Examination of the Lame Dog and Cat Flashcards
Name 3 things which may limit the differential list in a lame animal (4)
- Signalment
- History
- Clinical signs
- Response to treatment
What would you put on your differential list if you are presented with a lame labrador?
Elbow dysplasia
What would you put on your differential list if you are presented with a lame West highland white terrier?
Cruciate disease
What would you put on your differential list with a lame older animal?
Osteoarthiritis
What would you put on your differential list with a lame younger animal?
Panosteitis
What would you put on your differential list with a lame young-middle aged animal?
Cruciate disease
What disease is chronic and progressive in onset?
Osteoarthiritis and degenerative joint disease
Name 2 things which causes acute onset lameness (3)
- Trauma
- Infection
- FB
What 2 diseases are acute or chronic in onset of lamness?
Cruciate rupture on patella subluxation.
Pathological fracture resulting from bone neoplasia
What disease causes waxing and waning lameness?
Panosteiitis
What disease has a history of being acutely lame followed by a slow improvement?
Cruciate rupture
Name 2 diseases which have a history of being acute and intermittent
- Patella subluxation
- Superficial digitial flexor instability
What would give a clinical history of being worse on harder surface?
Foot pathology including foreign body and corns
How can you approach the clinical exam of a lame dog?
- Observation in the consulting room (difficult with cats)
- Dogs walked outside
- Full clinical examination
- Lameness examination
- Neurological examination
What would you see in the consult room with a cervical disc with root signature?
HEad carriage
What would you see in the consult room with panosteitis?
Attentive and interested or depressed
What should you do before a clinical exam of a lame dog?
Observation at walk and brisk trot
What does a head nod mean in a dog?
The nod = the good leg
What does a hip rise mean in a dog?
Affected leg rises and falls quicker. The hip rise = bad leg
If the animal is shwing respratory signs and lameness what would you think of?
Pulmonary osteopathy
What does urinary tract disease have to do with lameness?
•Association with lumbosacral discospondylitis and resulting lameness
What does prostatic disease have to do with lameness?
Metastatic spread to long bones
If an animal is young and pyrexic, what 2 things would you think of?
- Metaphyseal osteopathy
- Panosteitis
If an animal is pyrexic, lame and of any age, what would you think of?
Polyarthritis
Where is muscle atrophy commonly seen?
- Scapula muscle with shoulder lameness
How should you examine feet and pads?
–Palpate digits and pads individually
–Twist each nail
–Any wear to nails
- Examine nail beds
Why should you examine nail beds in the lame cat?
Site of pulmonary adenocarcinoma metastasis
How should you examine joints in the lame dog?
–Palpate for effusions especially the stifle
- Run hands down both legs
- Sharp margins of patella ligament – normal. Not sharp maybe an effusion
–Painful?
–Medial buttress to stifle?
–Instability e.g. cruciate
•Cranial draw or tibial crest
–Abnormal movement e.g. inter-tarsal subluxation, carpal hyperextension
What do you look for in ligaments and tendons in a lameness exam?
–Palpate for swelling
–Pain
–Heat
–Resulting instability if ruptured
–Maybe unstable in their grooves e.g. SDF and LDE
How may a patella subluxate?
Medially or laterally
How can you bring about subluxation?
Need to flex and extend with pressure on patella
What two tests can we do for a cruciate rupture?
- Cranal drawer
- Tibial thrust
How can a cranial drawer be performed?
- In many dogs can be performed conscious
- Standing or lying
When is a tibial thrust easier to perform?
If joint painful
How can we examine bones in a lameness exam?
–Observe – e.g. the bone will look wider as if steamrollered if the dog has pulmonary osteopathy
–Palpate
–Squeeze – e.g. panosteitis dogs will resent this
–Pain on gentle palpation – e.g., neoplasia
–Often overlooked
What should we do in a neuro exam of a lame dog?
- Neck or thoracolumbar pain?
- Palpate the axilla again
- Rectal examination if hind limb neurological deficits
- Check anal and rectal tone
- Check the peripheral nerves and see if there are any central lesions
What do we need to distinguish between on radiography with polyarthritis?
Erosive and non-erosive forms
What is the mainstay of further examinations of a lame dog?
Radiographs
What do we need to examine radiographs for? (what disease types)
Primary and secondary disease
When would you do joint taps of multiple joints?
Polyarthritis
What stain do we use in horses with a joint tap?
Diff Quick
What is many neutrophils in joint tap suggestive of?
Sepsis or if in several joints polyarthritis
Name 2 specific blood tests we might do in a lame animal (3)
- RF for rheumatoid arthritis
- ANA for SLE
- Borellia burgdorferi serology or PCR for Lymes disease
Name a time CT is reallygood (2)
–Particularly useful for elbows when can clearly see FCP and humeral intercondylar fissure
–Also mineralisation of the infra and supraspinatus tendons
Name a time MRI is gooff in lameness (2)
–Better soft tissue definition and good for stifles, shoulders and the detection of foreign bodies
–Also to examine spine for nerve root tumours and lumbosacral disease
When is ultrasound good? (3)
- Bicipital tendon
- Achilles
- Flexor tendon
What 3 sites is an arthroscopy good for?
- Shoulder
- Elbow
- Stifle
What two sites is arthroscopy difficult to access?
- Carpus
- Talocrural joint
Other than imaging, name 3 further tests we might need to use in lameness (4)
•Biopsy : any mass or swellings
–To biopsy a possible bone tumour take from centre of mass
- Nerve conduction studies
- EMG
- Muscle biopsies : e.g. Labrador retriever myopathy
