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KWANANOCHA I, AKARAPHUTIPORN E, UPARIPUTTI R, LEKCHAREONSUK C, WANGDEE C. Short-term outcomes of cranial cruciate ligament rupture treated surgically with tibial plateau leveling osteotomy or non-surgically in small-breed dogs weighing less than10 kg. J Vet Med Sci 2024; 86:428-435. [PMID: 38417876 PMCID: PMC11061578 DOI: 10.1292/jvms.23-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/12/2024] [Indexed: 03/01/2024] Open
Abstract
Cranial cruciate ligament rupture (CCLR) is a common cause of stifle joint pain in dogs. This study assessed the short-term outcomes in the management of CCLR, with or without concurrent medial patellar luxation (MPL), in small-breed dogs, comparing surgical intervention using tibial plateau leveling osteotomy (TPLO) with non-surgical approaches. Dogs weighing less than 10 kg and suffering from CCLR were divided into two groups: surgical and non-surgical (nine stifles per group). Both groups followed the same rehabilitation protocol. Measurements were taken on days 0, 14, 28, 42, 56, 70, and 84. These measurements included the mean difference in orthopedic assessment score (diffOAS) and thigh muscle circumference (TMC) assessed by veterinarians, as well as the Canine Brief Pain Inventory score (CBPI) evaluated by the owners. Six stifles had concurrent MPL in the surgical group and five in the non-surgical group. No significant differences were observed in diffOAS (P=0.685), TMC (P=0.557), CBPI pain severity score (P=0.062), and CBPI pain interference score (P=0.29) between the two groups. However, both groups showed a significant decrease (P<0.05) in diffOAS and CBPI. The TMC remained relatively stable in the non-surgical group (P>0.05), but it significantly increased in the surgical group (P<0.05). Both groups demonstrated improved clinical outcomes in the short term, with no significant differences. However, cautious consideration should be given to a conservative treatment in small-breed dogs, particularly when considering the exclusive improvement observed in TMC within the TPLO group.
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Affiliation(s)
- Irin KWANANOCHA
- Research and Academic Service, Faculty of Veterinary
Medicine, Kasetsart University, Bangkok, Thailand
| | - Ekkapol AKARAPHUTIPORN
- Department of Veterinary Surgery, Faculty of Veterinary
Science, Chulalongkorn University, Bangkok, Thailand
| | - Rutaitip UPARIPUTTI
- Rehabilitation Unit, Small Animal Teaching Hospital,
Chulalongkorn University, Bangkok, Thailand
| | - Chalermpol LEKCHAREONSUK
- Department of Companion Animals Clinical Sciences, Faculty
of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Chalika WANGDEE
- Department of Veterinary Surgery, Faculty of Veterinary
Science, Chulalongkorn University, Bangkok, Thailand
- Veterinary Clinical Stem Cells and Bioengineering Research
Unit, Chulalongkorn University, Bangkok, Thailand
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Shimada M, Huang C, Yamakawa S, Fujie H, Murakami S, Kanno N, Hara Y. Biomechanical effects of cranial closing wedge osteotomy on joint stability in normal canine stifles: an ex vivo study. BMC Vet Res 2024; 20:72. [PMID: 38402170 PMCID: PMC10893735 DOI: 10.1186/s12917-024-03923-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/08/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Cranial closing wedge osteotomy (CCWO) is a functional stabilisation technique for cranial cruciate ligament (CrCL) ruptures. This biomechanical study aimed to evaluate the influence of CCWO on the stability of the stifle joint. Eighteen Beagle stifle joints were divided into two groups: control and CCWO. The stifle joints were analyzed using a six-degree-of-freedom robotic joint biomechanical testing system. The joints were subjected to 30 N in the craniocaudal (CrCd) drawer and proximal compression tests and 1 Nm in the internal-external (IE) rotation test. Each test was performed with an extension position, 135°, and 120° of joint angle. RESULTS The stifle joints were tested while the CrCLs were intact and then transected. In the drawer test, the CCWO procedure, CrCL transection, and stifle joint flexion increased CrCd displacement. The CCWO procedure and CrCL transection showed an interaction effect. In the compression test, the CCWO procedure decreased and CrCL transection and stifle joint flexion increased displacement. In the IE rotation test, CCWO, CrCL transection, and stifle joint flexion increased the range of motion. CONCLUSIONS CCWO was expected to provide stability against compressive force but does not contribute to stability in the drawer or rotational tests. In the CCWO-treated stifle joint, instability during the drawer test worsened with CrCL transection. In other words, performing the CCWO procedure when the CrCL function is present is desirable for stabilizing the stifle joint.
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Affiliation(s)
- Masakazu Shimada
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino, Tokyo, 180-8602, Japan.
| | - Chenxu Huang
- The Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, Minamiosawa, Hachioji- shi, Tokyo, Japan
| | - Satoshi Yamakawa
- The Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, Minamiosawa, Hachioji- shi, Tokyo, Japan
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Hiromichi Fujie
- The Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, Minamiosawa, Hachioji- shi, Tokyo, Japan
| | - Sawako Murakami
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino, Tokyo, 180-8602, Japan
| | - Nobuo Kanno
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino, Tokyo, 180-8602, Japan
| | - Yasushi Hara
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino, Tokyo, 180-8602, Japan
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Giansetto TE, Pierrot E, Picavet PP, Lefebvre M, Rives A, Farnir F, Claeys S, Balligand M. Patellar Proximo-Distal Displacement following Modified Maquet Technique Is Not Predictive of Patellar Luxation. Vet Comp Orthop Traumatol 2023; 36:63-67. [PMID: 36588290 DOI: 10.1055/s-0042-1757590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to test the low sensitivity of the Allberg and Miles index to the stifle opening angle, evaluate the displacement of the patella after a Modified Maquet Technique using this index and assess the incidence of patellar luxation post-Modified Maquet Technique in dogs. STUDY DESIGN Medical records were reviewed from 2012 to 2017. Allberg Miles index were determined for each stifle pre- and postoperatively, as well as the stifle joint opening of each case. Occurrence of patellar luxation was recorded. RESULTS 137 stifles on 116 dogs were reviewed. The stifle opening angle did not influence the Allberg Miles index. Pre- and postoperative index showed a distal displacement of the patella after a Modified Maquet Procedure, especially at 135° of stifle opening angle. Only 1/137 cases demonstrated patellar luxation after the surgery. CONCLUSION Based on our statistical analysis, we were able to conclude that within the maximum stifle opening angle range recorded in our series of cases; the Allberg Miles index variation was not significant. While patellar baja is clearly induced by the Modified Maquet Technique, the latter did not seem to predispose patients to post-operative patellar luxation in our study population.
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Affiliation(s)
- Thomas Elie Giansetto
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Emilie Pierrot
- Department of Diagnostic Imaging, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Pierre P Picavet
- Department of Veterinary Management of Animal Ressources, Biostatistics, Université de Liège Clinique Vétérinaire des Anomaix de Compagnie, Liege, Belgium
| | - Michael Lefebvre
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Albane Rives
- Department of Veterinary Management of Animal Ressources, Biostatistics, Université de Liège Clinique Vétérinaire des Anomaix de Compagnie, Liege, Belgium
| | - Frédéric Farnir
- Department of Veterinary Management of Animal Ressources, Biostatistics, Université de Liège Clinique Vétérinaire des Anomaix de Compagnie, Liege, Belgium
| | - Stéphanie Claeys
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Marc Balligand
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
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Mazdarani P, Miles JE. Ideal Anchor Points for Patellar Anti-rotational Sutures for Management of Medial Patellar Luxation in Dogs: A Radiographic Survey. Vet Comp Orthop Traumatol 2023; 36:68-74. [PMID: 36588291 DOI: 10.1055/s-0042-1757592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to identify the ideal anchor point for patellar anti-rotational sutures for adjunctive stabilization of medial patellar luxation in both small and large breed dogs. STUDY DESIGN Retrospective radiographic survey was performed on 110 stifles from 101 dogs. Radiographs were grouped based on patient weight (≤15 kg; >15 kg) and diagnosis (medial patellar luxation, cranial cruciate ligament rupture, and normal joints). Radiographic measurements included: the proximal, middle, and distal points of the trochlear ridge, the caudal aspect of Blumensaat's line (roof of the intercondylar notch), the centre of the lateral fabella, as well as the "best-fit" centre of a circle overlying the trochlea. These landmark coordinates were used to calculate radii for comparison, and for scaling between joints. RESULTS Use of the fabellar centre resulted in larger radii (corrected p <0.001) than those from the best-fit circle centre for all but one combination of patient group and trochlear end point locations. Using the best-fit circle centre, radius variation was less marked than with the fabellar centre. Significant differences in location for centres of the best-fit circle and fabella were seen across all patient categories (Pillai's trace p <0.001). CONCLUSION The fabella is unlikely to be the best choice for anchoring a patellar anti-rotational suture. Use of the best-fit circle centre to place a suture anchor should be preferred to maximise suture isometry during joint flexion and extension in large and small breed dogs.
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Affiliation(s)
- Parisa Mazdarani
- College of Veterinary Medicine, University of Florida, Gainesville, Florida, United States
| | - James Edward Miles
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg C, Denmark
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Pegram C, Brodbelt DC, Diaz-Ordaz K, Chang Y, von Hekkel AF, Church DB, O'Neill DG. Risk factors for unilateral cranial cruciate ligament rupture diagnosis and for clinical management in dogs under primary veterinary care in the UK. Vet J 2023; 292:105952. [PMID: 36708945 DOI: 10.1016/j.tvjl.2023.105952] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
This study aimed to evaluate demographic risk factors associated with unilateral cranial cruciate ligament (CCL) rupture diagnosis and to explore demographic and clinical risk factors associated with management of unilateral CCL rupture in dogs under primary veterinary care in the UK. A retrospective cohort study design was used. Clinical records were automatically searched and manually verified for incident cases of unilateral CCL rupture during 2019 and additional clinical management information extracted. Multivariable logistic regression modelling was used to evaluate associations between risk factors and: (1) CCL rupture diagnosis; and (2) clinical management (surgical or non-surgical). The analysis included 1000 unilateral CCL rupture cases and a random selection of 500,000 non-cases. After accounting for confounding factors, dogs aged 6 to < 9 years, male neutered and female neutered dogs, insured dogs, and Rottweiler, Bichon Frise, and West Highland White terrier breeds, in particular, had increased odds of unilateral CCL rupture diagnosis. Insured dogs and dogs ≥ 20 kg had increased odds of surgical management, while dogs ≥ 9 years and dogs with one non-orthopaedic comorbidity at diagnosis with CCL rupture had reduced odds. These findings inform identification of at-risk dogs, with Rottweilers and Bichon Frise particularly predisposed. Additionally, they contribute to a greater understanding of the clinical rationales used in primary-care veterinary practices to decide between surgical or non-surgical management of unilateral CCL rupture.
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Affiliation(s)
- C Pegram
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.
| | - D C Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK
| | - K Diaz-Ordaz
- Department of Statistical Science, University College London, Gower Street, London WC1E 6BT, UK
| | - Y Chang
- Comparative Biomedical Sciences, The Royal Veterinary College, Hatfield Herts AL9 7TA, UK
| | - A Frykfors von Hekkel
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK
| | - D B Church
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK
| | - D G O'Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK
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Etiopathogenesis of Canine Cruciate Ligament Disease: A Scoping Review. Animals (Basel) 2023; 13:ani13020187. [PMID: 36670727 PMCID: PMC9855089 DOI: 10.3390/ani13020187] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
The spontaneous rupture of the cranial cruciate ligament in dogs remains a pathoetiologic puzzle. Despite much progress in research over the past years, the systemic and local mechanisms leading to ligament degeneration and structural failure remain largely obscure. This scoping review focuses on pathogenesis and aims at summarizing and interpreting today's knowledge on causes of canine cruciate ligament rupture, i.e., the multifactorial mechanisms leading to degenerative stifle joint disease with collagen matrix degeneration and structural failures. Thus, the initial view of traumatic ligament rupture, fostered by "wear and tear", has clearly been replaced by a new concept of systemic processes linked to progressive degenerative joint disease and ligament failure; thus, the term "cranial cruciate ligament disease" has been coined and is generally accepted. In addition, cruciate ligament rupture in people shares some similarities with the lesion in dogs; therefore, the review also includes comparative studies. The methods used were based on the PRISMA-ScR model (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews).
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Villatoro AS, Langenbach A, Yoon J, Garcia TC, Marcellin‐Little DJ. Stifle joint osteoarthritis in small‐breed and medium‐breed dogs is more severe after cranial cruciate ligament injury than medial patellar luxation. Vet Radiol Ultrasound 2022. [DOI: 10.1111/vru.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
| | | | - Jin Yoon
- Veterinary Surgical Centers Vienna Virginia USA
| | - Tanya C. Garcia
- J. D. Wheat Orthopedic Research Laboratory School of Veterinary Medicine University of California, Davis Davis California USA
| | - Denis J. Marcellin‐Little
- J. D. Wheat Orthopedic Research Laboratory School of Veterinary Medicine University of California, Davis Davis California USA
- Veterinary Department of Surgical and Radiological Sciences School of Veterinary Medicine University of California, Davis Davis California USA
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Determination of the Stifle Angle at Standing Position in Dogs. Vet Sci 2022; 9:vetsci9110644. [PMID: 36423095 PMCID: PMC9697634 DOI: 10.3390/vetsci9110644] [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: 10/12/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary The cranial cruciate ligament rupture is one of the most common orthopaedic diseases encountered in dogs. Surgical techniques have been developed to stabilize the stifle, with an overall accepted benefit of tibial osteotomies, among which is the tibial tuberosity advancement. Prior to surgery, the required tibial tuberosity advancement must be determined on a strict lateral radiographical view of the affected stifle with femur and tibia at an angle of 135° as initially recommended. We sought to determine if this particular stifle angle around mid-stance phase was similar among multiple dog breeds. A mean value of stifle angle of 145° was obtained. Mean stifle angle at mid-stance phase in a healthy dog is regularly higher than 135° and is likely breed and individual dependent. The pre-operative measurement of the required advancement made on stifles in 145° extension, a value close to full physiological extension, could contribute to decreasing the incidence of late post-operative meniscal lesion, consecutive to the underestimation of the tibial tuberosity advancement. Abstract Background: The cranial cruciate ligament rupture is one of the most common orthopaedic diseases encountered in dogs. Surgical techniques have been developed to stabilize the stifle, with an overall accepted benefit of tibial osteotomies among which is the tibial tuberosity advancement (TTA). Prior to surgery, the required TTA must be determined on a strict lateral radiographical view of the affected stifle with femur and tibia at an angle of 135° as initially recommended. This value, initially determined in only two dog breeds, has been considered the mean standard value of the canine stifle angle during the mid-stance phase. Methods: We sought to determine if this particular stifle angle around mid-stance phase was similar among multiple dog breeds. We built up a custom-made radiographic system for stifle angle measurement in standing dogs. Results: A mean value of stifle angle of 145° was obtained. Mean stifle angle at mid-stance phase in a healthy dog is regularly higher than 135° and is likely breed and individual dependent. Conclusions: The pre-operative measurement of the required TTA made on stifles in 145° extension, a value close to full physiological extension could contribute to decreasing the incidence of late post-operative meniscal lesion, consecutive to underestimation of TTA.
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Griffeuille E, Ronot P, Fragano B, Gibert S, Dunié‐Mérigot A. Extracapsular stabilization for the treatment of cranial cruciate ligament rupture in a ferret. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Pierre Ronot
- Exotics Department CHV Languedocia Montpellier France
| | | | - Sophie Gibert
- Surgical Department CHV Languedocia Montpellier France
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Tabar MD, Tabar J, Naranjo C, Altet L, Roura X. Detection of vector-borne pathogens in owned dogs with cranial cruciate ligament rupture living in the Mediterranean area. Parasit Vectors 2022; 15:105. [PMID: 35534857 PMCID: PMC9088045 DOI: 10.1186/s13071-022-05205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background Cranial cruciate ligament rupture (CCLR) results from a multifactorial degenerative process that leads to rupture of the ligament. Vector-borne pathogens (VBP) in dogs can induce joint disease but their role in CCLR has not been previously investigated. The aim of the present work is to evaluate the prevalence of VBP in dogs with CCLR. Methods This was a prospective study that included 46 dogs presented for CCLR surgical treatment and 16 control dogs euthanized for diseases unrelated to the joints. Specimens collected included blood, synovial fluid, and synovial membrane biopsy. Pathogen testing consisted of serology for Leishmania infantum (quantitative ELISA), Ehrlichia canis/ewingii, Borrelia burgdorferi, Anaplasma phagocytophilum/platys, and Dirofilaria immitis (4DX IDEXX test), and PCR for L. infantum, Ehrlichia/Anaplasma spp., Bartonella spp., piroplasms (Babesia spp. and Theileria spp.), and filariae (D. immitis, Dirofilaria repens, Acanthocheilonema dracunculoides, Acanthocheilonema reconditum, and Cercopithifilaria spp.) on both EDTA-whole blood (EB) and synovial fluid (SF) samples. SF cytology and histopathological evaluation of synovial membrane were also performed. Results The prevalence of VBP was 19.6% in the CCLR group and 18.8% in the control group, with no statistical difference among them. The presence of synovitis was not more frequent in CCLR dogs (45.6%) than in control dogs (43.7%). Lymphoplasmacytic infiltration was the most common inflammatory pattern detected in the joints of both groups of dogs. Conclusions This study failed to demonstrate a role of canine VBP in CCLR or the presence or different pattern of joint inflammation in pathogen-positive dogs. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05205-x.
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Affiliation(s)
- María-Dolores Tabar
- Hospital Veterinario San Vicente Vetsum, Calle del Veterinario Manuel Isidro Rodríguez García Nº17, San Vicente del Raspeig, 03690, Alicante, Spain
| | - Javier Tabar
- Hospital Veterinario San Vicente Vetsum, Calle del Veterinario Manuel Isidro Rodríguez García Nº17, San Vicente del Raspeig, 03690, Alicante, Spain
| | | | - Laura Altet
- Vetgenomics, Parc de Recerca Universitat Autònoma de Barcelona, Edifici Eureka, 08193, Bellaterra, Spain
| | - Xavier Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Carrer de l´Hospital s/n, 08193, Bellaterra, Spain.
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