looking for help on a FL lameness case.

[Guest guest]

Hello, having a difficult case. 9 year old FS Siberian Husky

initially presented to our surgeon on 8/25 for 6 month history of

limping right front leg with reduced activity, pain to touch, no

longer wanting to jump. Rimadyl and Tramadol from rDVM didn't make a

difference. PE revealed Grade 3/4 lameness RL with pain on external

rotation of shoulder and pressure on caudal aspect of shoulder,

neuro signs WNL and no neck pain. MRI performed 9/17 showed mod

increase in fluid in joint, med aspect of shoulder joint " wider than

typical " . R shoulder scope done on 10/29 - showed normal biceps

tendon, mild synovitis, mild tearing of humeral attachment of

subscapularis and mild fraying of cranial aspect of med glenohumeral

ligament, no cartilage lesions, lat joint capsule WNL.

So, dog was sent to rehab: she has a significant head bob with RFL

lameness, after exertion her R elbow will start to externally

rotate. Painful with R elbow flexion, shoulder extension with

concurrent reduced ROM. Small click palpated near dorsum of carpus

at end range extension. Scapula is nice and mobile, no neck pain.

Moderate amt atrophy over scapula, mild atrophy bi's and tri's.

Owner has not been consistent with bringing to therapy (we've seen

her 4 times in 5 weeks) and we've seen no improvements. The surgeon

doesn't know what else to do for the dog.

Suggestions?

Thank you,

Shinas, LVT, CCRP