Scuba
8-year old Mixed Breed
55 lbs
Veterinarian: Ann Sherwood, DVM
HISTORY –
Right hind limb lameness first noticed in June of 2020 – gradually worsened over time and progressed to be associated muscle atrophy. At the time Scuba was undergoing chemotherapy for hypercalcemic T cell mediastinal lymphoma and the concern was that this was associated with neoplasia.
Scuba also experienced decreased appetite and activity when painful. He was treated with NSAIDs and Adequan® with the hope of avoiding surgery in an at-risk patient. Scuba had the extra complication of having developed worsening azotemia over time likely due to hypercalcemia associated with lymphoma and/or chemotherapy medications.
EXAM –
Right hind limb grade 2-3/5 lameness of nearly 12 months duration
Associated muscle atrophy from decreased use.
DIAGNOSTICS –
Orthopedic evaluation by DVM and DVM trained in rehabilitative medicine
Radiographs taken on several occasions including 4/2021
DIAGNOSIS –
Partially torn right cranial cruciate ligament with associated thickening of stifle and caudal muscle atrophy.
Hypercalcemic T cell mediastinal lymphoma.
Azotemia.
TREATMENTS -
PREVIOUS THERAPIES
Daily Omega 3 Fish oil supplementation
Rimadyl® (Carprofen) 100 mg daily (SID or split into BID dose) started August 2020
Adequan® 120 mg SQ twice weekly for 4 weeks then monthly administration – started April 2021
PHYSICAL MEDICINE — JUNE 3, 2021
Scuba was placed under heavy sedation using butorphanol and dexdomitor.
His right stifle was clipped and surgically prepared in a routine fashion.
A 22 g 1” needle was placed in a lateral to medial direction to penetrate the synovial space.
A small amount (0.4 ml) of synovial fluid was extracted using a 3 ml syringe. This syringe was removed from the needle and 1.4 ml of sterile Spryng™ with OsteoCushion™ Technology was injected into the joint.
Spryng™ was injected smoothly through the 22 g needle. The needle was removed and the arthrocentesis site was compressed for ~ 1 minute.
The stifle was flexed and extended to disperse the particles in the joint.
Scuba recovered uneventfully and was discharged to his person several hours later.
OUTCOME -
Scuba was continued on Rimadyl® post-injection. His condition remained stable initially.
He did not have any complications following the intra-articular injection.
Over the ensuing weeks he gradually started to exhibiting considerably less lameness – progressing from a grade 3 to a grade 1 lameness over 3 weeks.
As previously stated, he had considerable muscle atrophy which likely contributed to his more gradual improvement.
As his lameness improved, his appetite and general activity level increased steadily.
Over time his NSAID medication was reduced and eventually discontinued.
Several months following the intra-articular injection of Spryng™ with OsteoCushion™ Technology, Scuba limps only very rarely when initially rising from resting. When he runs around in the yard you would never be able to guess that he still has a partially ruptured cranial cruciate ligament.
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24 MONTHS POST INJECTION — JUNE 2023
Scuba’s Spryng™ injection was 24 months ago, and he is still running strong!
Although Scuba is now over 10 years of age with a past unilateral CCL injury, he is still very active. In fact, he is more active now than he was prior to his cancer diagnosis.
His lameness is 0/5 most days but may increase to 1/5 after heavy exercise. He is able to run, jump and play with other dogs.
Scuba has only continued to take Dasuquin® Advanced and an Omega-3 fatty acid supplement (as of July of 2021). He has been maintained at a healthy weight and has a BCS of 5/9.
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