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Aspergillosis 81

a nonpainful pseudoarthrosis with an ade-
quate range of motion.
VetBooks.ir due to a femoral neck remnant and often Diseases and Disorders
• Continued lameness after FHNE is usually
resolves if this remnant is removed.
• Chronic femoral capital physeal fractures (in
cats and dogs) can be confused with aseptic
necrosis on radiographs, but the cause is
different.

Technician Tips
• Postoperative radiographs should include an
extended-limb ventrodorsal view and a
frog-leg view with femurs pulled cranially
(parallel to the spine) to highlight femoral
ASEPTIC NECROSIS OF THE FEMORAL HEAD Ventrodorsal view of the coxofemoral joints of a 10-month-old neck remnants.
pug with left hindlimb lameness and hip joint pain. Note the bone deformation of the left femoral head (arrow) • Leash-controlled walking and range-of-
compared with the normal right joint. motion exercises should be started immedi-
ately after surgery to encourage normal limb
Chronic Treatment Possible Complications use.
• The same surgical options can be used in • Pain due to inadequate removal of the Client Education
chronic cases, but postoperative recovery may femoral neck in FHNE • Breeders of dogs at risk should be warned
be less satisfactory due to learned behavior • Poor limb usage from inadequate physical that this condition is heritable. Affected
(avoidance of use of the affected leg) or rehabilitation after FHNE animals should be removed from the breeding
chronic muscle atrophy. pool.
• If surgery is not done or lameness resolves Recommended Monitoring • For postoperative care at home, provide
incompletely, one of the following nonster- • Postoperative radiographs to evaluate FHNE client with client education sheet: How
oidal antiinflammatory drugs (NSAIDs) can osteotomy to Perform Range-of-Motion Exercises
be given on an intermittent or (if necessary) • Monthly physical examinations to evaluate (www.ExpertConsult.com).
daily basis: limb function until normal
○ Carprofen 2.2 mg/kg PO q 12h or 4.4 mg/ SUGGESTED READING
kg PO q 24h; or PROGNOSIS & OUTCOME
○ Deracoxib 1-2 mg/kg PO q 24h; or Towle Millard HA, et al: Miscellaneous orthopedic
○ Meloxicam 0.1 mg/kg PO q 24h • Lameness resolves in > 80% of cases after conditions. In Johnston SA, et al, editors: Veterinary
surgery: small animal, St. Louis, 2018, Elsevier, p
FHNE or THR. 1309.
Nutrition/Diet • Lameness resolves in < 25% of cases with
• Aim to maintain normal body condition. medical treatment alone. Reproduced from the third edition in modified
form.
• Dietary supplements do not appear to be
helpful. PEARLS & CONSIDERATIONS THIRD EDITION AUTHORS: D. Michael Tillson, DVM, MS,
DACVS; Katrin Saile, DVM, MS, DACVS
Drug Interactions Comments AUTHOR & EDITOR: Kathleen Linn, DVM, MS, DACVS
• Concurrent administration of glucocortico- • Radiographic changes are subtle early in the
steroids and NSAIDs can result in severe course of the disease; serial radiography may
gastrointestinal irritation, ulceration, and be helpful in diagnosis.
perforation. • Physical rehabilitation is important for
• Chronic NSAID treatment can exacerbate obtaining the best results after FHNE.
liver or renal dysfunction. Range-of-motion exercises, swimming, and
limited weight-bearing exercises help create

Aspergillosis Bonus Material
Online

BASIC INFORMATION GENETICS, BREED PREDISPOSITION • Sinonasal: other primary nasal disease,
• Systemic aspergillosis: German shepherd dogs immunoglobulin A deficiency, prolonged
Definition overrepresented antibiotic use, nasal conformation
Regional or disseminated infection with • Sinonasal aspergillosis: medium- to large-
the opportunistic hyphal fungus Aspergillus breed, dolichocephalic dogs overrepresented. CONTAGION AND ZOONOSIS
spp Conversely, brachycephalic cat breeds (e.g., Aspergillosis is an opportunistic infection; it
Persian) are predisposed to upper respiratory is not zoonotic or contagious.
aspergillosis (sinonasal or sino-orbital).
Epidemiology ASSOCIATED DISORDERS
SPECIES, AGE, SEX RISK FACTORS • Systemic: discospondylitis
Dogs more commonly affected than cats; often • Systemic/disseminated: immunosuppression, • Sinonasal: chronic rhinitis; fungal sinusitis
middle-aged adults primary immune deficiencies

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