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Small animal surgery technology nearly parallels human medicine

By Michelle Hall

 

Don't give up if your beloved pet is suffering from arthritis in the hip. Or liver problems. Or a knee rupture. Or an ear infection. Or a leg fracture. The Veterinary Medical Teaching Hospital at Kansas State University has various surgical procedures and technology that can help -- some you might not even have realized were available for animals.

The surgical staff at the hospital performs soft tissue and orthopedic procedures daily. They see more patients with orthopedic problems, because the equipment they use is very expensive and most veterinarians do not have access to it, said Dr. James Roush, section head of small animal surgery at the hospital.

Roush and colleagues are able to perform total hip replacements -- and now do about 20 per year. They also are "gearing up" in arthroscopy, Roush said, which is where a small incision -- rather than a large one -- is made in the patients' skin and small instruments are used to look inside the joint. The images are then linked up to a screen.

Tibial plateau leveling osteotomy, or TPLO, is another new procedure that Roush and his colleague, Dr. Walter Renberg, have been performing. This method is used for cruciate ligament ruptures, most often seen in large, athletic dogs. The ruptures occur when too much stress is placed on a dog's tibia plateau -- dogs stand on their toes with their knees bent forward and the femur tends to bear down heavily on the cranial cruciate ligament, the only thing opposing the large bone. TPLO surgery levels the tibial plateau, eliminating the need for the ligament -- doctors such as Roush go in and cut the bone and turn it. Roush said the effects of this surgery are tremendous for the animals.

"I love this surgery because the dogs are able to walk immediately on their legs," Roush said. "It's exciting for me."

Roush is also conducting research with a force plate analyzer, testing which arthritis drug better aids in reducing lameness. The analyzer consists of a small aluminum plate flush with a walkway that measures where and how hard each leg of an animal hits. It also measures the peak force, or where the animal hits hardest and how the pressure is different as the step occurs. For example, dogs generally step with 100 percent of their body weight on their front leg and only 60 percent on their hind leg.

The analyzer allows the doctors to see where the animal is lame.

"We can see exactly how the animal is striding," Roush said. The analyzer is mainly used for dogs and horses, although Roush said it will measure "from mouse to elephant size." He said they have found through use of the analyzer that they are "not right as often as we think we are with which leg is lame just looking at the dog."

Although the analyzer is used primarily for research, they also are able to use it for patients to determine lameness. Another technique Roush and his fellow surgeons have available to determine where and to what degree an animal is lame is a bone scan. An injected isotope goes to the areas of inflammation and they then show up on the scan. This can show anything from fractures to arthritis, Roush said.

Next up for the surgeons at the teaching hospital: working toward minimally invasive surgery, including laparoscopy, which is where a small, telescope-like instrument is inserted through a small incision into the abdomen to examine internal organs and reproductive organs. They have embraced the new MRI and CT scanner in the radiology suite of the hospital (see related story) for the ability to see tendon injuries they wouldn't have been able to diagnose before. Recently, Roush was able to diagnose and fix a problem in the shoulder of a performance dog with the aid of the MRI. Doctors there also are involved in trying out feed additives to fight osteoarthritis.

And after that? Roush said they would like to branch into animal rehabilitation, perhaps obtain an underwater treadmill and definitely more technicians, although they would like to research animal rehab more before beginning anything.

Roush said most people are surprised to see the type and level of care K-State's teaching hospital can provide to animals.

"The general public is amazed to find out the level of medicine here is similar to what you see in human medicine," Roush said. The only kind of surgery they do not commonly attempt at the K-State Veterinary Medical Teaching Hospital is brain surgery. But, "any kind of fracture, joint problem, are done in animals and done just as well," he added. "It's been a long time since I've had to amputate a leg for an orthopedic problem." He said it's a shame when pet owners don't know about the services and techniques animal hospitals and specialists offer and give up on a pet without trying them out.

Spring 2003