Page 964 - Cote clinical veterinary advisor dogs and cats 4th

Histiocytic Diseases 473

○ Limited activity for 1 month
○ Radiography after sling application and
VetBooks.ir • For open repairs Diseases and Disorders
if lameness recurs
○ Restricted ambulation for 1-2 months
○ Radiography if lameness recurs and based
on fixation method
PROGNOSIS & OUTCOME

• Variable with closed reduction: 50% fail
due to technical error or unrecognized joint
disease
• Good to excellent with most operative
procedures of acute injuries (i.e., previously
normal joint)
HIP LUXATION Postoperative ventrodorsal projection of hip joints of an obese 45-kg dog treated for traumatic • Guarded for dysplastic hips unless TPO,
bilateral hip luxation. Bilateral toggle pins and greater trochanter–to–ilium wires were used for stabilizing injuries. FHNE, THR performed
and rectus femoris muscle, iliofemoral • Nonsteroidal anti-inflammatory drugs PEARLS & CONSIDERATIONS
suture, synthetic sutures to replace capsule, (NSAIDs) as needed to reduce pain and
gluteal muscle tenodesis inflammation Comments
○ Intraarticular techniques: toggle pinning, ○ Carprofen 2 mg/kg PO q 12h (dogs), or • With normal hips, reduction/stabilization is
fascia lata loop or sacrotuberous ligament ○ Deracoxib 1-2 mg/kg PO q 24h (dogs; preferred over FHNE for all patient sizes.
transposition may use 3-4 mg/kg PO q 24h for first 7 • Extensive joint capsule and ligament damage
• Triple or double pelvic osteotomy can days only), or impede successful closed reduction.
be performed for mildly dysplastic, ○ Meloxicam 0.1 mg/kg (dogs), 0.05 mg/ • Femoral head ligament avulsion fractures are
immature dogs with no degenerative joint kg (cats) PO q 24h, or often not recognized radiographically.
changes. ○ Firocoxib 5 mg/kg PO q 24h (dogs)
• For chronic injuries, open reduction is dif- Technician Tips
ficult because of muscular contraction and Possible Complications Ehmer slings require frequent monitoring for
tissue fibrosis; cartilage degeneration exists. • Reluxation pes ischemia or wounds beneath the tape.
FHNE or THR may be required in place • Implant failure
of primary repairs. • Degenerative joint disease SUGGESTED READING
• Infection Wardlaw JL, et al: Coxofemoral luxation. In Tobias
Chronic Treatment KM, et al, editors: Veterinary surgery: small animal,
• Physical rehabilitation to maintain muscle Recommended Monitoring ed 2, St. Louis, 2018, Elsevier, pp 956-964.
tone, joint health, and overall limb functions • For closed reduction AUTHOR: Joseph Harari, DVM, MS, DACVS
• Controlled activity to avoid reluxation, ○ Frequent sling evaluations and removal EDITOR: Kathleen Linn, DVM, MS, DACVS
implant failures 7-10 days after application

Histiocytic Diseases Client Education
Sheet

BASIC INFORMATION ○ Cutaneous Langerhans cell histiocytosis ○ Malignant fibrous histiocytoma: despite
(LCH) includes multiple skin lesions that its name, this focal lesion is a unique soft-
Definition resemble histiocytomas and can involve tissue sarcoma and is not discussed here.
A complex group of syndromes resulting from lymph nodes. The histiocytic infiltrate is not neoplastic
an accumulation of histiocytes, which include • Reactive histiocytic disorders (from activated and is of questionable importance.
cells of macrophage or dendritic origin and DCs, dogs only)
function as antigen-presenting cells. Clinical ○ Cutaneous histiocytosis (CH): a benign Synonyms
and histologic characteristics are needed to accumulation of histiocytes in the skin Histiocytic sarcoma (disseminated): malignant
distinguish tumors and syndromes. Most with predisposition for the nasal planum, histiocytosis
arise from dendritic cells (DCs), specifically head, and neck Epidemiology
interstitial DCs, and less commonly from ○ Systemic histiocytosis (SH): similar to
Langerhans DCs (in the epidermis). Histiocytic cutaneous histiocytosis but characterized SPECIES, AGE, SEX
diseases occur in dogs and cats, although reports by lymph node and organ involvement • Histiocytic diseases have predominantly been
in cats are sparse and are limited to malignant • Malignant histiocytic neoplasia (from reported for dogs, but reports exist for cats
neoplasia. Histiocytic disorders can be simplified interstitial DCs) (malignant histiocytosis).
into the following groups: ○ Histiocytic sarcoma (HS): focal or dissemi- • Cutaneous histiocytosis can occur in younger
• Benign tumors nated; the latter is commonly considered dogs, compared with systemic histiocytosis
○ Histiocytoma: spontaneously regressing synonymous with malignant histiocytosis. and disseminated HS in middle-aged dogs
skin tumor of Langerhans cells common ○ Hemophagocytic histiocytic sarcoma (median age, 6 years).
in young animals originates from macrophages. • Equal prevalence in males and females

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