Lameness

Lameness is one of the most common reasons for dogs to come and see us. It can vary from a severe acute incident where the dog comes in not being able to weight bear on a leg to a mild intermittent lameness that has been grumbling on for a few weeks or even more.

 

We grade lameness out of 10. A 1\10 lameness would be barely noticeable, and a 10\10 lameness is non-weightbearing. Any lameness over 5\10 usually requires veterinary attention. Many milder lameness`s may just be a tight muscle or strain that will get better with rest in a few days. Even very mild lameness that continues over several weeks will warrant investigation.

 

Symptoms of lameness include pain, an unusual gait, swelling, reduced muscle mass, odd posture, reduced exercise tolerance or dragging paws. There are many reasons for a dog to become lame and it is not always obvious as to the initiating cause.

 

With a sudden onset lameness on a walk we would initially examine the foot of the offending leg to check for wounds to the pads, broken nails, or foreign bodies. All of which are very common. Fractures to toes are an injury we see frequently - these are usually associated with a severe lameness; the broken toe is swollen and often the fracture is palpable. We can diagnose the fracture with an x-ray and treatment depends on the type of fracture. Some will heal with rest, but some displaced fractures will require pinning. If the foot seems clear we move up the leg checking each joint for signs of heat, pain, swelling and reduction in movement. Again, this can be very easy to locate with a severe injury, but subtle ones can be harder to diagnose particularly in a nervous, fractious or aggressive patient.

 

If a fracture is suspected this would generally only occur after a serious accident such as an RTA so we would make sure the dog is stable with no life-threatening injuries prior to x-raying. Again, fractures vary in severity - they might involve a joint or be an open fracture with broken skin. Some may be repaired in practice, but some may need to be referred for expert orthopaedic surgery.

 

Other traumatic injuries can be ligament or tendon strains or sprains. These can be harder to diagnose and we often end up x-raying to rule out any bone changes first. Soft tissue injuries do not show up on x-rays.

 

A common traumatic injury of the hindleg is a full or partial cruciate tear in the knee joint. The cruciate ligament runs across the joint and is often torn when dogs twist and turn quickly. Bad conformation can put increased strain on a ligament making it more likely to rupture. Depending on the size and bounciness of a dog there are a variety of surgeries available to repair a ligament. Some partial tears can be left to heal on their own but often take 6-8 weeks due to the poor blood supply in ligaments.

 

A shifting lameness in younger dogs could be growing pains but equally it could be something more sinister such as cartilage or growth deformities. Elbow or hip dysplasia is commonly seen as the dogs become skeletally mature. These problems are more often seen in large breeds but not exclusively. Elbow or hip dysplasia can affect one or both sides. They are part developmental and part hereditary conditions. Some mild cases can be managed with medication, but more severe cases can require surgical intervention. Inevitably most dogs will develop arthritis in the affected joints at some point.

 

A shifting lameness in older dogs is usually arthritis. Dogs will typically slow down on walks, take their time to get up or down and owners often describe any lameness wearing off after 5 minutes. Joints can be swollen, painful and usually have a reduced range or movement but this varies with the extent of any bone changes in the joint. Arthritis shows easily on x-rays. Most cases can be managed medically but some might require joint replacement or fusion.

 

Bone tumours are mainly seen in older dogs and are much more common in large breeds. They are nearly always malignant. They are associated with a moderate to severe lameness and can be diagnosed with an x-ray and bone biopsy. Treatment with amputation or radical surgery is palliative rather than curative in most cases.

 

Bone infections are uncommon and usually occur after a wound. They require a long and strong course of antibiotics.