Bacterial resistances to antimicrobial drugs pose serious public health challenges. The observed increase of resistances is attributed to the uncontrolled, massive and often unnecessary administration of antibiotics both in human and veterinary medicine. To support the responsible use of antimicrobials in animals and help veterinarians selecting the most suitable antimicrobial drugs, we developed the AntibioticScout.ch as a comprehensive decision supporting tool providing online access to the current knowledge of rational antibiotic prescription practices. User-friendly search functions allow for the fast and efficient retrieval of information that is structured in this database by animal species, organ systems and therapeutic indications. In addition, an online form allows to report treatment failures in order to identify problematic cases as well as ensuing risks and take appropriate mitigation measures. The present report describes the workflow of this decision support system applied to the prudent use of antimicrobials in companion animal medicine.
Objectives To investigate the accuracy and intra‐ and interobserver reliability of the cranial drawer test (CD), tibial compression test (TCT), and the new tibial pivot compression test (TPCT) in an experimental setting resembling acute cranial cruciate ligament rupture (CCLR) and to elucidate the ability to subjectively estimate cranial tibial translation (CTT) during testing. Study design Experimental ex vivo study. Sample population Ten cadaveric hindlimbs of large dogs. Methods Kinetic and 3D‐kinematic data was collected while three observers performed the tests on each specimen with intact (INTACT) and transected cranial cruciate ligament (CCLD) and compared using three‐way repeated‐measures ANOVA. Subjectively estimated CTT (SCTT), obtained during a separate round of testing, was compared to kinematic data by Pearson correlation. Results CTT was significantly higher for CCLD than for INTACT for all tests, resulting in 100% sensitivity and specificity. TPCT induced the highest CTT and internal rotation. Intra‐ and interobserver agreement of translation was excellent. For rotation and kinetics, agreement was more variable. SCTT strongly correlated with the objectively measured values. Conclusion The CD, TCT and the new TPCT were all accurate and reliable. The high translations and rotations during TPCT are promising, encouraging further development of this test. SCTT was reliable in our experimental setting. Clinical significance Veterinary manual laxity tests are accurate and reliable in acute CCLR. The TPCT might have potential for the assessment of subtle and rotational canine stifle instabilities. The high reliability of SCTT implies that grading schemes for stifle laxity, similar to human medicine, could be developed.
Cranial cruciate ligament rupture is one of the most important diseases in canine orthopedics. Despite the frequent occurrence of the disease and the extensive literature available, there is still controversy about the best treatment method. The aim of this review article is to present a new, more specific approach to treatment selection in dogs with cranial cruciate ligament rupture. Patients are divided into different groups and particular treatment methods are then recommended according to group membership. In order to develop the treatment recommendations, the patient groups were initially defined based on criteria that are important for treatment selection, such as type of cranial cruciate ligament rupture, chronicity, degree of instability, size and weight of the patient, stage of osteoarthritis, the presence of bone deformities, concurrent medial patellar luxation or rotational instability. A detailed literature search was conducted through MEDLINE/PUBMED; CAB Abstracts, Google-Scholar and in conference proceedings abstracts from 1990-2019. Based on the available literature, treatment recommendations were developed for each patient group. These patient group-specific recommendations based on best available evidence are intended to simplify the decision-making process for treatment selection in dogs with cranial cruciate ligament disease.
Objectives To investigate stifle kinematics and kinetics following TPLO and TPLO combined with an extra‐articular lateral augmentation (TPLO‐IB) during the tibial compression test (TCT) and the tibial pivot compression test (TPT), applied with an external (eTPT) and an internal moment (iTPT). Study design Experimental ex vivo study. Sample population Ten cadaveric hindlimbs of dogs weighing 23–40 kg. Methods 3D‐kinematic and kinetic data were collected while performing TCT, eTPT, and iTPT and compared under the conditions (1) normal, (2) CCL deficient, (3) TPLO, and (4) TPLO‐IB. Two‐way repeated‐measures ANOVA was used to examine the effect of test and treatment on kinetic and kinematic data. Results Mean ± SD preoperative TPA was 24.7° ± 1.7°, postoperative TPA was 5.9° ± 0.7°. During TCT, there was no difference in cranial tibial translation between the intact stifle and after TPLO (p = .17). In contrast, cranial tibial translation was six times larger in TPLO compared to intact when performing eTPT and iTPT (p < .001). Cranial tibial translation with TCT, eTPT and iTPT was not different between intact stifle and TPLO‐IB. Intraclass correlation coefficient for eTPT and iTPT after TPLO and TPLO‐IB was excellent being 0.93 (0.70–0.99) and 0.91 (0.73–0.99), respectively. Conclusion Whereas TCT is negative after TPLO, instability persists when a rotational moment is combined using eTPT and iTPT. TPLO‐IB neutralizes craniocaudal and rotational instability when performing TCT, eTPT, and iTPT.
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