Tibial Plateau Leveling Osteotomy for the Treatment of Cranial Cruciate Ligament Rupture in a Grey Wolf (Canis lupus)
A 9-year-old spayed female grey wolf (Canis lupus) presented with acute lameness that did not respond to anti-inflammatory therapy. Physical examination revealed a positive cranial drawer sign and cranial tibial thrust. Tibial plateau leveling osteotomy (TPLO) and partial medial meniscectomy were performed to treat the cranial cruciate ligament deficient stifle and meniscal tear, respectively. Three weeks postoperatively, the surgical incision dehisced. An examination and culture did not reveal an obvious cause. The incision was treated by lavage, debridement, and delayed primary closure, but opened again twice more in a 6-week period. The chronic sinus was considered a possible reaction to the implants, an adverse effect reported in 1.1–5.2% of TPLO cases.1 The site was managed as an open wound with daily chlorhexidine lavage and topical antibiotics until the plate could be removed at 15 weeks postoperatively and the incision closed. Repeated self-mutilation of the site prolonged recovery for another 8 weeks, requiring 4 additional surgeries to lavage, debride and close the wound. Several preventative modalities were attempted to prevent self-mutilation and maintain closure of the incision, including psychotropic drugs and physical barriers. A combination of two Elizabethan collars, a tranquilizer (acepromazine), and casting of the leg finally proved effective in complete wound healing. After 8 months, this animal was successfully reintroduced to the pack. Ultimate recovery was excellent in terms of limb function.
We would like to thank the staff and keepers of the Toledo Zoo, as well as veterinary technicians, Erin Balfour, LVT, and April Dieter, LVT, and veterinary resident, Justin Schlanser, DVM.
1. Boudrieau, R.J. 2009. Tibial plateau leveling osteotomy or tibial tuberosity advancement? Vet Surg. 38:1–22.