NorthStar VETS Cool Case Rudy R

The team at NorthStar VETS is doing innovative and amazing things every day as they work to advance the level of care available to your pet. This series of posts highlights cool cases at NorthStar VETS and the types of things done to save pets and improve their quality of life. These are cases using innovative and cutting-edge medical techniques, and/or stories of pets beating the odds. This is the story of Rudy, a patient of our Surgery team.

About Rudy
Rudy is a fantastic, friendly, and active little dog who had the unfortunate luck of being hit by a pick-up truck after escaping from his yard. As with many dogs that are hit by cars, he sustained significant crush injuries to his hind end. Some injuries that can be associated with this type of trauma include fractures (pelvic, hindlimb, and spinal), neurologic injury resulting in loss of limb function or incontinence, bladder rupture or leakage, muscle tearing and/or bruising, and skin wounds. When pets are presented to the hospital after trauma, we are initially focused on life-saving stabilization such as treating for shock, bleeding, breathing trouble, and metabolic alterations. After pets are stable, we may then be able to care for other injuries such as fractures.

Rudy’s Condition
Rudy was fortunate in that he did not sustain any severe life-threatening trauma. His most significant injuries were multiple fractures throughout his pelvis. In animals, the pelvis is made up of multiple bones (pubis, ischium, and ilium.). Depending on the location of the fractures, some injuries may heal well on their own, and others require surgical repair to restore proper alignment and weight-bearing function.

Rudy’s Treatment
Rudy had several fractures including pubic bone fractures, an ischial fracture, and a significantly displaced sacro-iliac separation/luxation (SI luxation.) The sacroiliac joint is where the pelvis (specifically, the ilium) meets the spinal column (sacrum) and it is an important area in that several spinal nerves are in close proximity. Many minimally displaced SI luxations can be treated conservatively with rest so they can heal on their own, but when they are very displaced, it results in lack of support and pain when walking, as well as possible nerve stretching injuries. When appropriately stabilized, most of these injuries have an excellent prognosis.

Rudy’s SI luxation required surgical stabilization. The goal of surgery is to pull the ilium back into position and stabilize it in position to the sacrum, typically with bone screws. The challenges of this surgery are mostly related to the very small area of the sacrum where implants can be placed (the end of the spinal cord with its important nerve roots is often millimeters away from where the screws need to be placed.) To aid in placement of the screws, as well as to minimize soft tissue trauma, Rudy’s surgery was performed under fluoroscopy (“real time” X-ray) in our operating room equipped with a c-arm. This allowed us to make an inch-long keyhole incision and use X-ray to direct us to the proper location in the small sacrum for screw placement.

How Things Went for Rudy
Rudy’s surgery went very well, and he was able to leave the hospital soon after to continue his recovery with his family. At recheck 2 weeks postoperatively, his pet parents noted he was mostly back to normal and feeling great. Rudy was walking normally and he is not expected to have any long-term problems from his injuries.

Learn more about the Surgery service at NorthStar VETS

Kelly Kraus, VMD, DACVS
Dr. Kraus is originally from Connecticut. She obtained a Bachelor of Science degree from Loyola University in Baltimore, Maryland in 2003 before moving to Philadelphia, where she did molecular genetics research for two years at the University of Pennsylvania. Dr. Kraus then completed veterinary school at the University of Pennsylvania in 2009. After graduating, she completed a rotating internship at Oradell Animal Hospital in Paramus, NJ. She then moved to Texas to complete a one-year internship in surgery at Gulf Coast Veterinary Specialists. She was fortunate to then move back to New Jersey for a three-year residency in surgery at Red Bank Veterinary Hospital, which she completed in 2014.

She is excited to be part of the surgery team at NorthStar VETS. Her special surgical interests include, but are not limited to, wound management and reconstructive surgery, surgical oncology, cardiothoracic surgery, and hepatobiliary surgery. Dr. Kraus also enjoys management of orthopedic conditions. She is trained in the tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament disease. Outside of work, Dr. Kraus enjoys spending time with her family, cooking, traveling, and helping her local SPCA.

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