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Undiagnosed Lameness In Dogs

author
Elaine Sutton
• Monday, 08 March, 2021
• 10 min read

Lameness in Dogs | VIA Animal Hospital We’re committed to keeping clients and staff safe during COVID-19 with NEW admittance and check-out processes. Lameness of unknown origin is common in dogs of all types and sizes.

(Source: www.borntorunmassage.com)

Contents

An arthrocentesis in which the joint fluid is removed and sent to a veterinary pathologist for analysis may also be performed. In most cases, your veterinarian will be able to accurately diagnose the cause of lameness and provide your pet with specific treatment.

Your veterinarian will determine the best course of action based on your pet's condition and the results of diagnostic tests. The most common cause of lameness is trauma or injury to joints, ligaments, tendons, muscles, or bones.

Finding the cause of a pet's lameness usually starts with a complete history and physical examination. Osteoarthritis (OA) is a complex condition involving inflammation and degeneration of one or more joints.

Methylsulfonylmethane is given by mouth and is used over the counter and off label to treat inflammatory conditions such as arthritis. Side effects are uncommon but may include stomach upset, restlessness, or tiredness.

Signs of musculoskeletal disorders include weakness, lameness, limb swelling, and joint dysfunction. In order to diagnose the problem, your veterinarian will examine your dog and review any previous injuries and current overall health.

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(Source: narellanvet.com.au)

If a forelimb is lame, the animal generally raises its head when putting weight on that limb. The veterinarian will feel the animal’s bones, joints, and soft tissue for abnormalities such as swelling, pain, instability, a grating or crackling sound, reduced range of motion, and wasting away of muscle.

These include x-rays and ultrasonography, as well as less common techniques such as nuclear scenography, computed tomography (CT), and magnetic resonance imaging (MRI). During these procedures, the veterinarian will probably use a heavy sedative or anesthesia to reduce your pet’s pain and stress.

Arthroscopy is a type of minor surgery in which a flexible tube called an endoscope is inserted into the joint through a small incision. For diagnosis, the endoscope has a small camera attached to the end that allows the veterinarian to see the inside of the joint.

Common conditions that can be diagnosed or treated by arthroscopy include osteochondrosis, tenosynovitis, joint fractures, and injuries to ligaments and cartilage. Relieving pain is an important component of treatment for lame animals, and may allow faster recovery.

Other methods of pain relief that may be suggested in addition to (or instead of) drugs, include acupuncture, massage, and changes in diet. Stem cell therapy or supplements may also provide relief, but the scientific basis for their use is not yet established.

diabetes symptoms dogs health
(Source: www.petdialog.co.uk)

Here I am tidying up my last year reports and analyzing my Vet Consent Form data when a recurring theme struck me. It isn’t foreign body, growth or wound related, but then the lameness goes after a few days.

Many of my clients have approached me for a consultation following a conclusion of ‘ unresolved/ undiagnosedlameness.’ Some having spent hundreds or even thousands on tests they themselves had insisted the vet undertake. It means that in the vet’s professional opinion, having ruled out everything else, the issue is likely to be muscular either directly or indirectly.

I specialize in the rehabilitation of soft tissue and muscular injury in dogs. This includes identifying and dealing with the presence of strains, sprains, scar tissue, muscle spasms, hypo and hypertonicity of the muscle, trigger points/knots, myofascial issues coupled with the physical restriction and the discomfort or pain this inevitably brings.

Not only do I seek to identify and treat the muscular issue/s, address the habitual holding pattern treat the areas of overcompensation but also to pinpoint from a list of your dogs daily activities (ADL’s) the most likely contributor. If you have a real medical concern for your dog you should, without hesitation, seek veterinary advice.

Before becoming a Canine Massage Practitioner I had taken part in high impact, full contact sporting activities and knowing what I know about muscular injury and its effects on my body and my mobility I chose to seek out to a sports or deep tissue massage therapist to take care of and provide me after care advice for my muscles. Of course, now having trained with the Canine Massage Therapy Center, I can check my dogs over myself.

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(Source: sarcoma-ultrasonography.jimdo.com)

They may begin to lie down to eat or drink from their bowl, or you may see changes in their coat or witness their skin twitch. This means that with vet consent 48 – 72 post surgery I can help to unblock lymphatic pathways to allow for the release of the build up of toxins and lymph, reducing lymphedema (swelling) thus helping to speed up recovery.

Let me share with you some feedback from a client of mine, a fabulous Canine Behaviorist. This feedback was received long after her treatment which consisted of just 2 sessions, where I targeted some minor muscular issues and significant overcompensation.

Friendly and Professional Angela was very calm and in control even though my dog wasn’t the most compliant of patients! I finally feel confident in letting my dog off lead again for a run around without the worry that she may be too stiff or lame afterwards.

Lameness is a clinical sign of a more severe disorder that results in a disturbance in the gait and the ability to move the body about, typically in response to pain, injury, or abnormal anatomy. And if both hind limbs are involved, forelimbs are carried lower to shift weight forward.

Your veterinarian will perform a thorough physical exam on your pet, taking into account the background history of symptoms and possible incidents that might have led to this condition. This process is guided by deeper inspection of the apparent outward symptoms, ruling out each of the more common causes until the correct disorder is settled upon and can be treated appropriately.

(Source: inpractice.bmj.com)

Computed tomography (CT) scans and magnetic resonance imaging (MRI) will also be used when appropriate. Your veterinarian will assist you in creating a food plan that will best work for your dog according to its breed, size and age.

For example, pain relievers may be prescribed, along with steroids that can be used help to reduce inflammation in the muscles and nerves, allowing healing to take place. Most of the time we only treat the symptoms with analgesia, dietary modifications, “nutraceutical” and/or, when appropriate, exercise restriction in order to make our patients comfortable.

However, in fairness to fellow veterinarians and to clients, sometimes the clinical manifestations of lameness, in conjunction with age, breed (which narrow the list of probable causes), other health issues and client financial limitations makes a full diagnostic workup, which can be expensive, an academic exercise that does not alter the prognosis nor the treatment options. Nevertheless, I think I speak for most veterinarians and pet owners when I advocate a full diagnostic workup so that we are certain that the ameliorative treatment we provide does not mask an insidious and potentially serious underlying problem.

Acute onset lameness is most often precipitated by a traumatic event, though in the absence of a supportive history, metabolic, cardiogenic, vascular (thrombus? Animals are frequently in dire pain and while addressing this it is imperative that the definitive diagnosis be established early to identify a potentially important underlying problem and to prevent the development of a progressive and potentially life-long affliction that jeopardizes the animal's quality of life.

The purpose of this page will be to provide a broad overview of small animal lameness es, with illustrations if possible, that demonstrate anatomical and physiological relationships of those components which directly impact locomotion, namely the central and peripheral nervous systems, muscles, bones and joints and miscellaneous soft tissues. In addition, when appropriate, the physiological basis of metabolic, infectious, congenital and other more esoteric causes of lameness will be explained, hopefully in a manner that is readily understandable to any pet owner, as it should be.

These impulses pass down the spinal cord in specific and highly organized tracts towards the target (second nerve then) muscle and ultimately initiate movement, as will be described. Figure 1, though not of high resolution, illustrates this relationship: Vertebral column is divided into cervical (neck), thoracic (chest), lumbar (lower) and sacral (hip) segments.

Figure 2 is a schematic illustration of what the cord would look like if half of each vertebral bone were removed (for visualization) In the case of a limb muscle, the stimulation provided by the input electrical impulse that originated higher up (e.g. in the brain) causes changes in the movement of specific charged molecules in the cell membrane.

The exact magnitude and direction of movement will depend on what other bone and soft tissue associations are concurrently involved. The next figure (Figure 4) represents the cross-sectional view of the spinal cord and includes labels and arrows whose purpose is to illustrate the approximate location and direction and consequence of some electrical impulses generated from sensory (e.g. pain, touch, itch, stretch) stimuli (yellow).

An example of the latter is the patella reflex : the knee ligament is gently tapped, stretching ligaments and tendons and sensory nerves within them; the impulse travels in the sensory (yellow) branches of the nerves to the spinal cord and stimulates the motor (blue) branch i n the same segment of the spinal cord to send an impulse back to the muscles of the leg to “jerk” (kick). This particular concept can be useful in physically localizing the presence of a neurological cause of lameness to a specific region of the spinal cord as well as assessing the severity of the problem.

So...it is important to realize that many kinds of lesions that perturb the spinal cord, the nerve roots and/or the sensory or motor nerves that connect to muscles, joints, bone and other tissues can result in abnormalities in gait or attitude that we label as lameness “. Then the topic will digress to non-neurological causes of lameness, such as inherited or acquired orthopedic syndromes--joint, bone, ligament---as well as other inherited, metabolic and infectious diseases that cause muscle weakness, lameness and/or pain (manifest as lameness).

This is a big topic... I intend to slowly hone in on the information you need to help your pet... I simply want to be sure you have the foundation to fully appreciate it. In some animals, trauma or simple degenerative changes to cartilage result in the bulging or extrusion of disc material into the small canal containing the spinal cord.

Afflicted animals may demonstrate weakness and abnormal gait (staggering, falling down) and even paralysis if damage is severe. Quite often, medical resolution is not possible and to prevent irreversible loss of neurological integrity, surgical intervention is required.

The next discussions will explore bone and joint abnormalities that can result in lameness es; after that diseases of muscle! It happens primarily to large breed dogs and is caused by complex genetics (polygenic) and environmental factors.

The uppermost aspect of the thigh-bone (the femur) consists of an angled appendage (the femoral neck & head) at whose end there is a hemispheric component (the head) that normally fits into a hollowed/concave hemispheric space known as the acetabulum on the pelvis (hip bone). Both the head and the acetabulum are coated with a slippery cartilage and the these are further surrounded with a thick, lubricating fluid which, together, provide an environment that prevents friction from leading to damage to structures and maximizes functionality.

In order for this joint to function optimally, the femoral head must articulate at a precise angle appropriate for maximal weight-bearing; misalignment of the participating structures resulting from inappropriate force, or angle of articulation as well as malformation of the head or the acetabulum will lead to degenerative joint disease, and, potentially life-long pain. Heredity : Many genetic determinants may, collectively, be responsible; the mechanism(s) which lead to clinical the manifestation of signs is complex and incompletely understood.

This results in greater stress forces on immature bone and growth plate cartilage. Consequently, microfractures within growth plates and exacerbation of (genetically predisposed) joint structure alignments ensues.

Excessive High-Impact Exercise : This may similarly affect joint and growth plate integrity. Clinical History : Young-Dog Syndrome : A young (4-12 months) large-breed canine with sudden decrease in activity or onset of hind limb lameness may be associated with some loss of hip muscle mass.

For example) Examples: On Mondays, Wednesdays and Fridays, go for leash walks, swimming (minimal stress to joint while building muscle mass) and mild retrieving...promote the “trot” rather than speed running (which is high impact). The TPO is ideally performed early (6-12 months of age) before the development of arthritis and degenerative joint disease.

RULES OF THUMB: This procedure should NOT be done on any animal with degenerative joint disease or who is greater than 18 months of age. NOT appropriate if there is significant muscle mass atrophy or if there is infection anywhere (e.g. dental disease/gingivitis, urinary tract, skin).

This surgery promotes the generation of a fibrous capsule which, along with normal thigh and pelvic muscles, stabilizes and supports the limb and the pelvis. Two small but extremely important ligamentous structures are found within the joint and each is specifically connected to strategic portions of bone thus providing strength, stability and integrity.

The following illustrations reveal the nature of this relationship under normal conditions and following rupture of the cranial cruciate ligament. During flexion of the joint, the cranial and caudal cruciate ligaments actually twist on each other; this prevents abnormal “inward” rotation of the tibia (relative to the femur).

There are two collateral ligaments: one on the inside (medial-facing the inner thigh) and one on the outside (lateral-the side easily seen in a standing dog) aspects of the stifle joint. In most, but not all instances, there is pain, swelling and inflammation and...ultimately, complete rupture ensues.

Often in animals undiagnosed partial or complete rupture is followed by the deposition of fibrous tissue around the joint. Other: Note...some animals with partial tears or longstanding cruciate ligament avulsion may not demonstrate any of the above-mentioned abnormal responses.

Exploratory Arthrotomy : Provides the most direct method for assessing and concurrently repairing damage to the joint. Aggressive medical management : In very small dogs with acute injury, it is occasionally possible to effect resolution via: Strict Exercise Restriction and Joint Immobilization: At least 4-6 weeks of kennel confinement.

Prognosis: Is usually good with surgery (80%-90% return to normal function) but the success rate is less than 80% if there is concurrent damage to the meniscus. Pancreas is a disease in which there is inflammatory and degenerative changes of the medullary (the medulla= the middle compartment of long (e.g. leg) bones.

X-Rays: radiographs of affected long bone(s) show variable changes in the density of the medullary cavity; the appearance varies with the phase (early, middle or late) of the disease.

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Sources
1 www.epicurious.com - https://www.epicurious.com/recipes/food/views/classic-andalusian-gazpacho-106874
2 www.allrecipes.com - https://www.allrecipes.com/recipe/24399/andalusian-gazpacho/
3 eatingeuropean.com - https://eatingeuropean.com/andalusian-gazpacho/
4 www.finecooking.com - https://www.finecooking.com/recipe/andalusian-gazpacho