Canine Lameness Assessment

Question 1

Examination appropriate to history (general health check has been done)

Answer 1

Observe whole animal (posture, stance, atrophy)
Palpate limb (joint effusion/pain/instability/thickening, soft tissue heat/swelling/pain, bone palpation/squeezing)
Examine paw (palpate digits and pads, examine/twist each nail)
Compare to contralateral limb (could do normal limb first so you remember)
Lameness evaluation in walk and brisk trot (instruct owner to walk away from you and back towards you at appropriate paces)

Question 2

Evaluate, ignoring plate

Answer 2

Sclerosis (new bone) in stifle indicates proliferative reaction

Question 3

Evaluate

Answer 3

Osteophytes (extensive proliferative disease)
Severe osteoarthritis in elbow joint

Question 4

Evaluate

Answer 4

Osteosarcoma likely (marked proliferation and destructive loss of cortex)

Question 5

Evaluate

Answer 5

Joint effusion, new bone on fabellae and trochlea ridges

Question 6

Evaluate

Answer 6

Hip dysplasia (severe, immature dog)

Question 7

Conservative management for osteoarthritis

Answer 7

NSAID treatment trial (meloxicam/carprofen/firocoxib, stop if GI signs, test renal function)

Weight loss
Consistent, low level exercise

Physiotherapy? Acupuncture? Hydrotherapy? CBD oil?

Other drugs: Grapiprant, Paracetamol, Gabapentin, librella

Question 8

Soft tissue injury treatment

Answer 8

NSAIDs and rest (cage, lead walks, supervised in garden etc.)

Question 9

Next steps of treatment

Answer 9

Reassessment in 2 weeks or sooner if it gets worse

Other? Arthroscopy, steroids in joint, surgical management