Page 12 - Clinical Connections - Spring 2017.indd

RVC RESEARCH STUDY VETERINARYSERVICES RVC.AC.UK
Research News
n FELINE HYPERTENSION Rosanne Jepson, Lecturer in Small Animal Internal Medicine, is part of an international group of veterinary experts that produced consensus guidelines on the diagnosis and management of feline hypertension1.
The International Society of Feline Medicine guidelines focus on the practical aspects of measurement of blood pressure,
diagnosis of hypertension and best practice for treatment of cats where systemic hypertension is identified.
Although hypertension is a well-recognised condition in cats,
it is likely to be significantly underdiagnosed.The clinical consequences of hypertension can be severe, due to target organ damage (TOD) affecting the eyes, heart, brain and kidneys, and some damage may be irreversible.
Approximately 50% of cats diagnosed with systemic hypertension will have ocular lesions, including retinal haemorrhage, hyphaema and retinal detachment. Unfortunately, the latter may result in blindness that is irreversible particularly if anti-hypertensive therapy is not implemented quickly.
Unless marked TOD is detected, the presence of hypertension is unlikely to be apparent without blood pressure monitoring.
Therefore, more widespread routine BP monitoring would likely enable an earlier diagnosis of hypertension and facilitate the prompt provision of effective therapy to prevent TOD and reduce the morbidity associated with hypertension.
Monitoring blood pressure in cats over nine years old is of importance, as this is the demographic most at risk of conditions which have been associated with hypertension, such as chronic kidney disease and hyperthyroidism. Measuring blood pressure is a simple and well tolerated procedure in most cats and can be integrated into routine consultations.
Taylor S S, Sparkes A H, Briscoe K, Carter J, Sala S C, Jepson R E, Reynolds B S, Scansen B A (2017) ISFM Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats. Journal of Feline Medicine and Surgery, Mar;19(3): 288-303
n TRAUMA TRAJECTORY
Research into tarsocrural instability by three RVC surgeons was published in Veterinary and Comparative Orthopaedics and Traumatology2.
Richard Meeson, Lecturer in Orthopaedic Surgery, veterinary specialist-in-training Lee Beever, and deputy head of Small Animal Orthopaedics Elvin Kulendra reviewed records of dogs treated between 2007 and 2014. Surgical techniques, complications and long-term outcomes were assessed.
A total of 24 dogs (and 26 joints) were included in the study. All injuries were traumatic and all joints had associated fractures. Eight joints had internal fracture fixation and transarticular external skeletal fixator, six had external fixator alone, four had prosthetic ligaments with external fixator, and four had prosthetic ligaments with external coaptation.Two joints had pantarsal arthrodesis and two had primary ligament repair.
This study has been able to recommend best practice of avoidance of prosthetic ligaments due to infection risk, and suggests that primary repair and temporary immobilisation with an external skeletal fixator is the preferable technique. Despite the severe and complex nature of the injury, a repair was deemed preferable to arthrodesis or amputation, and owner satisfaction of the final outcome was high.
Beever L J, Kulendra E R, Meeson R L (2016) Short and long-term outcome following surgical stabilization of tarsocrural instability in dogs.Veterinary and Comparative Orthopaedics andTraumatology, 29(2): 142-8
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12 Spring 2017
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