20.9.2: Examination of the lame dog

Question 1

What age of dog might you expect to see panosteitis in?

Answer 1

Younger animal

Question 2

Describe these clinical exam findings and what they indicate

Answer 2

Palmargrade stance indicative of hyperextension injury

Question 3

A dog with a history of patella luxation for several years suddenly presents acutely lame. What is likely to be the cause of the problem?

Answer 3

• Unlikely to be the patella luxation suddenly causing acute lameness - dog is used to this
• More likely that something else has gone wrong e.g. cruciate rupture

Question 4

What is the condition pictured here and how would this dog appear in the consult room?

Answer 4

Pulmonary osteopathy
* This animal presents with flat “steamrolled” feet

Question 5

Which diagnostic test is pictured here and what does it test the function of?

Answer 5

• Cranial drawer test
• Tests for cruciate rupture

Question 6

Stifle pathology may show itself in atrophy of which muscle(s) in particular?

Answer 6

Quadriceps

Question 7

Hip pathology may show itself in atrophy of which muscle(s) in particular?

Answer 7

Gluteals

Question 8

Shoulder pathology may show itself in atrophy of which muscle(s) in particular?

Answer 8

Scapular muscles

Question 9

How might you determine if the patient’s lameness originates from a lesion in the paw?

Answer 9

• Walk on a variety of surfaces
• Pain originating in the paw will present with worse lameness on hard surfaces
• Also examine the paw, checking between the toes and pads for foreign bodies, puncture wounds etc.

Question 10

What is a root signature?

Answer 10

• Root signature: when a disc extrusion traps nerves supplying a limb.
• For example, a dog may present in the consult room turning its whole body to look at you (suggestive of neck pain) or with abnormal head carraige.
• If these signs occur concurrently with lameness/neuro deficits in the limbs, might be suspicious of a cervical disc extrusion with a root signature

Question 11

If a patient keeps their hindlimbs protracted forward, what are they trying to do?

Answer 11

This posture often represents an effort to get pressure off the lumbosacral region

Question 12

A head nod indicates lameness:
a) on the leg that touches the ground when the head nods down
b) on the opposite leg when the head nods down

Answer 12

a) “Down on the sound”
The head nods down when the good limb is touching the ground.

Question 13

A hip hike indicates lameness:
a) on the opposite side to the lifted hip
b) on the same leg/side where the hip is being lifted

Answer 13

b) Hip lifts to keep the bad leg further from the ground

Question 14

How can you exaggerate neuro deficits to make them easier to observe in the patient?

Answer 14

• Walk the patient in circles
• Walk the patient slowly

Question 15

How might you observe lameness/neuro deficits in the cat who is unwilling to move in the consult room?

Answer 15

• Try to encourage movements with treats and an open basket
• Place the basket/cat facing a corner - this may encourage the cat to turn around and walk away from this area
• Ask the owners for a video

Question 16

What is neurogenic atrophy and what should you do if you notice it?

Answer 16

• Neurogenic atrophy: marked, rapid muscle atrophy that follows pattern of innervation.
• Palpate the relevant nerve plexus (e.g. check for swellings in the axilla) to check for a nerve root tumour

Question 17

What might suggest an effusion is present in the stifle joint?

Answer 17

• Swelling or pain
• The edges of the patella tendon become less obvious with an effusion