LIMPING DOGS AND CATS

PISCES RULE!!!

...now that I've gotten that out of the way, let's get on with our topic for this week.

EOB-9....

As I was putting together several topics for presentation in future issues of Questions On Dogs and Cats, I realized that, in almost 5 years of doing this, we haven't discussed lameness in your pets.  Lameness (or limping), whichever you prefer, is one of the most likely things a pet owner will notice if they watch their pet over a period of time.  The British, in their own special manner, might refer to this as "a disorder of the gait." 

Perhaps the following letter from a dog owner will remind you of a similar occurrence involving your own pet:

Persistent limp in a pet should not go ignored

Christi Camblor, D.V.M.

Question:  We have a 1-year-old, 83-pound pit bull who is very fit, but every couple of months he starts limping. We figure because he is so muscular, maybe he just pulls a muscle. His limping usually stops within one or two weeks. Any ideas on what might be causing this limp?

Answer:  Anytime there is a persistent limp in a companion animal, a veterinary visit is in order. A veterinarian can perform a thorough orthopedic exam, plus or minus X-rays, to determine the underlying cause and recommend the appropriate treatment.

Sometimes dogs and cats can have soft-tissue injuries that resolve with rest. However, more serious injuries, such as fractures and bony injury, joint disease or torn ligaments, are also common and do require specialized treatment, sometimes even surgery.

In other cases, there may even be a systemic illness or tick-borne disease, which can cause joint pain and would warrant immediate medical intervention.

Whatever the underlying cause, it's critical to identify the issue and determine the best course of treatment. Veterinarians can also prescribe pain medications and anti-inflammatories to help your pet stay comfortable while he heals. It is important never to give your pet any medications yourself, as many human medications can have very serious side effects, including death, when administered to companion animals.

Adapted from:  http://www.sfgate.com/pets/askthevet/article/Persistent-limp-in-a-pet-should-not-go-ignored-2323840.php

The really important thoughts to take from this response are that there could be many different causes for your pet to be favoring one of its legs and that you really do need to have a veterinarian examine your pet in order to zero in on what that cause might be.

Limping and Lameness in Dogs

Limping indicates a structural problem, pain, or weakness in the involved leg. It is a common sign of bone and joint disease, but it also occurs with muscle and nerve injuries.

Determining the Cause

Consider the history and circumstances surrounding the appearance of lameness. Did the lameness appear spontaneously or was there an injury? Which leg is involved? A dog often holds up the paw or places less weight on a painful leg, especially one that has been recently injured. A dog usually takes shorter steps on a painful or weak leg. You may notice that his head bobs or drops as his weight comes down on the painful leg. With chronic lameness, the dog may simply take very short strides with no obvious limp. This is also true if more than one leg is injured or hurts. The dog’s head bobs up on the painful side and down on the side with the sound leg.

Having identified which leg is involved, try to identify the specific site and possible cause. First examine the foot and look between the toes. Many cases of lameness are due to foot injuries such as sprains, pad lacerations, broken nails, and penetrating puncture wounds caused by thorns and splinters. Carefully feel the leg from the toes up. Locate areas of tenderness by applying gentle pressure. You may also feel areas of swelling. Next, flex and extend all joints from the toes to the shoulder looking for resistance (lack of easy movement). Resistance is a sign of joint pain, which will be evident when the dog attempts to pull the leg free. If you aren’t sure if something you feel is normal, check the dog’s other leg. You have one for a comparison for both front and rear leg problems.

Adapted from:  http://pets.webmd.com/dogs/limping-lameness-dogs

OK, now you've had a chance to look at the leg that is apparently bothering your dog.  You may or may not have come to a conclusion as to what is causing the lameness.  Your next step should be to have your veterinarian evaluate the situation.

Lameness (Limping) in Dogs

By: Dr. Nicholas Trout

Canine lameness, or limping, can be caused by any underlying reason for a dog to have pain. Any decrease in an animal's ability to bear weight on a limb or a decrease in the normal mobility and function of a limb can be considered lameness. Lameness can be extremely subtle or profound, affecting one limb or several limbs. It can be intermittent or constant, worse in the morning, worse at night, worse after rest, worse after or during exercise.

There is no breed, age or sex predeliction for lameness. Lameness may be associated with a traumatic event, such as being hit by a car, or it may develop gradually, as in a bone tumor in an affected leg. The underlying cause of a lameness may be life threatening or it may be detrimental to a good quality of life such as debilitating and painful hip dysplasia and its associated arthritis.

What to Watch For

• Obvious inability to walk or run normally

• Crying behavior suggesting that your dog is in pain

• Reluctance to perform normal activity, like going up or down stairs

• Refusing to place any weight on a leg

Diagnosis

 • History and physical. Your veterinarian will take a detailed history with regard to the onset, duration and variations in the lameness. S/he will also carefully watch your dog stand, sit, walk and trot. Your veterinarian will also give your dog a general physical examination that includes a careful orthopedic examination. During the physical examination, they will evaluate where your dog is most painful and for any palpable abnormalities of the bones or joints.

• Neurologic exam. Not all lameness is due to orthopedic disorders. A neurological examination of the limb(s) may be suggested if your veterinarian believes the problem may lie at the level of the brain, spinal cord, nerves or muscles that they supply.

• Radiographs. Dependent on the physical examination findings, radiographs may be taken of painful or suspicious areas of a limb(s). Opposite limbs may also be X-rayed for comparison or where bilateral (both sides) disease is suspected.

• Other diagnostic tests may be performed such as joint taps (removal of joint fluid and evaluation of this material by a pathologist), ultrasound, CT, MRI, myelography (a dye study of the spinal canal), biopsy, and contrast radiography such as arthrography where dye is injected into a joint.

Adapted from:  http://www.petplace.com/dogs/lameness-in-dogs/page1.aspx

Disorder of the Gait in Dogs

Lameness is a clinical sign of some 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.

Symptoms and Types

Lameness may involve one or more limbs and varies in severity from subtle pain or tenderness to an inability to place any weight on the limb (i.e., carrying the leg). If only one forelimb is involved, the head and neck move upward when the affected limb is placed on the ground and drops when the unaffected limb bears weight. Meanwhile, if only one hind limb is involved, the pelvis drops when affected leg bears weight, rises when weight is lifted. And if both hind limbs are involved, forelimbs are carried lower to shift weight forward. In addition, lameness may become worse after strenuous activity or alleviate with rest.

Other signs and symptoms associated with lameness include:

 •Pain

 •Decreased range of motion

 •Loss of muscle mass (muscle atrophy)

 •Abnormal posture when standing, getting up, lying down, or sitting

 •Abnormal gait when walking, trotting, climbing stairs, or doing figure-eights

 •Nervous system signs — confusion, trembling, etc.

 •Bones and/or joints may be abnormal in size, shape

 •Grating sound with joint movement

Causes

The list of possible causes (differential diagnosis) will depend on many things, among them the involvement of either a front leg or a rear leg and the relative age of the animal. 

Forelimb lameness in still growing dogs that are less than 12 months of age;

Forelimb lameness in mature dogs that are older than 12 months of age;

Hindlimb lameness in growing dogs that are less than 12 months of age;

Hindlimb lameness in mature dogs that are greater than 12 months of age.

Younger dogs might be experiencing problems with a metabolic disorder involving the growth of the long bones in the legs, a congenital problem, or nutritional imbalances.  Mature (older than 1 year) dogs might be experiencing problems with degenerative arthritic joints or a cancerous process.  Your veterinarian will have to take all of these things into consideration.

Risk Factors

 •Breed (size)

 •Overweight?

 •Frequent, strenuous activity

Diagnosis

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. Standard tests include a complete blood profile, a chemical blood profile, a complete blood count, and a urinalysis.

Because there are so many possible causes for lameness, your veterinarian will most likely use differential diagnosis. 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.

Your veterinarian will first try to differentiate between musculoskeletal, neurogenic and metabolic causes. The urinalysis may determine whether a muscle injury is reflected in the readings. Diagnostic imaging will include X-rays of the area of the lameness. Computed tomography (CT) scans and magnetic resonance imaging (MRI) will also be used when appropriate. Your doctor will also take samples of joint fluid for laboratory analysis, along with tissue and muscle samples in order to conduct a muscle and/or nerve biopsy to look for neuromuscular disease.

Adapted from:  http://www.petmd.com/dog/conditions/musculoskeletal/c_dg_lameness

At this point, some of our cat owners are scratching their heads and wondering if any of this might be different for their critters.  Well, in the guise of a definitive answer...maybe yes, maybe no.  A lot of what can make a dog limp will also affect a cat in the same way; however, there are some additional considerations with a cat:

Limping: Causes of Lameness in Cats 

You see that your cat is limping. What could be the cause of this lameness? There are actually many causes of lameness, and your veterinarian will need to examine your cat to discover why he is limping or not using the leg properly.

What are some of the causes of limping in cats?

• Muscle sprain or strain
• Contusion/bruise
• Tendonitis: inflammation of a tendon
• Myositis: inflammation of the muscle
• Nerve injury to a nerve in the affected limb, e.g., radial nerve paralysis
• Diskospondylitis
• Joint disease...Dysplasia, e.g., hip arthritis/degenerative joint disease
• Luxated joint: the joint is out of its socket, most commonly the hip
• Infections, e.g., calicivirus
• Immune-mediated, e.g., progressive polyarthritis Bone disease
• Cancer
• Fracture
• Injury to the foot
• Broken nail
• Laceration
• Frostbite or burn
• Diseases of the pad
• Foreign body: piece of metal, plant material, etc.
• Animal bite or scratch, snakebite 
• Metabolic diseases
• Diabetes

How is the cause of the limping diagnosed?

Your veterinarian will do a complete physical exam on your cat to help determine the exact location of the problem. The age of your cat, history of any trauma, onset of the problem (acute or chronic), severity of the lameness, and whether multiple legs are involved are all indicators as to the possible source of the problem.

Special testing may be required in some circumstances. Most commonly this may include one or more of the following:

Radiographs (x-rays)

Biopsies

Blood testing for infectious or immune-related diseases

Collection and examination of joint fluid

How will the lameness be treated?

Treatment will depend on what the specific diagnosis may be. It may include anything from simple rest to complex surgery. The prognosis (predicted outcome) will be dependent on multiple factors including the cause of the limping, the severity of the condition, and the time lag between the first symptoms and the time of diagnosis and treatment.

Adapted from:  http://www.peteducation.com/article.cfm?c=1+2175&aid=240

As always, any questions or comments should either be sent to
 Helpful Buckeye at: dogcatvethelp@gmail.com or registered in the
 comment section at the end of this issue.

~~The goal of this blog is to provide general information and advice to help you be a better pet owner and to have a more rewarding relationship with your pet. This blog does not intend to replace the professional one-on-one care your pet receives from a practicing veterinarian. When in doubt about your pet's health, always visit a veterinarian.~~