Non-selective cutaneous sensory neurectomy as an alternative treatment for auto-mutilation lesion following arthrodesis in three dogs
F. Forterre (1), A. Jaggy (2), Y. Malik (1), J. Howard (3), S. Rüfenacht (4), D. Spreng (1)
(1) Department of Surgery, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland; (2) Department of Neurology, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland; (3) Clinical Laboratory, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland; (4) Department of Dermatology, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland
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 self-mutilation 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
Arthrodesis, Neurectomy, sensory nerve, automutilation
DOI
http://dx.doi.org/10.3415/VCOT-08-09-0091