Fracture repair

At Peterborough Pet Hospital we offer our clients a full range of orthopedic services for the treatment of long bone fractures, hip fractures and dislocations, treatment for joint injuries and osteoarthritis. On occasion there may be fractures or conditions that we would recommend a referral to a large Orthopedic Center which we arrange on your behalf.

Most long bone fractures are repaired by internal fixations with surgical plates and screws. For small breeds we use the ALPS (Advanced Locking Plate System) plating system by KYON. These are very fine titanium plates and locking screws that allow us to repair very tiny bones with minimal disruption to the bones blood supply. For larger patients we use stainless steel plates and screws by Synthes. 

Elbow surgery : The PAUL (Proximal Abducting Ulnar Osteotomy) surgical procedure addresses osteoarthritis in the elbows of dogs that suffer from elbow dysplasia and medial coroniod process disease. Surgery involves cutting the Ulna bone just below the elbow joint and applying a special offset plate that widens the joint space on the medial side of the elbow, taking pressure off of the medial coronoid process and reducing discomfort. It is used extensively in Italy and Europe for the treatment of medial compartment disease of the elbow and shows promising results for patients. 

Patients with severe medial luxating patellas (dislocating knee caps) that are not candidates for the traditional trochleoplasty and tibial crest transposition surgeries can now benefit from surgically implanted replacement grooves (PGR-Patellar Groove Replacement) developed by KYON. These implants have an industrial diamond coating on Titanium and show lots of promise in treating this condition. 

Through continuing education seminars and training Dr. Muise provides many on site procedures and follows up with cases until orthopedic healing is complete.  

Lifestyle Vaccines

Vaccines are a very important part of your pets total preventive health care program. At Peterborough Pet Hospital we offer the standard "CORE" vaccines that all puppies and kittens should have, the mandatory RABIES vaccine and additionally, what we call Lifestyle vaccines which we Taylor individually for your pets risk.

CORE vaccines are those for Distemper, Hepatitis, Para influenza and Parovirus for dogs and Herpes, Calici, Chlamydia, Panleukopenia and Leukemia virus for cats. Colostrum that puppies and kittens nurse in the first few days of life contain antibodies from the mothers blood that offers "PASSIVE" immunity and protection in the first few weeks of life. This then wears off and pets must now develop "ACTIVE" immunity in order to maintain protection in years to follow. Vaccines are given at 6, 8, 12 and 16 weeks in order to stimulate their immune system to start production of antibodies and develop a memory in their immune system for these diseases. Without these CORE vaccines, passive immunity is gone and your pet becomes at risk for these deadly contagious diseases. Periodic booster vaccination throughout your pets life helps keep their immune system primed and ready to fight these diseases should your pet come into contact with these viruses. Starting in the 3rd year of your pets life we offer titer testing as an alternative to continual vaccination to ensure your pet remains protected. Vaccines will be given when your pets titer is not adequate for protection.

RABIES is an exposure disease and not a contagious disease. Local by-laws dictate Rabies vaccination. Rabies is a public health concern and falls under the Ministry of Health. Pets must be vaccinated for Rabies by a licensed veterinarian in Ontario. Pets are typically vaccinated at 16 weeks of age, then repeated at 1 year of age. At two years of age Dogs can be vaccinated using a 3 year vaccine. We recommend every other year vaccination for Rabies as research shows there becomes a risk in the third year - 12% of dogs may not sustain protective immunity.  We do not recommend 3 year rabies vaccines for cats due to reports of some cats developing injection site tumors that can be related to the "adjuvant" in the multiyear vaccine.  We use a recombinant rabies vaccine in cats that is given annually, no preservatives or adjuvant. 

Lifestyle vaccines are those for Bordetella ( kennel cough ), Leptospirosis and Lyme disease. These are Bacterins not vaccines as these diseases are cause by bacteria, not a virus. Intranasal Bordetella vaccines provide topical immunity right in the upper respiratory tract of your pet, as it is transmitted through nasal ingestion. Leptospirosos is a bacteria found in puddles and stagnant water zones, spread by infected urine from a number of animal species. It attacks the kidneys and leads to severe kidney disease and even death. Immunity duration for this bacterin is 1 year and annual vaccination must be maintained for protection. Lyme disease is REAL. For years it was thought not to exsist in Ontario. There are growing numbers of positive cases and Peterborough is experiencing this. New York State is a hotspot for Lyme disease. The bacteria is carried by certain Ticks and they  travel on migratory birds. This gets into the local wildlife population and spreads. Humans are at risk for contracting Lyme disease and it is now being diagnosed more in Ontario. The Bacterin is initially given to your pet and boosted 4 weeks later. Annual vaccination is required to maintain immunity, again because it is a bacteria and not a virus. There is no bacterin currently available for humans but this is being developed. There are preventive measures that pet owners can take to reduce the risk of exposure for them and their families. Oral medications that kill the ticks are now on the market for dogs. These can be given monthly or every 3 months depending on the product used. Many people have their pets on these medications as pets frequently sleep with their owners or children in the family and ticks can be brought into the house on pets. If your pet gets a tick, remove it and bring it into the hospital. We will examine the tick and see if it is the species that can carry Lyme disease at not cost to you. if it is the species of tick that can carry Lyme disease we can send the Tick out to a lab for analysis.

People worry about vaccines and health issues related to vaccination. Vaccines are safe and have been part of normal health care for many years. Some animals may have an "ADVERSE REACTION" when vaccinated. This is not the vaccine, this is a genetic predisposition that your pets immune system has. They are rare and certainly do not warrant people from shying away from immunizing their pets. Benefit greatly out-weighs any risk of adverse reactions. These reactions if they occur are usually mild and can be treated by the veterinarian. Vaccination is the most cost effective procedure that you can do for your pet to ensure it has a long healthy life.

We continually stay in the fore-front of change in vaccine protocols to ensure a long healthy life for your pets. Vaccine usage is dictated by Health Canada and Canadian licensed veterinarians must follow their guidelines and Product Monograms. 

Dentistry

Dental health is a very important part in maintaining your pets overall general health. It is recommended that as part of your pets complete health program, oral care be high on the list and that owners should pay particular attention to their pets diets, treats, tartar control and overall oral health. Good and proper oral health will mean that your pet will have a longer, healthier life and help avoid many of the medical conditions can arise in later years due to poor oral hygiene.

Our veterinarians will examine your pets mouth on their annual wellness examination to assess the dental/oral health and make any recommendations that may be needed to ensure your pet maintains a healthy mouth. We also examine the mouth for any signs of other diseases such as gum disorders, congenital conditions, teeth alignment, retained baby teeth and cancers.

We believe so strongly about the importance of dental health and disease prevention related to poor dental health that we offer our clients affordable routine dental scaling and cleanings. We will do a no cost oral assessment in order to book your pet in for dental cleaning and discuss any additional costs that may apply if extractions or other oral procedures are required. We have an ongoing dental program that runs all year long, not just at certain times of the year. Please ask our staff and doctors about routine oral care for your pet, and things that you can do at home for your pets oral health.

Flexible Endoscopy

FLEXIBLE ENDOSCOPY can be used in pets for retrieving foreign bodies from the esophagus, stomach and upper small intestines. As well, it can be used to explore, biopsy and diagnose various disease conditions of the upper and lower bowls, lungs, nasal cavity and urinary tract . Various sized fiberoptic scopes of approximately 1 meter long are used depending on the animal size and procedure required.

Dr. Muise has been routinely performing endoscopic procedures since 1991. In most cases animals can be sent home the same day without the need of specialized home care.

To Laser or Not to Laser

One of the most frequently asked questions is, "Do We Offer Laser Surgery ". Quite often the person asking the question is really not familiar with what laser surgery actually does.

Surgical Lasers are used in place of a scalpel blade to make an incision, and cauterize bleeding at the same time. They were first introduced into the human surgical field back in the 1980's. It  was not very well received and interest dropped off. The focus was then turned to veterinary surgery market. Again, it was not really well received.

There can be occasional cases where Laser has a benefit but actual usage is fairly sporadic and not cost effective for most cases.

At Peterborough Pet Hospital we chose not to go with Lasers and instead added Radio frequency ( RF ) electrosurgical surgical units into our two surgical theaters. These units have both Monopolar and Bipolar mode capability which greatly expands its useability for the surgeon and patient. We feel that these RF units give our surgery the flexibility and patient safety we need. Monopolar mode gives a nice controlled cut / cautery function, while Bipolar mode allows very controlled pinpoint cautery needed for delicate surgicalprocedures, as well as during laparoscopic surgery. Surgeons require special training for these units to ensure maximum benefit and safety to patients

Anterior Cruciate Disease

The canine stifle ( knee ) is a complex joint that lacks a true ball and socket type design. The femoral condyles rest on a tibial plateau aided by two cartilage meniscus pads which are cupped and substitute as a socket for the femoral condyles to rest. The two main intra- articular ligaments that give stability to the knee are called Cruciate Ligaments. They are the Anterior Cruciate Ligament ( ACL ) and Caudal Cruciate Ligament ( CCL )  On occasion the medial cartilage pad (meniscus ) can be injured ( torn ) with or without concurrent cruciate ligament tears.  This creates pain in the knee joint and subsequent lameness. Fortunately for dogs, they walk on 4 legs and often get along on 3 legs or transfer enough weight  and appear to cope with a mild injury. This leads to intermittent lameness after exercise, medial swelling on the knee joint capsule ( medial buttress ) and osteoarthritis in the knee. Once completely torn the dogs often holds the leg up and are reluctant to want to weight bear on the leg. Most ligament tears occur in the ACL, less commonly in the CCL. Often with a meniscus tear a clicking noise can be heard and felt when the knee is flexed and extended.

In humans the tearing of the ACL is mostly the result of direct trauma. In dogs the onset of the lameness may appear to be from a trauma however, it is now know that a factor called the "tibial plateau angle" plays a significant role in predisposing the ACL to tears. The human knee has a tibial plateau that is just slightly off the horizontal plane by a few degrees. In the dog the plateau angle is quite significant, often in excess of 24 degrees in the posterior direction  ( slopes backwards away from the front of the knee ). This slope places direct tension on the ACL that is directly related to the degree of slope. Over time this stretches, fatigues and weakens the ACL. Then the ligament can tear from a traumatic event and appear that the onset is acute ( sudden ).

Once the ACL is torn, surgery is the best option to get stability back in the knee and resume usage. There have been over 230 different surgical techniques developed over the years to address a torn ACL. To date, even with all of our advancements in surgery, there is no one technique that is the "magic bullet" for this condition.  The most commonly used techniques for the dog are;  Lateral Suture Imbrication, Tibial Plateau Leveling Osteotomy ( TPLO ) and Tibial Tuberosity Advancement ( TTA ). Recently, a second generation TTA2 procedure has been developed which uses less implants and speeds healing for selected cases.

Lateral Suture Imbrication involves applying a monofilament suture ( similar to fishing line ) to the outer aspect of the lateral joint capsule in such a direction as to mimic the line of tension of the ACL.  This gives lateral stability to the knee, but little to no rotational stability. The knee functions more as a hinge joint.  This predisposes the knee to meniscial injuries ( tears ). It is a relatively simple surgery and can be performed by veterinarians with good surgical technique and training

TPLO and TTA surgeries address the biomechanics of knee forces instead of the direct stability of the knee joint. They are often referred to as Geometric surgeries. These surgeries neutralize the cranial tibial thrust force. After surgery the knee will function in the abcense of an intact ACL.

TPLO has been a very popular technique and has had good success in returning dogs back to function. It involves making a curved cut in the proximal tibia separating the tibial plateau from the tibial shaft, rotating the plateau to 6 degrees off horizontal and fixing it with a bone plate. It has a few draw backs, in that the weight bearing axis is changed in the leg, the popliteal muscle is elevated off the tibial bone for the osteotomy procedure which results in some loss of rotational stability in the knee and  tension is removed from the patella tendon which may lead to patellar tendonitis post op. Reported complication rates are as high as 28 to 30% post operatively. It requires special training and equipment and should not be attempted by veterinarians not proficient in Orthopedic Surgery.

TTA surgery also neutralizes the " cranial tibial thrust " force by an osteotomy to free up the tibial crest and advance it forward. The crest is fixed it in place with a metal cage and specialized fork plate. This techniques keeps the same weight bearing axis for the leg, does not affect the function of the popliteal muscle and maintains tension of the patellar tendon.  The reported complication rate is about 6 to 8% post op. It  too should be performed by surgeons experienced in Orthopedic Surgery. TTA2 is a variation of TTA and reduces the amount of implants needed for the procedure.

Here at Peterborough Pet Hospital Dr. Muise prefers and routinely performs TTA surgery and TTA2  for the treatment of Anterior Cruciate Ligament disease. 

TTA 

The Gentle Spay : Laparoscopy

Laparoscopy is a minimally invasive surgical technique used to perform surgical procedures on internal structures of the body. A laparoscope with digital camera is inserted through a trocar port via a small incision into the body wall. It magnifies internal structures on television monitors for more direct viewing. Additional access ports are inserted to facilitate the use of surgical specialized instruments. In the past, the most common application of laparoscopy was to perform a biopsy of internal organs. With advancements in equipment and techniques, laparoscopy can now be used for Ovariectomy, Ovariohysterectomy, Cryptorchid, Exploratory, Gastropexy, Feed tube placement, Cystotomy for calculi removal and chest procedures. Laparoscopic surgical procedures are considerably less painful postoperatively and speeds recovery following surgery. Most are outpatient procedures, with minimal exercise restriction needed post operatively during the healing phase. Post-op pain medication is often not necessary.

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Exercises; Especially for Dogs

Moderate walking twice a day.

Swimming with your dog or tossing a flexible toy or ball that floats on the water for him to fetch. Swimming is especially good for arthritic dogs since it is a low-impact activity – and that means less jarring of joints.

Fetching on land with a favorite toy.

If you prefer inside games, try hide and seek. A human-canine form of hide and seek is an effective and fun way for your dog to use his scenting abilities and it’s great exercise. It also promotes that special bond between owner and dog. Best of all, your dog is always “it” and likes it!!

Pets and Stress

When thinking of ways to reduce stress in life, usually techniques like meditation, yoga and journaling come to mind.

These are great techniques, to be sure. But getting a new best friend can also have many stress relieving and health benefits.

While human friends provide great social support and come with some fabulous benefits, research shows that, unless you’re someone who really dislikes animals or is absolutely too busy to care for one properly, pets can provide excellent social support, stress relief and other health benefits—perhaps more than people!

When We Lose A Pet

Pets are like members of our family.  When a beloved pet becomes ill or dies, it affects those left behind. For many, it is a grieving process like any other.

The link below will allow you to download a brochure to offer advice about this trying time in a family's life.

Ten Tips on Coping With Pet Loss