Implant removal rate from infection after tibial plateau leveling osteotomy in dogs

To determine implant removal rate associated with infection after tibial plateau leveling osteotomy (TPLO) in dogs and to report antimicrobial susceptibility patterns for isolates.

Retrospective case series.

Dogs (n = 255; 282 TPLO).

Medical records (April 2006-April 2008) for dogs that had TPLO with ≥ 18 month follow-up were reviewed. Dogs that had implant removal with confirmed bacterial isolation from the implant were studied. Cefazolin (22 mg/kg intravenously) was administered before anesthesia induction for TPLO, every 2 hours intraoperatively, and every 6 or 8 hours until the next morning. Antimicrobial susceptibility testing was performed on isolates.

Twenty-one (7.4%) of 282 TPLO required implant removal because of infection. Bacterial species isolated were Actinomyces spp. (1), Corynebacterium spp. (1), Enterococcus spp. (3), hemolytic Staphylococcus coagulase negative (2), nonhemolytic Staphylococcus coagulase negative (3), Staphylococcus spp. coagulase positive (7), methicillin-oxacillin-resistant Staphylococcus coagulase positive (2), and Serratia marcesens (2). Of the antibiotics that had ≥10 isolates tested against them, gentamicin had the highest susceptibility rate (94%), followed by tribrissen (71%), and amoxicillin/clavulanic acid (67%).

Staphylococcus spp. was reported in 14 of the 21 infections cultured in this study. Based on antimicrobial susceptibility testing, amoxicillin/clavulanic acid would be the best empirical treatment.