I recently attended a course and wet lab on regenerative medicine at Veterinary Orthopedics and Sports Medicine Group in Annapolis Junction, Maryland. I have always been interested in alternative medicine and believe strongly that healing orthopedic injuries requires a combination of a good diagnosis, physical therapy and in many instances’ surgery. Let’s talk about how lameness occurs and how to diagnose.
Most of the lameness cases I see are in active young dogs or older dogs. The weekend warriors are over represented. These dogs may get walked daily or have an exercise yard but generally do not have vigorous exercise daily. The history may go something like this:” My daughter brought her new dog over for the weekend and they had a blast playing. He slept for two days and is now lame in his hind end.” Or another one, “We went camping this weekend and the dogs took off after deer. They followed us while we were riding or 4 wheeling.” Whatever the cause, dogs are always up for an adventure and have no problem pushing themselves to the limit, as a matter of fact they can injure themselves and not even notice because the adrenaline rush is so high. They let you know later, pitifully hopping around… the lame leg is obvious at this point. From my perspective it would be nice if you came in to get the lameness looked at or at least recorded which leg and the date. Most injuries are minor and seem to resolve in a few days. The injuries that do not resolve may be more serious. Even minor injuries can affect the dog’s overall fitness and cause compensation. Dogs have 4 legs and can carry one when they run. They can protect one by always jumping off the sound leg or landing on the sound leg in the case of forelimb lameness. What I see is atrophy of muscles from disuse. Remember the adrenaline rush? When your dog sees that squirrel or deer, he forgets he has a weak leg and goes full speed on all fours. Now a minor strain or ligament tear that has been protected by disuse is now more vulnerable due to muscle atrophy. A minor injury now becomes a major injury.
I take the history, grade of lameness and duration into account. At this point a good physical exam looking for instability in a joint, pain on palpation, gait abnormalities, swelling in the joint. Diagnostic tools include radiographs, ultrasound and of course a tick panel for Lyme’s Disease.
As you can see, there are a lot of factors involving lameness in dogs. Dogs that are involved in active sports have specific injuries related to those sports. They typically have soft tissue injuries related to tendon and ligament strains, not that they can’t have catastrophic injuries. It is imperative to their athletic careers to get properly diagnosed and treated as soon as possible!
How about the older chronically lame dogs that I see every day? Most are suffering from arthritis probably from the excursions of years past contributing to injury, joint instability, gait abnormalities, disuse atrophy all leading to unhealthy joints that are painful.
What can be done to alleviate pain? Anti-inflammatories, glucosamine supplements and pain meds have been the mainstay. Alternatives such as acupuncture, laser, shockwave, therapeutic ultrasound head the list and have been proven to alleviate pain and stimulate healing. During the next few blogs I will be introducing Regenerative Medicine as a treatment for both acute injuries and chronic injuries leading to arthritis.
Katherine B. Gray, DVM
Agape Vet Clinic
The Plains, Va.
