaço
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Animal Science, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Pedro Leite
- Neadvance Machine Vision SA, 4705-002 Braga, Portugal
| | - Fintan McEvoy
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Copenhagen, Denmark
| | - Mário Ginja
- Department of Veterinary Science, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| |
Collapse
|
2
|
Aghapour M, Bockstahler B, Kneissl S, Vezzoni A, Gumpenberger M, Hechinger H, Tichy A, Vidoni B. Radiographic Diagnosis of Hip Laxity in Rottweilers: Interobserver Agreement at Eight- and Twelve-Months of Age. Animals (Basel) 2023; 13:ani13020231. [PMID: 36670771 PMCID: PMC9855059 DOI: 10.3390/ani13020231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Hip laxity is one of the predisposing factors of canine hip dysplasia. The early diagnosis of hip laxity allows veterinarians to prevent the participation of dysplastic dogs in breeding programs, which could lower the disease's prevalence due to its genetic background. Furthermore, it allows them to plan preventive/therapeutic procedures for mild/near-normal hips to reduce the symptoms of the disease at older ages. A reliable screening program must be repeatable and reproducible, and intra- and inter-observer studies can help us to determine the best methods. In this study, we aimed to evaluate the radiographic parameters used for the early diagnosis of hip dysplasia in Rottweilers at 8 and 12 months of age with five observers to assess the interobserver agreements. According to our findings, there were high interobserver agreements at both ages for the quantitative values, such as the center edge angle (CEA), dorsal acetabular rim slope (DARS), distraction index (DI), and Norberg angle (NA), whereas we recorded from poor to moderate agreements for the qualitative values, such as the grading of the dorsal acetabular rim (GDAR), grading of the degenerative joint disease (GDJD), location of the center of the femoral head (LCFH), and sclerosis of the cranial acetabular rim (SCAR).
Collapse
Affiliation(s)
- Masoud Aghapour
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
- Correspondence:
| | - Barbara Bockstahler
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Sibylle Kneissl
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Aldo Vezzoni
- Clinica Veterinaria Vezzoni S.R.L., 26100 Cremona, Italy
| | - Michaela Gumpenberger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Harald Hechinger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Alexander Tichy
- Platform Bioinformatics and Biostatistics, Department for Biomedical Services, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Britta Vidoni
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| |
Collapse
|
3
|
Alves JC, Santos A, Jorge P, Lavrador C, Miguel Carreira L. The influence of IL-1 and C-reactive protein levels in synovial fluid of companion dogs with bilateral hip osteoarthritis on various clinical disease parameters. Am J Vet Res 2022; 83:1-10. [PMID: 36087306 DOI: 10.2460/ajvr.22.05.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate IL-1 and C-reactive protein (CRP) levels in the synovial fluid in dogs with bilateral hip osteoarthritis and their relation to animals' clinical, radiographic, and thermographic disease signs. SAMPLE 100 joints from police working dogs. PROCEDURES Synovial fluid, IL-1, and CRP levels, weight distribution, joint range of motion, thigh girth, digital thermography, and radiographic signs of the joints were recorded. Data from 4 clinical metrology instruments (CMIs) were collected. Results were compared by age, sex, and Orthopedic Foundation for Animals hip scores with the independent samples t test, ANOVA, and Pearson correlation coefficient (P < .05). RESULTS The sample included 100 pelvic limbs, equally distributed between left and right pelvic limbs 30 males and 20 females, with a mean age of 6.5 ± 2.4 years and body weight of 26.7 ± 5.2 kg. IL-1 levels, particularly above 200 pg/mL, may be related to the development of caudolateral curvilinear osteophyte, which then expresses a toll on the patient's levels of pain and activity. It was unclear if the CRP levels were a consequence of inflammatory activity within the joint or a reflection of a better prognosis. Increasing body weight was related to worse CMI scores. CLINICAL RELEVANCE We described the relation of IL-1 and CRP synovial concentration levels with several clinical signs, diagnostic imaging, laboratory findings, and CMI results of animals with osteoarthritis. Further studies are required to determine the interest of each parameter for the prognosis and treatment monitoring.
Collapse
Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana, Lisbon, Portugal.,Instituto Mediterráneo de Agricultura, Medio Ambiente y Desarrollo, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Évora, Portugal
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana, Lisbon, Portugal
| | - P Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana, Lisbon, Portugal
| | - C Lavrador
- Instituto Mediterráneo de Agricultura, Medio Ambiente y Desarrollo, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Évora, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health, University of Lisbon, Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre, Barreiro, Portugal
| |
Collapse
|
4
|
Ball E, Uhlhorn M, Eksell P, Olsson U, Ohlsson Å, Low M. Repeatability of radiographic assessments for feline hip dysplasia suggest consensus scores in radiology are more uncertain than commonly assumed. Sci Rep 2022; 12:13916. [PMID: 35978034 PMCID: PMC9385612 DOI: 10.1038/s41598-022-18364-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
Variation in the diagnostic interpretation of radiographs is a well-recognised problem in human and veterinary medicine. One common solution is to create a 'consensus' score based on a majority or unanimous decision from multiple observers. While consensus approaches are generally assumed to improve diagnostic repeatability, the extent to which consensus scores are themselves repeatable has rarely been examined. Here we use repeated assessments by three radiologists of 196 hip radiographs from 98 cats within a health-screening programme to examine intra-observer, inter-observer, majority-consensus and unanimous-consensus repeatability scores for feline hip dysplasia. In line with other studies, intra-observer and inter-observer repeatability was moderate (63-71%), and related to the reference assessment and time taken to reach a decision. Consensus scores did show reduced variation between assessments compared to individuals, but consensus repeatability was far from perfect. Only 75% of majority consensus scores were in agreement between assessments, and based on Bayesian multinomial modelling we estimate that unanimous consensus scores can have repeatabilities as low as 83%. These results clearly show that consensus scores in radiology can have large uncertainties, and that future studies in both human and veterinary medicine need to include consensus-uncertainty estimates if we are to properly interpret radiological diagnoses and the extent to which consensus scores improve diagnostic accuracy.
Collapse
Affiliation(s)
- Elisabeth Ball
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Margareta Uhlhorn
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | | | - Åsa Ohlsson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Matthew Low
- Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| |
Collapse
|
5
|
Vidoni B, Aghapour M, Kneissl S, Vezzoni A, Gumpenberger M, Hechinger H, Tichy A, Bockstahler B. Inter-Observer Agreement in Radiographic Diagnosis of Coxofemoral Joint Disease in a Closed Cohort of Four-Month-Old Rottweilers. Animals (Basel) 2022; 12:1269. [PMID: 35625115 PMCID: PMC9137964 DOI: 10.3390/ani12101269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Canine hip dysplasia is a complex and multifactorial disease. The early diagnosis of dysplastic dogs under one year of age helps veterinarians to plan proper preventive/therapeutic methods. Having an accurate screening method increases the chance of the early detection of dysplasia. The goal of our study was to assess the inter-observer reliability of eight radiographic parameters in four-month-old Rottweilers. Radiographs of the 28 Rottweilers were investigated by five experienced observers. The radiographs were taken in ventrodorsal view with extended legs, frog-leg ventrodorsal view, distraction view, and dorsal acetabular rim view. Four quantitative parameters such as Norberg angle (NA), distraction index (DI), dorsal acetabular rim slope (DARS), and center edge angle (CEA) and four qualitative parameters such as sclerosis of the cranial acetabular rim (SCAR), location of the center of the femoral head (LCFH), grading of the degenerative joint disease (GDJD), and grading of the dorsal acetabular rim (GDAR) were evaluated. High inter-observer agreements were recorded for quantitative values, whereas the inter-observer agreement of the qualitative parameters was low. It can be deduced that the evaluated quantitative parameters are reliable, and a combination of these methods with clinical examinations might increase the accuracy of the examinations.
Collapse
Affiliation(s)
- Britta Vidoni
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Masoud Aghapour
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Sibylle Kneissl
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria; (S.K.); (M.G.); (H.H.)
| | - Aldo Vezzoni
- Clinica Veterinaria Vezzoni S.R.L., 26100 Cremona, Italy;
| | - Michaela Gumpenberger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria; (S.K.); (M.G.); (H.H.)
| | - Harald Hechinger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria; (S.K.); (M.G.); (H.H.)
| | - Alexander Tichy
- Platform Bioinformatics and Biostatistics, Department for Biomedical Services, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Barbara Bockstahler
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
| |
Collapse
|
6
|
Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. Effect of a single intra-articular administration of stanozolol in a naturally occurring canine osteoarthritis model: a randomised trial. Sci Rep 2022; 12:5887. [PMID: 35393497 PMCID: PMC8989994 DOI: 10.1038/s41598-022-09934-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/23/2022] [Indexed: 11/21/2022] Open
Abstract
Osteoarthritis (OA) is a disease with a high negative impact on patient’s quality of life and a high financial burden. It is a source of chronic pain and affects all mammals, including humans and dogs. As the dog is a common model for translation research of human OA, and exploring spontaneous dog OA can improve the health and well-being of both humans and dogs. To describe the effect of the intra-articular administration of stanozolol in a naturally occurring canine OA model, forty canine (N = 40) hip joints were randomly assigned to receive stanozolol or saline (control). On treatment day and at 8, 15, 30, 90, and 180 days post-treatment, several evaluations were conducted: weight distribution, joint range of motion, thigh girth, digital thermography, and radiographic signs. Also, synovial fluid C-reactive protein and interleukin-1 levels were evaluated. Results from four Clinical Metrology Instruments was also gathered. Results were compared with Repeated Measures ANOVA, with a Huynh–Feldt correction, paired-samples t-test, or Wilcoxon signed-rank test, with p < 0.05. OA was graded as mild (90%), moderate (5%), and severe (5%), including both sexes. They had a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2 kg. No differences were found between groups at treatment day in all considered evaluations. Weight distribution showed significant improvements with stanozolol from 15 days (p < 0.05) up to 180 days (p < 0.01). Lower values during thermographic evaluation in both views taken and improved joint extension at 90 (p = 0.02) and 180 days (p < 0.01) were observed. Pain and function scores improved up to 180 days. In the control group, radiographic signs progressed, in contrast with stanozolol. The use of stanozolol was safe and produced significant improvements in weight-bearing, pain score, and clinical evaluations in a naturally occurring canine OA model.
Collapse
Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal. .,MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - P Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - C Lavrador
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
| |
Collapse
|
7
|
Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. Comparison of clinical and radiographic signs of hip osteoarthritis in contralateral hip joints of fifty working dogs. PLoS One 2021; 16:e0248767. [PMID: 33735210 PMCID: PMC7971486 DOI: 10.1371/journal.pone.0248767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 03/05/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study aimed to compare the symmetry of clinical and radiographic signs of right and left pelvic limbs of dogs with bilateral hip osteoarthritis (OA) and evaluate the association of physical findings and radiographic abnormalities. PATIENTS AND METHODS One hundred pelvic limbs of police working dogs with bilateral hip OA were evaluated, following a screening program. Weight distribution, joint range of motion at flexion and extension, thigh girth, and radiographic signs were recorded and compared with the results of the contralateral limb and by breed, age, and sex with the Paired Samples T-Test and Pearson correlation coefficient, with p<0.05. RESULTS The sample mean age was 6.5±2.2 years, and the bodyweight of 26.7±5.3kg. No significant differences were observed when comparing weight distribution, joint range of motion, and thigh girth of left and right limbs. Weight distribution and age showed a statistically significant correlation with joint extension. The right limbs showed a significantly higher frequency of circumferential femoral head osteophyte (CFHO) regarding radiographic signs. Limbs with CFHO or caudolateral curvilinear osteophyte had significantly larger joint flexion angle (p = 0.02) and smaller extension angle (p<0.01), respectively, compared to those that did not. Age showed a significant correlation with the presence of several radiographic findings, as did different breeds. CONCLUSION Clinical and radiographic signs occur symmetrically in naturally occurring hip OA in police working dogs. Several correlations were observed between the evaluations performed and differences between breeds, which can be useful in assessing and early diagnosis of hip OA.
Collapse
Affiliation(s)
- J. C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
- MED–Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Évora, Portugal
| | - Ana Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
| | - Patrícia Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
| | - Catarina Lavrador
- MED–Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Évora, Portugal
| | - L. Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal
- Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon, (FMV/ULisboa), Lisbon, Portugal
- Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
| |
Collapse
|
8
|
Alves JCA, Santos AMMPD, Jorge PIF, Lavrador CFTVB, Carreira LMA. Management of Osteoarthritis Using 1 Intra-articular Platelet Concentrate Administration in a Canine Osteoarthritis Model. Am J Sports Med 2021; 49:599-608. [PMID: 33428459 DOI: 10.1177/0363546520981558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteoarthritis (OA) represents a significant burden to societies, as it affects quality of life and performance and implies a large cost in terms of health care. Autologous platelets are a regenerative treatment modality for OA that are thought to be a potential stimulation of the natural healing cascade. PURPOSE To describe the effect of the platelet concentrate V-PET in the management of OA in a naturally occurring canine model, using several outcome assessment modalities. STUDY DESIGN Controlled laboratory study. METHODS A total of 40 joints of active working police dogs with hip OA were randomly assigned to a control group (CG) and a platelet concentrate group (PCG; treatment) and evaluated. At treatment day (T0) and 8, 15, 30, 90, and 180 days after treatment, weight distribution, joint range of motion at flexion and extension, thigh girth, digital thermography, radiographic signs, 4 clinical metrology instruments, and synovial fluid interleukin 1 and C-reactive protein levels were recorded. Results were compared using repeated-measures analysis of variance with a Huynh-Feldt correction, paired-samples t test, or Wilcoxon signed rank test, with P < .05. RESULTS Dogs were 6.5 ± 2.4 years old (mean ± SD) and had a body weight of 26.7 ± 5.2 kg. At T0, 32 (80%) joints were graded as having mild OA, 6 (15%) as moderate, and 2 (5%) as severe. No differences were found between groups at T0. Between the PCG and CG, the symmetry index showed significant improvements in the PCG from 8 days (P = .01) to 180 days (P = .01). Joint flexion also improved in the PCG up to 90 days (P < .05) and extension improved up to 180 days (P < .01). Several clinical metrology instrument scores also improved up to 90 to 180 days after treatment. In the CG, radiographic signs progressed, while the PCG showed some improved signs. In both groups, increasing body weight and age corresponded with worse clinical and laboratory findings. CONCLUSION A single injection of platelet concentrate had a positive effect, lasting up to 6 months, on several clinical, imaging, and laboratory signs in a naturally occurring canine OA model. CLINICAL RELEVANCE We characterized the effects of this platelet concentrate in dogs, considered the gold standard of the study of OA, with a group of working animals with similar high demands as athletes.
Collapse
Affiliation(s)
- João Carlos Agostinho Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana, Lisbon, Portugal.,Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Évora, Portugal
| | | | | | | | - Luis Miguel Alves Carreira
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health, University of Lisbon, Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre, Barreiro, Portugal
| |
Collapse
|
9
|
Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. The intra-articular administration of triamcinolone hexacetonide in the treatment of osteoarthritis. Its effects in a naturally occurring canine osteoarthritis model. PLoS One 2021; 16:e0245553. [PMID: 33471857 PMCID: PMC7816979 DOI: 10.1371/journal.pone.0245553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/03/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate the effect of an intra-articular (IA) administration of triamcinolone hexacetonide, compared with saline. PATIENTS AND METHODS Forty (N = 40) hip joints were randomly assigned to a treatment group (THG, n = 20, receiving IA triamcinolone hexacetonide) and a control group (CG, n = 20, receiving IA saline). On treatment day (T0), and at 8, 15, 30, 90 and 180 days post-treatment, weight distribution, joint range of motion, thigh girth, digital thermography, radiographic signs, synovial fluid interleukin-1 and C-reactive protein levels were evaluated. Data from four Clinical Metrology Instruments was also gathered. Results were compared Repeated Measures ANOVA, with a Huynh-Feldt correction, Paired Samples T-Test or Wilcoxon Signed Ranks Test. A Kaplan-Meier test was performed to compare both groups, with p<0.05. RESULTS Joints were graded as mild (65%), moderate (20%) and severe (15%). Patients of both sexes, with a mean age of 6.5±2.4 years and bodyweight of 26.7±5.2kg, were included. No differences were found between groups at T0. Comparing THG to CG, weight distribution showed significant improvements in THG from 8 (p = 0.05) up to 90 days (p = 0.01). THG showed lower values during thermographic evaluation in the Lt view (p<0.01). Pain and function scores also improved from 30 to 180 days. Increasing body weight, age, and presence of caudolateral curvilinear osteophyte corresponded to worse response to treatment. Results of the Kaplan Meier test showed significant differences between groups, with THG performing better considering several evaluations and scores. CONCLUSION THG recorded significant improvements in weight-bearing and in with the considered CMIs, particularly pain scores. Lower thermographic values were registered in THG up to the last evaluation day. Age, sex, and radiographic findings did significantly influenced response to treatment.
Collapse
Affiliation(s)
- João C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
- MED – Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Évora, Portugal
| | - Ana Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
| | - Patrícia Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
| | - Catarina Lavrador
- MED – Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Évora, Portugal
| | - L. Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal
- Interdisciplinary Centre for Research in Animal Health (CIISA) – University of Lisbon, (FMV/ULisboa), Lisbon, Portugal
- Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
| |
Collapse
|
10
|
Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. Clinical and diagnostic imaging findings in police working dogs referred for hip osteoarthritis. BMC Vet Res 2020; 16:425. [PMID: 33160336 PMCID: PMC7648415 DOI: 10.1186/s12917-020-02647-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
Background Osteoarthritis (OA) is the most commonly diagnosed joint disease in veterinary medicine, with at least 80% of the cases of lameness and joint diseases in companion animals being classified as OA. Sporting and working animals are more predisposed to develop OA since they are exposed to chronic fatigue injuries, leading to bone and muscular tissue damage and failure, resulting in clinical signs. To characterize the clinical signs and diagnostic findings of Police working dogs presenting with bilateral hip OA at the time of diagnosis. Fifty animals were evaluated with a bodyweight ≥ 15 kg, be older than two years, and without any medication or nutritional supplements for ≥ 6 weeks. Results Weight distribution, joint range of motion at flexion and extension, thigh girth, digital thermography, and radiographic signs were collected. Data from different Clinical Metrology Instruments (CMI) were collected: Canine Brief Pain Inventory, Liverpool Osteoarthritis in Dogs, Canine Orthopedic Index, and the Hudson Visual Analogue Scale. Results were compared by breed, age, sex, and Orthopaedic Foundation for Animals hip grades with the Independent Samples T-Test, ANOVA followed by a Bonferroni post hoc test, and Pearson correlation coefficient, with p < 0.05. The sample included 30 males and 20 females, with a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2 kg. Animals with weight distribution below normal levels had significant variations of joint extension and function scores. This evaluation was the only not correlated with at least one breed. Animals with caudolateral curvilinear osteophyte showed a poorer clinical presentation and worse scores in all considered CMIs. Radiographic changes correlated with age and corresponded to worse CMIs scores and weight distribution. Dutch Shepherd Dogs showed better CMI scores than the other considered breeds. Conclusions Police working dogs presented with complaints related to hip OA at an early stage of the disease. Hip scores influenced clinical presentation, with moderate cases showing lower thigh girth and worse pain interference and severity, and function scores than mild cases. Patients with severe OA had lower thermographic evaluations than patients with moderate OA. Age was the primary variable influencing considered CMI scores.
Collapse
Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal. .,MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora , Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - P Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - C Lavrador
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora , Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon, FMV/ULisboa, Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
| |
Collapse
|
11
|
Pulkkinen HSM, Reunanen VLJ, Hyytiäinen HK, Junnila JJT, Laitinen-Vapaavuori OM, Lappalainen AK. The intra- and intertester repeatability of radiographic elbow incongruity grading is high in chondrodystrophic dog breeds. Vet Radiol Ultrasound 2020; 61:329-335. [PMID: 32141167 DOI: 10.1111/vru.12853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/20/2019] [Accepted: 01/08/2020] [Indexed: 11/26/2022] Open
Abstract
Elbow incongruity is a form of elbow dysplasia that causes osteoarthritis, pain, and lameness, and it is common in chondrodystrophic dog breeds. The objective of this retrospective secondary analysis study was to evaluate the intra- and interobserver repeatability of a novel radiographic incongruity grading system for assessing elbow incongruity in three chondrodystrophic dog breeds-the dachshund, Skye Terrier, and Glen of Imaal Terrier. We conducted an observer agreement study that included 220 mediolateral antebrachial radiographs from 110 dogs with the elbow in 90° flexion. The radiographs were independently assessed by three observers at three time points, using a four-stepped grading scale. The proportion of agreement and Kappa coefficient were calculated. Both the intra- and interobserver proportions of agreement were substantial when three grades were required to be identical (.705-.777 and .609, respectively), and almost perfect for two identical grades (.991-1.000 and .991, respectively). Some differences in repeatability between breeds were noted; specifically, the intraobserver repeatability was higher in the dachshund, and the interobserver repeatability was lower in the Glen of Imaal Terrier. Our study showed that the radiographic imaging protocol and incongruity grading system have high repeatability when assessing elbow incongruity in chondrodystrophic dog breeds.
Collapse
Affiliation(s)
- Hanna S M Pulkkinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.,4Pharma Ltd, Helsinki, Finland
| | - Vilma L J Reunanen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.,4Pharma Ltd, Helsinki, Finland
| | - Heli K Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.,4Pharma Ltd, Helsinki, Finland
| | - Jouni J T Junnila
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Outi M Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.,4Pharma Ltd, Helsinki, Finland
| | - Anu K Lappalainen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.,4Pharma Ltd, Helsinki, Finland
| |
Collapse
|
12
|
Gilbert S, Langenbach A, Marcellin-Little DJ, Pease AP, Ru H. Stifle joint osteoarthritis at the time of diagnosis of cranial cruciate ligament injury is higher in Boxers and in dogs weighing more than 35 kilograms. Vet Radiol Ultrasound 2019; 60:280-288. [PMID: 30768744 DOI: 10.1111/vru.12718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 12/08/2018] [Accepted: 12/09/2018] [Indexed: 11/30/2022] Open
Abstract
Osteoarthritis is a ubiquitous disease in dogs. The purpose of this retrospective study was to characterize the severity and distribution of osteoarthritis (OA) within the joint and to identify differences among dog breeds in the severity of OA in the cranial cruciate ligament (CCL)-deficient stifle joint. Radiographs of 240 stifles from 51 Boxers, 66 German Shepherds, 100 Labrador Retrievers, and 23 Siberian Huskies with confirmed CCL rupture were included. Radiographs of the stifle joint were evaluated and OA severity was graded at 33 sites within and around the joint, and patella alta was graded as present or absent for a potential total stifle OA score of 100. Osteophyte size was correlated to OA severity score. Total OA scores were calculated and compared within and between breeds globally as well as at each joint site. Dogs weighing >35 kg had a higher total OA score than those weighing <35 kg. Osteoarthritis scores were highest at the apical patella, proximolateral tibia, and sesamoid bones, corresponding to the proximal, lateral, and caudal aspects of the joint, respectively. No statistically significant differences were found among the mean OA scores of various stifle joint regions. Boxer dogs had a higher total OA score than other breeds. We concluded that dogs have a consistent distribution pattern of OA within the stifle joint after CCL injury. Radiographic OA is more severe in the proximal, lateral, and caudal aspects of the joint. Boxers had more severe OA than the other breeds evaluated in the study.
Collapse
Affiliation(s)
| | | | - Denis J Marcellin-Little
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, 95616
| | - Anthony P Pease
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824
| | - Hongyu Ru
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607
| |
Collapse
|
13
|
Bogaerts E, Van der Vekens E, Verhoeven G, de Rooster H, Van Ryssen B, Samoy Y, Putcuyps I, Van Tilburg J, Devriendt N, Weekers F, Bertal M, Houdellier B, Scheemaeker S, Versteken J, Lamerand M, Feenstra L, Peelman L, Van Nieuwerburgh F, Saunders JH, Broeckx BJG. Intraobserver and interobserver agreement on the radiographical diagnosis of canine cranial cruciate ligament rupture. Vet Rec 2018; 182:484. [DOI: 10.1136/vr.104523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 01/05/2018] [Accepted: 01/12/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Evelien Bogaerts
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Elke Van der Vekens
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Geert Verhoeven
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
- Algemene Dierenkliniek Randstad; Borsbeek Belgium
| | - Hilde de Rooster
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Bernadette Van Ryssen
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Yves Samoy
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | | | | | - Nausikaa Devriendt
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | | | - Mileva Bertal
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Blandine Houdellier
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Stephanie Scheemaeker
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Jeroen Versteken
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Maryline Lamerand
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Laurien Feenstra
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Luc Peelman
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Filip Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences; Ghent University; Ghent Belgium
| | - Jimmy H Saunders
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Bart J G Broeckx
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| |
Collapse
|
14
|
Cunningham DP, Mostafa AA, Gordan-Evans WJ, Boudrieau RJ, Griffon DJ. Factors contributing to the variability of a predictive score for cranial cruciate ligament deficiency in Labrador Retrievers. BMC Vet Res 2017; 13:235. [PMID: 28806971 PMCID: PMC5557256 DOI: 10.1186/s12917-017-1154-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 08/03/2017] [Indexed: 11/10/2022] Open
Abstract
Background We recently reported that a conformation score derived from the tibial plateau angle (TPA) and the femoral anteversion angle (FAA), best discriminates limbs predisposed to, or affected by cranial cruciate ligament disease (CCLD), from those that are at low risk for CCLD. The specificity and sensitivity of this score were high enough to support further investigations toward its use for large-scale screening of dogs by veterinarians. The next step, which is the objective of the current study, is to determine inter-observer variability of that CCLD score in a large population of Labrador Retrievers. A total of 167 Labradors were enrolled in this cross-sectional study. Limbs of normal dogs over 6 years of age with no history of CCLD were considered at low risk for CCLD. Limbs of dogs with CCLD were considered at high risk for CCLD. Tibial plateau and femoral anteversion angles were measured independently by two investigators to calculate a CCLD score for each limb. Kappa statistics were used to determine the extent of agreement between investigators. Pearson’s correlation and intraclass coefficients were calculated to evaluate the correlation between investigators and the relative contribution of each measurement to the variability of the CCLD score. Results The correlation between CCLD scores calculated by investigators was good (correlation coefficient = 0.68 p < 0.0001). However, interobserver agreement with regards to the predicted status of limbs was fair (kappa value = 0.28), with 37% of limbs being assigned divergent classifications. Variations in CCLD scores correlated best with those of TPA, which was the least consistent parameter between investigators. Absolute interobserver differences were two times greater for FAAs (4.19° ± 3.15) than TPAs (2.23° ± 1.91). Conclusions The reproducibility of the CCLD score between investigators is fair, justifying caution when interpreting individual scores. Future studies should focus on improving the reproducibility of TPA and FAA measurements, as strategies to improve the agreement between CCLD scores.
Collapse
Affiliation(s)
- Devin P Cunningham
- Western University of Health Sciences, Pomona, CA, 91766, USA.,, University of Missouri, Columbia, MO, USA
| | - Ayman A Mostafa
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
| | | | - Randy J Boudrieau
- Cumming's School of Veterinary Medicine at Tufts University, Grafton, North, MA, 01536, USA
| | | |
Collapse
|
15
|
Guevara F, Franklin SP. Triple Pelvic Osteotomy and Double Pelvic Osteotomy. Vet Clin North Am Small Anim Pract 2017; 47:865-884. [DOI: 10.1016/j.cvsm.2017.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Abstract
Diagnostic imaging is the principal method used to screen for and diagnose hip dysplasia in the canine patient. Multiple techniques are available, each having advantages, disadvantages, and limitations. Hip-extended radiography is the most used method and is best used as a screening tool and for assessment for osteoarthritis. Distraction radiographic methods such as the PennHip method allow for improved detection of laxity and improved ability to predict future osteoarthritis development. More advanced techniques such as MRI, although expensive and not widely available, may improve patient screening and allow for improved assessment of cartilage health.
Collapse
Affiliation(s)
- J Ryan Butler
- Small Animal Surgery, Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, PO Box 6100, Mississippi State, MS 39762, USA.
| | - Jennifer Gambino
- Diagnostic Imaging, Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, PO Box 6100, Mississippi State, MS 39762, USA
| |
Collapse
|
17
|
Geissbühler U, Drazovic S, Lang J, Howard J. Inter-rater agreement in radiographic canine hip dysplasia evaluation. Vet Rec 2017; 180:357. [DOI: 10.1136/vr.104053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2016] [Indexed: 11/04/2022]
Affiliation(s)
- U. Geissbühler
- Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - S. Drazovic
- Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - J. Lang
- Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - J. Howard
- Diagnostic Clinical Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty; University of Bern; Bern Switzerland
| |
Collapse
|