Re: Gait in German Shepherd

July 24, 2012

Hi Beverly, I certainly will defer to others, but have you considered fibrotic myopathy? They tend to act the same with or without NSAIDS, with or without painmeds. The second video looks like a GSD patient of mine with fibrotic myopathy... An inability to completely flex the hip or to extend the stifle. Good luck! Pam Nichols DVM, CCRPSent from my iPadDr. Pam Nichols cell office

Hello All,

I need some assistance with a case that hopefully your expertise can help me with. Karma is a 3 year old spayed female German Shepherd that my associate first saw on July 2. She presented with an abnormal gait that was more pronounced at a run than a walk. She had an acute injury approximately 1 month prior to presentation. She was running up a hill when the owner noticed that her right rear leg was turned at a 45 degree angle. She never seemed to be painful. Shortly after the injury the owners left town at which time she was "rested". On their return they took her running and they noticed the gait abnormality again. I have attached the radiographs as photos under the album "Karma". At the time of presentation she was started on nsaids, rest, and massage. She has not worsened or improved since that time. These are videos of her at her recheck on the 16th. The plan was for her to see me next week.

Thank you in advance for your assistance.

Beverly Fritzler, DVM, CCRT

July 24, 2012

Beverly,I agree with Pam that this likely fibrotic myopathy but in your patient it involves the semitendinosus muscle for certain +/- gracilis. The semitendinosus involvement is recognized by the rapid internal rotation of the left pelvic limb during the later part of the swing phase. The semitendinosus along with deep gluteals are internal rotators of the pelvic limb, as the limb moves forward in the swing phase the fibrotic contracture is encountered resulting in the observed gait abnormality, internal rotation, hock out. There is also a reduced extension of the stifle.I like the addition of the music to the videos.Rick Wall, DVMThe Woodlands, TX

July 24, 2012

Yeesh Rick! You are the smartest guy I know! Seriously love your ability to explain. Pam Sent from my iPadDr. Pam Nichols cell office

Beverly,I agree with Pam that this likely fibrotic myopathy but in your patient it involves the semitendinosus muscle for certain +/- gracilis. The semitendinosus involvement is recognized by the rapid internal rotation of the left pelvic limb during the later part of the swing phase. The semitendinosus along with deep gluteals are internal rotators of the pelvic limb, as the limb moves forward in the swing phase the fibrotic contracture is encountered resulting in the observed gait abnormality, internal rotation, hock out. There is also a reduced extension of the stifle.I like the addition of the music to the videos.Rick Wall, DVMThe Woodlands, TX

July 24, 2012

Pam,

Thank you! Can I forward your message to my wife, daughter and staff members

and let all the females that control my life know that I really am smart because

they don't believe me when I tell them!

Rick Wall

July 25, 2012

Thank you for posting these videos. They serve as important sources

for me as I learn more about gait deviations in dogs.

One clarification and one additional observation for comment:

Clarification: It is the dog's RIGHT rear limb, not left, that is

affected, correct?

Observation: At times, I notice a tremendous amount of excessive low

thoracolumbar spinal flexion as the dog attempts flexion of the right

hip. This is especially noticeable in the 3rd video at the time

marker of 1:17 to 1:19 if you slow it down. I assume this is

compensatory spinal flexion since it is difficult for the dog to flex

at the hip joint itself in face of a fibrotic semi-tend/gracilis which

would act to 'keep' hip in extension. Also, would you expect to see

some pain (e.g. muscle soreness/irritability/trigger points) in spinal

muscles because of this compensation?

Thanks,

Zimny, CCRT, PT

Quoting " Rick Wall, DVM " :

> Beverly,

>

> I agree with Pam that this likely fibrotic myopathy but in your

> patient it involves the semitendinosus muscle for certain +/-

> gracilis. The semitendinosus involvement is recognized by the rapid

> internal rotation of the left pelvic limb during the later part of

> the swing phase. The semitendinosus along with deep gluteals are

> internal rotators of the pelvic limb, as the limb moves forward in

> the swing phase the fibrotic contracture is encountered resulting in

> the observed gait abnormality, internal rotation, hock out. There

> is also a reduced extension of the stifle.

>

> I like the addition of the music to the videos.

>

> Rick Wall, DVM

> The Woodlands, TX

July 25, 2012

Yes , the pain associated in spinal muscles is due to compensation and Yes it's right hind. I have used acupuncture, massage e-stim etc, but not meds for the pain associated with the lumbar spinal area muscles. Rick? meds or manual therapies? Pam Nichols DVM, CCRPSent from my iPadDr. Pam Nichols cell office