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Peer-reviewed veterinary case report

Implant removal due to infection after dog tibial plateau surgery

By Gallagher, Alissa D & Mertens, W Daniel·Published in Veterinary surgery : VS·2012·Carolina Veterinary Specialists, United States·View original on PubMed

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Original publication title: Implant removal rate from infection after tibial plateau leveling osteotomy in dogs.

Species:
dog

Plain-English summary

A group of dogs that underwent a tibial plateau leveling osteotomy (TPLO) surgery had some complications, with 21 out of 282 needing their surgical implants removed due to infection. The most common bacteria found in these infections were various types of Staphylococcus. To prevent these infections, dogs were given a strong antibiotic called cefazolin during and after surgery. For treating the infections that did occur, amoxicillin combined with clavulanic acid was identified as the most effective antibiotic.

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Abstract

OBJECTIVE: To determine implant removal rate associated with infection after tibial plateau leveling osteotomy (TPLO) in dogs and to report antimicrobial susceptibility patterns for isolates. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 255; 282 TPLO). METHODS: Medical records (April 2006-April 2008) for dogs that had TPLO with ≥ 18 month follow-up were reviewed. Dogs that had implant removal with confirmed bacterial isolation from the implant were studied. Cefazolin (22 mg/kg intravenously) was administered before anesthesia induction for TPLO, every 2 hours intraoperatively, and every 6 or 8 hours until the next morning. Antimicrobial susceptibility testing was performed on isolates. RESULTS: Twenty-one (7.4%) of 282 TPLO required implant removal because of infection. Bacterial species isolated were Actinomyces spp. (1), Corynebacterium spp. (1), Enterococcus spp. (3), hemolytic Staphylococcus coagulase negative (2), nonhemolytic Staphylococcus coagulase negative (3), Staphylococcus spp. coagulase positive (7), methicillin-oxacillin-resistant Staphylococcus coagulase positive (2), and Serratia marcesens (2). Of the antibiotics that had ≥10 isolates tested against them, gentamicin had the highest susceptibility rate (94%), followed by tribrissen (71%), and amoxicillin/clavulanic acid (67%). CONCLUSION: Staphylococcus spp. was reported in 14 of the 21 infections cultured in this study. Based on antimicrobial susceptibility testing, amoxicillin/clavulanic acid would be the best empirical treatment.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/22822724/