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High prevalence of gait abnormalities in pugs

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The objective of this prospective study was to determine the prevalence of gait abnormalities in a cohort of Swedish pugs by using an owner-based questionnaire targeting signs of gait abnormality and video footage showing the dog’s gait. This study also evaluated associated conditions of abnormal gait, including other health disorders prevalent in the breed. Five hundred and fifty (550) pugs registered in the Swedish Kennel Club, of one, five and eight years of age, in 2015 and 2016, were included in the study. Gait abnormalities were reported in 30.7 per cent of the responses. In the majority of cases, the character of the described gait indicated a neurological cause for the gait abnormality. An association was observed between abnormal gait and age, with gait abnormalities being significantly more common in older pugs (P=0.004). An association was also found between abnormal gait and dyspnoea, with dyspnoea being significantly more common in pugs with gait abnormalities (P<0.0001). This study demonstrated that the prevalence of gait abnormalities was high in the Swedish pug breed and increased with age. Future studies on the mechanisms behind these gait abnormalities are warranted.
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Vet RecoRD | 10.1136/vr.104510 1
PaPer
High prevalence of gait abnormalities
inpugs
Cecilia Rohdin,1,2 Karin Hultin Jäderlund,3 Ingrid Ljungvall,1 Kerstin Lindblad-Toh,4,5 Jens Häggström1
The objective of this prospective study was to determine the prevalence of gait abnormalities in a cohort of
Swedish pugs by using an owner-based questionnaire targeting signs of gait abnormality and video footage
showing the dog’s gait. This study also evaluated associated conditions of abnormal gait, including other
health disorders prevalent in the breed. Five hundred and y (550) pugs registered in the Swedish Kennel
Club, of one, ve and eight years of age, in 2015 and 2016, were included in the study. Gait abnormalities
were reported in 30.7 per cent of the responses. In the majority of cases, the character of the described gait
indicated a neurological cause for the gait abnormality. An association was observed between abnormal gait
and age, with gait abnormalities being signicantly more common in older pugs (P=0.004). An association
was also found between abnormal gait and dyspnoea, with dyspnoea being signicantly more common in
pugs with gait abnormalities (P<0.0001). This study demonstrated that the prevalence of gait abnormalities
was high in the Swedish pug breed and increased with age. Future studies on the mechanisms behind these
gait abnormalities are warranted.
Introduction
Gait is a manner of coordinated limb movement,
with the canine walk and trot described as symmet-
rical gaits.1 Although incompletely studied, the gait
of short-legged dogs, including the pug, has been
described.2 Abnormal gait can be the result of ortho-
paedic and/or neurological conditions. The pug
breed is predisposed for specific orthopaedic condi-
tions3 4 and neurological problems in the breed
have become increasingly recognised in the last few
years.5–14
In a British study, lameness, as the result of ortho-
paedic problems, and spinal cord disorders, charac-
terised by paresis and ataxia, were reported in 2.4 per
centversus 1.4 per centof the pugs attending primary
veterinary care.15 The prevalence of spinal cord disor-
ders presented from the UK15 corresponds poorly to a
Swedish report,i which suggested a sevenfold increase
in mortality rate for ataxia, paresis and collapse in
pugs compared withother breeds. Adding the atten-
tion ‘wobbly pugs’ are given on the internet suggests
a need to systematically determine the prevalence of
gait abnormalities in the breed.
The aim of this prospective study was to investigate
the prevalence of gait abnormalities in a cohort of Swed-
ish pugs by using an owner-based questionnaire target-
ing signs of gait abnormality. Specialist evaluation of
the gait using video footage of parts of the patient pop-
ulation, to compare with the owners’ responses, was
an additional aim. The study also evaluated associated
conditions of abnormal gait, including other health dis-
orders prevalent in the breed.
Materials and methods
Data collection
An invitation to participate in the study was sent by
mail to all owners of pugs registered in the Swedish
Kennel Club that had dogs aged one, five or eight years
in 2015. The following data were obtained from the
Swedish Kennel Club register: pedigree number, the
dog’s name and date of birth, name and address of the
owner. An online standardised questionnaireii was sent
to all owners who accepted the invitation. To increase
the number of dogs included in the study, a second
i
AGRIA insurance data. Updated dog breed statistics: 2006–2011. 2015.
AGRIA Insurance Ltd, Stockholm, Sweden.
ii
Netigate survey platform, Stockholm, Sweden.
10.1136/vr.104510
Veterinary Record (2018) doi: 10.1136/vr.104510
1Department of Clinical Sciences,
Swedish University of Agricultural
Sciences, Uppsala, Sweden
2Anicura, Albano Animal Hospital,
Danderyd, Sweden
3Department of Companion Animal
Clinical Sciences, Norwegian University
of Life Sciences, Oslo, Norway
4Department of Medical Biochemistry
and Microbiology, Science for Life
Laboratory, Uppsala University, Uppsala,
Sweden
5Broad Institute of Harvard and
Massachusetts, Institute of Technology,
Cambridge, MA, USA
E-mail for correspondence:
cecilia. rohdin@ slu. se
Provenance and peer review Not
commissioned; externally peer
reviewed.
Received May 13, 2017
Revised September 22, 2017
Accepted November 11, 2017
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2
paper-based questionnaire including the same ques-
tions as in the online version, but with one additional
question (Fig 1), was sent by post to all owners of pugs
that turned one, five or eight years of age in 2016 and
were registered in the Swedish KennelClub. The three
age groups, rather than the whole pug population,
were selected to optimise recognition of age-related gait
abnormalities indicating distinct aetiologies, and to
limit the amount of questionnaires/data.
Questionnaire
The investigators used a questionnaire, targeting imme-
diate signs of unsound gait, for example, lameness,
ataxia/incoordination, weakness and indirect signs
of gait abnormality (eg, inability to jump, abnormal
wearing of the nails and/or the skin on the dorsum of
the paws) (Fig 2a,b) (Table1). The owners could either
state that their dogs had a normal gait with none of the
following signs: lameness, ataxia incoordination, weak-
ness, inability to jump or raise up, abnormal wearing of
the nails and/or the skin on the dorsum of the paws, or
that their dogs had an abnormal gait with signs of lame-
ness, ataxia incoordination, weakness, inability to jump
or raise up, abnormal wearing of the nails and/or the
skin on the dorsum of the paws. When an abnormal gait
was stated, owners were asked to define the problem as
acute; less than one-month duration, or chronic; more
than one-month duration.
Pugs assessed by their owners to have an abnormal
gait, and pugs reported by their owners as having a nor-
mal gait but which exposed an unsound gait later in the
questionnaire (by their owners’ response to questions
about wearing of nails and/or paws) were assessed by
the authors as having an abnormal gait and includ-
ed in group 1. Pugs that were not included in group 1
were described by the authors as having a normal gait
(group 2).
Specic questions aimed to further characterise
a possible gait abnormality and questions regarding
the general health of the pug were asked. In case the
pug was no longer alive, the owners were asked to
provide information regarding reason/cause of death
(Table1).
For most of the questions, the respondent’s answers
were limited to a xed set of responses: either a simple
yes or no question, or multiple-choice questions where
the respondents had several options to choose from.
No preset options were available for certain questions
and the owners were able to respond to them freely. The
questionnaire did not oer preset options to actively re-
spond ‘do not know’ and‘choose not to answer’; how-
ever, for every question there was a possibility for the
owners not to respond or to respond to more than one
alternative.
Video footage
In addition to being asked to complete the question-
naire, theowners of all pugs were encouraged to send
video footage of their pug, showing their dog walking
back and forth, slowly on a leash, and also showing the
dog walking from the side.iii Two board-certified veter-
inary neurologists (CR and KHJ) evaluated all videos
independently, each on two separate occasions, and
classified the dogs as having normal or abnormal gait.
Results from the two raters were compared and in cases
of disagreement the videos were examined again in
normal and slow motion before arriving at a final, joint
decision. The specialist’s evaluation of the gait was then
compared withthe owner’s responses in the question-
naire. A normal gait in the videos was defined as coordi-
nated walking or trotting without signs of pacing,2 with
no visible or audible lameness or paresis and with no
scuffing of the nails and/or skin on the dorsum of the
paws.
Statistical analysis
The statistical analyses were performed using a
commercially available statistical software program.iv
Descriptive statistics were used for dog characteris-
tics, gait abnormalities and presence of comorbidities.
Continuous variables were reported as median and IQR.
If owners had made multiple choices each single reply
was included in the analysis.
iii
https://www.youtube.com/watch?v=raIfVZba2I8&feature=youtu.be
iv
JMP Pro V.11.2.0, Cary, NC, USA.
(a) (b)
FIG 1: The following question was added to the paper-based questionnaire
sent out in 2016 in the study of gait in pugs. Which sitting position does your
pug prefer: (a) or (b)? Both options could be chosen.
(b)(a)
FIG 2: In this questionnaire-based study of the gait in pugs, the owners
were asked if their pug would wear their nails (a)and/or the skin (b)on the
dorsum of their paws as shown in the picture.
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The chi-squaredtest or Fisher’s exact test wasused
to test for dierences in proportions concerning general
health disorders in age groups and in gait abnormali-
ty groups. Dierences in continuous variables between
groups were tested using Wilcoxon test.
Possible associations between presence of gait ab-
normalities and dog characteristic (age, sex, weight)
variables and presence of specic comorbidities (fae-
caland urinary incontinence, seizures, syncope, dysp-
noea, pigmentary keratitis, corneal ulcer, abnormal
scratching around neck/ears and head, chronic skin
problems, demodicosis, pug dog encephalitis, y snap-
ping and licking the air) were investigated using back-
ward stepwise multivariate logistic regression analysis.
Only variables with a Pvalue of <0.2 in the univariate
regression analysis were included in the multivari-
ate analysis. Level of statistical signicance was set at
P<0.05.
Results
Response rate
Of the 2374 invitations and questionnaires sent to
selected pug owners, 26 per centwere returned. Five
hundred and fifty owners specifically responded to the
main question concerning gait (normal vs abnormal
gait) (Fig 3).
In the 550 returned questionnaires, with responses
concerning normal versus abnormal gait, the response
rate for individual questions ranged from 220/550
(40.0percent) (signs of pain) to 528/550 (96.0percent)
(any seizures).
General description of the study population
A detailed description on signalment and clinical varia-
bles in the entire cohort of pugs is presented in Table2.
Information about sex, weight andsitting position by
age groups is presented in Table3.
Prevalence of gait abnormality
In the responses to the questionnaire, ‘a normal gait’
was described by the owners in 79.6 per centof the pugs.
An abnormal gait for less than a month’ was described
in 4.4 per centof the pugs and ‘a chronic gait abnor-
mality (>1 month duration)’ in 16.0 per centof the pugs.
One hundred and twenty-eight pug owners responded
that their dog wore down their nails and/or the skin
on the dorsum of their paws. Fifty-seven of these 128
owners responded, in the same questionnaire, that their
pug had a normal gait. Adding these 57 pugs showing
indirect signs of unsound gait (wearing their nails and/
or the skin on the dorsum of the paws from scuffing)
resulted in a prevalence of 30.7 per centfor gait abnor-
malities (group 1).
TABLE 1: Questions included in the questionnaire sent to owners of pugs one, five and eight years of age and registered in the Swedish Kennel Club. When
limited or fixed sets of responses were available they are shown in brackets
Questions related to gait Questions related to general health
Normal or abnormal gait?
Age when abnormal gait was rst noticed (six months; one, two, three, four, ve, six, seven or eight years of age)
Onset of abnormal gait (acute, insidious)
Course of abnormal gait (constant, progressing, improving)
What legs are involved in the abnormal gait? (thoracic limbs, pelvic limbs or both)
Symmetrical or asymmetrical involvement of legs
Ability to jump up and down a sofa
Signs indicating abnormal wearing of the nails or the skin on the dorsal aspect of the paws
What legs are involved in abnormal wearing of the nails and/or the skin on the dorsal aspect of paws? (thoracic limbs,
pelvic limbs or both)
When did the abnormal wearing of the nails and/or the skin on the dorsal aspect of the paws start? (as a puppy, at
one year of age, more than six months ago, more than one year ago)
Reluctance to walk on specic grounds (asphalt, parquet, gravel, grass)
Use of paw protection
Signs indicating pain (vocalising, reluctance to go for walks, resenting being lied, unwilling to wear a collar, diculty
nding a resting position, avoiding specic positions, unwilling to be petted and irritable mood)
Tail carriage (double curled, tight, weak)
Incontinence (faecal, urinary)
Incontinence seen aer laying down, during playing, during eating, when excited
Diculties posturing while urinating/defecating
Describe your pug’s clinical sign (owner allowed to respond freely)
Any previous traumatic event (owner allowed to respond freely)
Veterinary examination performed due to abnormal gait, wearing of the nails and/or the skin on the dorsum of the paws
Any relatives with unsound gait
Has your pug ever shown any of these signs or been
diagnosed with any of these disorders?
Seizures
Syncope
Dyspnoea
Has your dog had surgery for dyspnoea?
Pigmentary keratopathy
Corneal ulcers
Abnormal scratching around neck/ears/head
Chronic skin problems
Demodicosis
Pug dog encephalitis
Fly snapping
Licking the air
Is the dog alive?
In case the dog is no longer alive:
Was the dog euthanased or did it die?
Why did the dog die/why was the dog euthanased? (gait
abnormality, dyspnoea, skin problems, incontinence,
epilepsy, pug dog encephalitis, eye problems, other
disorder)
FIG 3: Flow chart over the number of responses to the questionnaires sent
to owners of pugs one, five and eight years of age registered in the Swedish
Kennel Club.
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Course of owner-perceived gait abnormality
The owners reported that in 63/92 (68.5 per cent) of the
pugs the first signs of gait abnormality were insidious
in nature, and in 36/99 (36.4 per cent) of the dogs, a
progression of clinical signs was described. An insid-
ious onset was reported in 21/32 (65.6 per cent) of the
pugs with a thoracic limb involvement, and in 19/23
(82.6 per cent) of the dogs with pelvic limb involvement.
The clinical signs were described as progressing in 6/32
(18.8 per cent) and in 13/25 (52.0 per cent) of pugs
with affected thoracic versus pelvic limbs
Characteristics of gait abnormality (group 1)
The median age when the gait abnormality started was
two (2.0) years (IQR=3.5) (Fig 4). The debut of abnormal
gait in the thoracic limbs was reported at a younger age
(median one (1.0) year, IQR=0.5) compared withpugs
with an abnormal gait affecting the pelvic limbs (median
three (3.0) years, IQR=3) (P<0.001).
TABLE 2: Distribution of signalment and clinical variables in 550 pugs with a normal and an abnormal gait. Pugs with an abnormal gait included all pugs
perceived by their owners to have a gait abnormality, and all pugs that were reported to wear down their nails and/or the skin on the dorsum of their paws
independent of their owner’s perception of the gait. Note that there was a possibility for the owner to include more than one answer or provide no response
to a specific question, which is the reason why the numbers in each column may not add up to the total in the adjacent column
Variable Total number of dogs Normal gait Abnormal gait
Number of pugs   
Sex
Female   
Male   
Spayed female   
Neutered male   
Unknown sex   
Median age (months)  (IQR=)  (IQR=)  (IQR=)
Median bodyweight (kg)  (IQR=)  (IQR=)  (IQR=)
Abnormal wearing of nails / (.%) / (.%)
Thoracic limbs / (.%) / (.%)
Pelvic limbs / (.%) / (.%)
Thoracic and pelvic limbs / (.%) / (.%)
Wearing nails to the extent they bleed / (.%) / (.%)
Abnormal wearing of skin on paws / (.%) / (.%)
Abnormal wearing of skin on paws to the extent it bleeds / (.%) / (.%)
Incontinence
Faecal / (.%) / (.%) / (.%)
Urinary / (.%) / (.%) / (.%)
Sitting position (a) / (.%) / (.%) / (.%)
Sitting position (b) / (.%) / (.%) / (.%)
Pain / (.%) / (.%) / (.%)
Double curled tail / (.%) / (.%) / (.%)
Unable to jump up a bed or a sofa / (.%) / (.%) / (.%)
TABLE 3: Sex, bodyweight, preferred sitting position (
Fig 1
) and gait
status by age group in 550 pugs. Pugs with an abnormal gait included all
pugs perceived by their owners to have a gait abnormality, and all pugs that
were reported to wear down their nails and/or the skin on the dorsum of
their paws independent of their owner’s perception of the gait. Note that
there was a possibility for the owner to include more than one answer or
provide no response to a specific question, which is the reason why the
numbers in each column may not add up to the total in the adjacent column
Variable One year Five years Eight years
Number of pugs   
Sex
Female  (.%)  (.%)  (.%)
Male  (.%)  (.%)  (.%)
Spayedfemale  (.%)  (.%)  (.%)
Neuteredmale  (.%)  (.%)  (.%)
Unknown sex  (.%)  (.%)  (.%)
Bodyweight (kg)  (IQR=)  (IQR=)  (IQR=)
Sitting position (a) / (.%) / (.%) / (.%)
Sitting position (b) / (.%) / (.%) / (.%)
Pugs with a normal gait / (.%) / (.%) / (.%)
Pugs with an abnormal gait / (.%) / (.%) / (.%)
Number of dogs
35
30
25
20
15
10
5
0
0.5 1234 56
78
Age (years)
FIG 4: Distribution of age of onset of gait abnormality in this questionnaire-
based study in pugs. The figure includes the 109 pugs whose owners
responded to the question related to onset of gait abnormality.
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Among dogs with an abnormal gait (group 1), tho-
racic limb involvement 81/158 (51.3 per cent) was
more commonly reported than pelvic limb involvement
28/158 (17.7 per cent, P<0.001). Of pugs with an ab-
normal gait, involvement of both pelvic and thoracic
limbs was reported in 49/158 (31.0 per cent).
Abnormal wearing of nails and skin on dorsum of the paws
Wearing of the nails was more common in the thoracic
limbs; thoracic limb involvement was reported in
113/118 (95.8 per cent) of the pugs wearing nails
(P<0.001). In 56/120 (46.7 per cent) the pugs had been
wearing their nails since they were a puppy, whereas
98/120 (81.7 per cent) of the pugs had been wearing
their nails since one year of age. Abnormal wearing of
the skin on the dorsum of the paws was most common
in the thoracic limbs, and 11/17 (64.7 per cent) of the
pugs who wore down the skin on the dorsum of their
paws showed thoracic limb involvement. In 13/19
(68.4 per cent) the pugs had been wearing the skin on
the dorsum of their paws since one year of age.
Prevalence of pain
Prevalence of pain in pugs with gait abnormality (group
1) is described in Table2. The most common sign of pain
described by the owners in association with gait abnor-
malities was reluctance to go for walks, 17/30 (56.7 per
cent). The least common signs of pain described by the
owners in association with gait abnormalities were an
irritable mood, 1/30 (3.3 per cent) and an unwilling-
ness to be petted, 2/30 (6.7 per cent).
Prevalence of general health disorders
The prevalence of general health problems was
compared between one, five and eight-year-old pugs
(Table4) and between pugs with a normal gait (group
2) and pugs with a gait abnormality (group 1) (Table5).
A signicant association was found between gait
abnormality perceived by the owner and age, dyspnoea
and abnormal scratching around the neck/ears and
head (Table6). A signicant association was also found
TABLE 4: Distribution of general health disorders by age in 550 pugs. Number of positive answers in relation to the total number of answers for the specific
question by agegroup
Variable One year Five years Eight years Pvalue
Seizures / (.%) / (.%) / (.%) <.
Syncope / (.%) / (.%) / (.%) <.
Dyspnoea / (.%) / (.%) / (.%) <.
Surgery for dyspnoea / (.%) / (.%) / (.%) .
Pigmentary keratopathy / (.%) / (.%) / (.%) <.
Corneal ulcers / (.%) / (.%) / (.%) <.
Abnormal scratching around neck/ears/head / (.%) / (.%) / (.%) .
Chronic skin problems / (.%) / (.%) / (.%) .
Demodicosis / (.%) / (.%) / (.%) .
Pug dog encephalitis / (.%) / (.%) / (%) .
Fly snapping / (.%) / (.%) / (.%) .
Licking in the air / (.%) / (.%) / (.%) .
TABLE 5: Distribution of general health disorders by gait abnormality in 550 pugswith a normal and an abnormal gait. Pugs with an abnormal gait included
all pugs perceived by their owners to have a gait abnormality, and all pugs that were reported to wear down their nails and/or the skin on the dorsum of their
paws independent of their owner’s perception of the gait
Variable Total number of dogs Normal gait Abnormal gait Pvalue
Seizures / (.%) / (.%) / (.%) .
Syncope / (.%) / (.%) / (.%) .
Dyspnoea / (.%) / (.%) / (.%) <.
Surgery for dyspnoea / (.%) / (.%) / (.%) .
Pigmentary keratopathy / (.%) / (.%) / (.%) <.
Corneal ulcers / (.%) / (.%) / (.%) .
Abnormal scratching around neck/ears/head / (.%) / (.%) / (.%) <.
Chronic skin problems / (.%) / (.%) / (.%) .
Demodicosis / (.%) / (.%) / (.%) .
Pug dog encephalitis / (.%) / (.%) / (.%) .
Fly snapping / (.%) / (. %) / (.%) .
Licking in the air / (.%) / (.%) / (.%) <.
TABLE 6: The Pvalues and ORs and 95%CIs for dog characteristic
variables and comorbidities remaining in the final multivariate logistic
regression model including owner-perceived gait abnormality (no/yes) as
outcome variable in 550 pugs
Variable Pvalue OR (95% CI)
Age <. . (. to .)
Dyspnoea . . (. to .)
Abnormal scratching around neck/ears/head . . (. to .)
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6
between abnormal gait as assessed by the authors
(group 1) and age and dyspnoea (Table7).
Prevalence of incontinence
Of 13 pugs with faecal incontinence, three (23.1 per
cent) were described by their owners as having a normal
gait and eight (61.5 per cent) as having a chronic gait
abnormality. Of 23 pugs with urinary incontinence,
nine (39.1 per cent) were described as having a normal
gait and 14 (60.9 per cent) as having a chronic gait
abnormality.
Reason for death/euthanasia
Forty-seven owners reported one or several causes for
their dog’s death/euthanasia: abnormal gait was recog-
nised as the single, listed, most frequent cause of death/
euthanasia of pugs in this study, 17/59 (28.8 per cent).
Veterinary consultation
Prevalence of owners who had sought veterinary care
for their pug’s abnormal gait or for wearing of the nails
and/or the skin on the dorsum of the paws is described
in Table8.
Video evaluation of gait
Eighty-nine videos were sent for evaluation. Seven
videos were excluded due to poor quality or other tech-
nical reasons. Twenty-three videos were not accom-
panied by a corresponding questionnaire, and were
excluded. The remaining 59 videos included: 26 videos
(44.1 per cent) of one-year-old pugs, 20 videos (33.9 per
cent) of five-year-old pugs and 13 videos (22.0 per cent)
of eight-year-old pugs. Forty-six of 59 (78.0 per cent)
owners submitting a video recording claimed their dogs
had a normal gait. Subtracting from this the number of
videotaped dogs that were reported to wear their nails
and/or skin on the paws (six pugs) decreased the number
of pugs reported by their owners to show a normal gait
from 78.0to 67.8 per cent. The corresponding numbers
for the videos analysed by the specialists were that 40
out of 59 (67.8 per cent) pugs showed a normal gait.
In 16/59 (27.1 per cent) of the analysed videos, there
was disagreement between owners and specialists. The
specialists considered the gait as abnormal in 11 dogs,
in which the owners had considered the gait as being
normal. The owners assessed the gait as abnormal in
five dogs, for which the authors had considered the
gait as normal. In four of these five pugs, the owners
described abnormal wearing of the nails. Three (3/19)
pugs showed lameness as an isolated gait abnormality
in the analysed videos.
Discussion
This study showed that the prevalence of gait abnor-
malities in the pug breed was high and that it increased
with age. Indeed, the single most common cause for
death/euthanasia, reported by the owner, was an
abnormal gait, which suggests gait abnormalities to be
a more significant health problem than what previous,
published scientific literature has suggested.15
In general, most causes of lameness are orthopae-
dic in origin, whereas most causes of paresis and atax-
ia are neurological. Wearing of the nails and/or on the
dorsum of the paws, scung, is associated with neu-
rological disorders as a consequence of proprioceptive
decits and motor dysfunction.16–18Although this study
did not aim to dierentiate orthopaedic from neurologi-
cal causes for gait abnormalities, the high prevalence of
wearing of nails reported in the questionnaires, and the
fact that lameness was not a common nding in sub-
mitted videos, suggest that the majority of gait abnor-
malities in the pugs were indeed related to neurological
rather than orthopaedic disorders. This is in accordance
with a Swedish insurance database report, presenting a
sevenfold increase in mortality rate for ataxia, paresis
and collapse in the pug compared withthe risk in oth-
er breedsi. Data from that same source did not show an
increase in relative risk for general locomotor problems
in pugs compared withthe risk in other breeds. It has
previously been shown that the insured dog population
is similar to the general population of Swedish dogs.19
The assessment of the dog’s gait was performed by
the owners, likely making the results from the ques-
tionnaire less reliable. This was also suggested in the
analysis of the videos, where the specialists identied
more dogs with gait abnormalities than the owners did,
32.2 per centversus 22.0 per cent. Interestingly, when
adding the pugs from the videos where the owners de-
scribed a normal gait but with wearing of nails and/or
TABLE 7: The Pvalues and ORs and 95%CIs for dog characteristic
variables and comorbidities remaining in the final multivariate logistic
regression model including gait abnormality (no/yes) as outcome variable
in 550 pugs. Pugs with an abnormal gait included all pugs perceived by
their owners to have a gait abnormality, and all pugs that were reported
to wear down their nails and/or the skin on the dorsum of their paws
independent of their owner’s perception of the gait
Variable Pvalue OR (95% CI)
Age . . (. to .)
Dyspnoea <. . (. to .)
TABLE 8: Prevalence of pugs whose owners, of 550 pugs, had sought
veterinary care for their pug’s abnormal gait, for wearing of the nails or the
skin on the dorsum of the paws. Pugs with an abnormal gait included all
pugs perceived by their owners to have a gait abnormality, and all pugs that
were reported to wear down their nails and/or the skin on the dorsum of
their paws independent of their owner’s perception of the gait
Variable
Number of positive answers in
relation to the total number of
answers for the question
Pugs perceived by their owners of having a chronic gait
abnormality
/ (.%)
Pugs with an abnormal gait / (.%)
Pugs wearing down their nails / (.%)
Pugs wearing down their nails to the extent they would
bleed
/ (.%)
Pugs wearing down the skin on the dorsum of the paws
to the extent they would bleed
/ (.%)
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skin on the dorsum of the paws, the specialists and the
owners reported identical numbers of pugs with a gait
abnormality.
The diculty to evaluate locomotion, as shown in
this study, has previously been described,20 and the
results from the videoanalysis could be questioned. It
is reasonable to assume that mild or intermittent gait
abnormalities might not have been appreciated by the
owners or by the specialists; thus, the prevalence of gait
abnormality in the breed found in this study could in-
deed have been underestimated. Ideally, the results in
this study should be conrmed by objective gait studies,
using kinetic and kinematic analysis, in the future.
For the video evaluation of the gait in the present
study, we dened the normal gait in the pug as a coor-
dinated walk or trot without pacing,2 with no visible or
audible lameness or paresis and with no wearing of the
nails and/or the skin on the dorsum of the paws. Abnor-
mal wearing of the nails and/or skin on the dorsum of
the paws could not be easily identied in the submit-
ted videos explaining why four pugs were classied as
having an abnormal gait by the owners but as having
a normal gait by the specialists. A relatively small pro-
portion, 59/550 (10.7 per cent) of the responders, sub-
mitted a video footage of their dog’s gait, whichcould
have aected the result. In addition, the video analysed
group of pugs were not agematched with the question-
naire-based group of pugs, and the lower proportion of
submitted videos of eight-year-old pugs might have af-
fected the result.
Pugs with a gait abnormality (group 1; 30.7 per
centof all pugs) included all pugs with an owner-report-
ed gait abnormality (20.4 per cent) and all pugs that lat-
er in the questionnaire were reported to actually scu,
to wear down their nails and/or the skin on the dorsum
of their paws. In the present study, pug owners reported
abnormal gait more oen in the pelvic limbs than the
thoracic limbs. This nding was inconsistent with that
of a gait abnormality (group 1) being more commonly
reported in the thoracic limbs. Also, in almost a third
of the pugs with a gait abnormality, both thoracic and
pelvic limbs were aected. This inconsistency could be
a result of dierent underlying pathology aecting the
thoracic and the pelvic limbs, but could also be the con-
sequence of owners not associating wearing of the nails
and/or skin on the dorsum of the paws with abnormal
gait. Furthermore, the clinical experience of the authors
is that dogs with neurological gait disorders, aecting
both thoracic and pelvic limbs, are easily misjudged
by laymen as only aecting either or. A disorder with
obvious aection of the pelvic limbs may therefore be
accompanied by a subtle involvement of the thoracic
limbs and vice versa. Nonetheless, neurological de-
cits in dogs are seen more commonly in the pelvic limbs
than in the thoracic limbs in general,21 and for pugs,
vertebral anomalies, including hemivertebrae,8 12 14 22–25
degenerative disc disease,5 26 constrictive myelopathy6 23
and subarachnoid diverticula (SAD),5 7 9–11 27 are found
more oen in the thoracolumbar area. In most of the
pugs with abnormal wearing of their nails, the wearing
involved the thoracic limbs and had developed already
when the dog was one year old, suggesting a congenital
or an early onset underlying pathology. The possibility
that the wearing of nails is the result of other unrelat-
ed causes, for example, conformation, also needs to be
considered. Wearing of nails and skin on the dorsum of
the paws has previously been described in pugs in asso-
ciation with SAD13 28;in these pugs, neurological signs
were more pronounced in the thoracic limbs and from a
young age.13 28 29
Our results show that the prevalence of gait abnor-
malities in pugs is a greater health problem than what
has previously been described.15 Clinical data from
primarycare veterinary practices in the UK15 included
conditions that the owners had sought medical atten-
tion care for. In the present study, the majority of the
owners of pugs with a gait abnormality had not sought
veterinary care for their dog’s gait, wearing of the nails
or incontinence. Possible explanations could be that a
veterinarian is only sought if the abnormality is actually
appreciated by the owner as abnormal, or if the gait ab-
normality seems associated with signs suggesting suf-
fering (pain).
This study showed an association between abnor-
mal gait (group 1) and age, and an association between
abnormal gait and dyspnoea was also conrmed. It has
previously been shown that obesity is associated with
the brachycephalic airway syndrome30 and dyspnoea
might be the natural consequence of a pug that is not
exercising, and therefore gains weight. Weight was
however not associated with gait abnormalities and
the development of a chronic gait abnormality might
therefore be related to dyspnoea and chronic airway
obstruction in other, yet unknown, ways. The impor-
tance of nding an association between two common
health problems in a breed, for example, dyspnoea and
abnormal gait, may be questioned. However, specic
breed-related characteristics may predispose the pug
to health problems not previously associated with the
brachycephalic syndrome.
Faecal and urinary incontinence were more common
in pugs with an abnormal gait in comparison to pugs
with a normal gait (Table2). The larger number of pugs
with urinary incontinence cannot be explained by neu-
tering or spaying as these were not more frequently in-
continent compared withintact pugs. A possible asso-
ciation between gait abnormalities and incontinence in
the pug needs verication.
The majority of the pugs in this study preferred a sit-
ting position the owners associated with dog (b) (Fig 1).
The sitting position in dogs with a chronic gait abnor-
mality was almost exclusively associated with image (b).
The sitting position (b) has previously been preferred by
dogs with specic orthopaedic disorders,31 referred to
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8
as a positive ‘sit-test’.21 Sitting with fully extended stie
joints can also be observed in dogs with spinal cord dis-
orders.32 33 However, position (b) was also reported by
more than 50 per centof owners assessing their pugs
having a normal gait and also increased with age in
pugs with and without gait abnormality. It needs to be
veried if the preferred sitting position (b) might be an
indication of a gait abnormality in pugs.
The response rate (26 per cent) of this study might
have been aected by the Swedish petition for the right
of brachycephalic breeds to breathe; launched the same
year the invitation was sent and supported by a large
number of Swedish veterinarians, it threatened many
owners of brachycephalic breeds, which might have
made owner population more reluctant to participate
in this study. A pilot study launched before the petition
reached a response rate of 35 per cent. It has, however,
been shown that a low response rate does not necessar-
ily indicate non-response bias.34 Suggesting all non-re-
sponders belonged to group 2, the prevalence of gait
abnormality in the entire study population would have
been 7.3 per cent. Additionally, although accepting to
participate in the study, many owners did not complete
the survey by leaving specic questions unanswered.
Since the majority of pugs in Sweden are registered
in the Swedish Kennel Club,v the general study popu-
lation is most likely representative of the Swedish pug
breed. The nal study population might however be
biased; it could be that owners of pugs suering from
obvious gait abnormalities are more prone to respond
to the questionnaire. It might also be possible that there
is another population of owners who have pugs with a
normal gait that have specic interests in responding,
for example, breeders.
In conclusion, gait abnormalities were a common
nding in the pug breed with a prevalence of 30.7 per
cent. Wearing of the nails and/or skin on the dorsum of
the paws, predominately in the thoracic limb, was fre-
quently found and from a comparably young age. The
aim of this study was to investigate the prevalence of
gait abnormalities in the pug breed with no ambition
to determine their underlying pathology or prognosis.
The results presented in this article may serve as a back-
ground to future, urgentstudies on underlying patholo-
gy and clinical signicance of gait abnormalities in the
pug breed.
Acknowledgements The authors wish to acknowledge the Swedish Mopsorden for
their commitment and support and for promoting the participation in this study.
Funding The study was supported by the Swedish Kennel Club (SKK) and AGRIA’s
research fund.
Competing interests None declared.
Open Access This is an Open Access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-commercially, and
license their derivative works on different terms, provided the original work is properly
v
Statistics Sweden 2012.
cited and the use is non-commercial. See: http:// creativecommons. org/ licenses/ by- nc/
4. 0/
© British Veterinary Association (unless otherwise stated in the text of the article)
2018. All rights reserved. No commercial use is permitted unless otherwise expressly
granted.
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High prevalence of gait abnormalities in pugs
Lindblad-Toh and Jens Häggström
Cecilia Rohdin, Karin Hultin Jäderlund, Ingrid Ljungvall, Kerstin
published online February 5, 2018Veterinary Record
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... The high prevalence of neurological gait abnormalities in pugs 6,28 and the growing evidence of thoracolumbar myelopathy with a uni- ...
... 67 It needs to be questioned whether the decreased activity in some pugs with thoracolumbar myelopathy was because of the inability to walk normally, because of any concomitant breed related dyspnea, or, in fact, a reflection of pain. 28,68 We acknowledged that this descriptive study, having more than 1 pathologist examining the pugs, was limited by the lack of possibility for objective comparison and statistical analysis. However, the pathologists independently confirmed the major pathological findings of this study, that is, meningeal fibrosis, and concomitant spinal cord lesions, and also the presence of lympho-histiocytic CNS inflammation. ...
Article
Full-text available
Background: Thoracolumbar myelopathies associated with spinal cord and vertebral column lesions, with a similar clinical phenotype, but different underlying etiologies, occur in pugs. Objectives: To further characterize the clinical and neuropathological characteristics of pugs with longstanding thoracolumbar myelopathy. Animals: Thirty client-owned pure-bred pugs with a history of more than a month of ataxia and paresis of the pelvic limbs, suggesting a myelopathy localized to the thoracolumbar spinal cord, were included in the study. Methods: Prospective clinicopathological study. Included pugs underwent a complete neurological examination and gross and histopathologic postmortem studies with focus on the spinal cord. Computed tomography (n = 18), magnetic resonance imaging (n = 17), and cerebrospinal fluid analysis (n = 27) were performed before or immediately after death. Results: Twenty male and 10 female pugs had a median age at clinical onset of 84 months (interquartile range, 66-96). Affected pugs presented with a progressive clinical course and 80% were incontinent. There was circumferential meningeal fibrosis with concomitant focal, malacic, destruction of the neuroparenchyma in the thoracolumbar spinal cord in 24/30 pugs. Vertebral lesions accompanied the focal spinal cord lesion, and there was lympho-histiocytic inflammation associated or not to the parenchymal lesion in 43% of the pugs. Conclusions and clinical importance: Meningeal fibrosis with associated focal spinal cord destruction and neighboring vertebral column lesions were common findings in pugs with long-standing thoracolumbar myelopathy.
... This, together with the fact that veterinarians are trained at identifying and recognising these signs, possibly explains the difference in perception of problematic airway-related signs assessed by owners and veterinarians. [21][22][23] Although 80% of PER/EXO show cats were assessed by the veterinarian of the study to have epiphora, only 33% of cat owners reported that their cat had epiphora at least once weekly. This discrepancy may again, potentially, be explained by normalisation among owners to typical features commonly seen in cats of these breeds. ...
Article
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Objectives: The primary objectives of the study were to examine the diversity in facial conformation characteristics within a group of Persian (PER) and Exotic Shorthair (EXO) show cats, and to contrast the results to findings within a group of non-purebred domestic shorthair (DSH) and domestic longhair (DLH) cats. The secondary objectives were to determine the PER/EXO show cat owners' perceptions of the breathing status of their cats, and to evaluate if remarks from the cat show judges concerning the cats' head and facial conformation were exclusively related to the aesthetic features of the cats. Methods: Sixty-four PER and 12 EXO show cats were prospectively examined at five international cat shows, and 20 DSH/DLH cats were examined at an animal hospital. Facial conformation characteristics were evaluated by examining photos of the cats. Owners of the PER/EXO show cats answered a questionnaire concerning their cats' health status, and they were encouraged to send in the judges' score sheets from the cat shows. Results: The PER/EXO show cats had higher diversity in facial conformation characteristics than the DSH/DLH cats, and high incidences of hypoplasia of the nose leather (95%), the nose leather top positioned above the level of the lower eyelid (93%), moderate-to-severe stenotic nares (86%), epiphora (83%) and entropion (32%). Owners of 6/76 PER/EXO show cats stated that their cat had increased respiratory sounds and/or trouble breathing at least once a week. The cat show judges' written comments were exclusively related to aesthetic features of the cats' head and facial conformation details. Conclusions and relevance: Hypoplasia of the nose leather, high position of the nose leather top, stenotic nares, epiphora and entropion were common findings in the PER/EXO show cats but not in the DSH/DLH cats. Few of the cat owners perceived that their cat had problems related to the airways.
... A growing concern is that some of the behaviors are so common in a particular type/breed of dog that they may be becoming normalized, and their clinical significance is going unrecognized as a result. Recently, Rohdin and colleagues [68] reported that more than three quarters of pugs with an abnormal sitting posture (one leg tucked under the body, sometimes referred to as "lazy sit") also had an abnormal gait. Dogs with an abnormal gait were not only more likely to be irritable, reluctant to go for a walk, and unable to jump up, but they also had a much higher prevalence of adjunctive behaviors, which might be less widely associated with pain. ...
Article
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We argue that there is currently an under-reporting of the ways in which pain can be associated with problem behavior, which is seriously limiting the recognition of this welfare problem. A review of the caseloads of 100 recent dog cases of several authors indicates that a conservative estimate of around a third of referred cases involve some form of painful condition, and in some instances, the figure may be nearly 80%. The relationship is often complex but always logical. Musculoskeletal but also painful gastro-intestinal and dermatological conditions are commonly recognized as significant to the animal’s problem behavior. The potential importance of clinical abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed by clinicians in general practice, even when they are common within a given breed. In general, it is argued that clinicians should err on the side of caution when there is a suspicion that a patient could be in pain by carefully evaluating the patient’s response to trial analgesia, even if a specific physical lesion has not been identified.
... Previous studies had shown an association between abnormal gait and age 25 and the presence and severity of caudal articular process dysplasia with the occurrence of intervertebral disc protrusion in aged (>8 years old) Pug dogs (Nishida H, Nakata S, Maeda S, Kamishina H. Characteristics of the caudal articular process abnormalities in Pugs with thoracolumbar disk herniation. Poster 44 in ESCN/ECVN congress proceedings, Helsinki, Finland, 2017). ...
Article
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Objectives The aim of this article is to present the outcome of vertebral stabilization using pins and polymethylmethacrylate in isolation or with concurrent spinal cord decompression for thoracolumbar myelopathies in Pug dogs with associated caudal articular process dysplasia. Materials and Methods Retrospective case review of 14 Pug dogs with thoracolumbar myelopathy and concurrent caudal articular process dysplasia identified with magnetic resonance imaging and computed tomography. Pug dogs were graded based on the Texas Spinal Cord Injury Scale and clinical follow-up was performed immediately after surgery, at the discharge and at during the postoperative period (median 5 months). Postoperative computed tomography was performed immediately post-surgical intervention in all cases and a variable postoperative time (6 weeks or 6 months). Follow-up with telephone interview with owners was performed at a median time of 12 months postoperatively. Results Median age of presentation was 8.5 years. In 10/14 cases, neurological improvement was observed, while urinary/faecal incontinence resolved in only two of seven affected cases. Other congenital vertebral malformations were identified in 9/14 cases. Clinical Significance In our population of Pug dogs with thoracolumbar myelopathy and concurrent caudal articular process dysplasia, vertebral stabilization in isolation or with concurrent spinal cord decompression appeared to result in a favourable clinical outcome in the majority of patients. This technique may be favourable for myelopathies with a reportedly poor surgical outcome in this breed.
... Anatomically, the neurological deficits from a T3-L3 myelopathy could theoretically correspond to any CVM in the T1-L3 area of the vertebral column (Evans, 1993). Gait abnormalities, with the majority indicating neurological causes, have been shown common in the pug (Rohdin et al., 2018), but the importance of CVMs in the development of these is not fully elucidated. ...
Article
Congenital vertebral malformations (CVMs) are common in brachycephalic dogs such as the pug, and are often considered incidental findings. However, specific CVMs have been suggested to be associated with neurological deficits in pugs. The objective of this study was to investigate the clinical importance of CVMs in the pug by comparing computed tomography studies of the thoracolumbar spine from pugs without neurological deficits with those from pugs with a confirmed T3-L3 spinal cord lesion and neurological deficits consistent with a chronic T3-L3 myelopathy. A total of 57 pugs were recruited into the study from Sweden (n=33), United Kingdom (n=21) and Norway (n=3); 30 with neurological deficits and 27 without. Focal T3-L3 pathology was confirmed in all pugs with neurological deficits by magnetic resonance imaging (n=29) and/or pathology (n=15). Computed tomography studies of the thoracolumbar spine from pugs with and without neurological deficits were compared to investigate possible associations between presentation of neurological deficits consistent with chronic T3-L3 pathology and signalment variables, presence of CVMs and type of CVMs. Congenital vertebral malformations were as common in pugs with, as in pugs without, neurological deficits. Regardless of neurological status, the majority of pugs (96 %) presented with one or more CVM. An association between presence, or type of CVM in the T1-L3 vertebral column, and neurological deficits consistent with T3-L3 pathology could not be confirmed. Keywords: Caudal articular processes; CT; Hemivertebrae; Myelopathy; Transitional vertebrae
Article
Full-text available
Background: Little is reported about the role of medical management in the treatment of spinal arachnoid diverticula (SAD) in dogs. Objectives: To describe the outcome of 96 dogs treated medically or surgically for SAD. Animals: Ninety-six dogs with SAD. Methods: Retrospective case series. Medical records were searched for spinal arachnoid diverticula and all dogs with information on treatment were included. Outcome was assessed with a standardized questionnaire. Results: Fifty dogs were managed medically and 46 dogs were treated surgically. Dogs that underwent surgery were significantly younger than dogs that received medical management. No other variables, related to clinical presentation, were significantly different between both groups of dogs. The median follow-up time was 16 months (1-90 months) in the medically treated and 23 months (1-94 months) in the surgically treated group. Of the 38 dogs treated surgically with available long-term follow-up, 82% (n = 31) improved, 3% (n = 1) remained stable and 16% (n = 6) deteriorated after surgery. Of the 37 dogs treated medically with available long-term follow-up, 30% (n = 11) improved, 30% (n = 11) remained stable, and 40% (n = 15) deteriorated. Surgical treatment was more often associated with clinical improvement compared to medical management (P = .0002). Conclusions and clinical importance: The results of this study suggest that surgical treatment might be superior to medical treatment in the management of SAD in dogs. Further studies with standardized patient care are warranted.
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Background: The Pug is an ancient dog breed and was the fifth most commonly registered UK pedigree breed in 2014. However, the breed has been reported to be predisposed to several disorders including ocular, respiratory and dermatological problems. The VetCompass Programme collates de-identified clinical data from primary-care veterinary practices in the UK for epidemiological research. Using VetCompass clinical data, this study aimed to characterise the demography and common disorders of the general population of Pugs under veterinary care in England. Results: Pugs comprised 2709 (1.03 %) of 264,260 study dogs under veterinary care from September 1(st), 2009 to 30(th) April, 2015. Annual proportional birth rates showed that Pugs rose from less than 1 % of annual birth cohorts before 2008 to comprise 2.8 % of the 2013 annual birth cohort. The most common colours of Pugs were fawn (63.1 %), black (27.7 %), apricot (7.6 %) and silver (2.1 %). Of the 1009 pugs under veterinary care in the study during 2013, 688 (68.19 %) had at least one disorder recorded. The most prevalent disorders recorded overall were overweight/obesity (number of events: 133, prevalence: 13.18 %, 95 % CI: 11.12-15.43), corneal disorder (88, 8.72 %, 95 % CI: 7.05-10.63) and otitis externa (76, 7.53 %, 95 % CI: 5.98-9.34). The most prevalent disorder groups were ophthalmological (n = 164, prevalence: 16.25 %, 95 % CI: 14.03-18.68), dermatological (157, 15.60 %, 95 % CI: 13.38-17.95) and aural (152, 15.06 %, 95 % CI: 12.91-17.42). The most prevalent body locations affected were the head-and-neck (n = 439, prevalence = 43.51 %, 95 % CI: 40.42-46.63) and abdomen (195, 19.33 %, 95 % CI: 16.93-21.90). The most prevalent organ systems affected were the integument (321, 31.81 %, 95 % CI: 28.15-35.72) and digestive (257, 25.47 %, 95 % CI: 22.54-28.65). The most prevalent pathophysiologic processes recorded were inflammation (386, 38.26 %, 95 % CI: 34.39-42.27) and congenital/developmental (153, 15.16 %, 95 % CI: 12.61-18.13). Conclusions: Ownership of Pugs in England is rising steeply. Overweight/obesity, corneal disorder and otitis externa are the most common disorders in Pugs. Identification of health priorities based on VetComapss data can support evidence-based reforms to improve health and welfare within the breed.
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Background Canine patellar luxation is one of the most common orthopaedic disorders of dogs and is a potential welfare concern because it can lead to lameness, osteoarthritis and pain. However, there are limited epidemiological data on the disorder relating to the general population of dogs in England. This study aimed to investigate the VetCompass Programme database of dogs attending primary-care veterinary practices in England to report on the prevalence, risk factors and clinical management of diagnosed patellar luxation cases. Results The study included all dogs with at least one electronic patient record in the VetCompass database from September 1st, 2009 to August 31st, 2014. Candidate patellar luxation cases were identified using free-text word searching of the clinical notes and VeNom diagnosis term fields. Univariable and multivariable binary logistic regression modelling was used for risk factor analysis. The overall dataset comprised 210,824 dogs attending 119 clinics in England. The prevalence of patellar luxation diagnosis in dogs was 1.30 % (95 % confidence interval (CI) 1.21–1.39). Of the 751 incident cases, 293 (39.0 %) received medical management, 99 (13.2 %) received surgical intervention and 28 (3.7 %) were referred for further management. Multivariable modelling documented 11 breeds with increased odds of patellar luxation compared with crossbred dogs, including the Pomeranian (odds ratio [OR]: 6.5, 95 % CI 4.0–10.7, P < 0.001), Chihuahua (OR: 5.9, 95 % CI 4.4–7.9, P < 0.001), Yorkshire Terrier (OR: 5.5, 95 % CI 4.3–7.1, P < 0.001) and French Bulldog (OR: 5.4, 95 % CI 3.1–9.3, P < 0.001). Dogs with bodyweight below their mean for breed and sex had a 1.4 times odds of diagnosis (95 % CI 1.2–1.6, P < 0.001). Dogs aged ≥ 12.0 years showed 0.4 times the odds (95 % CI 0.3–0.5, P < 0.001) compared with dogs aged < 3.0 years. Females had 1.3 times the odds (95 % CI 1.1–1.5, P < 0.001), neutered dogs had 2.4 times the odds (95 % CI 1.8–3.2, P < 0.001) and insured dogs had 1.9 times the odds (95 % CI 1.6–2.3, P < 0.001). Conclusions Patellar luxation warrants inclusion as a welfare priority in dogs and control strategies that include this disorder should be considered as worthwhile breeding goals, especially in predisposed breeds.
Article
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Background: A novel test using whole-body barometric plethysmography (WBBP) was developed recently to diagnose brachycephalic obstructive airway syndrome (BOAS) in unsedated French bulldogs. Hypothesis/objectives: The hypotheses of this study were: (1) respiratory characteristics are different between healthy nonbrachycephalic dogs and brachycephalic dogs; and among pugs, French bulldogs, and bulldogs; and (2) obesity and stenotic nares are risk factors for BOAS. The main objective was to establish a diagnostic test for BOAS in these 3 breeds. Animals: A total of 266 brachycephalic dogs (100 pugs, 100 French bulldogs, and 66 bulldogs) and 28 nonbrachycephalic dogs. Methods: Prospective study. Exercise tolerance tests with respiratory functional grading, and WBBP were performed on all dogs. Data from WBBP were associated with functional grades to train quadratic discriminant analysis tools to assign dogs to BOAS+ and BOAS- groups. A BOAS index (0-100%) was calculated for each dog. Receiver operating characteristic (ROC) curves were used to evaluate classification ability. Results: Minute volume was decreased significantly in asymptomatic pugs (P = .009), French bulldogs (P = .026), and bulldogs (P < .0001) when compared to nonbrachycephalic controls. Respiratory characteristics were different among breeds and affected dogs had a significant increase in trace variation. The BOAS index predicted BOAS status for each breed with 94-97% (95% confidence interval [CI], 88.9-100%) accuracy (area under the ROC curve). Both obesity (P = .04) and stenotic nares (P = .004) were significantly associated with BOAS. Conclusions and clinical importance: The WBBP can be used as a clinical tool to diagnose BOAS noninvasively and objectively.
Book
Advances in the Canine Cranial Cruciate Ligament, the first book in the Advances in Veterinary Surgery series, presents a state-of-the-art summary of current knowledge on cruciate rupture, one of the most important orthopaedic conditions in dogs. Written by leading specialists and edited by a highly respected veterinary orthopaedic surgeon and researcher, the book takes a cross-disciplinary, evidence-based approach. It provides the information necessary to accurately diagnose, treat, and manage cruciate rupture cases and is a valuable reference for clinicians seeking the most current information on this important condition.
Book
Organized by functional neurologic system, the 3rd edition of this authoritative reference provides the most up-to-date information on neuroanatomy, neurophysiology, neuropathology, and clinical neurology as it applies to small animals, horses, and food animals. Accurate diagnosis is emphasized throughout with practical guidelines for performing neurologic examinations, interpreting examination results, and formulating effective treatment plans. In-depth disease descriptions, color images, and video clips reinforce important concepts and assist with diagnosis and treatment. Expert authors bring more than 50 years of experience in veterinary neuroanatomy and clinical neurology to this book - Dr. Alexander DeLahunta and Dr. Eric Glass offer their unique insights from both academic and practitioner perspectives. Disease content is presented in a logical case study format with three distinct parts: Description of the disorder Neuroanatomic diagnosis (including how it was determined, the differential diagnosis, and any available ancillary data) Course of the disease (providing final clinical or necropsy diagnosis and a brief discussion of the syndrome) More than 600 full-color photographs and line drawings, plus approximately 150 high-quality radiographs, visually reinforce key concepts and assist in reaching accurate diagnoses. The book comes with free access to 370 video clips on Cornell University's website that directly correlate to the case studies throughout the book and clearly demonstrate nearly every recognized neurologic disorder. High-quality MR images of the brain are presented alongside correlating stained transverse sections for in-depth study and comparison. Vivid photos of gross and microscopic lesions clearly illustrate the pathology of many of the disorders presented in the book.
Article
Objective: To describe a novel technique for ameliorating cerebrospinal fluid flow obstruction secondary to pia-arachnoid fibrosis in dogs and report outcome. Study design: Descriptive report and retrospective case series. Animals: Dogs with cerebrospinal fluid (CSF) flow obstruction (n = 7). Methods: Medical records were searched for dogs that had a subarachnoid-subarachnoid shunt placed for treatment of CSF flow obstruction. Data collected included age, sex, breed, clinical signs and duration of signs prior to examination, neurologic status and localization prior to surgery, pre-surgical diagnostics, surgical technique, histopathology, postoperative neurologic examination, time to discharge from hospital, and outcome. Results: All dogs were diagnosed at surgery with a fibrotic adhesion between the arachnoid and pia mater. A subarachnoid shunting tube was implanted to allow CSF flow across the lesion site. Five dogs showed improvement of clinical signs, 3 of which showed complete recovery and 2 of which showed improvement without resolution of all clinical signs. Two dogs showed no change at 7 and 24 months postoperatively. Conclusion: Bridging a region of pia-arachnoid fibrosis with a tube placed in the subarachnoid space can ameliorate or prevent progression of associated clinical signs.
Article
Congenital vertebral malformations are common incidental findings in small breed dogs. This retrospective observational study evaluated the type and prevalence of thoracic vertebral malformations in 171 neurologically normal and 10 neurologically abnormal screw-tailed brachycephalic dogs. Neurologically normal dogs underwent CT for reasons unrelated to spinal disease, while affected dogs underwent MRI. Imaging studies were reviewed and vertebral malformations including hemivertebrae, block vertebrae, transitional vertebrae, and spina bifida were documented. The group of clinically normal dogs consisted of 62 French bulldogs, 68 Pugs and 41English bulldogs. The group of affected dogs consisted of one French bulldog and nine Pugs. Overall, 80.7% of neurologically normal animals were affected by at least one vertebral malformation. There was a significant influence of breed, with thoracic vertebral malformations occurring more often in neurologically normal French bulldogs (P<0.0001)and English bulldogs (P=0.002). Compared to other breeds, hemivertebrae occurred more often in neurologically normal French bulldogs (93.5%; P< 0.0001 vs. Pugs; P=0.004 vs. English bulldogs) and less often in neurologically normal Pugs (17.6%; P=0.004 vs. English bulldogs). Neurologically normal Pugs were more often diagnosed with transitional vertebrae and spina bifida compared to other breeds (P<0.0001 for both malformations). Of Pugs included in the study, 4.7% were diagnosed with clinically relevant thoracic vertebral malformations. When compared to the general veterinary hospital population, this was significantly more than the other two breeds (P= 0.006). This study indicates that thoracic vertebral malformations occur commonly in neurologically normal screw-tailed brachycephalic dogs. While hemivertebrae are often interpreted as incidental diagnostic findings, they appear to be of greater clinical importance in Pugs compared to other screw- tailed brachycephalic breeds.
Article
Articular process anomalies are considered congenital. Their occurrence in specific breeds may be indicative of undetermined genetics. Clinical significance varies and is interdependent upon location, function and anatomy. Etiology, uniform nomenclature and classification of vertebral articular process anomalies in the dog are lacking; however recent efforts are beginning to address this deficit. This author proposes that the term articular process dysplasia appropriately encompasses the spectrum of anomalies in severity as well as including those affecting both the cranial and caudal articular processes. The general category description of articular process dypslasia doesn't preclude, but rather allows for more specific designations.