Tuesday 22nd Jan, 2019

Titus the 6 month old American Bulldog - CT Scan Case Study

Titus had been lame on his right forelimb for a number of weeks, and had been fed a raw diet for about a month when he was around 4 months old.

On exam he had medial elbow pain, and pain on flexion of his right elbow. After discussion with the owners, we decided the best plan was to proceed with CT for what we thought was likely elbow dysplasia.

The specialist CT report described Titus as having an ununited anconeal process (UAP) of the right ulna, as well as suggestion of changes around the medial coronoid process, but no evidence of a fragmented cornoid process or elbow incongruity. The left elbow also had mild medial coronoid process sclerosis but no fragmentation. The UAP can be seen in the image above.

So Titus's main problem was his UAP, and this we treated by placement of a lag screw through the caudal ulna and into the UAP. This will encourgae boney fusion of the UAP back to where it should be. To reduce the forces present on this repair, and the risk of failure of repair we also performed an osteotomy of the ulna. The osteotomy we did was at specific angles which have been shown to 'offload' the medial elbow joint, and also reduce forces on the UAP repair. The image below shows the UAP after repair and ulna osteotomy.


Titus's care is a great example of the uses of CT. While the use of X-rays may still have diagnosed UAP they would not been as effective at assessing for incongruity, and the presence of coronoid disease both factors we wish to manage to help Titus.

An as for the raw diet the CT specialists assessed his bone cortical density, as a marker for whether there could have been secondary hyperparathyroidism changes - this was found to be OK.
Next Post: Eddy the 9 month Pug - CT Scan Case Study

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