Case File
Seeing Clearer with CT! - a Case Story
by Amy Parsons BVetMed GPCert (SAS) MRCVS Group Surgical Lead
Betty first saw us with her sore leg back in December. After hearing a scream from the other room, her worried owners found her lying in shock on the floor. It soon became apparent that she was very uncomfortable on her right hindlimb with a swollen tarsus (ankle joint).
After being examined, Betty was admitted for radiographs and assessment under sedation. Cruciate ligament rupture was ruled out and radiographs did not show any obvious fractures. Betty was discharged with anti-inflammatories and advised to rest. Although improvement was seen, a few weeks later after some rough and tumble at doggy day care, Betty re-presented with a swollen tarsus.
The decision was then taken to perform computed tomography (CT) using our new scanner to get greater detail. After a short anaesthetic the CT images were sent to our specialist imagers who came back with a diagnosis.
The blue arrows indicate the soft tissue swelling associated with the injury but more interestingly the yellow arrows indicate some displacement of bone fragments from the distal fibula (orange arrows) indicating a small fracture.
This was important as it enabled us to distinguish from a developmental condition and implement an appropriate treatment plan. As the fracture fragments were very small and from a non-vitally weight bearing bone of the limb, surgical fixation or casting was not required and we referred internally to our hydro.vet rehab team headed up by physio Viv.
A rest and physio exercise programme was devised to help Betty recover from her injury and regular appointments ensured we were on track. 6 weeks later Betty was signed off and is now back to her ‘normal’ self. Which is 100% crazy!
Betty’s mum says:
‘Once the diagnosis was made through the CT scan, the care plan for Betty was really thorough and explained simply and in detail. The physio exercises that were recommended were easy to follow at home and she really enjoyed them!
Careful monitoring by the veterinary team meant that her recovery was steady and incremental until she was given the all-clear.
Now it’s a real joy to see Betty running and playing again at full capacity.
Many thanks to you all again,
Tina’
This case showed how beneficial CT was in diagnosing something that traditional radiographs couldn’t detect, we are so lucky now to have this as another implement in our toolkit to work-up our cases.