Pete Wed­der­burn

Bray People - - NEWS - Pete WED­DER­BURN

WHEN SALLY the Lurcher came in to see me, it was ob­vi­ous that she was limp­ing: her head nod­ded down ev­ery time she put weight on her right front leg. But her left back leg also seemed to be mov­ing in an un­even way. So which leg was caus­ing the prob­lem?

I car­ried out a phys­i­cal ex­am­i­na­tion of Sally, and soon dis­cov­ered that the source of her pain was her left front leg. She was lift­ing her body up when she walked on her left fore­leg to avoid putting pres­sure on it, and this made her head dip down when she put weight on her right fore­leg, which is why she was “nod­ding”. And her back left leg was mov­ing oddly as part of the com­pen­sa­tion process as her body tried to move her along evenly.

It can be dif­fi­cult pin­point­ing which leg a dog is lame on, and even when this has been done, the di­ag­nos­tic process has just be­gun. In Sally's case, I then had to work out which part of her left front leg was caus­ing her to limp.

When a hu­man is lame, or walk­ing with a limp, the prob­lem is usu­ally caused by a prob­lem with one of their two legs. With pets, the pos­si­bil­i­ties are dou­bled: in­stead of just two legs, an­i­mals have four. The forelegs are the equiv­a­lent of the hu­man arms, but their func­tion is com­pletely dif­fer­ent: they sup­port the body rather than be­ing used to op­er­ate tools and to carry out other tasks. The forelegs carry 60% of the weight of an an­i­mal's body, so they are un­der sig­nif­i­cant daily pres­sure. It's no won­der that many lame­nesses of pets af­fect the forelegs rather than the hindlegs.

There are five main ar­eas in the fore­leg that can be the source of lame­ness: the shoul­der, the el­bow, the wrist (called the “car­pus” in an­i­mals), the equiv­a­lent of the hand bones (called the “metacar­pus) and the an­i­mal ver­sion of “fin­gers” (known as the “dig­its”). To find out which part of Sally's left fore­leg was caus­ing prob­lems, I had to poke, twist and tweak each sep­a­rate part of her left fore­leg.

When I did this, I dis­cov­ered where she was sore: it was the equiv­a­lent of her lit­tle fin­ger, known in dogs as “digit num­ber five”, col­lo­qui­ally de­scribed as her out­er­most toe. When I squeezed and poked this, Sally whined and pulled away from me.

I could tell by feel­ing the toe that it wasn't frac­tured, but there were still sev­eral pos­si­ble causes. She had only been lame for one day, so it seemed likely that she might have just sprained it. Dogs like Sally tend to rush around the place at break­neck speed, throw­ing them­selves around cor­ners and putting ma­jor twist­ing and stretch­ing stresses on their toes. Per­haps it's sur­pris­ing that they don't sprain joints more of­ten.

I gave Sally a sim­ple ini­tial treat­ment: a five day course of pain re­liev­ing anti-in­flam­ma­tory med­i­ca­tion, com­bined with strict rest. She made a prompt re­cov­ery, and two weeks later, she was rush­ing around, with her nor­mal grace­ful, smooth gait, as if she'd never been in­jured.

There are many other pos­si­ble causes of fore­limb lame­ness. The sim­ple “sprain” that Sally had suf­fered is the most com­mon, with the dig­its, el­bow or shoul­der most com­monly af­fected. Rest and time, com­bined with pain re­lief, are usu­ally enough to solve these cases.

Dis­lo­ca­tions - when one side of the joint be­comes dis­con­nected from the other side - are also seen oc­ca­sion­ally: the shoul­der and el­bow are most com­mon af­fected. Ob­vi­ously, the lame­ness is sud­den and dra­matic: a rapid visit to the vet is needed, and with luck, the joint can be popped back into place un­der gen­eral anaes­the­sia. Frac­tures also cause dra­matic lame­ness, and al­though a clas­si­cal case of a bro­ken leg has an ob­vi­ous “hang­ing free” ap­pear­ance, there are many types of frac­ture that are more sub­tle. X-rays is al­ways needed, and the treat­ment ap­proach de­pends on the de­tails of the bro­ken bone.

Bone tu­mours are an­other cause of fore­limb lame­ness. In most cases, the lame­ness starts off as a mild limp, but it gets steadily worse with time, over days or weeks. An x-ray is

“Per­haps the most com­mon cause of long term fore­limb lame­ness in pets is arthri­tis”

needed to make the di­ag­no­sis, and in rare cases, a bone biopsy may need to taken to con­firm what's hap­pen­ing. Surgery to re­move the tu­mour usu­ally means am­pu­tat­ing the limb. In many cases, even this is not enough, be­cause bone tu­mours tend to be ma­lig­nant, spread­ing to else­where in the body.

Per­haps the most com­mon cause of long term fore­limb lame­ness in pets is arthri­tis, or as it's known these days, “de­gen­er­a­tive joint dis­ease”. This of­ten fol­lows devel­op­men­tal prob­lems in a young grow­ing dog: the joint sur­face of the el­bow or shoul­der can de­velop un­even patches that go on to be a fo­cus for arthri­tis as the dog grows older. Treat­ment of such cases in­volves a patch­work of med­i­ca­tion, phys­io­ther­apy and life­style man­age­ment: a dog with ad­vanced arthri­tis may need a ramp to get into a car, rather than be­ing able to jump up as nor­mal.

The fi­nal part of the fore­limb to men­tion from a lame­ness per­spec­tive is the feet: dogs walk every­where in their bare feet, so they are prone to stand­ing on sharp or ir­ri­tat­ing ob­jects. A care­ful in­spec­tion of ev­ery toe is an im­por­tant part of any lame­ness in­ves­ti­ga­tion.

If your dog de­vel­ops a lame­ness that doesn't get bet­ter af­ter a few days' rest, a visit to your vet is needed: Sally was walk­ing smoothly and com­fort­ably within a cou­ple of hours of her treat­ment start­ing.

It can be dif­fi­cult to pin­point which leg a dog is lame on

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