Musculoskeletal Ultrasound Course
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Introduction to Musculoskeletal Ultrasound
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16 CE Credits
Total Cost: $7,750 (Normally $11,050)
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Additional Modules: $1,250 Each
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Medial Shoulder Syndrome, Why is it Becoming so Common?
In the Clean Run Learning Center
Earn 3 RACE-Approved CE Credits
Why is Medial Shoulder Syndrome (MSS) becoming so common, and how do you prevent it?
For a long time, MSS has been the most common forelimb orthopedic condition seen in agility dogs; however, over the past few years, the global incidence is rising at a startling rate. Why? In this webinar, Dr. Canapp digs deep into the cause of the injury, diagnostics, treatment options, prevention techniques, and maintenance (including supplements, home modalities, shoulder exercises, conditioning activities, etc.).
Dr. Canapp also shares the results of the landmark MSS study, Return to Agility Following MSS, 2006-2019. This data includes what owners were noticing as it related to performance problems. Did dogs that were spayed/neutered have a higher incidence of injury? What were the most common running surfaces where the injury occurred? Which therapies worked and which failed? Were the dogs able to return to agility after treatment and at what level? And much, much more!
Whether you train and compete in agility or other performance dog sports, or you are a veterinarian or rehab specialist that works with agility dogs, you need to tune in. It’s all about education, awareness, early identification, and prevention.
Iliopsoas Strains Webinar Plus in the Clean Run Learning Center
Earn 1 RACE-Approved CE Credit
Iliopsoas strains are generally regarded to be an overuse injury. While any of us can injure our iliopsoas, sprinters, gymnasts, athletes who perform repeated hip flexion movements, and athletes who engage in plyometric jumping exercises (short-term, high-energy exercises) are at a much higher risk for the condition, due to the nature of their activities.
Our canine athletes are also required to sprint as well as perform high-energy jumping and other repetitive activities. So, it's easy to understand why hip flexor strains are identified so often in performance dogs.
Whether you train and compete in performance dog sports, or you are a veterinarian or rehab specialist that works with performance dogs, you need to tune in. It’s all about education, awareness, early identification, and prevention.
Cranial Cruciate Injury, A Global Approach to Treatment
Earn 2 RACE-Approved CE Credit
In this webinar, we take a deep dive into all aspects of CCL injuries in dogs. We will cover everything from the performance-related signs being noted in training, competition, or playing in the yard; physical exam findings; anatomy; basic to advanced diagnostic techniques; novel treatment options; cause of injury; post-injury rehab techniques and maintenance (including supplements, home exercises, etc.).
Nutraceuticals, Supplementation for Agility/Sporting/Working Dogs - On-Demand Webinar
Earn 1 RACE-Approved CE Credit
This webinar is a summary of the what, why, and when for canine supplements that Dr. Debra Canapp has personally researched and chosen to be worthy of her money, time, and expectations to meet the high standard she has set to be a "Canapp Approved Product" for her dogs.
Ultrasonographic Findings in 41 Dogs Treated with Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for a Supraspinatus Tendinopathy: A Retrospective Study
Overall, treatment of an ST with BMAC-PRP was associated with a decrease in individual tendon CSA over time, and a return of the affected tendon CSA to that of the contralateral limb, where an unaffected contralateral tendon was available for evaluation. An evaluation of fiber pattern and echogenicity revealed an improvement in most cases. Resolution of architectural changes was rarely achieved, however, the follow-up period was short, and resolution of sonographic abnormalities may not be a realistic goal in a setting of chronic tendinopathy. Additional, prospective, controlled, studies are required to evaluate the clinical and functional benefits of BMAC-PRP, however, it appears to be a potentially viable treatment alternative for ADPC-PRP in dogs with an ST.
Average Tibial Plateau Angle of 3,922 Stifles Undergoing Surgical Stabilization for Cranial Cruciate Ligament Rupture
Our reported preoperative TPA in a large sample of dogs is higher than what has been previously published. In reviewing 3,922 stifles, the average preoperative TPA was 29°. We report the average preoperative TPA in specific breeds and report that neutered dogs have a significantly higher TPA than intact dogs. This updated information may guide clinicians in management decisions regarding treatment for CrCL rupture.
Evaluation of Achilles Tendon Injuries with Findings from Diagnostic Musculoskeletal Ultrasound in Canines – 43 Cases
CONCLUSION: Diagnostic musculoskeletal ultrasound was used to identify lesions of Achilles tendon consistent with different grade of strain, as well as identifying the specific region of injury. Diagnostic ultrasound findings were correlated to the surgical findings and previous literature.
Sensitivity and Specificity of a Weight Distribution Platform for the Detection of Objective Lameness and Orthopaedic Disease
The WDP provided the highest combined sensitivity and specificity at cut-off point 2 below the normal value for the detection of both OL and OD.
Scintigraphic evaluation of dogs with acute synovitis after treatment with glucosamine hydrochloride and chondroitin sulfate.
Analysis of results of this study suggest that prior treatment with GlAm-CS for 21 days had a protective effect against chemically induced synovitis and associated bone remodeling. Prior treatment with GlAm-CS also reduced lameness in dogs with induced synovitis.
Quantitative Comparison of the Walk and Trot of Border Collies and Labrador Retrievers, Breeds with Different Performance Requirements
RESULTS: The mean T/P TPI% for Border Collies at a walk and at a trot were significantly lower than for Labrador Retrievers (p = 0.0007 and p = 0.0003). Border Collies had a significantly lower ST% than Labrador Retrievers for the thoracic limbs and pelvic limbs at a walk (p = 0.0058 and 0.0003) and the trot (p = 0.0280 and 0.0448). There was no relationship between ST% and TSrL in Border Collies and an inverse correlation between ST% and TSrL in Labrador Retrievers (p = 0.0002).
Fortetropin inhibits disuse muscle atrophy in dogs after tibial plateau leveling osteotomy
Dogs receiving Fortetropin® had a similar increase in stance force on the affected limb, no
significant increase in serum myostatin levels, and no significant reduction in thigh circumference at the end of the period of forced exercise restriction compared to the placebo.
These findings support the feeding of Fortetropin® to prevent disuse muscle atrophy in
canine patients undergoing a tibial plateau leveling osteotomy.
Adhesive Capsulitis in Eight Dogs: Diagnosis and Management
Adhesive capsulitis is an uncommon cause of chronic forelimb lameness. Further investigation is needed to describe the etiology and pathogenesis of adhesive capsulitis in dogs to evaluate the effectiveness of both non-surgical and surgical treatment modalities, establish treatment protocols, and evaluate short- and long-term clinical outcome of patients.
Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013)
RESULTS: All grades of MSI were represented. Implants were placed successfully in all dogs. Complications (4 major and 2 minor) were recorded for 6 of 39 (15%) dogs; all were treated successfully. Function at the time of last follow-up (6 to 68 months) was deemed full in 30 of 39 (77%) dogs and acceptable in 9 (23%).
Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study
The use of BMAC–PRP and ADPC–PRP shows promise for the treatment of early partial CCL tears in dogs. Further studies are needed and should be randomized, blinded, and controlled.
Retrospective Study on External Canine Limb Prosthesis used in 24 patients
External prosthetics may help improve quality of life and should be considered as an alternative to euthanasia where full amputation or alternative methods of limb spare are not an option.
Canine Platelet-Rich Plasma Systems: A Prospective Analysis
RESULTS: Platelet concentration was significantly increased for System 1 (p=0.0088) and System 3 (p<0.0001), and was significantly decreased for System 2 (p<0.0001). All five systems significantly decreased the red blood cell concentration (p<0.0001 for each system comparison). Neutrophil concentration was significantly decreased for System 2, System 3, and System 4 (p<0.0001 for each system comparison). Neutrophil concentration was significantly increased for System 5 (p=0.0089).
The Use of Adipose-Derived Progenitor Cells and Platelet-Rich Plasma Combination for the Treatment of Supraspinatus Tendinopathy in 55 Dogs: A Retrospective Study
These findings suggest that ADPC-PRP therapy should be considered for dogs with ST.
Supraspinatus Tendinopahty in 327 Dogs: A Retrospective Study
These findings suggest concurrent shoulder and/or elbow pathology is not uncommon in dogs with ST. Further, ST often fails to respond to NSAID therapy and rehabilitation therapy.
Rate of return to agility competition for dogs with cranial cruciate ligament tears treated with tibial plateau leveling osteotomy
RESULTS: 20 of 31 (65%) dogs returned to agility competition after TPLO, 16 (80%) of which returned within 9 months after TPLO. The mean convalescent period for returning dogs was 7.5 months (range, 3 to 12 months). No dog that returned to competition sustained an injury to the affected limb during
the follow-up period. No significant difference was identified between dogs that returned or did not return to agility competition regarding severity of osteoarthritis or proportions with meniscal injury or partial (vs complete) CrCL tears.
Traumatic fracture of the medial coronoid process in 24 dogs
RESULTS: Twenty-four dogs were included in this study. All dogs in this study were free of radiographic evidence of medial coronoid pathology. All dogs were diagnosed with a single, large, displaced or non-displaced fracture of the medial coronoid process, with no other joint pathology. Dogs generally had an excellent short-term outcome following arthroscopic treatment.
Evaluation of Iliopsoas Strain with Findings from Diagnostic Musculoskeletal Ultrasound in Agility Performance Canines - 73 Cases
Diagnostic musculoskeletal ultrasound was used to identify lesions of the iliopsoas tendon consistent with acute and chronic injury, as well as identifying the region of pathology. The majority of agility performance dogs had low grade acute strains based on the tiered system, with mixed acute and chronic lesions being noted frequently.
Rehabilitation Therapy for Elbow Disorders in Dogs
SUMMARY: Thoracic limb lameness caused by elbow pathology occurs commonly in dogs. The etiopathogenesis and surgical management for elbow disorders are well documented; however, recommendations and protocols for rehabilitation therapy after surgical intervention are not well described.
Rehabilitation after elbow injury or elbow surgery follows a sequential and progressive multiphased approach with the ultimate goal being to return the dog to its previous functional level as quickly and safely as possible. Several key principles must be addressed when rehabilitating the elbow: (1) the effects of immobilization must be minimized, (2) healing tissue must not be overstressed (3) the dog must fulfill certain criteria throughout the phases of rehabilitation, (4) the program must be based on current scientific and clinical research, (5) the
process must be adaptable to each dog and their specific goals, and (6) the rehabilitation program must be a team effort between the surgeon, rehabilitation therapists, owner, and dog. Communication between each team member is essential to successful outcomes.
Disorders of the Canine Thoracic Limb
This chapter focuses primarily on the most common shoulder conditions in sporting, working, and companion dogs (supraspinatus tendinopathy, medial shoulder syndrome, biceps tendinopathy, and osteochondrosis dissecans).
Evaluation and Rehabilitation Options for Orthopedic Disorders of the Forelimb
Rehabilitation assessment of orthopedic conditions of forelimb involves capturing subjective data including history of present condition, client's goals for their animal, thorough medical history, and objective data including posture, gait, functional activities, strength, palpation, passive range of motion (PROM), muscle flexibility, joint play, and special tests.
Xerostomia, Xerophthalmia, and Plasmacytic Infiltrates of the Salivary Glands (Sjögren's-like syndrome) in a Cat
A 2.5 year old spayed female domestic shorthair cat was referred to the University of Missouri-Columbia Veterinary Medical Teaching Hospital for evaluation of dysphagia and weight loss of 4 weeks duration. The owner described that the cat had become a sloppy eater during the preceding 2 months. According to the owner, the cat would allow pieces of food to fall from its mouth and was having difficulty chewing and swallowing. The cat was allowed indoors and outdoors.
Reocurring Scruff VAS Latissimus Muscle Flap Surgery
A latissimus dorsi muscle flap was used to reconstruct a proximal scapular defect in a cat after excision of a fibrosarcoma that had recurred after eight surgeries, radiation therapy, and chemotherapy.
Regenerative Medicine in the Canine: A Translational Model
A number of animal models have been used to explore the various potential applications of regenerative medicine procedures. One of the most seemingly applicable and robust models is that of dog.
A Vasectomy Technique for Egyptian Fruit Bats (Rousettus Aegyptiacus)
Bats in captivity reproduce well and contraceptive techniques are needed. In initial attempts at vasectomy using a prescrotal approach, it was difficult to identify the mesoductus deferens. The technique described here uses a scrotal approach with exteriorization of the testis, followed by identification and ligation of the mesoductus deferens. Nine Egyptian fruit bats (Rousettus aegyptiacus) underwent vasectomy for this study. No postoperative complications were seen (n = 18 testes), but some of the testes (5/18, 27%), which previously moved freely from the scrotum to the abdominal cavity, were still adhered to the scrotal sac 14 mo postoperatively. This technique appears safe, is fast, and is relatively easy to perform.
The Canine Stifle
Cranial cruciate ligament (CCL) injury is a leading cause of lameness in dogs. Recent advances in diagnostic visualization and surgical treatments for CCL injury have stimulated an increased emphasis on early clinical recognition and an early return to function.
Conservative Treatment Options for Partial and Complete CCL Tears in Dogs
Cranial cruciate ligament (CCL) insufficiency is the most common cause of hind limb lameness in dogs. In 2003 alone, dog owners in the U.S. spent $1.32 billion for the treatment of CCL injuries in their pets. As an important stabilizer of the stifle joint, the CCL’s three main functions are to prevent hyperextension of the stifle, internal rotation of the tibia, and most importantly to prevent tibial thrust in relation to the femur.
External Fracture Fixation
External skeletal fixation (ESF) is a versatile method of fracture repair that can provide both primary and ancillary support.1 ESF consists of multiple percutaneous transcortical pins placed proximal and distal to the fracture, osteotomy, or joint, which are incorporated in a surrounding external frame.
Rest, Relief and Recovery: The Science
Behind Therapeutic Dog Bed Technology
From padded blankets to memory foam, what your pet sleeps on can dramatically improve or impede their joint health. What truly makes a pet bed orthopedic? To first understand this question, let’s review why your pet can benefit from an orthopedic bed.
Canine Elbow Dysplasia
In this article, we will focus on the presentation, diagnosis, and treatment of chronic elbow dysplasia. Chronic elbow dysplasia is defined as progressive degenerative joint disease as a result of one or more of the contributing disease processes. This may occur with the primary disease(s) untreated or treated with incomplete healing (incomplete or absence of fibrocartilage formation) or with further fragmentation of the articular cartilage or after secondary degenerative changes were already established at the time of treatment
Kartagener’s Syndrome in a Dachshund Dog
Kartagener’s syndrome (KS) is a rare, congenital condition characterized by situs inversus, rhinosinusitis, and bronchiectasis. An underlying ciliary dysfunction (e.g., immotility or dyskinetic beating) produces most of the clinical signs seen in affected animals. This case report reviews the history, clinical signs, and diagnosis of KS in a male, long-haired dachshund. This is the first known report of KS, and thus primary ciliary dyskinesia, in this breed of dog.
Laser Therapy in Veterinary Regenerative Medicine
Laser therapy, or photobiomodulation therapy (PBMT) as it is becoming increasingly known, has been used in the treatment of sports injuries in humans for decades (Ohshiro et al., 1986). Its value and importance in conditioning and exercise have also been prominent in human literature for the last ten years.
Make sure you train your dog to build up his muscle strength, endurance, and ligament strength before asking him to compete. You also should condition your dog to be symmetrical, training him to turn one way as strongly and as frequently as the other.
Clinical Efficacy of Platelet Rich Plasma for the Treatment of Elbow Osteoarthritis in Twenty Dogs
Fourteen dogs had bilateral elbow osteoarthritis, three dogs had left elbow osteoarthritis, and three dogs had right elbow osteoarthritis. Mean elbow flexion at Day 0 and 90 were 50.3° and 43.9°, respectively, in the PRP treatment group, and 48.4° and 46°, respectively, in the control group. Mean TPI% at a walk at Day 0 and 90 were 28.8% and 29.6%, respectively, in the PRP treatment group, and 28.6% and 29.4%, respectively, in the control group. Statistical analysis results are pending.
Jump Down Syndrome
“Jump down syndrome” or traumatic fragmented medial coronoid process is a condition in the elbow joint of dogs that appears to occur commonly in performance dogs. Unlike the classic condition of fragmented medial coronoid process (FMCP) affecting the elbow joints of skeletally immature large to giant breed dogs, jump down syndrome (JDS) appears to have no age or size limitations.
17 Complications Associated with Rehabilitation Modalities
Pain is an unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder. Inflammation is defined as a localized, protective reaction of tissue to irritation, injury, or infection characterized by pain, redness, swelling...
Disorders of the Canine Forelimb: Veterinary Diagnosis and Treatment
Shoulder conditions are common causes of forelimb lameness in dogs, particularly performance dogs. The authors have found subscapularis tendinopathy, supraspinatus tendinopathy, biceps tendinopathy, and infraspinatus myopathy to be the most frequently diagnosed conditions, respectively. The etiologies of these conditions are not fully understood but appear to be related to repetitive strain injuries. Rest and nonsteroidal anti‐inflammatory drugs (NSAIDs) are typically prescribed at initial presentation but are largely ineffective, resulting in continued or recurring lameness.
Stem Cell Therapy in Bone Repair and Regeneration
Stem cells of various origins, particularly endothelial progenitor cells (EPCs), have potential to enhance bone repair and regeneration. EPCs are resident in the bone marrow and home to ischemic sites to initiate vasculogenesis. Although it was previously believed that only local endothelial cells arrive at ischemic sites, new evidence suggests that EPCs are recruited from the periphery. This finding has a considerable array of therapeutic implications.
Getting Consistent Outcomes with Laser Therapy Just Got Easier
Technological advances continue to make treatment of many conditions in veterinary medicine more effective and efficient, and laser therapy is no exception.
A Response to: Traumatic Fracture of the Medial Coronoid Process in 24 dogs
The objective as stated in the manuscript was to describe the traumatic fracture of the medial coronoid process in dogs as a clinically distinct disease unrelated to congenital elbow dysplasia. It was neither the objective nor the goal of this retrospective study to describe any outcome measures or prognosis. Respectively, we do disagree that having longer follow-up would have provided any additional information in this particular study.
Can Synovial Fluid Viscocity Be Used as a Physical Marker for Osteoarthritis Severity?
The objective of this project is to test these hypotheses using data from two separate studies, one in dogs and one in humans. The canine study was initiated to evaluate whether intravenous injections of hyaluronic acid in dogs with acute and chronic cranial cruciate ligament rupture are beneficial. It is well known that dogs that rupture the cranial cruciate ligament are predisposed to developing OA (pondnuki model) . The human study was initiated to determine whether glucosamine and chondroitin sulfate was effective in improving rheological and clinical symptoms in subjects with severe OA.
The Stryker Regenkit PRP Kit Does Not Concentrate Canine Platelets
The objective of this study was to evaluate the cellular composition of the final plasma product using the Stryker RegenKit system in dogs. A peripheral blood sample was obtained from ten healthy adult dogs and compared to the final plasma product.
The Canine Shoulder: Selected Disorders and Their Management with Physical Therapy
The shoulder joint is the most mobile of all main limb joints. While its primary motion is in a sagittal plane, the shoulder has a significant amount of abduction and adduction, and internal and external rotation. Its stability is ensured by the joint capsule, by its specialized bands (medial and lateral glenohumeral ligaments), and by large tendons located inside (eg, tendon of origin of the biceps brachii muscle) or immediately outside the joint (eg, supraspinatus, infraspinatus, teres minor, and subscapularis).
Fluoroscopic-guided Shoulder Arthroscopy in a Yellow-headed Snapping Turtle (Elseya irwini) with Focal Degenerative Joint Disease
The yellow-headed snapping turtle, Elseya irwini, is an Australian freshwater species that is very rare in captivity. A routine radiographic examination of a captive female showed a moderate loss of bone across the left glenohumeral joint. No clinical signs had been observed. Results of computed tomography showed pathologic changes in both the proximal humerus and glenoid; no other joints were affected.
These modalities are discussed in detail covering mechanism of action, parameters, settings, and indications/contraindications of use in our small animals. Although these modalities are important in the physical rehabilitation of small animals, they need to be incorporated with a proper diagnosis, manual therapy, and home exercise program into a specific and individualized patient treatment protocol.
Hip Toggle Stabilization Using the TightRope® System in 17 Dogs: Technique and Long‐Term Outcome
To describe the technique for, and long‐term clinical outcome of, a modified hip toggle stabilization using the TightRope® system for coxofemoral luxation repair.
Effects of Low‐Intensity Pulsed Ultrasound on Radiographic Healing of Tibial Plateau leveling Osteotomies in Dogs: A Prospective, Randomized, Double‐Blinded Study
To determine the influence of low‐intensity pulsed ultrasound (LIPUS) on radiographic healing and limb function after uncomplicated, stable osteotomies in dogs.
Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study
To evaluate outcomes in 36 dogs with a partial cranial cruciate ligament (CCL) tear treated with autologous bone marrow aspirate concentrate (BMAC) or adipose-derived progenitor cells (ADPC) with platelet-rich plasma (PRP) combination.
The Effect of Topical Tripeptide‐Copper Complex on Healing of Ischemic Open Wounds
A significant decrease in wound area was seen in the TCC group, but not the vehicle group, when compared with the control group on days 3 to 5, 6 to 9, and 11 to 13 and when TCC was compared with TCC vehicle on days 3 and 9. On day 13, initial wound area had decreased by 64.5% in the TCC group, 45.6% in the vehicle group, and 28.2% in the control group. On days 6, 10, and 13, TCC‐treated wounds contained significantly lower concentrations of TNF‐α and MMP‐2 and MMP‐9 than control wounds.
Validation and Characterization of Platelet-Rich Plasma in the Feline: A Prospective Analysis
A prospective study was performed from January 2019 to April 2019. 11 adult, healthy cats were used to prospectively analyze a commercially available PRP system1. A whole blood sample and a PRP sample that was processed immediately following blood draw according to the manufacturer's protocol were collected from each cat. The mean whole blood and PRP product platelet, RBC, WBC, neutrophil, monocyte, and lymphocyte concentrations were determined. The mean PRP product values were compared to the mean whole blood baseline values using a paired t-test with significance established at p = 0.05.
Clinical outcomes associated with the initial use of the Canine Unicompartmental Elbow (CUE) Arthroplasty System®
We evaluated mid- to long-term outcomes with respect to function and complications in dogs undergoing canine unicompartmental elbow (CUE) arthroplasty for treatment of medial compartment disease of the elbow.