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Osteoarthritis 721

into alveolar mucosa. The labial mucosa sites after thorough debridement and irriga- Prevention
(epithelium and supporting connective tion of the wound can be combined with Preventative care and prophylactic treatment
VetBooks.ir lary attachments. The epithelium lining Nutrition/Diet Technician Tips Diseases and Disorders
information is provided on pp. 776 and 1090.
tissue) is dissected free from its maxil-
closure of the flap covering the oronasal
fistula.
the oronasal fistula on the palatal side
is resected. Necrotic or injured tissue is
always be examined by means of periodontal
trimmed from the flap edges. Sharp bony Soft food for 2 weeks The teeth of animals with nasal discharge should
surfaces are smoothed. The periosteum at probing.
the base of the flap is incised to make it Behavior/Exercise
tension free. The wound is rinsed again. No hard treats and toys for 4 weeks Client Education
The edges of the flap are gently apposed Teach owners about good home oral hygiene
and sutured to freshly incised edges of Possible Complications and provide related client education sheets.
epithelium. A barrier material (auricular Dehiscence: avoid tension as previously
cartilage, flexible bone membrane) may be described. If the flap tissue tends to pull back SUGGESTED READING
placed under the flap. when placed across the defect before sutures are Reiter AM, et al: Applied feline oral anatomy and
• Double-flap technique: initially, a full- placed, it is too tight, and additional dissection tooth extraction techniques —an illustrated guide.
thickness mucoperiosteal palatal flap is raised is required. J Feline Med Surg 16:900, 2014
but remains hinged at the medial margin of AUTHOR: Lenin A. Villamizar-Martinez, DVM, MS, PhD
the defect. The flap should be transposed to PROGNOSIS & OUTCOME EDITOR: Alexander M. Reiter, DVM, Dr.med.vet.,
cover the defect (palatal epithelium becomes DAVDC, DEVDC
nasal epithelium). A labial-based flap is then Excellent
raised, advanced, and sutured over the con-
nective tissue side of the first flap. PEARLS & CONSIDERATIONS
• Treatment of periodontal disease in other
areas of the mouth is important. This often Comments
requires extraction of other maxillary teeth Gentle tissue handling and avoidance of tension
on the same side; closure of these extraction at the suture line improves healing.

Osteoarthritis Client Education
Sheet

BASIC INFORMATION • Secondary osteoarthritis: commonly results • Chondrocytes attempt to repair the damaged
from trauma or joint instability, incongruity, collagen network, but eventually, repair activ-
Definition immobilization, or osteochondrosis ity cannot keep up, resulting in progressive
Progressive, noninflammatory, irreversible and irreversible loss of articular cartilage
deterioration of articular cartilage HISTORY, CHIEF COMPLAINT structure and function.
• Reluctance to ambulate or jump • Periarticular fibrosis develops as a second-
Synonyms • Lameness and stiffness after exercise or ary process directed toward stabilizing the
Degenerative joint disease, osteoarthrosis, OA prolonged rest joint.
○ Pet owners are more likely to recognize
Epidemiology lameness due to OA in pet dogs than in
SPECIES, AGE, SEX cats. DIAGNOSIS
Dogs and cats; increasing prevalence with age • Irritable behavior when approached or Diagnostic Overview
touched Osteoarthritis is suspected based on signal-
GENETICS, BREED PREDISPOSITION • Decreased grooming, elimination outside ment, history, and especially physical find-
• Elbow dysplasia: rottweilers, Labrador of litter box in cats may be seen without ings (lameness; thickened, painful joint).
retrievers, Bernese mountain dogs recognized lameness Confirmation requires imaging (primarily
• Hip dysplasia: many breeds radiographs).
• Cranial cruciate ligament rupture, patellar PHYSICAL EXAM FINDINGS
luxation: many breeds Orthopedic exam (p. 1143): Differential Diagnosis
• Arthropathy: Scottish fold cats • Lameness • Infectious arthritis
• Stiff or altered gait (e.g., bunny hopping) • Immune-mediated arthritis (erosive or
RISK FACTORS • Joint pain, crepitus, instability, and/or nonerosive)
• Joint instability (hip dysplasia, cranial cruci- decreased range of motion • Neoplasia (synovial sarcoma, osteosarcoma)
ate ligament rupture, trauma) • Joint effusion, thickening
• Joint incongruity (elbow dysplasia, trauma) • Muscle atrophy Initial Database
• Obesity • Clinical exam localizing joint pain
• Work duty or athletics Etiology and Pathophysiology • Radiography: subchondral sclerosis, joint
• Disruption in joint homeostasis begins space narrowing, osteophytosis, enthesophy-
Clinical Presentation with abnormalities in cartilage or joint tosis, joint capsule thickening, subchondral
DISEASE FORMS/SUBTYPES biomechanics, which induces extracellular sclerosis, intraarticular calcified bodies, soft-
• Primary (idiopathic) osteoarthritis: unknown matrix degradation by cytokines and other tissue calcification or subchondral cysts, bone
cause; more common in cats inflammatory mediators. remodeling, joint effusion

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