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12 Achilles Tendon Injury

other medications such as opioids, dextromethor- • Phenazopyridine (Pyridium) is metabolized AUTHOR: Kirsten Waratuke, DVM, DABT
phan, pseudoephedrine, or phenylephrine. into acetaminophen and an aniline dye. EDITOR: Tina Wismer, DVM, MS, DABVT, DABT
VetBooks.ir Client Education SUGGESTED READING
• Owners should be aware that OTC pain
Sellon RK: Acetaminophen. In Peterson ME, Talcott
relievers might not be safe for pets. They should
2013, Elsevier.
always contact a veterinary professional before PE, editors: Small animal toxicology, ed 3, St. Louis,
administration of any OTC medications.

Achilles Tendon Injury Bonus Material Client Education
Sheet
Online

BASIC INFORMATION • Gaps in tendon fill with fibrous tissue, Advanced or Confirmatory Testing
causing gait/stance change due to excessive Magnetic resonance imaging (p. 1132) provides
Definition tendon length superior detail; canine normals have not yet
• The common calcanean or Achilles tendon been established.
is composed of three tendons inserting on DIAGNOSIS
the calcaneus: the gastrocnemius tendon; the TREATMENT
combined tendon of biceps femoris, semi- Diagnostic Overview
tendinosus, and gracilis; and the superficial Diagnosis is confirmed by results of Treatment Overview
digital flexor (SDF) tendon. physical, radiographic, and ultrasonographic Therapeutic goals are to restore normal length
• Injuries include lacerations, acute rup- examinations. and strength of the common calcaneal tendon.
tures, and chronic rupture due to tendon
degeneration. Differential Diagnosis Acute General Treatment
• Fracture of the calcaneus • Tendinopathies without calcaneal avulsion
Synonyms • Tarsal hyperflexion injury can be treated with immobilization in exten-
Achilles mechanism failure, common calcanean • Distal tibia/fibula fractures sion (cast, splint, calcaneotibial screw,
tendon rupture, Achilles tendinopathy, dropped external skeletal fixation, or orthotic) for 2-4
hock Initial Database weeks, followed by controlled weight bearing
• Lameness examination (p. 1143), palpation for a further 2 weeks.
Epidemiology of Achilles tendon, simultaneous flexion/ • Avulsed heads of gastrocnemius muscle
SPECIES, AGE, SEX extension of stifle and hock joints repaired with wire/heavy suture around
• Mature dogs; working or racing breeds • Mediolateral and caudocranial radiographic fabella and into the distal femur
• Cats; females > males projections of stifle and hock • Acute midsubstance tears of each tendon
• Ultrasonography of common calcaneal are anastomosed using three-loop pulley,
GENETICS, BREED PREDISPOSITION tendon complex Bunnell, or locking-loop pattern.
Labrador retrievers and Doberman pinschers • CBC and chemistry panel based on signal- • Tendons avulsed from tuber calcanei are
appear to be overrepresented for tendon rupture. ment and nature of injury; usually unremark- reattached by Krackow or locking loop suture
able with tendon injury alone passed through bone tunnels.
RISK FACTORS
Overuse in active, large-breed dogs
Clinical Presentation
DISEASE FORMS/SUBTYPES
Insertional avulsion, chronic tendinopathy,
avulsion of gastrocnemius origin from the
femur, musculotendinous ruptures, midsub-
stance tendon lacerations and tears
HISTORY, CHIEF COMPLAINT
May present as an acute injury or as a chronic
progressive lameness with tendinopathies
PHYSICAL EXAM FINDINGS
Variable lameness, palpable gap or swelling
within tendon, plantigrade stance, dropped
hock (excessive tarsal flexion during stance),
excessive toe flexion (with ruptured gastrocne-
mius, intact SDF tendon)
Etiology and Pathophysiology
• Acute lesions caused by trauma, overload; ACHILLES TENDON INJURY Doberman showing classic stance of a chronic Achilles tendinopathy injury.
repetitive stresses can lead to chronic degen- Note the left stifle extension, hock flexion, and digit flexion; also note overconditioning (body condition score
erative changes. 8/9).

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