Tibial Plateau Leveling Osteotomy Update
Bud Siemering, DVM

The SouthPaws Surgery Department began performing TPLOs in August 2001.  Since that time, we have completed approximately 130 of these surgeries.  Although the learning curve and cost of the instrumentation is high, the results are truly impressive. Most patients are 100% weight bearing at the time of the 8-week postoperative radiograph, and we have had only one complication, a mild subcutaneous infection at the distal end of the plate. Compared to all other surgeries we have done for rupture of the cranial cruciate ligament, this is by far the most successful. We simply do not receive calls from owners about their dog limping after the final exam at 8 weeks postoperative. The owners are delighted with the results, as well as the referral to SouthPaws for the procedure.

TPLO is Dr. Siemering's procedure of choice on every size dog, and he no longer performs the lateral stabilization technique.  Dr. Brehm was certified to perform the procedure in mid April.  There is a description of TPLO in lay terminology on our web site, which you should feel free to download, modify, and give to your clients.

Managing Feline Diabetes Mellitus
Fiona McClure, BVSc MVSc  DACVIM

I doubt that anyone will ever tell you that managing diabetes mellitus (DM) is a "piece of cake". For a disease with a fairly straight forward pathophysiology, it really does provide a challenge to all of us. Some new ideas pertaining to managing this disease in our feline friends are interesting and in my experience have made treatment a lot easier and more successful. I now recommend a low carbohydrate diet (Purina DM canned and dry, canned kitten food) for diabetic cats unless they are moderately to severely azotemic (I use a cut-off of BUN ~ 80 mg/dl). I have found that the canned kitten food is the tastiest and have had less success with the dry DM compared with the canned DM (the cats seem to need more insulin). The diet should be meal-fed (BID feedings), not given free choice. When I meet a diabetic cat that is already receiving insulin and I change his diet to a low carbohydrate diet I definitely decrease the insulin dose (best to halve it) to be sure that hypoglycemia does not occur.

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