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Occurrence, Etiology, Clinical Findings, Management and Outcomes of Musculoskeletal Limb Conditions in Dogs Presented to Selected Clinics in Nairobi County, Kenya

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Occurrence, Etiology, Clinical Findings, Management and Outcomes of Musculoskeletal Limb Conditions in Dogs Presented to Selected Clinics in Nairobi County, Kenya OCCURRENCE, ETIOLOGY, CLINICAL FINDINGS, MANAGEMENT AND OUTCOMES OF MUSCULOSKELETAL LIMB CONDITIONS IN DOGS PRESENTED TO SELECTED CLINICS IN NAIROBI COUNTY, KENYA A thesis submitted in partial fulfillment of the requirements for the award of the degree of Master of Veterinary Surgery of the University of Nairobi Dr. Zahra Zulfikar Mamujee (B.V.M) University of Nairobi College of Agriculture and Veterinary Sciences Faculty of Veterinary Medicine Department of Clinical Studies September 2020 DEDICATION I dedicate my thesis work to my family that has supported me tremendously throughout this journey and my academic friends for the guidance and support that they offered. I would like to especially thank and dedicate my work to my father Dr. Zulfikar, without whose constant encouragment and patience this would not have been possible. ii ACKNOWLEDGEMENT I would like to thank my supervisors Prof. John Demesi Mande and Prof. James Nguhiu- Mwangi for all the effort, encouragement, guidance, patience and countless hours that they put to this entire process in guiding me. I wish to thank the members of staff of the University of Nairobi, Small Animal Clinic for their support and the five private veterinary clinics including the University of Nairobi, small animal clinic that permitted their participation in this study. Finally I would like to thank Dr. Lilyan Mathai, Dr. Peter Kimeli, and Dr. Willy Mwangi for guiding and developing my skills. iii TABLE OF CONTENTS DECLARATION………..…………………………………………………………………i DEDICATION……………….……………………………………………………………ii ACKNOWLEDGEMENT………………………………………………………………..iii TABLE OF CONTENTS…………………………………………………………………iv LIST OF TABLES………………………..……………………………………………...vii LIST OF FIGURES…………………………..…………………………………………..xi LIST OF APPENDICES………………………………………………………………...xii ABSTRACT………………………………………...…………………………………..xiii CHAPTER ONE……………………………………….………………………………….1 1.0 INTRODUCTION…………………………………………………………………….1 1.1 Problem Statement………………………………….........................................2 1.2 Hypothesis……………………………………………………………………..3 1.3 Objectives…………………………..………………...……………………….3 1.3.1 General objective…………………………...……………………..3 1.3.2 Specific Objectives…………………………..……………………3 1.4 Justification………………………………………………..…………………..4 CHAPTER TWO……………………………………………………….…………………5 2.0 LITERATURE REVIEW………………………………………….………………….5 2.1 Definition of musculoskeletal conditions………………….………………….5 2.2 Anatomical features of the forelimb and hind limb……….………..…………5 2.2.1 The forelimb…………………………………………….…………5 iv 2.2.2 The hind limb………………………………….…………..………5 2.3 Musculoskeletal conditions affecting the limbs…………….………………..11 2.3.1 Fractures………………………………………………………….11 2.3.2 Joint conditions…………………………………………………..12 2.3.3 Soft tissue injuries………..………………………………………17 2.3.4 Neoplasia…………………………………………………………18 2.3.5 Neurological disorders: Paralysis / Paresis of limbs……………..20 2.3.6 Metabolic and nutritional disorders……………………………...21 2.4 Management of musculoskeletal conditions affecting the limbs…………….22 2.4.1 Medical (conservative) management…………………………….22 2.4.2 Surgical management…………………………………………….24 2.5 Prognoses of common limb conditions in dogs……………………………...24 CHAPTER THREE……………………………………………………………………...26 3.0 MATERIALS AND METHODS…………………………………………………....26 3.1 Study area……………………………………………………………………26 3.2 Study design………………………………………………………………….26 3.3 Selection of small animal veterinary clinics and sample size determination...26 3.3.1 Selection of the small animal clinics…………………………….26 3.3.2 Sample size (number of dogs)….………………………………..27 3.4 Data collection……………………………………………………………….27 3.5 Data management and analysis………………………………………………28 CHAPTER FOUR……………………………………………………………………….31 4.0 RESULTS……………………………………………………………………………31 v 4.1 The occurrence of musculoskeletal conditions of the limbs of dogs………...31 4.2 The causes, clinical findings and diagnosis of musculoskeletal limb conditions in dogs………………………………………….…………….………………34 4.3 Treatment / management and outcomes of musculoskeletal limb conditions in dogs…………………………………………………………………………..54 4.4 The treatment methods for musculoskeletal limb conditions of dogs that influence outcomes ……..…………………………………….......................61 CHAPTER FIVE………………………………………………………………………...63 5.0 DISCUSSION…………………………………………….. ………………………...63 CHAPTER SIX…………………………………………………………………………..72 6.0 CONCLUSIONS AND RECOMMENDATIONS…………………………………..72 6.1 CONCLUSIONS…………………………………………………………….72 6.2 RECOMMENDATIONS……………………………………………………74 7.0 REFERENCES………………………………………………………………………75 8.0 APPENDICES……………………………………………………………………….94 8.1 Appendix I: Data collection sheet I………………………………………….94 8.2 Appendix II: Data collection sheet II………………………………………..94 vi LIST OF TABLES Table 4.1: Occurrence of cases of dogs recorded with musculoskeletal limb conditions presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…………………………………………………………32 Table 4.2: Monthly occurrence of cases of dogs recorded with musculoskeletal conditions of the limbs in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018………….……………………………………………………………….33 Table 4.3: Occurrence of the causes of musculoskeletal limb conditions affecting the dogs presented to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018………………………………………………………………………..37 Table 4.4: The weight range (kg) distribution among the cases of dogs presented with musculoskeletal limb conditions in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018………………………………………………..…37 Table 4.5: The age grouping for dogs as adopted for use in this study. Borrowed from Pet health network: how old is your dog in people years. www.woofpurrpetsit.com.........…39 Table 4.6: Occurrence of musculoskeletal limb conditions per age category of dogs in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…………………………………………………………………..…………..………40 vii Table 4.7: The table categorizing the dog breeds to their corresponding weight ranges, which was adopted for the current study. Borrowed from www.dogtime.com, www.cuteness.com........................................................................................................…40 Table 4.8: The occurrence of musculoskeletal conditions of the limbs according to dog breed categories presented for treatment in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018….……………………………………….41 Table 4.9: Occurrence of musculoskeletal limb conditions per specific breeds of dogs presented to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…………………………………………………………………………..41 Table 4.10: Occurrence of clinical findings presented by dogs affected with musculoskeletal limb conditions presented for treatment in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018.……………………………………………………………………………………...43 Table 4.11: Occurrence of Musculoskeletal conditions involving different anatomical structures of the limbs of dogs that were presented for treatment in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…….....………44 Table 4.12: Occurrence of musculoskeletal conditions in the specific anatomical structures of the limbs of dogs presented for treatment in the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…………………...…………….................................................................................45 viii Table 4.13: Occurrence of musculoskeletal conditions affecting limbs of dogs presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…...…………………………………………………………………...47 Table 4.14: Occurrence of various soft tissue conditions affecting limbs of dogs presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018………………………………………………………...……………...48 Table 4.15: Occurrence of various joint conditions affecting limbs of dogs presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018.………………………………………………………………………….50 Table 4.16: Occurrence of fractures of various bones of the limbs and the adjoining trunk of the dogs that were presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018.…….……………………………52 Table 4.17: Occurrence of the types of neoplasms affecting the limbs of dogs presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2005 to December 2018----------------------------------------------------------------------------------53 Table 4.18: Occurrence of the various drugs used in the medical / conservative management of dogs affected with musculoskeletal limb conditions that were presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018.…………….…………………………………………………………56 ix Table 4.19: Occurrence of the various Corticosteroids and NSAIDs used in the medical / conservative management of dogs affected with musculoskeletal limb conditions that were presented for treatment to the five veterinary clinics in Nairobi County, Kenya from January 2009 to December 2018…………………….………….………………………..57 Table 4.20: Occurrence of the different surgical procedures used in the surgical management of dogs affected with musculoskeletal limb conditions that were presented for treatment to the five veterinary clinics in Nairobi County,
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