PRICE LIST OF SERVICES OF THE STELLA VETERINARY CLINIC
The veterinary clinic "STELLA" strives to ensure that veterinary services are in demand for the majority of pet owners, therefore prices in our veterinary clinic are very affordable.
dog over 10 kg (without the cost of anesthesia and blankets)
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A fracture is a break in the integrity of a bone. The basis of the treatment of any fracture is the comparison of bone fragments with their fixation. The type of fixation of bone fragments depends on the type of fracture. Fundamentally different:
1. Conservative closed reduction with the imposition of a fixing bandage in the form of splint or plaster.
2. Operative reposition, the essence of which is to connect bone fragments with the help of plates, pins, pins fixed inside the medullary canal, on the bone or passing through the bone and fixed on the surface of the body (external structures).
For pet owners, the most “familiar” is the first method with the application of a plaster cast. In practice, fixation with external dressings has only one indisputable advantage - cheapness. Although this advantage is debatable in the event that after 3-4 weeks it is necessary to re-fix the damaged bone already by surgery.
Metaphyseal fracture of the femur in a cat. Permanent intraosseous fixation with wires.
Intramedullary osteosynthesis of an oblique comminuted diaphyseal fracture of the femur in a cat.
Dislocation of the femur with a rupture of the round ligament. Fixation of the femur
External fixation of an intra-articular fracture of the wrist
Lameness
- the main symptom with which pet owners turn to an orthopedist. Lameness of the hind limbs is more often associated with pathology of the hip (HJ) or knee joints. Consider the two most common congenital pathologies of the development of the hip joints: aseptic necrosis of the femoral head and hip dysplasia (HTBS).
Legg-Calve-Perthes disease (aseptic or ischemic necrosis of the femoral head, juvenile osteochondrosis) affects representatives of dwarf dog breeds, develops at a young age of 5-10 months. The starting point for the development of pathology is a violation of the blood circulation of the bone tissue of the femoral head, which leads to necrosis of the femoral head and its deformation. The development of lameness occurs gradually or suddenly after a jump or fall due to injury, the affected area of the bone.
The picture of the development of Perthes disease corresponds to 5-8 months. age when the animal develops lameness, aggravated after physical exertion. Physically and radiographically, aseptic necrosis of the femoral head should be differentiated from arthritis (typical for older dogs), dislocation of the patella (possible reduction with restoration of limb function, displacement of the patella is clearly visible in the picture) and hip dysplasia (typical for large breeds, has certain radiographic characteristics). Over time, the dog completely ceases to rely on the diseased limb and muscle atrophy develops. With bilateral damage to the joints, the animal shows inactivity, pain when trying to force movement.
The radiographically affected femoral head is irregular, often nearly triangular in shape, with uneven bone density.
In the early stages of the disease, pain and lameness can be controlled by the use of painkillers and anti-inflammatory drugs, as well as the regular use of chondroprotectors (glucosamine, chondroitin), but this is a short-term and ineffective effect. The most common way to solve the problem is to remove the femoral head, after which pain disappears in the animal, motor ability is restored, and sometimes lameness disappears.
Affected dogs must be excluded from breeding, as the disease is inherited. At the age of 5-6 months. it is desirable to do an x-ray of the hip joint for early detection of pathology.
Dysplasia is a violation of the formation of an organ or tissue. Dysplastic syndrome in orthopedics disrupts the development of connective tissue, which can manifest itself in the form of increased joint mobility in combination with weakness of the connective tissue. Hip dysplasia in dogs was first described in 1935 by G.B.Schnelh. Since then, it has been proven that the disease is of a genetic nature and is characteristic of large and giant breeds.
Clinical signs of dysplastic syndrome appear from 4-10 months. in the form of stiffness of the joint, lameness, soreness and weakness of the muscles of the pelvic limbs. X-ray reveals: dorsal displacement of the central part of the femoral head relative to the acetabulum; expansion of the joint space; flattening of the acetabulum; increase over 150gr. the angle between the neck and the axis of the femur; secondarily there are bone formations in the acetabulum and on the head of the bone. Based on these changes, five degrees of DHBS are divided (the interpretive and prognostic approach to determining the degree of dysplasia is different in different countries): A - a healthy joint; B - predisposition to dysplasia; C - predysplastic stage; D - initial destructive changes; E - Pronounced destructive changes. In Russia, with degrees D and E, dogs are not allowed for breeding.
DTBS should be differentiated from: osteochondrosis, Perthes disease, osteomyelitis, fractures of the growth zone of the femoral head.
The main methods used to treat the pathology of the hip joints:
- Conservative treatment is the most common and least effective approach.
- triple pelvic osteotomy - a complex surgical operation to change the geometry of the dog's pelvis to increase the area of support of the femoral head on the acetabulum.
- change in the cervical-diaphyseal angle of the femur - this operation is designed to increase the index of penetration of the head, is performed with a mild degree of dysplasia and prevention of hip joint dislocation.
- total hip arthroplasty.
- resection arthroplasty of the hip joint, called the removal of the femoral head. In fact, this is a complex operation, in which not only the amputation of the femoral head is performed, but also the plasticity of the thigh muscles, as a result of which the function of the limb is fully restored.
In our clinic, resection arthroplasty of the hip joint is performed.
Over the past twenty years, a look at Treatment of bone fractures in cats and dogs has changed, methods are constantly being improved and approaches are changing.
To date, the modern veterinary specialist has almost forgotten about the plaster cast. The use of osteosynthesis methods in clinical practice provides conditions optimal existence of cats and dogs with bone fractures and allow for adequate and rapid rehabilitation.
The process of speedy and high-quality recovery affects not only the professional interests of the doctor, but primarily the interests of the owners.
concept “osteosynthesis” comes from the Greek words osteon(bone) and synthesis(connection) and involves the connection of bone fragments and the elimination of their mobility with the help of fixing devices.
For many years, in the treatment of bone fractures, classical methods have been used, which include submersible and external osteosynthesis.
Internal osteosynthesis is a method that involves the use of stabilizing systems inside the tissues of the body and structures are located in the fracture zone.
Internal osteosynthesis, depending on the location of the fixator in relation to the bone, can be intraosseous (intramedullary), external and transosseous.
External osteosynthesis involves the use of stabilizing systems outside the bone fracture zone (external fixation devices).
There are combined methods that include a combination of two or more methods (intraosseous-osseous, transosseous, or intraosseous-transosseous).
The main task of the treatment of fractures of the International Association of Osteosynthesis (AO) is anatomical reduction, stable fixation, early loading.
To date, reposition and fixation are recommended to be performed taking into account the viability of tissues, therefore, the reduction of injuries and the preservation of blood supply are of paramount importance.
In animals, in our opinion, the main principles are stable fixation, axial reposition and early functional loading, which does not contradict the methods of biological osteosynthesis, and protocols and classification approaches to the choice of treatment method are not quite suitable for our patients, unlike humans.
Intramedullary osteosynthesis with pins and wires in cats and dogs(photo 1a, b, c).
Osteosynthesis with bone plates in cats and dogs(photo 2a-d).
Methods of external fixation (extrafocal osteosynthesis) in cats and dogs(photo 3a-e).
Combination of various methods of osteosynthesis in cats and dogs(photo 4a-d).
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Peri- and intra-articular fractures in cats and dogs(photo 5a-e).Arthrodesis in dogs(photo 6a, b, c, d).Reconstructive methods of osteosynthesis in cats and dogs(photo 7a, b).
Complications of osteosynthesis and methods of correction (false joint)(photo 8a-c).
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Anatomical and topographic data. The structure of the limbs of the dog is shown in the figures.
Some methods of osteosynthesis of the bones of the limbs of dogs. Many methods have been developed for connecting bone fragments to ensure their successful union.
Scheme of the area of the shoulder and forearm of the dog from the lateral surface: 1 - deltoid muscle; 2 - brachiocephalic muscle; 3 - shoulder muscle; 4 - saphenous vein of the shoulder; 5 - superficial branch of the radial nerve; 6 - radial extensor of the wrist; 7 - common extensor of the fingers; 8 - lateral extensor of the fingers; 9 - extensor III and IV fingers; 10 - long abductor of the thumb; 11 - dorsal branch of the nerve of the wrist; 12 - skin-palmar branch of the nerve of the wrist; 13 - ulnar extensor of the wrist; 14 - elbow flexor of the wrist; 15 - lateral head of the triceps muscle of the shoulder; 16 - long head of the triceps muscle of the shoulder
Currently, pin osteosynthesis is most widely used. The method is quite simple and provides the basic needs of veterinary practice. In veterinary practice, in case of multi-comminuted fractures, bone fragments are fixed on a plate; in case of fractures and detachments of peripheral bone protrusions (maklok, ulnar tubercle, calcaneal tubercle, etc.), screws and screws are used in some cases. In addition to these methods, for complicated fractures (especially for fractures of the lower jaw), a wire is used.
Cross section of the dog's forearm in the area of its middle: 1 - radial extensor of the wrist; 2 - common extensor of the finger; 3 - interosseous artery; 4 - long abductor of the thumb; 5 - lateral extensor of the fingers; 6 - extensor of the thumb; 7 - ulna; 8 - ulnar extensor of the wrist; 9 - ulnar head of the deep flexor of the fingers; 10 - wrist nerve; 11 - elbow flexor of the wrist; 12 - superficial finger flexor; 13 - shoulder head of the deep flexor of the fingers; 14 - radial flexor of the wrist; 15 - median nerve; 16 - ulnar artery; 17 - radial artery; 18 - square pronator; 19 - deep finger flexor; 20 - radius; 21 - saphenous veins of the forearm and saphenous branch of the radial nerve
Scheme of bone fixation with the Ilizarov apparatus: 1 - screws; 2 - knitting needles
Attempts have been made to use external fixation devices, both unilateral and bilateral, on animals. In particular, the most complex of the external fixation devices, the Ilizarov apparatus, is installed in dogs. The literature describes many other methods of fixing bone fragments using various staples.
Intramedullary osteosynthesis. Pins are made from various materials. Most often, metal or polymeric pins are used, for example, from a vinyl nitrogen copolymer. It is known from history that processed pieces of animal bones, and even the wood of some plants, were also used as pins. The length of the pin should slightly exceed the length of the medullary canal of the broken bone, and the thickness should correspond to the diameter of the narrowest part of the medullary canal. The shape of the pins on the cross section is different: they can be square, rectangular, semicircular, oval, round, with a groove along the planes of the faces (cross-shaped), U-shaped, etc.
Operational accesses depend on the method of osteosynthesis, on the localization of the injury.
With intramedullary osteosynthesis in dogs, developed in the 80s of the XX century, operative access for a fracture femur consists of two sections. The first incision is made over the fracture and the superficial layers, the aponeurosis between the biceps femoris and the lateral head of the quadriceps femoris are dissected, exposing the area of the fracture. Then, depending on the nature of the fracture, it is necessary to clean the adjacent area: remove blood clots, crushed tissues, loose and small bone fragments. The proximal end of the femur is lifted from the wound and, in order to maintain a single axis of the bone (medullary canal) for a straight pin, the epiphyseal bone plate is trepanned through the medullary canal from the side of the fracture in the area of the vertical cavity of the femur. The drill is removed and the conductor of the pin is inserted, moving the latter under the skin in the buttock area, where a second incision is made above it (by the size of the cross section of the pin) and through it, with the help of a conductor, the pin is inserted into the proximal fragment of the femur. If the pin enters the channel with difficulty, then it is advanced forward with light hammer blows. If strong impacts are needed to advance the pin, this will indicate that the hole diameter is insufficient for this pin. The pin is passed into the proximal canal of the femur until it appears in the fracture area. Then, the ends of the bone fragments are brought together and aligned at first at an obtuse angle, and then they are given the correct axial position and the pin continues to advance along the medullary canal of the distal femoral fragment until it stops at the epiphyseal bone plate.
They check with their hands the strength of the connection of bone fragments for twisting and other loads that occur during the functioning of the limb. At the final stage of the operation, if the pin is too long, it is cut down, closing the second wound with a sterile napkin, and then both surgical wounds are sutured in layers. This type of insertion is called retrograde.
For fractures tibia and tibia operational access is carried out through two incisions: the first - from the medial side, where the tibia is palpable under the skin, and the second (for the exit of the pin) - over the rough thickening of the outer crest of the tibia. The technique for inserting the pin does not differ from that in the femoral bone.
fractures humerus are less common and, as a rule, are diagnosed in the lower middle third of the diaphysis. Operational access is carried out from the lateral side through two incisions. The first incision is made over the fracture zone and, as a rule, there are vessels that cross over the humerus obliquely. It is difficult to maintain their integrity during the operation, and practice shows that it is not necessary. The second incision to exit the end of the nail is made above the tubercle of the humerus at the proximal end.
Experienced surgeons with closed bone fractures without displacement and without fragments sometimes carry out a direct insertion of the pin into the medullary canal through one small incision. In this case, the surgeon must clearly understand the structure of the bone and its landmarks under the skin, accurately find the place of trepanation of the epiphyseal plate from the outside, so that the axis of the pin immediately coincides with the axis of the bone. If the axes do not match, then inevitable cracks and breaks of the bone part in the area of the pin insertion or in other places of the bone are inevitable at the moment of insertion. It is difficult, but osteosynthesis is faster, less traumatic, microflora practically does not enter the area of injury. But here it is mandatory to carry out postoperative X-ray diagnostics. For metaphyseal (especially in young animals) and epiphyseal fractures, pins or screws are inserted from the side of the nearest joint. After osteosynthesis, bone fusion and removal of the pin, the joint is restored.
After healing of the fracture, which is confirmed by X-ray, the pin is removed. In place of the pin protruding from the bone, a small incision is made and the pin is exposed, grasped with a fixing instrument, and the pin is pulled out. If the pin is not polished, you have to resort to the help of a surgical hammer to remove it. The surgical wound is closed and treated in the usual manner.
The method is quite simple, requires a minimum of materials. Loop osteosynthesis is used in the treatment of syndesmosis ruptures (in particular, radioulnar and tibiofibular), oblique, spiral and large-comminuted fractures of long tubular bones as an independent compression system or in addition to other methods of osteosynthesis.
Fixation. The animal is fixed on the operating table with the affected area up, as a rule, in the supine position, if possible, and in the supine position.
Anesthetic protection. Same as for intramedullary osteosynthesis.
After a preliminary reposition in the direction of the aligned points of the fracture surfaces, a metal needle is passed through the fragments. With the help of a paired tubular conductor, a second knitting needle is carried parallel to it at a distance of 3 ... 5 mm. At the opposite ends of the spokes, support loops are formed, into which the opposite ends are inserted, uniting the system into a loop pair.
The ends of the spokes remaining from the support loops “bite”. The loops are immersed all the way into the bone fragments. The free ends of the spokes are installed and pulled in a bracket for skeletal traction. To increase the strength of osteosynthesis, a spiral twist is formed from the ends from the loops (one or two turns).
Loop osteosynthesis has a dynamic compressive effect that provides stable fixation of bone fragments; it is effective in the treatment of injuries of radioulnar and tibiofibular syndesmosis.
Loop osteosynthesis: a - with an oblique fracture; b - with syndesmosis
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The Vet.Firmika.ru portal provides information about Moscow veterinary clinics where osteosynthesis for pets can be performed. We have collected contact numbers and addresses of clinics, the cost of visiting doctors, and presented all this in tables that are visual and easy to compare. Feedback from veterinary clinic customers who have already entrusted their pets to specialists will also be useful. All this will allow you to make the most correct choice of a veterinary clinic.
Quite often, pet owners turn to the veterinarian with bone fractures of various locations. For example, a broken paw in a cat usually occurs due to a fall from a height, while a broken leg in a dog occurs when a car hits. In some cases, such an injury may be accompanied by internal bleeding, leading to death. For this reason, the pet must be urgently brought to an experienced veterinarian, while trying to ensure maximum immobility for the injured part of the body.
An excellent opportunity to create conditions for the speedy recovery of your pet will be osteosynthesis in animals in Moscow. It is carried out by connecting the bones with the help of a structure specially designed for this, whether it be knitting needles, pins and similar elements.
Why is bone osteosynthesis good for pets?
The use of additional materials contributes to faster and more successful healing of fractures and restoration of joint functions. A dog or cat is completely free from muscle atrophy, since in most cases, pets will be able to start using the injured limb almost immediately after the operation. In this case, incorrect bone fusion is completely eliminated, which can be achieved due to accurate and reliable fixation.
- Bone tissues that do not fuse without surgery.
- Fractures with an increased risk of sharp bone fragments damage soft tissues: blood vessels, skin, nerves or muscles.
- Incorrectly fused bones with a shift in the axis or violation of the length of the limb.
Osteosynthesis in cats and osteosynthesis in dogs are carried out by experienced veterinarians who are able to quickly restore mobility to the injured limb of a pet. For this, two types of surgery are used: transfocal and extrafocal. The choice of method for connecting fragments depends entirely on the nature of the injury and the size of the animal. The external type of fixation uses devices placed above the skin surface - bone fragments connect retaining elements that are attached to the bone outside the fracture site. Metal spokes and rods act as clamps. This type of osteosynthesis is suitable for both small and large types of pets.
The duration of rehabilitation after osteosynthesis of fractures in dogs and cats directly depends on the severity of the injury, the state of health of the pet, the need to repeat the operation to remove the fixing devices. Throughout the recovery period, the pet must be periodically taken to the veterinarian for examination.
Osteosynthesis for dogs and cats in Moscow
The osteosynthesis procedure is a modern operation offered by clinics that follow the latest in veterinary medicine. Experienced surgeons will be able to help the four-legged patient restore motor function as quickly as possible. Osteosynthesis for animals in Moscow is offered by many veterinary clinics. Our portal contains basic information on addresses, phone numbers and services of various establishments. Convenience is added by the availability of a detailed cost for the osteosynthesis operation in various veterinary clinics, the ability to select a suitable territorial specialist using the map.