Download PDF
Vet Comp Orthop Traumatol 2009; 22(03): 233-237
DOI: 10.3415/VCOT-08-09-0091
Case Report
Schattauer GmbH

Non-selective cutaneous sensory neurectomy as an alternative treatment for auto-mutilation lesion following arthrodesis in three dogs

F. Forterre
1   Department of Surgery, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
,
A. Jaggy
2   Department of Neurology, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
,
Y. Malik
1   Department of Surgery, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
,
J. Howard
3   Clinical Laboratory, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
,
S. Rüfenacht
4   Department of Dermatology, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
,
D. Spreng
1   Department of Surgery, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
› Author Affiliations
Further Information

Publication History

Received:24 September 2008

Accepted:17 January 2009

Publication Date:
17 December 2017 (online)

    Permissions and Reprints

Summary

Objective: To describe an alternative method for the treatment of non-responsive self-mutilation injuries in three dogs after carpal/tarsal arthrodesis. Study design: Case series Animals: Two dogs with carpal injury and one dog with tarsal injury treated by arthrodesis Methods: All dogs developed self-mutilation injuries due to licking and/or chewing of the toes within 21–52 days of surgery. Clinical signs did not resolve within one week after conservative treatment with wound debridement and protective bandages. Following general anaesthesia, a deep horseshoe-shaped skin incision, including the subdermal tissue, was performed proximal to the selfmutilation injury transecting the sensory cutaneous afferent nerves. The skin incision was closed with simple interrupted sutures. Results: All wounds healed without complication. Self-mutilation resolved completely within 24 hours after surgery in all dogs. No recurrence was observed (5 months to 3 years). Conclusion: Non-selective cutaneous sensory neurectomy may lead to resolution of self-mutilation following arthrodesis in dogs. Clinical relevance: Failure of conservative treatment in self-mutilation injuries often leads to toe or limb amputation as a last resort. The technique described in this case series is a simple procedure that should be considered prior to amputation. The outcome of this procedure in dogs self-multilating due to neurological or behavioral disturbances unrelated to carpal or tarsal arthrodesis is not known.

Keywords

Neurectomy - sensory nerve - automutilation - arthrodesis
 

  • References

  • 1 Scott DW, Miller WH, Griffin CE. Acral lick dermatitis. In: Muller and Kirk’s Small Animal Dermatology. 6th ed. Philadelphia: WB Saunders; 2001: 1058-1064.
    Google Scholar
  • 2 White SD. Naltrexone for treatment of acral lick dermatitis in dogs. J Am Vet Med Assoc 1990; 196: 1073-1076.
    PubMedGoogle Scholar
  • 3 Gross TL, Ihrke PJ, Walder EJ. et al. Skin Diseases of the Dog and Cat. Clinical and Histopathologic Diagnosis. Oxford, UK: Blackwell Science Ltd; 2005: 140-142.
    Google Scholar
  • 4 Wynchank D, Berk M. Fluoxetine treatment of acral lick dermatitis in dogs: a placebo-controlled randomized double blind trial. Depress Anxiety 1998; 8: 21-23.
    CrossrefPubMedGoogle Scholar
  • 5 Carlotti DN, Fourrier P, Magnol JP. Les pyodermites superficielles. Prat Med Chir Anim 1988; 23: 473-484.
    PubMedGoogle Scholar
  • 6 Denerolle P, White SD, Taylor TS. et al. Organic diseases mimicking acral lick dermatitis in six dogs. J Am Anim Hosp Assoc 2007; 43: 215-220.
    CrossrefPubMedGoogle Scholar
  • 7 Gnirs K, Prelaud P. Cutaneous manifestations of neurological diseases: review of neuro-pathophysiology and diseases causing pruritus. Vet Dermatol 2005; 16: 137-146.
    CrossrefPubMedGoogle Scholar
  • 8 Virga V. Behavioral dermatology. Vet Clin North Am Small Anim Pract 2003; 33: 231-251.
    CrossrefPubMedGoogle Scholar
  • 9 Newton CD. Elective orthopedic surgery. In: Lipowitz AJ, Caywood DD, Newton CD, Schwartz A, Complications in small animal surgery. Baltimore: Williams and Wilkins; 1996: 599-610.
    Google Scholar
  • 10 Roch SP, Clements DN, Mitchell RAS. et al. Complications following tarsal arthrodesis using bone plate fixation in dogs. J Small Anim Pract 2008; 49: 117-126.
    CrossrefPubMedGoogle Scholar
  • 11 Rapoport J, Ryland DH, Kriete M. Drug treatment of ca-nine acral lick: an animal model of obsessive-compulsive disorder. Arch Gen Psychiatry 1992; 49: 517-521.
    CrossrefPubMedGoogle Scholar
  • 12 van Ness JJ. Electrophysiological evidence of sensory nerve dysfunction in 10 dogs with acral lick dermatitis. J Am Anim Hosp Assoc 1986; 22: 157-160.
    PubMedGoogle Scholar
  • 13 Budras KD Claw. In König E, Liebig HG. eds Veterinary Anatomy of domestic mammals, Stuttgart: Schattauer. 2004: 609-13.
    PubMedGoogle Scholar
  • 14 Kubba R, Taylor JS, Marks KE. Cutaneous complications of orthopedic implants. A two-year prospective study. Arch Dermatol 1981; 117: 554-560.
    CrossrefPubMedGoogle Scholar
  • 15 Rostoker G, Robin J, Binet O. et al. Dermatitis due to orthopaedic implants. A review of the literature and report of three cases. J Bone Joint Surg Am 1987; 69: 1408-1412.
    CrossrefPubMedGoogle Scholar
  • 16 Hallab N, Merritt K, Jacobs JJ. Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg Am 2001; 83 A 428-436.
    PubMedGoogle Scholar
  • 17 Holden CEA. The pathology and prevention of Volksmann´s ischaemic contracture. J Bone Joint Surgery Br 1979; 61: 296-300.
    PubMedGoogle Scholar
  • 18 Aggarwal ND, Singh B, Gureja YP. Compression ischaemia of limbs from tight splintage. J Bone Joint Surg Br 1969; 51: 779-780.
    PubMedGoogle Scholar
  • 19 Anderson DM, White RAS. Ischemic bandage injuries: a case series and review of the literature. Vet Surg 2000; 29: 488-498.
    CrossrefPubMedGoogle Scholar
  • 20 Ikoma A, Rukwied R, Ständer S. et al. Neurophysiology of pruritus – interaction of itch and pain. Arch Dermatol 2003; 139: 1475-1478.
    PubMedGoogle Scholar
  • 21 von Frey M. Zur Physiologie der Juckempfindung. Arch Neerland Physiol 1922; 7: 142-145.
    PubMedGoogle Scholar
  • 22 Andrew D, Craig AD. Spinothalamic lamina I neurons selectively sensitive to histamine: a central neural pathway for itch. Nat Neurosc 2001; 4: 72-77.
    CrossrefPubMedGoogle Scholar
  • 23 Schmelz M, Schmidt R, Bickel A. et al. Specific C-receptors for itch in human skin. J Neuroscience 1997; 17: 8003-8008.
    CrossrefPubMedGoogle Scholar
  • 24 Drzezga A, Darsow U, Treede RD. Central activation by histamine-induced itch: analogies to pain processing: a correlational analysis of O-15 H2O positron emission tomography studies. Pain 2001; 92: 295-305.
    CrossrefPubMedGoogle Scholar
  • 25 Ghez C. Voluntary movement. In: Kandel ER, Schwartz JH eds. Principles of Neural Science, 2nd edn. New York: Elsevier 1985; 653-673.
    PubMedGoogle Scholar
  • 26 Coderre TZ, Katz J. Peripheral and central hyper-excitability: differential signs and symptoms in persistent pain. Behav Br Sc 1997; 20: 404-408.
    PubMedGoogle Scholar
  • 27 Schmelz M, Schmidt R, Weidner C. et al. Chemical response pattern of different classes of C-nociceptors to pruritogens and algogens. J Neurophysiol 2003; 89: 2441-2448.
    CrossrefPubMedGoogle Scholar
  • 28 Ikoma A, Fartasch M, Heyer G. et al. Painful stimuli evoke itch in patients with chronic pruritus. Neurol 2004; 62: 212-217.
    CrossrefPubMedGoogle Scholar
  • 29 Oliver JE, Lorenz MD, Kornegay JN. Pain, 3rd ed. Philadelphia: W.B. Saunders; 1997
    Google Scholar
  • 30 Plumb DC. Gabapentin. In: Plumb’s veterinary drug handbook, 5th ed. Ames: Blackwell 2005; 513-515.
    PubMedGoogle Scholar
  • 31 Ballinari U, Montavon PM, Huber E. et al. Pectineus myectomy, tenotomy of the iliopsoas and neurectomy of the joint capsule as symptomatic therapy for coxarthrosis of the dog. Schw Arch Tierheilkd 1995; 137: 251-257.
    PubMedGoogle Scholar
  • 32 Kinzel S, von Scheven C, Buecker A. et al. Clinical evaluation of denervation of the canine hip joint capsule: a retrospective study of 117 dogs. Vet Comp Orthop Traumatol 2002; 15: 51-56.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Kinzel S, Hein S, von Scheven C. et al. 10 years experience with denervation of the hip joint capsule for treatment of canine hip joint dysplasia and arthrosis. Berl Munch Tierarztl Wochenschr 2002; 115: 53-56.
    PubMedGoogle Scholar
  • 34 Foucher G, Pretz PL, Erhard L. La denervation articulaire, une réponse simple à des problèmes complexesde chirurgie de la main. Chir 1998; 123: 183-188.
    PubMedGoogle Scholar