We have created a quick educational video that reviews arthrocentesis of the elbow joint, which is a really useful tool that can be easily performed to rule out inflammatory joint disease (such as septic arthritis or immune-mediated joint disease) in dogs 🐕
We might perform this in dogs that present with pain and effusion of multiple joints to rule out immune-mediated polyarthritis; or in dogs where we are suspicious of septic arthritis - for example post-operatively, or with a sudden worsening of lameness in chronic arthritis cases 🔬💉
While the elbow can seem like a more daunting joint on which to perform arthrocentesis; if you know the landmarks it is actually pretty straightforward!
We hope this video helps you confidently perform your next elbow arthrocentesis 💪
We have created a quick educational video that reviews arthrocentesis of the stifle joint with analysis of cytology in clinic, which is a really useful tool that can be easily performed to rule out inflammatory joint disease (such as septic arthritis or immune mediated joint disease) in dogs 🐕
We might perform this in dogs that present with bilateral stifle effusions as part of a work up for cranial cruciate ligament disease to rule out immune mediated polyarthritis; or in dogs where we are suspicious of septic arthritis - for example post-operatively, or with a sudden worsening of lameness in chronic arthritis cases 🔬💉
Enjoy!
One of the most common things we see at AOW is cruciate disease! Here are some tips and tricks for positioning stifle xrays 🐾
🦴 Centre the x-ray on the stifle.
🦴 Extend the collimation to include the hock.
🦴 For the mediolateral view, elevate a calibration ball off the plate/table to the level of the center of the patella.
🦴 Remember your L/R marker.
🦴 For the caudocranial view position the calibration ball, again to the level of the center of the patella, which may be resting on the plate/table or elevated if you are using positioning aids.
* We use the calibration ball to increase accuracy for surgical planning. This is particularly important for dogs weighing under 25kgs, but ideally used for all patients.
For dogs over 25kgs, if you don't have a calibration ball you can use a standard L/R marker (with the ruler markings) positioned fully within the collimation, placed at the level of the plate/table.
AOW applies an evidence-based multimodal analgesia protocol to provide comfortable home-care after orthopaedic surgery.
Here is what we send home with our post-surgical patients:
NSAID consistent with the preoperative dosing regime.
Paracetamol 20-30mg/kg orally q8h
Gabapentin 20-30mg/kg orally q8h
Amantadine 3-5mg/kg orally BID
Rescue Analgesia - Buprenorphine 0.05mg/kg oral transmuscosal, formulated into CMC gel (see our previous video on how to make it up).
Rescue Anxiolysis - Trazodone 3-7mg/kg orally, with dose determined on an individual patient basis considering temperament and ASA level.
**The above is modified in feline patients (see link)
see link for the protocols we use!https://www.aowellington.com/_files/ugd/5ef700_bc7bc35c8b9243c89f68004a99ea172d.pdf
Bup Gel
Everyone comes to AOW for the drugs!!! 😉
Absorption of opiates via the oral transmucosal (OTM) route in dogs has historically been recognised to be poor. Administration of buprenorphine into the cheek pouch, when formulated into a CMC gel**, appears to have more reliable absorption.
The original paper described the formulation by mixing 0.5G of CMC powder with 17 mL of buprenorphine 0.3mg/mL injectable solution to get a desirable consistency. Adding 0.3G CMC to 10mL of buprenorphine is an equivalent ratio and we've found this is practical in-clinic.
See the link for the paper
Link https://pubmed.ncbi.nlm.nih.gov/20960411/
** CMC powder bought from Spotlight!
