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Lameness in Dogs
Limping - intermittent
Limping and possible Lyme
Diagnosing limping or lameness
Limp on rear leg
Limping in Rottweiler
Lameness in German Shorthair puppy
Lameness and loss of energy
Lameness in young dog
Lameness - not responsive to medication
Lameness and fleas
Bicepital Tendon Bursitis
Lameness in Greyhound mix
also see HODPlease note: The most recent medical information is at the top of the page to least current at the bottom.
also see Arthritis
also see Orthopedic
also see Ligament and Tendon
also see Motion and motor problems
Question: Dr. Richards,
We are stumped as to what might be wrong with our dog's (Bonnie's) right rear leg. She
started limping one day after chasing a rabbit in a field. After about 4 or 5 days she seemed
to be doing OK. She then went hiking (about 9 miles) with my husband and ran around a lot
and played with other dogs. Then that night we noticed her limp, but only for a few steps
after she would get up from lying down for a long period of time. She also seemed to have
limping problems on very stony paths. After she didn't get much better for a week, we took
her to her regular vet who thought she had a torn cranial cruciate ligament. We were
surprised, since she still seemed able to run around (in grass) without any pain. We then took
her to a specialist for her to be evaluated for the TPLO surgery.The specialist was very thorough and found that she had an infection between two of her toes
(on her right rear leg). The drawer test for the CCL was negative. Her x-rays showed no
arthritis in her hips, knees, or feet. (Bonnie is 5 1/2 years old and a mix between an
Australian Shepard and a terrrier.) Her x-rays did show signs of a slightly swollen toe on the
infected paw, and they also showed a very very small amount of fluid on her right rear stifle
joint, which the vet drew. However the lab analyzed the fluid and found it to be "normal".
The specialist excised the infected area between her toes, but could not find any seed or
sticker that might have caused the infection. He bandaged her paw, and Bonnie also took a
course of antibiotics for 10 days.Bonnie didn't limp the entire week that she had her bandage on her paw, and she didn't limp
for about a week afterward. We started taking her on gradually longer walks. Unfortunately,
one day I saw her step on a large stone with her bad leg. Immediately afterwards, she froze
and looked scared. I comforted her, and then Bonnie went trotting off and started running
again. She seemed to be just fine. However, that night she was back to limping for her first 5
or 6 steps after arising from lying down. After this initial "warm-up" period, she seemed to be
fine and would want to run around or play.It's now about two weeks later after very restricted activity. Most of the time, she seems just
fine and will want to run and pull on her leash. She never limps once she is up and active.
She even seems to be less frequently limping for the first five steps after rising. However,
every once in a while I'll still notice her limp after she has been lying down for a while,
particularly if she is outside where it's now a little cooler.So.... after this long story, what do you think might be causing her to limp only for a few steps
after rising? She will then seem completely normal once she is moving and warmed up. Do
you think it might still be a problem with her paw and the previous infection? Could she have
a pulled muscle? - If she stretches her hind legs right after she rises, she doesn't really seem to
limp on her first five steps. Or could she actually have a problem with her CCL?Thank you so much!!
Eileen
Answer: Eileen-
In our practice we always check for interdigital pyoderma (infection between the toes) as a
possible cause of lameness. We have a very high rate of allergies in our area and this often leads
to itchiness of the feet, which eventually leads to infections. When the infections are located
between the toes they are referred to as interdigital pyoderma. Even relatively minor infections
can cause lameness and severe infections will often cause dogs to carry the affected foot, unless
more than one foot is involved. So this is a strong consideration with a history of infection in this
region.Cranial cruciate ligament problems can be a long degenerative process and there are dogs who
have intermittent lameness for a long time prior to the time that the ligament ruptures and a
drawer movement can be detected. So I wouldn't want to rule out the possibility that the
cruciate ligament is responsible fro the lameness, even though it is not possible to confirm that
problem at the present time.There are a few dogs who injure the cartilage in the knee without damaging the ligaments. This
can lead to lameness and it is often intermittent or is present in the first few minutes of using the
knee but then gradually gets better with use. This problem is very hard to detect except with
MRI examination or surgical exploration of the knee. I don't think that I would want to do
surgery for a problem that isn't causing too much pain and you may or may not have access to
MRI scanning and the financial means to pursue that option.Dogs do get joint sprains and muscle, tendon or ligament strains. In addition, there are dogs
who have spinal disc problems or cauda equina syndrome (pressure on the nerve roots) who
are only sore in the first few steps they take.I'd look carefully for a recurrence of the interdigital pyoderma/infection. If that isn't present then
you have to figure out how hard to pursue a diagnosis. If you want to go all out, MRI
examination of the knee and back are reasonable options but if you want to be patient and see
what happens that is a justifiable option, as well. Early stifle (knee) injuries might respond to
administration of glucosamine and chondroitin products, such as Cosequin (tm).There are a fair number of dogs with minor limping on a regular basis in our practice that we
can't make a definite diagnosis for. Usually, if the lameness becomes severe again it is possible
to make a diagnosis at that time.Good luck with this.
Mike Richards, DVM
12/31/2001
Question: Dear Dr Mike,
I know everyone thanks you for the wonderful information on your
website and would like to add my thanks as well as a few questions.We recently adopted a 5 yr old mixed Newfoundland X Chow/Lab, 71-72 lbs,
male neutered, total sweetie, loves to go on long walks and chases
anything that moves.Gradual increase in left rear paw limp over 2-3 weeks, then it stabilized
but has not improved from that point over at least a week. Limp is worst
when he gets up after resting. Holds the paw off the ground when first
getting up, "toes" on that paw when walking and comes down more on the
opposite rear paw - when trotting has only slight limp.Initially I thought he was limping on Rt front paw but husband and vet
both think that was because of the way a left rear paw injury would affect
gait.No clear start to the limping (ie no clear injury).
Thought he had a fever one night (hot nose) but was afebrile at the vet's
the next day. This is the dog with the odd flesh-colored tick 2
months ago and Lyme is endemic here but vet thinks it's very unlikely since there is
only one limb involved and no documented fever.
Dog is reluctant to get up but otherwise acts normal, sleeps/ eats well.Exam at the vet - no evidence of pain anywhere (ie no flinching,
whining or yelping).
X-ray was clear (I assume of knee joint - don't know if they looked at
foot - bending foot both ways does not produce any reaction from the dog. I know
they were looking mainly for any evidence of osteosarcoma as we just lost
another dog this way).Vet thinks that the knee was slightly swollen and that he probably has a
knee injury such as a meniscus or anterior cruciate tear.We are treating by decreasing walks from 2-3 miles/ walk to about 1/2
mi and not otherwise exercising him (ie no ball-playing, etc). Vet
recommended ASA but we haven't tried it yet (I know you don't feel pain medication
increases chance of dog overdoing it and re-injury but I don't quite trust the dog not
go after a squirril or something).Vet is looking into an orthopedic referral, at least for evaluation.
Our questions:
1 - Would meniscus or ligament tears produce swelling? Or, put
another way, are other things more likely to cause swelling? (this is VERY mild
swelling, ie vet thinks there _might_ be swelling)2 - Should we be pursuing the Lyme question more aggressively? Could Lyme
cause arthritis which migrates from 1 limb to another over a couple of
weeks? Or could left rear limb injury look like right front limping before
it got bad enough for him to hold the paw off the ground when getting up?3 - I know you write about undiagnosed sesamoid fracture as a cause of
limping - does this sound like a possiblity?4 - He has a rear-feet-close-together rolling gait when walking slowly
which straightens out when he trots - could hip dysplasia produce these
symptoms?5 - Can an injury appear to come on gradually and get worse rather than
suddenly appear and then get better with time?6 - I know in humans the next step for a suspected knee injury would
be MRI and possibly arthroscopy if indicated - what happens in dogs? Is knee
surgery open or arthroscopic? How are they kept from re-injuring the knee
while it heals? For how long? And what sort of $$ (ballpark) is this
likely to cost if that's what it is?THANK YOU AGAIN so much for providing such an informative in-depth service
and for presuming intelligence on the part of pet-owners!!
Answer: Mai-Lan-
For convenience, I'll try to answer them "by the numbers":
1) Cruciate ligament ruptures in dogs usually occur as a degenerative
process, so they don't just suddenly tear, they just gradually deteriorate
until one day they aren't strong enough to do their job and the knee
develops laxity. For this reason, there is often swelling of the knee
before the ligament actually ruptures or swelling that develops afterwards.
Often, there is a noticeable difference in the size of an affected knee
when compared to the non-affected one within a few weeks after the laxity
in the joint becomes severe. This really doesn't feel like a fluid
swelling, to me, but more like the tissue around the knee has become
thicker --- because that is really what is happening. Sometimes this is
masked by the fact that the other knee is deteriorating at the same time
and may be having some joint swelling of its own. Sometimes, there isn't a
lot of joint swelling despite having a cruciate ligament injury. I am not
certain how much meniscal cartilage damage contributes to the presence of
swelling or even if it contributes at all.2) I am terrible at judging subtle gait problems and often think that more
than one leg is involved when only one is. So I think it is easy to mistake
gait differences or differences in the way a dog gets up or down as
injuries in an unaffected leg. My technician and my wife (also a vet) are
much better at lameness evaluation than I am and so I just have to rely on
them. You may be like me -- able to tell something is wrong but not as good
as your husband and vet at telling what it is. On the other hand, you
might be better than them, too!I don't see much Lyme disease, so I am far from an expert on this
condition. However, it is supposed to cause fever, joint swelling and lymph
node enlargement. Since the joint swelling is not a sure thing and the
other signs aren't present I would not worry a lot about this unless you
live in an area in which this is a very common problem. If that is the
case, your vet should be good at recognizing the disease and so it seems
reasonable to rely on his or her opinion.3) I think that sesamoid fractures are more common as a cause of front leg
lameness and are also more common in rottweilers than most other breeds.
Since my wife is fond of rottweilers and we have had them as companions for
most of our married life, I am sensitized to their problems. I probably am
overly sensitive about sesamoid fractures due to this -- but they are worth
considering in mystery lameness's, especially chronic ones that sort of wax
and wane.4) I think that the gait you describe could indicate hip dypslasia but
that X-rays of the hips would be necessary to confirm that suspicion. It
might be a good idea to take hip X-rays if it is necessary to continue to
try to pinpoint the diagnosis of the lameness in the future (if it
continues to be a problem).5) I think this one is explained in the answer to the first question ---
slow degeneration is actually the most common way for cruciate ligament
injuries to occur. Often, there is a lameness that sort of comes and goes
but is subtle and then all of sudden it gets markedly worse -- and then
gradually better again with time. I would not feel out of the woods on
osteosarcoma if the lameness persisted, either. We have taken X-rays a
month apart in a dog in which we could not see the osteosarcoma on the
first set of X-rays and it was severe on the second set. In retrospect,
looking back at the X-rays, we felt we could see very subtle signs of the
problem in our first X-rays, once we knew where to look for it, but this
problem can be hard to find in some cases even though it is already causing
lameness. In addition, there are metastases of other cancers, such as
lymphoma, to bone and these don't always occur where you would expect them
to in the bone, making them hard to spot at times. I don't want to be a
pessimist but with this breed, you have to think about osteosarcoma in any
persistent lameness.6) I think that MRIs would be a really good test to have available for
this sort of problem but since they are not readily available in many areas
and are quite costly, most people don't utilize this technology for knee
injuries. Examination under anesthesia can help to rule in or rule out
cruciate ligament damage. It may be a good idea to re-take the X-rays if
the lameness persists, especially if your dog carries the leg
preferentially. In some cases, it is necessary to look into the joint to
see what is going on. Arthroscopic examinations can be done and are being
done by some veterinarians, especially among orthopedic specialists.
Exploratory surgery involving the joint is also a reasonable option after a
careful attempt to localize the injury to the stifle joint (so ruling out
hip problems, spinal disc problems, lumbosacral instabilities,
osteosarcoma, hock and foot injuries should be done first).Hopefully, this lameness has cleared up and none of this discussion is
necessary. If not, the first step is probably just a re-examination by your
vet to see if any changes have occurred that make a diagnosis possible. If
not, further X-rays, referral to an orthopedic specialist or even the MRI
imaging are all potentially useful procedures to try to continue the
diagnostic process.Mike Richards, DVM
7/19/2001also see for continuation
ACL surgery in large dog - arthritis risks
Question: I have a 9 yr. old Border Collie (Ben) with limping in front legs, especially after he's been laying down. He has been on Synovicre MSM for 3 weeks and is half way through an 8 injections Adequan treatment. We are also trying to limit his exercise to easy walks. Unfortunately, he is one of 4 dogs and now that he has no sheep or
cows to herd, he insists on herding one of the dogs.
Question: If the Adequan does not work, what diagnostic tools such as Xray or ultrasound can help pinpoint
whether this is, indeed, arthristis in the ankle joint?
He has had 2 tests in the past 2 years for tick-born diseases. Should we test for that again. He has always
received Frontline monthly and now also wears a Preventic collar.I am willing to consider trying acupuncture. But I think that maybe we need to rule out any other causes to the
limping. AnnAnswer: Ann-
X-rays are usually sufficient to diagnose changes in bone, such as osteoarthritis. They can often help
with the diagnosis of soft tissue problems due to visible changes such as swelling in joints, but rarely
is it possible to be sure of a soft tissue injury with X-rays alone. The odds of this problem being
osteoarthritis are really high, though. So I would start with X-rays and then look for other problems if
nothing shows up on the X-rays. If the X-rays don't show a problem but there is joint soreness or
joint swelling that seem obvious on clinical exam, it might be a good idea to have a joint tap done, in
which a small amount of fluid is drawn from the joint and analyzed to determine if there is
inflammation or infection in the joint. Checking for lymph node enlargement and fever can help to rule
out the tick borne diseases (Lyme, ehrlichiosis, Rocky Mountain spotted fever, as can serum titer
tests. The incidence of Lyme disease and ehrlichiosis varies widely from one locality to another. Your
vet should have an idea how commonly these diseases are a problem in your area. In my area the
incidence is low enough that we don't worry too much about tick borne disease but we do try keep
them in mind. In other areas of the country these diseases are really common. You are taking good
tick control measures so that should help.A number of our patients are on chondoitin/glucose combinations, which seem to benefit many of
them. Essential fatty acid supplement might help if there is arthritis and Vitamin E is sometime
reported to be helpful, too. Acupuncture might be helpful for the chronic pain and there are good
medications for arthritis. I still like aspirin. Carprofen (Rimadyl Rx) and etodolac (Etogesic Rx) are
good when aspirin isn't potent enough. We use hydrocodone, codeine and occasionally morphine in
combination with these medications when it seems necessary. Some vets are experimenting with
tri-cyclic antidepressants for use in dogs with chronic pain since these are helpful in people.You are correct that finding a diagnosis would be a good idea and it is worth taking X-rays and
doing other testing to try to be sure of the diagnosis. If this is osteoarthritis in one or both elbows it
will be chronically painful and continued efforts at pain relief should be attempted, until you find
something that will make your border collie comfortable.Good luck with this.
Mike Richards, DVM
7/2/2001
Question: HI DR MIKE, IM A CURRENT SUBSCRIBER. I HAVE A ROTTWEILER WHO WILL BE 5 IN APRIL. LAST WEEK HE WAS LAYING ON THE BED AND WHEN HE GOT UP HE WAS LIMPING. AFTER A FEW MOMENTS HE WAS OK. SO I FIGURED HIS LEG FELL ASLEEP. AFTER THAT IT STARTING HAPPENING MORE AND MORE. NOW WHERE EVER OR HOW EVER HE LAYS DOWN WHEN HE GETS UP HE LIMPS. ITS ALWAYS HIS RIGHT LEG. THIS HAS NEVER HAPPENED UNTIL LAST WEEK. COULD THIS BE ARTHRITUS??
WHAT SHOULD I DO?THANKYOU, DEBBIE
Answer: Debbie-
There are a number of possible causes of a problem like this, especially in rottweilers. I will try to list
the most likely ones and then go from there. You didn't say whether this was a front leg or back leg,
so there will be some information that won't be useful, probably.Rottweilers are prone to hip dysplasia, osteochondritis dissecans, elbow dysplasia, lumbosacral
instability, osteosarcoma (a form of bone cancer), onychomadesis (loss of toenails) and fractures of
the sesamoid bones in the front feet. They get other orthopedic conditions that many breeds get,
such as degeneration or rupture of the cruciate ligaments of the knee, muscle strains and sprains,
intervertebral disc disease, myasthenia gravis and infectious diseases such as Lyme disease.Hip dysplasia usually affects both legs but can affect only one. Often one leg is markedly worse than
the other even when both are affected, though. Lameness when dogs first stand up is not unusual as
an early sign of this disorder causing problems. The pain usually improves as the dog starts to move
around but may become worse again with activity.Instability of the lumbosacral vertebral junction leads to pressure on the spine and can cause
neurologic signs in the rear legs in some cases or pain in others. In our experience, pain is usually
present as at least part of the problem.Cruciate ligament injuries affect the rear legs since they occur in the knee joint. They can cause
subtle lameness for a long time. Often, after weeks or months of on and off lameness a patient will
get suddenly worse if the ligament ruptures entirely. Dogs with this condition may not use the leg at
all even though they don't seem to be in much pain when it is manipulated.Osteochondritis usually causes problems when dogs are in the growth stage and would be unusual at
this age but rottweilers are prone to this, so I included it in the list. It is a very low probability
problem.Onychomadesis seems to be common in rottweilers, based on the ones in our practice. This is loss
of toenails. In rottweilers it seems to be due to an immune mediated disease. Usually the nail is
visibly damaged at the time that lameness occurs but I have had a couple of clients who hadn't
noticed this problem when they came in for lameness problems. Rottweilers tend to lose all their nails
over a few months but once this happens they seem to be more comfortable. So far, I haven't found
a way to stop the nail loss.Elbow dypslasia, as the name implies, occurs in the front legs and is also very common in rottweilers.
This condition is very painful but comes on slowly, so the lameness may not seem so bad in the first
few months. As the problem progresses the lameness becomes gradually worse. Pain relief
medications are helpful and some of our patients also seem to be helped a great deal by glucosamine
and chondroitin for this condition.Rottweilers are prone to breaking the sesamoid bones in their feet. These little bones are located in
the tendons and when they break they cause pain and inflammation in the tendon which leads to
lameness. We have seen this problem in two or three rottweilers and one non-rottweiler, so I think
of this as being predominantly a rottweiler problem. So far, we have only seen this problem affecting
front feet.The most serious problem that rottweilers are prone to is osteosarcoma, or bone cancer. This
problem is so prevalent in rottweilers that we are reluctant to take a "wait and see" attitude towards
lameness of any kind in a rottweiler. We have seen osteosarcomas affecting both front and back
legs, as well as other areas in the bone in rottweilers. This is a painful condition and we try to
discover it as soon as we can by taking X-rays earlier in rottweilers than we might in another dog
breed.Myasthenia gravis causes weakness and occurs in middle-aged and older dogs, but rottweilers are
low on the list of potential breeds for this particular problem. If this really seems more like weakness
than lameness and if it seems to become more generalized it would be a good idea to keep this in the
back of your mind, though.We don't see Lyme disease much in our area but it might cause the signs that you are seeing. Spinal
disc disease hasn't been a big problem in rottweilers in our practice but it can occur. This can cause
weakness, loss of use of one or more legs and pain.All dog breeds get arthritis from the wear and tear of general use on bones and joints. Since it is so
common, it is tempting to assume that it is the cause of minor aches and pains that occur and to treat
for it without really making an effort to diagnose the problem. Most of the time veterinarians and
clients who do this get away with doing this because arthritis is so common. For a rottweiler, though,
I really do think it is better to make an effort to diagnose exactly what the cause of weakness or
lameness is and to repeat this effort if no diagnosis is possible on the first try but the problem
persists.Good luck with this. I am sorry that it has taken so long to get back with you.
Mike Richards, DVM
4/12/2001
Lameness in German Shorthair Puppy
Question: Dear Dr. Mike,
We purchased a German Shorthair Puppy in March. She is now almost five months
old and for the past 2-3 weeks she has been limping on the right front leg. We can't see any
swelling or abnormality. She doesn't mind us manipulating it or touching it. It seems to be
getting worse as time goes on. She hasn't injured it as far as we know. She weighs about
thirty pounds and we feed her Iams Large Breed Puppy Food. She wasn't limping when we
brought her for her last puppy shots 3 weeks ago. She has an appointment Sat. for shots,
should I wait until then or should I bring her before? She is even limping after rest . I
appreciate any info you may have, you were very informative when I wrote to you about our
dog Buck. We really miss him and loved the breed so much we just had to have
another.
Sincerely, JoAnne
Answer: JoAnne-
I am sorry for the delay in responding to your question. I could not get online from the hotel in
Philadelphia this weekend, for some reason.A lameness that persists for two to three weeks in a puppy this age does call for an
examination. If nothing can be found on a physical examination, it is hard to decide whether to
pursue X-rays in order to rule out things like elbow dysplasia and osteochondrosis dissecans
(OCD) but I think it is better to go ahead and take these as long as anesthesia is not necessary
in order to get them. If anesthesia is necessary, then I tend to be a little more conservative, as
long as the lameness isn't progressive. In your puppy's case, it sounds like the lameness is
progressive, though.Your vet can help you decide the necessity for diagnostic procedures. Hopefully, in the time it
has taken me to reply the situation has improved.If the physical exam findings were normal and X-rays showed no problems, it might be
necessary to consider doing arthrocentesis (withdrawing fluid from one or more joints) to be
sure that there isn't an immune mediated disease, joint inflammation from other causes or even
joint infection. Usually there would be some swelling associated with these conditions but not
always.I hope things are improving.
Mike Richards, DVM
5/22/2000
Q: My male sheltie is nine years old and up to a year ago was very active, in fact crazy always playing, running and having a great time. He was walked twice a day for 1 hour or more depending on the weather. Now for the past year he has seemed to lost his energy. He still has small spurts but can't seem to keep up even for 20 mins. Of course I had him in to the vets constantly saying I knew that something just wasn't right and he was checked over thoroughly with no apparent problem showing up. Then just before Dec 96, one evening he went to get up and his hind legs wouldn't hold him and he kind of dragged himself. It was very frightening. So back in to the vets and another check up. There the vet thought he might have a testical tumor, so we immediately had him neutured. (She didn't think this was the problem) At that time a full set of spinal x-rays was taken. There was no tumor and the vet said she was looking for some kind of degenerate disease of the spine and was relieved to see none and no arthritis. She determined that it may be a pinched nerve and sent us home with robaxacet. This seems to pick my sheltie right up, but he is still having the episodes of lameness. And he has never regained his old energy. I realize he is older but I sense not is all right and wondered if you have any suggestions, even another area that my vet could check. I take him in everytime that he is having problems and she stands him up and puts each foot on the tiptoe to see how he responds and everything seems fine to her. Of course she hasn't seen him in a real episode of lameness as he always seems better the next day. Also I might mention that he does have periods of stiffness after laying down for awhile. What about treating with a low dose of aspirin on a daily basis? Thank you for your time. This is a wonderful site!!! And I did go through everything I could to see if this was addressed before. I was worried about dysplasia but would this not of shown up on the xrays? D.
A: Hip dysplasia should show up on the X-rays if it is present and his hips were included in the area examined radiographically. That is the easy part of your letter to answer.
There are many things that could lead to the loss of energy and general lethargy. I would worry about heart disease, endocrine problems like Cushing's disease, arthritis, organ system failures and problems like that for non-specific lethargy. The neurologic signs you reported make spinal problems more likely, as you are aware. If further signs of this develop, an MRI or myelogram might be worthwhile. Sometimes problems which affect the spinal cord itself, such as blood clots or cancer, will show up better on these tests than on plain X-rays. Basically, there are just a lot of possibilities and you will need to keep working with your vet to figure out what is going on. Your vet may wish to refer you to a specialist in internal medicine or neurology if the no specific problems can be found. It may not help but it is worth a try.
Good luck with this.
Mike Richards, DVM
Q: I have a 6 month old Rotti - I have been feeding her Science Diet for Large Breed Puppies. Literature tells me it is not necessary to give vitamin supplements as this will cancel out the benefits of this food. However - during this latest "spurt" of growth I have noticed she appears to have a problem with lameness in one hip. Should I include vitamins in her diet and would 500 u. of vit C do any harm to her? When my 10 yr. Boxer developed hip problems I gave her the C and the results were remarkable. Thanks for any thoughts on this. Carol
A: Carol-There really is no need to supplement your Rotti's diet with vitamins while you are feeding her a good dog food. The most common cause of lameness in young, growing large breed dogs (if rough playing can be ruled out) is panosteitis or inflammation of the long bones during growth. The most common clinical signs is periodic shifting lameness. Other causes can be OCD (osteochondritis dissicans) - a cartilage flap within the joint capsule (most commonly in the shoulder joints but can be in any joint) caused by the incomplete formation of bone from cartilage. Also, hip dysplasia in any large breed dog is a possibility although six mos. is a little young for clinical signs but I have seen puppies this age with clinical and radiographic signs of hip dysplasia. If the lameness does not improve or gets worse, I would take her to your regular veterinarian for an exam and possible xrays.
Mike Richards, DVM
Lameness - not responsive to medication
Q: Hi Dr. Mike: I love your site, and cruised it for similar questions, but didn't quite find one that's specific enough for me: I have a 5 year old pit/lab mix about 45 lb. who suddenly started dragging/lifting her left rear leg. At first it was only after long runs followed by a nap, then the it was after all naps, (maybe for an hour or so after) but now it's almost all time except for merely standing. I took her to the vet when she was first displaying symptoms and he made a quick, rather superficial determination (no xrays taken) that it is arthritis, and that it is degenerative. He said I could give her buffered aspirin 3 times a week, and he also prescribed prednisone, which I'm leery of because frankly, the side effects of the same drug killed my mother. But when my dog seemed to get worse, I started the aspirin, then the predinisone, and see little, if any effect. I'm about to get a second opinion, but then I found you. Questions: Is this a reasonable diagnosis since by dog's so young, so fit, so otherwise healthy, and exercised regularly but not usually to extreme? Can arthritis come on so quickly and deteriorate so quickly as well? (this is only over the past 2 MONTHS!). Any other possible diagnosis considering the symptoms? (I'm pretty sure it's not foot or knee, and vet seemed to rule out dysplasia). He said it would get progressively worse, but I thought he implied 5 or 6 years from now, not a month later! Is this just the way it's going to be for her for the rest of her life? I am open to nutritional or "alternative" relievers as well. She has eaten Nutro Max all her life, and the only drug she takes is Heartguard. Thank you, Jeff
A: Jeff- You either need to get a second opinion from another vet or you need to tell your vet you want to know what is wrong. In a dog this young it is best to confirm arthritis, especially when it is not responsive to medications. I strongly suspect a cruciate ligament injury or possibly even a luxating patella based on your description of the lameness but those things can only be confirmed on examination. It generally takes an examination under heavy sedation or general anesthesia to be able to definitely rule out cruciate ligament injuries. One way of getting an expert second opinion would be to request a referral to a board certified veterinary surgeon with an interest in orthopedics.
Mike Richards, DVM
Q: Dear Dr.Mike; I rescued an abandoned male Staffordshire Terrier mix (Pit and Boxer mix, we think)about 8 years ago. He has been quite healthy until recently, developing lameness in his right rear leg with no apparent signs of infection or tramua. His hip joints appear normal, although he seems have lost some weight as well as his overall muscle tone. Normally , at his last Vet visit Buck's weght was 90 lbs and solid as a rock. I would guess that he has lost 10lb. I have looked through your pages which have given me great information, but far reaching for an uneducated guess to my pets ailment. which onset of the lameness occured after having fleas. Currently I am making an appointment for him to see the Vet, although your opnion on-line would be appreciated to help with my concern. Thank you.
A: Although it is impossible to tell you what might be wrong without an examination, the most common cause of persistent lameness in one rear leg in middle aged and geriatric dogs in my practice is degeneration of the cranial cruciate ligaments. This is more common in overweight dogs and the weight loss would be helpful if it isn't from a dire illness. Curiously, there is a connection between flea infestation and the incidence of cruciate ligament injury, in my opinion -- just based on the histories clients give me. I really wonder if the persistent scratching while standing on just one leg contributes to this problem. It could just be my imagination, though. We have not kept careful statistics on this.
Mike Richards, DVM
Q: I have determined that the problem is in the dog's shoulder area. The top portion of her leg, approximately @ the shoulder joint is very sensitive. There also seems to be knotted or swollen portion. Are we still talking arthritis? My vet basically gave me the same advice as you did, although I have considered seeing an orthopedic specialist if nothing changes by Monday. Would that be pemature? Thanks for your previous reply.
A: It is possible that your dog may have bicepital tendon bursitis. That would cause lameness and pain in the shoulder region. This tendon is normally pretty painful when directly palpated if that is the problem. Your vet will know how to locate this tendon and see if it may be the problem. It is also possible that there is an arthritic problem in the shoulder joint or referred pain from somewhere else. If you are concerned and wish to seek a second opinion, I see no reason not to do that, especially since you are going to a specialist. It would make sense to call your vet and discuss where you think the pain is and consider a recheck with your usual vet since you feel you can localize the pain. That helps a lot in narrowing down the diagnostic workup necessary to confirm what is going on. It is often a lot easier to make a diagnosis on a second visit when the problem has had time to develop a little.
Mike Richards, DVM
Q: Dear Dr. Mike, We are very worried about our Lab/Greyhound Mix, Chance. Chance is about 10 years old (we rescued him as full-grown) and lately has been having severe problems with his rear legs. When we first got him in Key West, FL, we noticed that he walked a bit funny (sort of a sideways lope) and when he ran or played for a long period of time, he would often limp, usually in the rear legs. When the Vet checked him out, he didn't think it was a major problem, and it wasn't until recently. About a year ago, Chance started limping after a long run, and it continued for over a week. We took him in and had his lame leg x-rayed and the Vet said that he had very little cartilage in his joint areas in that leg. He did not suggest any action at the time, and the dog eventually began walking "normal" again. About a month ago, he began limping again, this time it was the other leg. His limping continued for several weeks and did not seem to be getting any better. We took him to yet another Vet and asked him to check for artheritis. The Vet did not seem to think that artheritis was present when he examined Chance but he suspected the problem was in his hips. He prescribed a "Perna Canaliculus Mussel" medication as well as Rimadyl. It is now three weeks later and Chance is not getting better, he is getting progressively worse. He rarely uses the bad leg at all when he walks, he has trouble standing and sitting, and His bad leg is noticably loosing all muscle tone. The medicine does not seem to have any effect at all. He does not seem to be in noticable pain, but we are worried nonetheless. Unfortunately, due to our living situation, stairs are a part of Chance's life (and he is too large to carry). Is there anything (or anyone) you could suggest? We love him very much and really want to help him.
A: It is not possible to diagnose a cause of limping over the computer. This is just something that has to be done in a "hands on" manner. It is possible to tell you that it seems likely that the true cause of Chance's problems has not been discovered yet, based on the response to treatment -- or that different treatment for the diagnosis made is necessary. In either case, it is necessary to talk with one of your vets again and ask for a further work-up of Chance's condition. It is often easier to diagnose an orthopedic condition on follow-up visits when more typical signs of a problem may be present or progression of the disease produces symptoms that are more clearly diagnostic. If your vet feels that it is necessary or if there continues to be no response to treatment, asking for referral to a veterinary orthopedic surgeon or a veterinary neurologist may be in order. I can't tell if you are still in Florida but the veterinary school there will have both of these specialists on staff if referral is necessary.
Good luck with this.
Mike Richards, DVM
Last edited 08/08/05