Canine Lameness
Is your dog limping?
Has your regular vet been unable to find the cause of the limp?
Are current treatments not improving your dog’s lameness?
At Southern Animal Health, we have a particular focus on diagnosing and treating lameness in dogs. Several of our vets (Dr Karin Davids, Dr Mike Voyce, Dr Marcus Hayes) have a special interest in canine musculoskeletal problems, as well as many years of experience in ‘hard to diagnose’ lameness cases. We are also proud to provide a number of treatment protocols and surgical options that many other veterinary clinics are not able to offer.
How is canine lameness diagnosed?
The starting point for us is to always have a discussion with you to get a full history of your dog’s lameness and symptoms, and then to perform a full clinical examination of your dog. This may also involve observing your dog walking and running. Sometimes we can get our answer within this initial consultation and examination, and other times further tests may be required. At Southern Animal Health we can provide the following diagnostic tests:
- Radiology (Xrays)
- Ultrasound
- CT scan (Drop your pet off at our hospital and we will transport him/her to and from the CT facility, have the scan performed, and then discuss the results with you afterwards)
- Joint fluid collection and analysis
- Diagnostic joint blocks
- Arthroscopy – Dr Karin Davids will soon be offering this service but until then, we can organise a specialist to perform arthroscopy at our hospital, (should your dog require it)
What different options are available for treatment of my dog’s lameness?
- Medications – There are many different anti-inflammatory and pain killer medications that we can use in either liquid, tablet or injectable form.
- Intraarticular medication (Injection of medication directly into the joint)
- Platelet rich plasma (PRP) – This can be used for treatment of osteoarthritis and some ligament/tendon injuries
- Splints/bandages/support braces
- Acupuncture
- Surgery – We offer a comprehensive surgical service for treatment of orthopaedic injuries including Advanced Fracture Repair, Tightrope Surgery and TPLO for cruciate ligament injuries, Juvenile Pubic Symphysiodesis (JPS) for early intervention of Canine Hip Dysplasia and Hip Joint Denervation for treatment of chronic hip pain
- Rehabilitation Therapy – A series of muscle massage techniques and strength building exercises may help in your dog’s recovery. We teach you how to do these at home on a regular basis
Common Causes of Canine Lameness
This list is by no means comprehensive, but some of the most common problems that we see include:
- Cruciate ligament disease/injury
- Luxating patella (Dislocating kneecap)
- Hip dysplasia
- Elbow dysplasia
- Medial shoulder instability
- Hip joint dislocation
- Osteoarthritis
- Spine problems and disc disease
- Fractures
- Soft tissue injuries/muscle sprains
- Growth plate injuries
- Angular limb deformities
Our main objective is to do all that we can to diagnose and resolve your dog’s problem so that they can continue to live an active and comfortable life. In hard to answer cases, we cross-refer within our hospital for second opinions and often have team meetings to discuss the best management plan for your dog.
Lameness
Lameness is a very common and large ranging topic. A little like many of our other “illness” signs, however, you don’t necessarily need to rush to see your vet at the first sign of lameness.
If one day you find your pet struggling a little in one leg, and there has been no history of a problem on that leg, so long as it is not severe and distressing for the pet, then a wait and see approach is fine. Give them a day or maybe 2 and see if it settles down. Always have a look and feel up and down the leg yourself however, as occasionally you may find a significant problem that needs immediate attention. It’s amazing how often people find a large cut inside the leg that isn’t bleeding, or a swelling such as an abscess, or even a lump that may be a tumour.
If, however, your pet is quite happy and you can’t find anything obvious yourself, then give them 24 hours and see what happens. Just like us, pets can often just bruise their foot, or strain a muscle or tendon that may be right the next day.
If on the other hand you discover something of concern, or in fact they’re no better the next day, then of course you should see your vet.
Here is a list of some common causes of lameness:
- Strained muscles and tendons
- Fractures
- Arthritis
- Congenital conditions such as elbow dysplasia
- Hip dysplasia
- Ruptured cruciate
- Luxating patellas (Knee caps)
- Abscess (cats)
- Cellulitis (cats)
- Cancer
Give your pet 24 hrs if there are no obvious concerns, if lameness persists then see your vet.
If there is a history of “subtle” lameness that seems to keep recurring every few weeks or even months, then these lameness should be examined and worked up. For instance, in young dogs this can be a sign of congenital problems such as elbow or hip dysplasia, and early intervention can have much better results. For older dogs then arthritis and cancer are of more concern.
Click here to read our article on “The Limping Dog – 10 Most Common Causes of Lameness”
Arthritis
This is a disease that strikes fear into a lot of pet owners, believing arthritis to be a severe and debilitating problem once diagnosed. Although this can certainly be the case in some individuals, arthritis is often only a mild to moderate ongoing problem. The reality is that all of us suffer from arthritis as we age, humans and cats and dogs. That’s a large part of the reason we all slow down. In any individual, the developing arthritis may be more or less severe, more or less rapidly progressing.
There are some breeds and some types of arthritis that are more likely to cause greater problems – for instance, hip dysplasia in many types of animals is a genetic pre-disposition that leads to a more severe type of arthritis at an earlier age.
The take home message on arthritis is to look for early signs, initiate preventative regimes as early as possible and tailor an individual treatment regime to each particular individual.
There are two main ways to treat arthritis when signs develop:
1. Anti-inflammatories
These are pain killers and can be likened to humans taking aspirin. Anti-inflammatories are fantastic at reducing pain and making your pet’s life much happier however, they merely mask the signs of arthritis, i.e. pain, but don’t actually treat the disease. The progressive nature of the developing arthritis continues. Also, the effects of continual use of anti-inflammatories can be detrimental to the liver and kidneys and intestines in the long term.
2. Chondro-protective agents
By chondroprotective agents we mean treatments that actually lubricate the affected joint and smooth the cartilage surface and decrease the progression of arthritis.
Of the above two treatment options, obviously the second is far preferred than the first. Certainly some pets may remain in significant discomfort despite the use of various chondro-protective agents, and are good candidates to use anti-inflammatories long term if this makes their life much happier. However the real trick to preventing arthritis actually getting to this stage is to use the various chondro-protective agents available to us early in the course of disease so as to hopefully never have to resort to needing long term anti-inflammatories.
Signs of Arthritis
The first signs of arthritis are usually very subtle. This is in fact the best time to start using protective agents. The biggest mistake pet owners make is delaying protective treatment because the signs their pets are showing are subtle and just put down to old age and natural slowing. If your pet shows the following signs then consideration to diagnosis and treatment is warranted:
- Taking just a little longer to get up after resting
- Not lasting quite as long on their walks
- Not jumping onto the couch or into the car as easily as they used to
- A little proppy for just a few steps after getting up
These are the sort of subtle signs to look out for. Obviously as the disease progresses, these signs become more obvious and worsen in severity.
Treatment of these First Signs of Arthritis
Ideally we sedate and x-ray the patient to get a better idea on the state of their joints. It’s amazing how often we have only very subtle clinical signs, yet x-rays reveal quite significant damage already. If x-rays don’t reveal significant damage then we tailor more conservative preventative regime than if we see more severe signs. Hence the great advantage of radiology is that if arthritis is more severe than the clinical signs are suggesting, tailoring a more aggressive preventative regime at this stage, rather than when the patient is struggling more, will give us a greater chance of a longer life without the need for anti-inflammatories.
The mainstay of the chondroprotective agents at our disposal are the following, (listed in order of what is most likely to help to what is least likely to help):
Cartrophen (Pentosan) course
This is a series of four injections given one week apart over four weeks. In our experience about 80% of patients respond well, approximately 10% have a subtle response and about 10% don’t seem to have much response at all. This treatment has by far the greatest chance giving a good response and protecting the joints.
Glucosamine and chondroitin preparations
There are a huge number of preparations in this field. You may be familiar with products such as Sasha’s Blend which advertises very well. In our opinion some are more likely to help than others, but all may or may not help to some extent.
Glucosamine and chondroitin preparations for humans
Again, there are a large number of products out there, many of them available from your local chemist. We’re certainly not against trialing them with our pets. Some patients do seem to improve on them and they’re worth trying if there hasn’t been great success with the above.
Hills Joint Formula food
Although skeptical when Hills first brought out their Joint Formula, we have been pleasantly surprised at how pets have had a good response when switching to this food and it is certainly worth considering for pet owners preferring commercial foods over natural diets. Ironically, our theory is that a lifetime of commercial foods may have exacerbated the condition in the first place!
Fish oils
Again a large number of preparations all of which may or may not help a little.
Antinol
A fatty acid supplement with evidence supporting its results of improved weight-bearing and pain control in dogs AND cats. It can be used long-term and also can be used in conjunction with anti-inflammatory medications. Most patients with mobility issues show a visible improvement after 10-14 days of treatment. Read more here.
How do I Know What to Use?
A great question, here is our advice! Firstly, have some x-rays done so we know exactly what we are dealing with. Then we will tailor a program specific for your pet:
- Start with the top of the list and work down
- Never use two products at the same time as we won’t know which one is and which isn’t working
- Trial each different product for at least six weeks before deciding how effective or otherwise it is. Then consider either changing to a different product if there was no effect, or adding another if there was a moderate effect.
- If a product gives a great effect, there’s probably no reason to try other products. Stick to that solution until such time as the condition may be worsening.
- Depending on x-ray results, decide on frequency and types of future treatments.
Anti-Inflammatories
As stated previously, these give great pain relief and clients often come rushing in wanting more of these because their pet was getting around so well. Our preference is to hold off these unless needed, or if the above options are not giving a great result. If we do recommend them, the following are our guide lines:
- For older patients, a blood test first to monitor liver and kidney health is warranted as these can be potentially damaged if on long term anti-inflammatories.
- After an initial 3-4 week course, we would recommend reducing the dose down to the minimum that gives us continued good results. We recommend this for two reasons. Firstly, because it is a lot healthier to use the minimum dose that is effective (liver and kidney damage). Secondly, it’s a lot cheaper for you!
- If a particular anti-inflammatory does not give a great result, there are others worth trying.
