EN: Dr. James Gannon / Muscles injuries

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EN: Dr. James Gannon / Muscles injuries

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The beginnings of veterinary sports medicine rehabilitation to the author‘s point of view started at Sandown Greyhound Veterinary Clinic in Melbourne, Victoria, Australia in the imagination and execution of one man, Dr. James Gannon. According to his long time apprentice and colleague, Dr. Des Fegan, “He reorganized a system of Greyhound care. Pre-Gannon, it was a true fire brigade service with dogs needing to exhibit profound lameness to warrant veterinary attention. Today his preventative musculoskeletal examination is the established norm in Australia. (A video is available from the American Greyhound Council and will be shown detailing this procedure.) He pioneered the use of ultrasound, magnetic field, laser and electrostimulation of muscles and connective tissues. He collected information on exercise physiology and logically applied his research to medical problems that he saw in Greyhounds week after week. He established preventative programs for exertional rhabdomyolysis, “water diabetes,” and kidney disease and time has proven that his thinking was almost flawless.”

Dr. Gannon was born in 1930 in Brisbane, Australia to a dairy farming family. He graduated with a degree in veterinary science from Queensland University in 1952 and worked as a veterinarian for the next almost 60 years. He had an intense interest in exercise physiology and athletic performance. His specialty was the racing Greyhound. Founding the exclusive Greyhound veterinary clinic at Sandown Race Track in Victoria, he had many years of working with these great athletes. As a practitioner, Dr. Gannon spearheaded a number of research projects publishing over fifty articles on these dogs with results that form the basis of many treatments used today. Sadly, shortly after this photo was taken on his 80th birthday, Dr. Gannon passed away in October of 2010. Details of his research and approach to practice both in prevention and treatment of athletic dog injuries will form the basis of this paper as well as a description of other important contributions of Dr. Gannon to Greyhound racing world wide.

Muscles injuries are one of the most common sports related injuries that occur in racing and training Greyhound. In 1978, Dr. Gannon published his first paper on the extent and therapy of muscle injuries in the racing Greyhound. He determined that the six most commonly damaged muscles were the gracilis, tensor fascia lata, and the pectineus of the pelvic limb and the flexor carpi ulnaris and long head of the triceps muscle in the thoracic limb. He developed a 3-minute examination procedure for veterinarians and owners that could check for these injuries both pre- and post-racing. He published a brochure to educate trainers at many local tracks in Victoria and subsequently internationally at many speaking engagements. He categorized muscle injuries into three stages. Stage 1 being myositis from simple contusions, bruising, or inflammation; Stage 2 was myositis plus an actual tear of the fascial sheath; and Stage 3 being a tearing of the muscle and its sheath from the origin or insertion with hematoma formation, commonly called a “dropped muscle.” It is important to note that muscle injuries do not cause a marked or persistent lameness as is seen with bone, joint, ligament or pad injuries and it is only when one looks specifically for these injuries, will they realize the presence and extent of the injury. Detailed methods of caring for each of these injuries and methods of bringing them back to performance level when possible were published most recently in his co-authored textbook, Care of the Racing and Retired Greyhound. It must be remembered that most all injuries heal, but for a racing athlete such as the Greyhound, the healing needs to occur with no or little reduction in the animal‘s ability to run as races are won by hundredths of seconds between dogs. Dr. Gannon developed and used physical therapy modalities of therapeutic ultrasound, laser, electrical muscle stimulation and magnetic field to enhance the healing process. He published on how to use these methods of rehabilitation along with a set of guidelines for use in returning the dog to training and/or racing, in the “Care” books.

Dr. Gannon was one of the first to publish on exertional rhabdomyolysis in the racing Greyhound in 1978 and 1980, stating that it was a metabolic disease of young healthy athletes with the underlying pathophysiology being due to a local muscle ischemia resulting in lysis of the muscle cell wall. He stated that the cause was multifactorial with factors such as lack of fitness, psychological response to training or racing, climatic and environmental factors, frequency of exercise and low potassium levels in the body. The latter factor led to the use of oral slow release potassium supplements that are now a standard part of the racing Greyhound nutrition. From what he saw clinically, he subdivided the disease into three categories; hyperacute, acute and subacute, based on severity of signs and suddenness of onset.

Hyperacute exertional rhabdomyolysis is the least common with the Greyhound exhibiting extreme distress hours after a run. The muscles, especially over the back appear swollen, are painful to touch and the dog is reluctant to move. Myoglobinuria develops from myoglobin escaping from the ruptured muscle cells. Excessive myoglobin in the blood will damage the kidney tubules causing subsequent necrosis and death from acute renal failure within 48 hours. These cases are medical emergencies and need body cooling, and rapid application of intravenous fluids, preferably Ringer‘s solution, and sodium bicarbonate over several days plus good nursing care.

Acute exertional rhabdomyolysis may also occur 72 hours post race but has predisposing factors of Greyhounds that are unfit, run too far, high strung or tense and/or racing under hot and humid environmental conditions. Panting under either condition results in a respiratory alkalosis, which is compensated by the kidneys excreting potassium and bicarbonate ions into the urine to lower the blood pH. Excessive drooling leads to dehydration. These factors compromise the Greyhound‘s ability to buffer the lactic acid produced in a run even if the dog is fit resulting in muscle cell damage, stiffness of gait, pain on palpation and plus/minus myoglobinuria. Treatment is the same as for the hyperacute condition. The chance of death is 25% if untreated with 100% recovery if therapy is instituted within 12 hours and a convalescence of 8 weeks is given.

Subacute exertional rhabdomyolysis is the most common form of this condition. Seen in fit Greyhounds that are raced too often, the slow decline in body potassium levels lost from exercising muscle cells results in reduced vasodilation at the cellular level during muscular contraction. This causes heat retention and a reduction of blood flow to the muscles resulting in ischemia and muscle cell breakdown. Muscle soreness is the primary clinical sign, especially when palpated over the “saddle area” (longissimus thoracic muscle groups). Treatment is aimed at flushing out the excess myoglobin, reduction of inflammation, reduction of racing or training schedules and good nursing for a week until recovered. Dr. Gannon developed a system of having trainers check the pH of their Greyhounds urine with common Dipstick methods. His theory was that normal Greyhound urine should be in the pH range of 6.0 to 6.5 and an overly stressed Greyhound‘s urine becomes more acidotic over several weeks resulting in a pH of 5.0 to 5.8 and continued loss of potassium. A critical stage is reached when a Greyhound passing acidotic urine over a period of time suddenly undergoes a dramatic shift from acidotic pH values of 5.0 to 5.8 to an alkalotic pH of 7.3 to 8.3 without any dietary or work load change. This indicates an actual metabolic alkalosis in the blood associated with potassium loss leaving the Greyhound most susceptible to subacute exertional rhadomyolysis. Having trainers test the first urine of the day with the Dipstick in the kennels, gave them a way of monitoring the condition of their racing Greyhounds.

Another metabolic condition that Dr. Gannon described which is not well known in the USA is “water diabetes” in the racing Greyhound. Different from the human problem known by this name, this condition is caused by moderate to severe polydipsia and polyuria in the Greyhound. Greyhounds in normal temperatures drink only ~½ liter per day in cool temperatures and up to 1 liter per day in hot climates. Amounts of water intake above these levels indicate a polydipsia in a Greyhound with a subsequent polyuria. Again, Dr. Gannon had three categories of this disease condition, hyperacute, acute and chronic. In the former, after a race, water intake is markedly increased (if unrestrained) reaching levels of 5 to 15 liters in the first hour after the run. It is believed that extreme stress has a negative feedback on the hypothalamic pituitary axis and a failure of antidiuretic hormone (ADH) release. This leads to dehydration in spite of water intake due to dilution of the body‘s electrolyte stores especially in the kidney tubules with a subsequent inability to concentrate urine. If untreated, death occurs as a result of dehydration within 24 to 48 hours. This is a medical emergency constituting intravenous fluids with electrolytes, administration of ADH, oral electrolyte supplementation and control of water ingestion. The acute category of “water diabetes” has water intake levels of 2 to 10 liters within 24 hours after a good racing performance. Treatment is similar to the hyperacute condition and both may occur concurrently with exertional rhabdomyolysis. The chronic condition is the most common form seen in Greyhounds and is associated with chronic stress from poor housing, aggressive kennelmates and poor management. Water intakes range from 1 to 2 liters per day yet the Greyhound will show clinical signs of dehydration using a skin pinch test and their racing performance is reduced. A study involving over 50 Greyhounds at Sandown Veterinary Clinic with this form of water diabetes showed that most had elevated white blood cell counts indicating chronic low grade infections. Subsequent treatment with antibiotics, hematinics and a review of the management program produced good results.

Excessive endogenous and exogenous corticosteroids are known to induce polydipsia and polyuria. One Australian study showed that the biggest increase in cortisol in racing Greyhounds occurs when they are brought out of their kennels at home and placed in a truck to go to the track. The effects of high levels of cortisol in “overstressed” Greyhounds may contribute to these water diabetes conditions. It must be noted that Greyhounds are very susceptible to the effects of exogenous corticosteroids and these should only be used at the lowest dose and shortest time period possible to avoid a drug-induced “water diabetes.”Prevention of injuries was the hallmark of Dr. Gannon‘s approach to practice. Teaching the people who handled these animals on a daily basis, practical ways they could monitor and improve their Greyhounds‘ care is what made him so beloved by people in the Greyhound industry. He ran regular client seminars with his primary philosophy to educate. Dr. Gannon was recognized for his work and leadership in many ways, the highlight of which were his induction into the Membership of the Order of Australia and being given the Australian Sport Medal. He was also the first veterinarian to be inducted into the Australian Greyhound Hall of Fame. His contribution to the two textbooks, Care of the Racing Greyhound (1984) and subsequent Care of the Racing and Retired Greyhound (2007), is the cornerstone of the success of these books for all people who work with athletic dogs. Dr. Gannon had a number of speaking engagements in the United States and had the opportunity to see how adoption of retired racing Greyhounds developed in this country. Subsequently, he started a Greyhound Adoption Service from Sandown Veterinary Clinic that developed into a large independent service provided by the Greyhound Racing Victoria (GRV) association on a 40 acre property in Seymour, Victoria. Dr. Gannon extensively studied books on human physiology and practice of physical therapy and brought this knowledge to practice in caring for Greyhounds. He was the impetus for and featured speaker at the First International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine in Corvallis, Oregon in 1999. The author truly considers him the “Father of Rehabilitation and Physical Therapy in Veterinary Medicine” which has had tremendous growth both in the United States and abroad. A quote he often said, if one thought to question his way of treating animals or propose alternative methods, was as follows:

“Whatever he said was right,
Whatever he did was good,
His actions are faultless, and
his thinking is flawless.

However,”
It was his way of acknowledging that while his way may not be the only way to achieve success in preventing injuries and/or returning a Greyhound to racing form, his ways were most highly successful in doing both. His wit, his intelligence, his kindness, his generosity in teaching others, and his love for Greyhounds will be his legacy for all those who were fortunate enough to have known him.
https://www.vetfolio.com/learn/article/ ... c-dog-care

Quelle: Greyhound-Data
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