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Joint disease and surgery
/content/chapter/10.22233/9781910443163.chap23
Joint disease and surgery
- Authors: Nigel Harcourt-Brown and Sorrel Langley-Hobbs
- From: BSAVA Manual of Rabbit Surgery, Dentistry and Imaging
- Item: Chapter 23, pp 305 - 318
- DOI: 10.22233/9781910443163.23
- Copyright: © 2013 British Small Animal Veterinary Association
- Publication Date: January 2013
Abstract
Rabbits suffer from a variety of different joint diseases. The recent increase in popularity of rabbits as pets means that the incidence and diagnosis of joint disease is also likely to increase. This chapter examines localization of lameness; osteoarthritis; septic arthritis; sore hocks; conditions affecting the hip joint; elbow luxation; intervertebral disc disease; diseases of the stifle; dislocation of the hock; and carpal and digital luxation. Operative Techniques: Reduction of a dislocated hip; Surgical repair of a dislocated elbow; Cruciate ligament repair.
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Figures
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23.1
This rabbit was lame on its left leg and was not placing full weight on the foot. The contralateral leg showed hair loss over the calcaneus (arrow) and greater wear of the pad of hair covering the whole foot. This foot has the potential to develop pododermatitis. © 2013 British Small Animal Veterinary Association
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23.1
This rabbit was lame on its left leg and was not placing full weight on the foot. The contralateral leg showed hair loss over the calcaneus (arrow) and greater wear of the pad of hair covering the whole foot. This foot has the potential to develop pododermatitis.
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23.2
Radiograph of the stifle joint of a 3-year-old Belgian Hare with apparently stable stifle joints that had reduced flexion and extension. Osteoarthritic changes can be seen. © 2013 British Small Animal Veterinary Association
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23.2
Radiograph of the stifle joint of a 3-year-old Belgian Hare with apparently stable stifle joints that had reduced flexion and extension. Osteoarthritic changes can be seen.
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23.3
Radiograph of a rabbit with a swollen distal limb. There is periosteal new bone formation on the 3rd digit and distal radius, as well as some radiolucency in the carpus. These radiographic changes were suggestive of septic arthritis and osteomyelitis. Amputation of the 3rd digit through the proximal part of the 1st phalangeal bone, and a long course of penicillin/streptomycin resolved the problem. © 2013 British Small Animal Veterinary Association
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23.3
Radiograph of a rabbit with a swollen distal limb. There is periosteal new bone formation on the 3rd digit and distal radius, as well as some radiolucency in the carpus. These radiographic changes were suggestive of septic arthritis and osteomyelitis. Amputation of the 3rd digit through the proximal part of the 1st phalangeal bone, and a long course of penicillin/streptomycin resolved the problem.
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23.4
Ulcerative pododermatitis. This rabbit was presented with sore hocks; both hocks were affected, and the avascular necrosis had caused a deep ulcer in spite of treatment. The rabbit was also overweight. Radiography showed deformity of the calcaneus and the superficial flexor tendon had displaced. Although the hocks were bandaged (see right hock) with a flexible bandage, non-adherent dressing and antiseptic, there was very little padding and the condition was progressive. © 2013 British Small Animal Veterinary Association
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23.4
Ulcerative pododermatitis. This rabbit was presented with sore hocks; both hocks were affected, and the avascular necrosis had caused a deep ulcer in spite of treatment. The rabbit was also overweight. Radiography showed deformity of the calcaneus and the superficial flexor tendon had displaced. Although the hocks were bandaged (see right hock) with a flexible bandage, non-adherent dressing and antiseptic, there was very little padding and the condition was progressive.
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23.5
Resting position of the hocks of a rabbit with unilateral ulcerative pododermatitis.(a) Unaffected leg. A lateromedial radiograph of the ‘good’ hock of the rabbit shows that the leg is positioned normally and there are only mild changes in the tibiotarsal joint. The plantar aspect of the hock adjacent to the calcaneus is very close to the ground. The digits are flexed normally, so the superficial flexor tendon is unaffected. This leg might still benefit from a padded ‘shoe’ (see
Figure 23.6
) as it is the major weight-bearing hindlimb and therefore at risk of developing pododermatitis. (b) A standing lateromedial radiograph of the affected hock shows that the digits are over-extended in a normal standing position. This is a sign of rupture or displacement of the superficial digital flexor tendon, the result of osteomyelitis of the calcaneus. The hock was hot, swollen and painful. Pressure caused pus to discharge from the tendon sheaths around the hock. Although antibiotics, analgesics, topical medication, weight loss, soft bedding and wound protection with a shoe may alleviate some of the clinical signs associated with these changes, the rabbit is permanently disabled by the displacement or rupture of the superficial flexor tendon. It will distribute its weight incorrectly, so that pressure is applied to the point of the hock. © 2013 British Small Animal Veterinary Association
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23.5
Resting position of the hocks of a rabbit with unilateral ulcerative pododermatitis.(a) Unaffected leg. A lateromedial radiograph of the ‘good’ hock of the rabbit shows that the leg is positioned normally and there are only mild changes in the tibiotarsal joint. The plantar aspect of the hock adjacent to the calcaneus is very close to the ground. The digits are flexed normally, so the superficial flexor tendon is unaffected. This leg might still benefit from a padded ‘shoe’ (see
Figure 23.6
) as it is the major weight-bearing hindlimb and therefore at risk of developing pododermatitis. (b) A standing lateromedial radiograph of the affected hock shows that the digits are over-extended in a normal standing position. This is a sign of rupture or displacement of the superficial digital flexor tendon, the result of osteomyelitis of the calcaneus. The hock was hot, swollen and painful. Pressure caused pus to discharge from the tendon sheaths around the hock. Although antibiotics, analgesics, topical medication, weight loss, soft bedding and wound protection with a shoe may alleviate some of the clinical signs associated with these changes, the rabbit is permanently disabled by the displacement or rupture of the superficial flexor tendon. It will distribute its weight incorrectly, so that pressure is applied to the point of the hock.
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23.6
A protective shoe made from pipe insulation material can be helpful for the management of sore hocks, as it will alleviate pressure and spread the rabbit’s weight over the entire foot. (Courtesy of Vladimir Jekl) © 2013 British Small Animal Veterinary Association
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23.6
A protective shoe made from pipe insulation material can be helpful for the management of sore hocks, as it will alleviate pressure and spread the rabbit’s weight over the entire foot. (Courtesy of Vladimir Jekl)
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23.7
Bilateral hip dislocation. © 2013 British Small Animal Veterinary Association
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23.7
Bilateral hip dislocation.
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23.8
This 10-week-old female rabbit was presented by the breeder for treatment for ‘splay leg’. The rabbit was lost to follow up. It is difficult to know whether the femoral deformity was a cause or effect of the condition. © 2013 British Small Animal Veterinary Association
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23.8
This 10-week-old female rabbit was presented by the breeder for treatment for ‘splay leg’. The rabbit was lost to follow up. It is difficult to know whether the femoral deformity was a cause or effect of the condition.
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23.9
This 1.6 kg Netherland Dwarf was suddenly lame after a fall that resulted in a luxated elbow. The chronic arthritic changes made manual reduction impossible. © 2013 British Small Animal Veterinary Association
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23.9
This 1.6 kg Netherland Dwarf was suddenly lame after a fall that resulted in a luxated elbow. The chronic arthritic changes made manual reduction impossible.
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23.10
Craniocaudal view of the right stifle of a giant rabbit, showing medial dislocation of the patella and mild periarticular osteophytosis. © 2013 British Small Animal Veterinary Association
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23.10
Craniocaudal view of the right stifle of a giant rabbit, showing medial dislocation of the patella and mild periarticular osteophytosis.
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23.11
This dwarf rabbit was presented lame with a sore, swollen carpus. (a) The radiograph shows cranial dislocation of the carpus. This was corrected and the leg splinted. (b) The rabbit made a good recovery within a few weeks. © 2013 British Small Animal Veterinary Association
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23.11
This dwarf rabbit was presented lame with a sore, swollen carpus. (a) The radiograph shows cranial dislocation of the carpus. This was corrected and the leg splinted. (b) The rabbit made a good recovery within a few weeks.
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23.12
This rabbit was presented lame, with a dislocated toe. The dislocation was easily reduced under general anaesthesia and did not recur. © 2013 British Small Animal Veterinary Association
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23.12
This rabbit was presented lame, with a dislocated toe. The dislocation was easily reduced under general anaesthesia and did not recur.
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Hip bones of a rabbit, showing the natural articulation.
Hip bones of a rabbit, showing the natural articulation. © 2013 British Small Animal Veterinary Association
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Hip bones of a rabbit, showing the natural articulation.
Hip bones of a rabbit, showing the natural articulation.
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Standing dorsoventral view of the hips following reduction after a dislocation.
Standing dorsoventral view of the hips following reduction after a dislocation. © 2013 British Small Animal Veterinary Association
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Standing dorsoventral view of the hips following reduction after a dislocation.
Standing dorsoventral view of the hips following reduction after a dislocation.
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The rabbit elbow. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The rabbit elbow. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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The rabbit elbow. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The rabbit elbow. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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This Ethibond comes with a swaged-on J-shaped needle that is ideal for passing through the gastrocnemius insertion.
This Ethibond comes with a swaged-on J-shaped needle that is ideal for passing through the gastrocnemius insertion. © 2013 British Small Animal Veterinary Association
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This Ethibond comes with a swaged-on J-shaped needle that is ideal for passing through the gastrocnemius insertion.
This Ethibond comes with a swaged-on J-shaped needle that is ideal for passing through the gastrocnemius insertion.
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Holes made using a small Jacob’s chuck and a large straight-cutting needle.
Holes made using a small Jacob’s chuck and a large straight-cutting needle. © 2013 British Small Animal Veterinary Association
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Holes made using a small Jacob’s chuck and a large straight-cutting needle.
Holes made using a small Jacob’s chuck and a large straight-cutting needle.
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Braided terylene forms a knot that tends to come undone. Using a polydioxanone (e.g. PDS) suture to hold the ends of the tie prevents this from happening. Some surgeons choose to melt the knot partially with diathermy.
Braided terylene forms a knot that tends to come undone. Using a polydioxanone (e.g. PDS) suture to hold the ends of the tie prevents this from happening. Some surgeons choose to melt the knot partially with diathermy. © 2013 British Small Animal Veterinary Association
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Braided terylene forms a knot that tends to come undone. Using a polydioxanone (e.g. PDS) suture to hold the ends of the tie prevents this from happening. Some surgeons choose to melt the knot partially with diathermy.
Braided terylene forms a knot that tends to come undone. Using a polydioxanone (e.g. PDS) suture to hold the ends of the tie prevents this from happening. Some surgeons choose to melt the knot partially with diathermy.