Snow Leopard

Snow Leopard

Monday, January 17, 2011

Canine Lameness

Limping is one of the most common signs that we see patients for. 

And before I go further, let me add that it is correctly referred to as a sign, not a symptom. A symptom, as defined by Dorland’s Medical dictionary, is “any subjective evidence of disease or of a patient’s condition (evidence perceived by the patient).”  A sign, on the other hand, is “any objective evidence of disease, as is perceptable to the examining physician.” Since our animals cannot tell us that they feel “x” in “y” location, they cannot have symptoms. But I’ll admit to not always using the absolute proper terminology here. 
There are numerous reasons why a dog could be limping. The history that our veterinary technicians take from you will often guide us in narrowing down possible causes. Is is something that just happened (acute) or something that the owner has been noticing a while, say weeks to months (chronic)? Is it associated with an event, trauma, activity, etc? Is it one leg or more than one leg? Does it shift from leg to leg? Is it getting better, worse, staying the same? Is your dog on any medications (did YOU medicate the dog without veterinary consultation)? If so, how did the dog respond? (If you answered anything but buffered aspirin - and even that has been shown to cause GI bleeds in dogs endoscopically without owners seeing a thing - I will cringe and tell you not to give it - ibuprofen, tyelenol, etc - again!)
ON a side note here and because I can..please call your vet BEFORE you give anything over the counter. Why do people call AFTER they give something to find out if it was OK to give? 
One of the biggest obstacles is often which leg is it? Unless the dog is holding the leg up, many times owners simply cannot tell us or they get confused. That is ok. Sometimes we can tell on examining the dog - we will feel all the way from the toes to the upper leg and the spine from head to tail. Sometimes, we’ll take the dog outside and have you walk or run him so we can see if we can detect a lameness. Just remember a dog’s right leg is HIS right leg not the leg you think is right when you look AT him from the front.  It’s very common for people to get this confused. 
So what caused your dog’s lameness? It could be something as simple as a traumatic event YOU know about - he slipped on the ice, you went for an extra long hike, your other dog ran into him, etc. These are often acute injuries. If there is joint paint or fever or shifting leg lameness, it could be Lyme disease (something we see A LOT of in the Lehigh Valley and NJ).  If it’s an older dog, it could be arthritis (this tends to be more progressive - gets worse over time, dog is stiff when he first gets up but does better after walking a bit) or bone cancer (for certain large breed dogs especially).  It could be a soft tissue issue - a muscle, tendon or ligament. Sometimes simple rest and a non-steroidal anti-inflammatory recommended by YOUR VET (be is aspirin or one of the FDA approved licensed for canine drugs out there) is all that is needed. It could be a congenital or traumatic injury that we will need x-rays to see. Some of these could end up becoming surgical cases. 
Cervical or neck pain can cause front leg lameness. Most people jump to the “he must have something in his paw” thought. But more often than not, it is NOT that. There are cases where a broken toe nail or pad issue IS causing the problem. In the case of a hind limb, it is very often a knee (stifle) issue or a hip issue. Cruciate tears (yes, like the football players get)  are very common in our larger breed dogs. 
Also something for you to know: the degree of change we see on an xray is NOT well correlated to how the dog is doing clinically. In other words, a dog with REALLY bad hips on an xray could be running around with no problems and a dog with very subtle, mild changes indicating degenerative joint disease, could be in a lot of pain. 
A joint supplement is never a bad idea but I will say this: be careful what you buy. This is one of the very few times, I really push a veterinary product. There have been tests done on over the counter glucosamine/chondroitin products for humans that have shown that some have all the say in them while some have nothing more than fillers. We know that Cosequin and Dasiquin HAVE exactly what the label says. 
When you bring your dog in for a lameness issue we may not always be able to tell you WHY at that time. There are things that can be ruled out by a simple but complete physical exam. Your vet can direct you on the best next step to take.

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