Forelimb lameness

[Guest guest]

Hi everyone...just looking for some ideas. Margarita is an 8 1/2 year old

spayed female Lab with 4-month history of left forelimb lameness. She has no

history of trauma, but is an avid, ball-crazed dog. The owners noticed in March

a mild lameness and just opted for rest and OTC aspirin. The limping became

worse where she was " dragging " her leg around, when they took her to the RDVM.

He was thinking a neurologic problem, did radiographs and didn't see much of a

problem, and put her on prednisone, Dasuquin and Carprofen, Omega-3 fatty

acids...varying dosages over 2 months. In May, she was doing a bit better, no

longer " dragging " but still lame. By June, not much improvement, owner opt for

Rehab.

When I saw her, she is a happy, active lab, but is minimal weight bearing on the

left leg. She is able to walk and run, but as you can see from the video, she

is not able to fully pick up her left from leg and has nail wear at P3 & P4 as a

result. Radiographs show some possible calcification on the humeral head at the

greater tubercle. She has severe muscle atrophy in the supraspinatus and

infraspinatus and biceps. Gulik measurement around the humerus is a 3 cm

decrease in muscle girth between the left (affected) and the right. She has

intact CP, Withdrawl and placing reflex. She is a difficult to work with, so

those are the only neuro checks I was able to do, I'll try to perform some more

at our next visit. She has decreased ROM in Left shoulder extension. I'm

thinking she has a possible supra/infraspinatus injury, or possible brachial

plexus injury? I've never had a brachial plexus injury that wasn't associated

with trauma, so not sure how that would happen. Any advice would be great...I'm

seeing her next week to come up with plan.

Thanks so much in advance

Amber Ihrke, DVM, CCRT

http://youtu.be/3OFYnOKxLBg

[Guest guest]

Hi,How is the dog's pain level? Where do you find pain on palpation? Are withdrawals and CP's completely symmetrical with the contralateral side? As a PT, my next step would likely be referral to a neurologist and/or referral back to the primary DVM for more advanced imagining. I'd be suspicious for something like a nerve sheath tumor. Good luck, please keep the group posted,Krista Niebaum, MPT, CCRTSent from my iPhone

[Guest guest]

I had a case with very similar presentation about 10 years ago. Active Guide Dog

with progressive lameness in the left thoracic limb, muscle atrophy at the

triceps, antebrachium, and infraspunatus muscle. Lameness progressed rapidly

until the limb was held loosely in a flexed position and dragged as in your

video (shoulder involvement decreased over time slightly). Until he was referred

back to the main campus for treatment, his regular vet and specialists were

unsure what was wrong with him.

He ended up having T cell lymphoma with a mass found in the axillary region

(confirmed with excision biopsy and MRI). He also had short periods of sharp

" unexplained " pain for " no reason " (obviously nerve pain) reported. He ended up

getting chemo concurrently with rehab and actually went into remission and

regained full function and muscle of the leg for nearly 14 months until it

metastasized to his brain.

L Hagler BS RVT CCRP CVPP CBW 

Certified Canine Rehabilitation Practitioner 

Certified Veterinary Pain Practitioner

Small Animal Osteoarthritis Case Manager

Canine Body Worker

www.goldengaitcanine.com

www.ivapm.org

Guide Dogs for the Blind, Inc.

Animal Wellness Center of Marin - Rehab and Pain Management

>

> Hi,

> How is the dog's pain level? Where do you find pain on palpation? Are

withdrawals and CP's completely symmetrical with the contralateral side? As a

PT, my next step would likely be referral to a neurologist and/or referral back

to the primary DVM for more advanced imagining. I'd be suspicious for something

like a nerve sheath tumor.

> Good luck, please keep the group posted,

> Krista Niebaum, MPT, CCRT

>

> Sent from my iPhone

>