Evaluating hindlimb lameness in juvenile dogs - DVM
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Evaluating hindlimb lameness in juvenile dogs
Get affected dogs back comfortably on all fours in your veterinary hospital by examining these most common causes and how they can be treated. (Part 2 of a 2-part series)


DVM360 MAGAZINE


Hip dysplasia


Photo 4A: A standard ventrodorsal hip-extended OFA view of the pelvis demonstrating bilateral coxofemoral subluxation and early degenerative changes.
Lameness localized to the coxofemoral joint in large and giant breeds (e.g., Newfoundlands, Great Pyrenees, German shepherds, mastiffs, Labrador and golden retrievers) and chondrodystrophic breeds (e.g., bulldogs, Shih Tzus and corgis) is most commonly attributed to coxofemoral dysplasia. Hip dysplasia is abnormal development and growth of the coxofemoral joint resulting in abnormal laxity and incongruity of the joint. It's a polygenic, heritable condition significantly influenced by environmental factors. Hip dysplasia and incongruity leads to laxity and subluxation of the coxofemoral joint, resulting in cartilage damage, followed by progressive degenerative changes and osteoarthritis.

Hip dysplasia is considered a biphasic disease, with dogs demonstrating signs at two stages of life. Signs generally include:

  • Bunny-hopping gait
  • Reluctance to climb stairs, jump or exercise
  • Stiffness after rest
  • Poor hindlimb musculature
  • Popping or clicking sound when sitting or rising.


Photo 4B: A standard PennHIP compression view of the pelvis.
Signs of hip dysplasia in juvenile dogs are due to hip laxity, subluxation of the femoral head, joint inflammation, effusion and pain. Signs in adults are from decreased range of motion, cartilage loss and remodeling, osteoarthritis, joint inflammation and pain.

In juvenile dogs, positive Ortolani or Barden signs are consistent with joint laxity and subluxation. Radiographs (OFA hip extended and PennHIP views) of the pelvis can confirm the diagnosis (Photos 4A-4C).


Photo 4C: A standard PennHIP distraction view of the pelvis.
Conservative treatment of hip dysplasia includes weight control, low-impact exercise, nonsteroidal anti-inflammatory agents, analgesics and chondroprotectives. Successful surgical treatments depend on an animal's age and degree of arthritis; a full explanation is beyond the scope of this article.*

Legg-Calvé-Perthes disease

This condition should be considered when lameness is localized to the coxofemoral joint in small breeds, especially toy breeds and terriers. The pathophysiology of Legg-Calvé-Perthes disease (LCP) is not completely known, but it is characterized by ischemic damage to the femoral head and neck resulting from vascular compression. Normal weight-bearing activities then cause compression and malformation of the head and neck.


Photo 5: A ventrodorsal view of the pelvis demonstrating Legg-Calvé-Perthes. Note the apple core appearance and irregularity of the right femoral head and neck.
An autosomal recessive gene linked to LCP has been identified. Clinical signs of LCP include hindlimb lameness, pain with manipulation of the coxofemoral joint and muscle atrophy. Diagnosis is based on signalment, clinical signs and radiographs (Photo 5). The treatment of choice is femoral head ostectomy.

Conclusion

Lameness in juvenile canines can have myriad causes but most commonly can be attributed to the conditions discussed in this two-part article series. Remember: The key to diagnosis of lameness is localization.

*For more on this topic, see: Henry WB. Surgery STAT: Diagnosis and treatment of juvenile canine hip dysplasia. DVM Newsmagazine Oct. 2009.

Dr. Janice Buback is a surgeon with Lakeshore Veterinary Specialists in Port Washington, Glendale and Oak Creek, Wis.


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Source: DVM360 MAGAZINE,
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