Pelvic Limb Research Articles

Arthroscopic Long Digital Extensor Tenodesis: Technique and Outcome in a Dog

AbstractAvulsion of the long digital extensor (LDE) tendon is an uncommon cause of pelvic limb lameness in the dog. Surgical exploration is recommended with reattachment of the tendon and the avulsed fragment of bone using a small screw in lag fashion. In more chronic cases, the bone fragment can be removed, and the tendon attached by suture or staple to the proximolateral tibia. Arthroscopic tenodesis of the LDE has not been previously reported in the literature. A 6-year-old male neutered Labrador Retriever was presented for evaluation of a left pelvic limb lameness that was localized to the stifle. Avulsion of the LDE tendon was diagnosed based on palpation and radiographs. Arthroscopic assessment of the joint was performed. The origin of the LDE was freed with the use of a mechanical 3.0-mm shaver and an arthroscopic punch. The freed end was then exteriorized from the lateral portal and mineralized tissue removed. The tendon end was captured using no. 2 braided suture loop using a SpeedWhip technique. A 4.75-mm SwiveLock® polyetheretherketone anchor was utilized to fasten the tendon in the proximal groove of the LDE. The dog returned to dock diving by 16 weeks postsurgery at the preinjury level of performance and remained free of lameness at 30 months postoperatively. Arthroscopic long digital tendon tenodesis is a feasible surgical option in canine patients.

Uso da imuno-histoquímica e genotipagem do gene da proteína priônica para detecção de Scrapie em ovinos no estado de Santa Catarina, Brasil

ABSTRACT: Scrapie is a contagious disease of sheep and goats caused by prions (PrPSc). This study described an outbreak of Scrapie in sheep in the state of Santa Catarina, Brazil. An 1-year and 3-month-old sheep developed clinical signs characterized by motor incoordination of the pelvic limbs, pruritus and alopecia for three days. The 38 sheep from the flock that were over 1 year of age underwent biopsies of the third eyelid and rectal mucosa, in addition to anti-PrPsc immunohistochemistry (IHC). Blood containing EDTA was collected for PRNP gene genotyping from these sheep. Of the 38, 16 (42.10%) had immunostaining againstPrPSc. IHC-positive animals were euthanized and necropsied, as well as lambs from positive mothers. Different organs of the 19 necropsied animals were collected in 10% buffered formalin for histopathological examination and anti-PrPSc IHC of the obex. The histopathology of the obex of the female with neurological signs presented discrete multifocal vacuolization of the cytoplasm of neurons and neuropil. The anti-PrPSc IHC showed that two out of the 19 obex samples had cytoplasmic immunostaining in neurons. The genotypes reported were ARQ/ARQ in 47.36%, ARR/ARQ in 36.84%, ARQ/VRQ in 10.52% and ARQ/VRR in 5.28%. The genotyping helps to identify susceptible animals and select animals more resistant to the development of Scrapie. The anti-PrPSc IHC from lymphoid biopsies, and genotyping demonstrated the high number of positive sheep classified in susceptible group.

Cauda equina syndrome in cattle: A clinical case study and analysis

Cauda equina syndrome is a rare phenomenon characterized by a partial or complete paralysis of the spinal nerves of the cauda equina and the organs innervated by them. The cauda equina and the lumbosacral plexus are responsible for innervating most of the muscles of the pelvic limb, pelvic floor, and sphincters. The etiology of this condition can be diverse, often related to injury leading to the narrowing of the spinal canal and compressive paralysis. This case study describes a cow diagnosed with cauda equina syndrome. The animal showed difficulties in standing and moving. Due to the deteriorating condition of the animal, a decision was made to cull it. The description of the case evaluated during veterinary visits was based on clinical, zoometric, and BCS assessments, cleanliness index, necropsy examinations, and laboratory blood analyses. The blood tests included several components, which varied depending on the day of the visit: ALT (15-18.9 U/l), AST (77.3-86.7 U/l), CK (124-270 U/l), and cortisol (10.4-14.5 ng/mL).

Acidente ofídico em equinos no Bioma Amazônico, Pará, Brasil

ABSTRACT: Bothrops atrox is the most common viper in the Amazon, and its venom causes local and systemic changes. This report describes the clinicopathological and laboratory findings of ophidism due to Bothrops in six horses in Pará, Brazil. The animals, which belonged to five different rural properties, showed clinical signs of apathy, anorexia, and increased touch sensitivity in areas of increased volume. Three animals were bitten in the distal part of the pelvic limbs and three in the head area. The affected animals in the distal limb area exhibited marked edema extending from the fetlock to the thigh and had difficulty moving. Those affected in the head region exhibited an increase in volume that gave the appearance of a “rhinoceros head,” as well as blackening of the mucosa of the lips and gums. All animals exhibited tachycardia and tachypnea, and laboratory findings of two animals showed anemia, leukocytosis, increased clotting time, and elevated liver (AST and GGT) and kidney enzymes (urea and creatinine). Treatment was ineffective, and three of four treated animals died. Necropsy was performed on three animals, revealing extensive hemorrhage in the tissues at the snake bite sites and incoagulable bloody fluid in the cavities. Congestion was observed in the diaphragm, in the serosa of the small intestine, and in lighter areas on the renal surface. Histopathology showed muscle degeneration, necrosis, acute tubular necrosis, hemorrhage, and hyaline casts in the kidneys. This case report highlights the clinicopathological findings of snakebite in horses. In addition, this seems to be the first report of bothropic envenom in a mule in Brazil.

Aneurisma biventricular em um cão

ABSTRACT: An aneurysm is defined as a localized dilation of a blood vessel or heart. It may have either a congenital or an acquired origin and occurs in both humans and animals. Cardiac aneurysms are rare, and are characterized by sacculations of the cardiac wall. The present case report describes the macroscopic and microscopic findings of an aneurysm affecting both ventricles of the heart in a dog. A 7-year-old mixed-breed female dog with osteosarcoma on the left pelvic limb was euthanized and submitted to the veterinary pathology laboratory for necropsy. Macroscopically, besides the lesions in the link, the pericardial sac was adhered to the pericardial surface of the heart and there were two sacculations in both ventricles which communicated widely with the respective ventricle. Microscopically, fibrous tissue adhered to the pericardium, atrophy and necrosis of the cardiomyocytes with replacement by adipocytes were observed in addition to hyperplasia of the tunica media of arterioles and thrombosis. A diagnosis of acquired biventricular cardiac aneurysm was made based on the necropsy findings and microscopic lesions in the heart. We emphasize the importance of performing a necropsy and examining tissues histologically for the diagnosis of this rare condition. Ventricular aneurysms should be included in the differential diagnosis of cardiovascular disease in dogs.

GenPup-M: A novel validated owner-reported clinical metrology instrument for detecting early mobility changes in dogs.

To use a previously validated veterinary clinical examination sheet, Liverpool Osteoarthritis in Dogs (LOAD) questionnaire, combined with kinetic and kinematic gait analysis in dogs with/without mobility problems to demonstrate the capacity of a novel clinical metrology instrument ("GenPup-M") to detect canine mobility impairments. Quantitative study. 62 dogs (31 with mobility impairments and 31 without mobility impairments). The dogs' clinical history was obtained from owners and all dogs underwent a validated orthopaedic clinical examination. Mobility impairments were diagnosed in the mobility impaired group based on clinical history and orthopaedic examination. Owners were asked to complete GenPup-M along with a previously validated mobility questionnaire (Liverpool Osteoarthritis in Dogs (LOAD)) to identify construct validity. As a test of criterion validity, the correlation between instrument scores and the overall clinical examination scores, along with force-platform obtained peak vertical forces (PVF) were calculated. GenPup-M underwent internal consistency and factor analysis. Spatiotemporal parameters were calculated for dogs with/without mobility impairments to define the gait differences between these two groups. Principal Component Analysis identified GenPup-M had two components with Eigenvalues >1 ("stiffness/ease of movement" and "willingness to be active/exercise"). Cronbach's α was used to test internal consistency of GenPup-M and was found to be "good" (0.87). There was a strong, positive correlation between GenPup-M and LOAD responses (r2 = 0.69, p<0.001) highlighting construct validity. Criterion validity was also shown when comparing GenPup-M to clinical examination scores (r2 = 0.74, p<0.001) and PVF (r2 = 0.43, p<0.001). Quantitative canine gait analysis showed that there were statistically significant differences between peak vertical forces (PVF) of mobility impaired and non-mobility impaired dogs (p<0.05). Analyses of PVF showed that non-mobility impaired dogs more evenly distributed their weight across all thoracic and pelvic limbs when compared to mobility impaired dogs. There were also consistent findings that mobility impaired dogs moved slower than non-mobility impaired dogs. GenPup-M is a clinical metrology instrument (CMI) that can be completed by dog owners to detect all mobility impairments, including those that are early in onset, indicating the versatility of GenPup-M to assess dogs with and without mobility impairments. Results of the study found that GenPup-M positively correlated with all three objective measures of canine mobility and consequently showed criterion and construct validity. Owner-reported CMIs such as GenPup-M allow non-invasive scoring systems which veterinary surgeons and owners can use to allow communication and longitudinal assessment of a dog's mobility. It is anticipated that GenPup-M will be used by owners at yearly vaccinations/health checks, allowing identification of any subtle mobility changes, and enabling early intervention.

Conservative treatment of recurrent intervertebral disc extrusions in a lionhead rabbit

ABSTRACTA 4‐year‐old lionhead rabbit with an acute onset of abnormal hindlimb gait was presented. L4–S3 neurolocalisation was determined based on clinical findings of paraparesis, bilateral proprioceptive positioning deficits, left pelvic limb hyporeflexia and discomfort during lumbar spine manipulation. The magnetic resonance imaging (MRI) revealed an intervertebral disc extrusion (IVDE) at L4–L5, with mild spinal cord compression. The condition was treated conservatively, with cage rest and non‐steroidal anti‐inflammatory drugs. The rabbit was fully normal after 1 month. Two months later, a relapse of clinical signs was observed. A new MRI study revealed a L5–L6 IVDE with mild spinal cord compression. Conservative treatment was repeated and full recovery was confirmed at 4‐month follow‐ups associated with MRI follow‐up study. To the authors' knowledge, this is the first case report of spontaneous IVDEs in a rabbit, where MRI was used to monitor the effectiveness of the conservative management of the disease in a rabbit.

Homeopathic Treatment of snakebite in dog – case report

Snakebite accidents are very common nearby forest areas. The majority of these incidents are caused by snakes of the genus Bothrops, which comprises over 45 species distributed in Central and South America. These snakes usually hunt small mammals and lizards at dusk. Snakebites from this genus generally occur in the head, limbs, and neck regions. Bothrops snakes are considered aggressive animals, characterized by inverted "V" markings along their bodies, triangular heads, smooth tails, and length ranging from 0.5m to 2m. They exhibit color variations of brown, green, and gray. Bothrops venom has necrotic, coagulating, vasculotoxic, and nephrotoxic effects, which can cause extensive necrosis at the bite site, tissue loss, and limb dysfunction, sometimes resulting in amputation. The bitten animal may experience prostration, tachypnea, localized edema and pain, petechiae, hemorrhages, and extensive necrotic areas. Hematuria, hypotension, pulmonary edema, and even death, as well as various laboratory abnormalities, may also occur. The case reported herein was attended at a veterinary clinic in Campos Altos, Minas Gerais, Brazil. It involved a mixed-breed female dog, 3 years old, weighing 4.5 kg, which had been bitten by a Bothrops snake approximately 90 minutes before. The animal presented edema and pain at the site of the bite (pelvic limb), as well as tachycardia. At once, it was administered intravenous polyvalent antiophidic serum, dexamethasone, serum, furosemide, tramadol, and ceftriaxone (antibiotic). Local treatment included corticosteroid and antibiotic ointment dressings. The animal remained stable, but after 24 hours, an extensive area with edema, hematoma, bleeding, and early necrosis at the bite site was observed, worsening with each passing hour. After 48 hours, therapy with Bothrops CH6 (5 globules every 8 hours) was initiated to reduce local effects (edema, hemorrhage, and necrosis). The animal showed rapid improvement in the appearance of the lesion, and after 5 days of treatment, there was no longer edema or bleeding, only a circumscribed cutaneous injury, which was managed with local dressings (cleaning and healing ointment). The animal recovered well without any sequelae.

Ciprofloxacin Ophthalmic DRESS Syndrome: Case Report

Introduction: Drug rash with eosinophilia and systemic symptoms (DRESS syndrome), also known as drug-induced hypersensitivity syndrome, is a rare severe systemic hypersensitivity drug reaction. Diagnosing DRESS syndrome is challenging due to non-specific manifestations that can make it difficult to recognize. Therefore, addressing and discussing this issue is extremely important, considering the potential lethality of a treatable syndrome. Clinical case: We describe the clinical characteristics of a 39-year-old female who presented with DRESS syndrome associated with the use of ciprofloxacin ophthalmic. The patient manifested a mild maculopapular rash located in the pelvic limbs with subsequent ascending distribution and generalized erythematoviolaceous affecting four extremities, trunk, facial region and scalp, together with fever and lymphadenopathy. Paraclinical tests revealed leukocytosis and eosinophilia. According to RegiScar's ranking, it scored 6 points, classifying it as the definitive case for DRESS. He concluded a schedule with prednisone 1 mg/kg/day with a slow reduction dose, obtaining a good response to treatment. Conclusions: DRESS syndrome should be suspected in a patient receiving medical treatment who presents with the following signs and symptoms: rash, fever (38°C), facial edema, and lymphadenopathy. Fortunately, this reaction is usually reversible, with a low incidence of residual damage or mortality, in the case of timely discontinuation of antibiotics and use of topical or systemic corticosteroids.

Arterial vascularization of the pelvic limb of the reindeer fetus

The reindeer is a representative of the order artiodactyls, most of the individuals inhabit the territory of the Northern hemisphere. It is a significant hunting and commercial species, and reindeer husbandry is the main branch of animal husbandry in the conditions of the Far North. The morphology of the reindeer has always been of interest to researchers. In different years, the architectonics of the vascular bed of the reindeer have been studied by many researchers [3, 4]. However, in the available literature sources, we have not found data concerning arterial blood supply to organs and tissues in reindeer fetuses. In the prenatal period of development, there is a restructuring of organs and tissues, and with them the vascular bed. The aim of the study was to study the arterial vascularization of the pelvic limb in a reindeer fetus, to give morphometric characteristics to the arteries. The studies were conducted on 5 reindeer fetuses at the age of 4.0-4.5 months. The fruits were delivered to the Department of Animal Anatomy of the St. Petersburg State University of Veterinary Medicine from reindeer herding farms of the Republic of Sakha (Yakutia). The fruits were extracted after the slaughter of vazhenok for household needs. Classical methods were chosen as research methods: fine anatomical dissection, morphometry, photographing and vasorentgenography. During the study, it was found that the main arterial trunk of the pelvic limb in a reindeer fetus is the external iliac artery. Skeletotopy and angioarchitectonics of the main arteries of the pelvic limb of the reindeer fetus have typical patterns characteristic of adult animals. Morphometric parameters of the arteries are consistent with the topographic position of the muscle groups – a greater number of large arterial branches are noted in the hip area. The presence of collateral blood flow in the foot area is noted – the vessels of the dorsal and plantar surfaces are connected to each other due to the perforating metatarsal and perforating metatarsal arteries, as well as at the confluence of the axial and non-axial finger arteries.

Evaluation of neurologic testing in guinea pigs (Cavia porcellus)

BackgroundUp-to-date, specialized literature provides very little information on performing and interpreting clinical neurological tests on small mammals, particularly guinea pigs. MethodsTwo clinical neurologists performed separate neurological examinations of 25 guinea pigs. The structure of the examination was similar to those performed in other companion animals and included hands-off examination, postural reaction tests, cranial nerve tests, and spinal reflex tests. Each test was evaluated for feasibility, reproducibility, and associated stress level for the animals. ResultsThe following tests revealed an excellent ability to elicit the expected response: hopping reaction in the thoracic limbs, wheelbarrowing and hemiwalking, medial and lateral palpebral reflex, auricular sensitivity, maxillary sensitivity, horizontal oculocephalic reflex, tone of the jaw, voluntary movement of the tongue, and direct pupillary light reflex. On the other hand, a poor ability to elicit the expected response was observed in the following tests: visual paw replacement of the thoracic limbs, tactile paw replacement in both thoracic and pelvic limbs, paper test for thoracic and pelvic limbs, mandibular sensitivity, vertical oculocephalic reflex, menace response, patellar reflex, cutaneous trunci reflex, and perineal reflex. The most reliable spinal reflex test with a good ability to elicit the expected response was the withdrawal reflex for both thoracic and pelvic limbs. The guinea pigs experienced the most stress during the spinal reflex tests. ConclusionIt is possible to apply several clinical neurological tests on guinea pigs and produce meaningful results. However, certain tests elicited high stress responses in the animals and should therefore only be used if necessary. Based on the results, we propose a possible protocol for neurological examination in guinea pigs. Clinical relevanceThis is the first study to evaluate a full range of clinical neurological tests performed on guinea pigs. The results of this study could lead to a better understanding of lesion localization and serve as a basis for further diagnostic and therapies in guinea pigs with neurological diseases.

Anatomical and topographic features of fascia of the gluteal-femoral region in the common lynx

The article presents anatomical features of the superficial and deep fascia, in particular on the pelvic limb of the common lynx, which are absent in the available literature. The material for the research was a sectional material - pelvic limbs (n= 6), selected from the common lynx, without external signs of pathologies of the musculoskeletal system. Methods of fine macro- and microanatomic dissection of the lynx's left pelvic limb were used. At the same time, a functional analysis of the studied structures and skeletotopic projection of muscles, fascia and fascial nodes were carried out. Based on the conducted studies, it was found that the deep fascia is separated from the superficial fascia by an interfacial space filled with loose connective (or fatty) tissue. In the pelvic limb area, it is represented by the gluteal-femoral fascia, and on the lower leg it continues as the deep fascia of the lower leg. In the process of dissecting the deep fascia, we noted that in the gluteal region, the deep gluteal fascia is fixed on the supracosteal ligament, in the area of the root of the tail, along the tail fold and up to the sciatic tubercle. We noted that the deep gluteal fascia begins from the vertebral head of the biceps femoris muscle and, in the cranial direction, covers successively the posterior, superficial gluteal and caudal part of the middle gluteus muscle. Along the way, the perimysium of the above muscles are interwoven into it, however, in the area of the iliac wing, it fuses with the perimysium of the middle gluteal muscle and then continues into the lumbar fascia. At the same time, it forms a fascial node in the maklok area. Distally, the deep gluteal fascia continues as the deep femoral fascia. The data obtained are the reference in assessing the structural and functional state of the fascial formations of the pelvic limb in the common lynx.

Ultrasound-guided sciatic nerve block in Wistar rat cadavers: Relevant anatomy and injection distribution

ObjectiveTo investigate the feasibility of an ultrasound-guided sciatic nerve block by describing the sonoanatomy and comparing the distribution of two volumes of bupivacaine dye solution for nerve staining. Study designRandomized, experimental, assessor-blinded cadaveric study. AnimalsA total of 40 adult female Wistar rat cadavers. MethodsAfter studying the sonoanatomy of the sciatic nerve and adjacent structures using a high-resolution linear transducer (19–5 MHz), rat cadavers were randomly divided into two groups that were administered either 0.1 mL (group 0.1) or 0.2 mL (group 0.2) of bupivacaine dye solution per nerve, delivered via an in-plane technique. The extent of nerve staining was subsequently evaluated following dissection. Statistical analysis consisted of assessing data distribution using the Shapiro–Wilk test, followed by paired t-tests for continuous data, Mann–Whitney U test and McNemar’s test for categorical data. Statistical significance was defined as p < 0.05. ResultsThe sciatic nerve was identified bilaterally as a double ellipsoid-shaped image, surrounded by a hyperechoic fascia separating the biceps femoris from the adductor muscle. The hypoechoic structure formed by the bupivacaine dye solution around the nerve was effectively visualized using ultrasound imaging. Sciatic nerve staining was successfully achieved in all pelvic limbs, with dye spread of 4.82 ± 1.55 mm and 5.47 ± 2.18 mm in groups 0.1 and 0.2, respectively (p = 0.128). Conclusions and clinical relevanceThis study achieved a detailed understanding of the sonoanatomy of the sciatic nerve and its adjacent structures, highlighting the feasibility of the ultrasound-guided technique for injection in Wistar rats. Furthermore, the results show a comparable distribution of dye solution in both groups. Use of the ultrasound-guided sciatic nerve block technique in rats not only exhibits substantial potential for regional anesthesia but also opens avenues for translational studies.

Left External Iliac Artery Aneurysm in horse – Case report

An aneurysm is defined as the abnormal and localized dilation of a blood vessel, which can be congenital or acquired. The main consequence is vessel rupture, leading to hemorrhage, hypovolemic shock, and subsequent sudden death. Clinical signs can also be silent or resemble other pathologies, making the diagnosis complex. This study aims to report the clinical case of a Criollo mare diagnosed with an aneurysm of the left external iliac artery, as well as the treatment and diagnostic methods. During the anamnesis, it was observed that the patient experienced episodes of acute abdominal discomfort with rapid and spontaneous resolution, anorexia, and progressive weight loss for approximately a year. Musculoskeletal evaluation revealed grade III lameness in the left pelvic limb. Rectal palpation revealed a parasagittal increase in volume near the lumbosacral segment with a palpable pulse in the region of the left abdominal aorta. Rectal ultrasound with a linear probe (5.5 MHz) revealed decreased and retrograde blood flow compared to the contralateral vessel, suggesting an aneurysm of the left external iliac artery. The prescribed treatment involved the administration of acepromazine, omeprazole, and acetylsalicylic acid for 90 days. Ultrasonography was essential for the final diagnosis and resolution of the reported case, along with the combination of drugs described in the therapeutic protocol.

Meningoencefalomielite por Cryptococcus spp. em felino

Cryptococcosis is a systemic mycosis caused by encapsulated yeasts from the gender Cryptococcus. It mainly affects the nasal cavity, adjacent tissue and lungs, and can spread to the central nervous system, eyes and skin, causing meningoencephalomyelitis. It can be noninfectious or infectious via yeasts and bacteria, and felines are the most prevalent when infected by the Feline Leukemia Virus (FeLV) or Feline Infectious Peritonits (FIP). The neurological signs of infection by criptococcus could be convulsion, depression, disorientation, ataxia, paralysis of the pelvic limbs, mydriasis and blindness. For diagnosis, the neurological exam is indispensable, and must be combined with the general full body physical exam, with the intention to find the injury. The aim of this study is to report the case of a cat, 10 months old, with meningoencephalomyelitis by Cryptococcus spp. The animal presented the clinical signs of abrupt change in behavior, excessive fear, lack of appetite and progressive weight loss. Methadone was administrated for the pain, used gabapentin that changed for pregabalin. Cerebrospinal fluid (CSF) analysis and MRI were performed to assist in the diagnosis. However, false negatives can occur, which may consequently hinder adequate treatment. In this report, diagnostic conclusion occurred post-mortem. Thus, the patient lacked the adequate treatment to stabilize in life.

Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006-2022).

To determine the incidence and severity of complications for subdermal plexus flaps in dogs and compare the complications when using sutures or staples for cutaneous closure of subdermal plexus flaps. Retrospective monocentric study. Ninety-seven client-owned dogs. Dogs that underwent wound reconstruction using subdermal plexus flaps were retrospectively identified. Type of flap, cutaneous closure technique, complications and level of complication associated with their use were recorded. Follow-up was considered adequate if it was more than 10 days postoperatively or until a complication occurred. Complications were seen in 52 dogs (53.6%), of which 13/18 (72.2%) of dogs had cutaneous closure with skin staples versus 39/79 (49.3%) with skin sutures. The location of the mass/wound on the head and use of an advancement flap was associated with lower incidence of complications (p < .001; p = .018 respectively). Location of the mass/wound on the proximal pelvic limb was associated with a low level of complications (p = .01) on univariable analysis only. On multivariable analysis, only an increased bodyweight was associated with an increased incidence of complications (p = .029). Increased weight may be associated with an increased risk of complications with subdermal plexus flaps. No risk factor was found to be associated with the severity of complications. Overall incidence of complications for subdermal plexus flaps in dogs in this study was 53.6%. The number of dogs included in the study was not sufficient to assess if the skin closure technique affects the incidence of complications.

Evaluación de aspectos clínicos relacionados con la amputación de miembros inferiores en personas que viven con diabetes mellitus tipo 2 en México

Introduction: Diabetes continues to be a leading cause of disability and death in the world's population. About 25% of people with diabetes will develop an ulcer in one of their lower pelvic limbs. Objective: The present study evaluates the clinical aspects related to lower pelvic limb amputation in a cohort of patients with diabetes mellitus. Methods: Retrospective, cross-sectional study, conducted in collaboration between the Mexican Institute of Social Security and the School of Pharmacy of the Autonomous University of Morelos State, involved a review of records of patients with type 2 diabetes mellitus at the Regional General Hospital "Ignacio García Téllez". One hundred clinical and electronic records were selected based on inclusion criteria, which included age over 18 years, affiliation at the study site, diabetes evolution of at least 10 years, pharmacological treatment for diabetes and diagnosis of diabetic foot with complete healing or amputation as an outcome. Statistical analyses were performed using STATA and ethical approval was obtained. Results: Patients with optimal glycemic control by quantifying their fasting glucose levels (&lt;130 mg/dl) as well as their glycated hemoglobin values (&lt; 7%) had a lower frequency of amputations (p˂0.001; Chi2) compared to those patients without adequate glycemic control. Conclusions: Being male, glycosylated hemoglobin values greater than 7% and mean fasting glucose values greater than 130 mg/L were found to increase the likelihood of having a lower extremity amputation.

Comparison of Subcutaneous versus Intramuscular Dexmedetomidine–Midazolam–Ketamine–Morphine (DMKM) Mixture as Chemical Restraint for Endoscopic Sex Determination in Aldabra Giant Tortoises (Aldabrachelys gigantea)

Sex identification through coelioscopy is a minimally invasive surgical technique used to determine the sex of chelonians by directly visualizing their internal reproductive organs. An adequate anaesthesiologic plan is essential to guarantee patient immobilization and proper analgesia during the entire surgical procedure. In this study, we evaluated the effects of a combination of dexmedetomidine (0.05 mg/kg), midazolam (1 mg/kg), ketamine (8 mg/kg), and morphine (1 mg/kg) (DMKM) randomly delivered intramuscularly (IM) or subcutaneously (SC) in twenty-one Aldabra giant tortoise (Aldabrachelys gigantea) into the right antebrachium for celioscopic sex identification. Heart rate (HR), respiratory rate (RR), and body temperature (BT) were measured, along with the skeletal muscle tone of the thoracic and pelvic limbs, neck retraction reflex, palpebral reflex, and jaw tone every 15 min. The anaesthesiologic plan was considered to be adequate at the loss of the thoracic and pelvic limb retraction reflexes. After a 45 min interval, if the anaesthetic plan was deemed insufficient for the celioscopic procedure, a 5 mg/kg dose of propofol was administered intravenously into the subcarapacial venous plexus. At the end of the procedure, atipamezole (0.5 mg/kg) and flumazenil (0.05 mg/kg) were administered intramuscularly into the left antebrachium as reversal agents. Both HR and RR decreased from baseline to both 15 and 30 min. Due to the persistence of thoracic and pelvic limb retraction reflexes 45 min after DMKM administration, 6/11 (55%) cases in the SC group required the additional administration of propofol, in contrast to only 1/10 (10%) cases in the IM group (p = 0.05). The recovery times were comparable between the successfully induced animals in the IM and SC groups. In this study, the intramuscular administration of a DMKM combination quickly produced chemical restraint, suitable for celioscopic sex determination.

Activity reconstruction of Rangifer tarandus feet in Fennoscandian -archaeology: Methodological considerations and application to archaeological material from two Sámi habitation sites

ObjectiveThis study explores the presence and prevalence of working Rangifer tarandus tarandus (domestic reindeer) through entheseal changes present in Rangifer tarandus phalanges at the Sámi habitation sites of Juikenttä and Nukkumajoki, located in Finland and dating from the 14th to the 18th centuries. MaterialsModern samples (n = 23 phalanges, Rangifer tarandus fennicus; n = 60 phalanges, Rangifer tarandus tarandus non-working; n = 72 phalanges, Rangifer tarandus tarandus working) with known life histories. Archaeological samples (n = 22 phalanges, Juikenttä; n = 118 phalanges, Nukkumajoki). MethodsWe analysed entheseal changes on the first and second phalanges of both the thoracic and pelvic limbs. The minute movements of reindeer feet create entheseal changes which are specific to different activity patterns. This analysis was compared to the results obtained from long-bone analysis. ResultsOur results show the presence of working reindeer at both sites and are consistent with previous analysis of the long bones found at the site. ConclusionsThis archaeological application of phalangeal entheseal changes suggests that reindeer phalanges may be used to assess both the presence and proportion of working animals in an assemblage. SignificanceThis study provides more evidence for the use of working reindeer as early as the 14th century in Northern Finland. This work also helps to provide archaeological evidence for Sámi subsistence patterns, as well as proving new tools for zooarchaeological assessment. LimitationsSmall sample size and taphonomy may affect assessment. Additionally, entheseal changes take time to envelope and may under-represent the number of working reindeer. Suggestions for further researchAssessment of additional modern and archaeological samples.

Correction of a Hyperflexed Hallux in a Saker Falcon (Falco cherrug) by Hemisectioning the Deep Digital Flexor Tendon.

A 3-year-old male saker falcon (Falco cherrug) was presented with a history of hyperflexion of the first digit of the left pelvic limb with what appeared to be a hypercontracted distal end of the deep digital flexor tendon (m. flexor hallucis longus). Conservative treatment, bandaging, and splinting techniques failed to resolve the hypercontraction of the deep digital flexor tendon and improve digit function. Intraoperatively, the deep digital flexor tendon was found to have formed adhesions with the tendon sheath as well as the bone and soft tissue structures underneath it, impeding its ability to move freely within the tendon sheath. The adhesions were surgically resolved, and the tendon was lengthened by hemisectioning the deep digital flexor tendon at its distal end. Postsurgically, the digit was maintained in an extended position by bandaging. Mild physiotherapy was provided at 5-day intervals to retain function and prevent adhesions. Digit extensibility and function were restored to nearly normal levels after 4 weeks.