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Lameness - Coggle Diagram

- - - - history and clinical signs
        
        stiffness and lameness of both hind limbs
        
        reluctant to exercise and play
        
        may have v upright hindlimb conformation (esp labradors)
        
        hindquarters may appear wobbly
        
        bunny hop instead of trot
        
        PE
        
        poor hindlimb muscle development
        
        pain on extension and sometimes abduction of hips
        
        crepitation or clunking of hip
        
        due to subluxation or reduction of joint
    - - medium/large dogs, spaniels and english bull terriers
      - hx and clinical signs
        
        significant joint pain
        
        often marked effusion 'puffy joint'
        
        pain via forced flexion of joint
        
        often bilateral, but lameness often lateralised as one joint is more uncomfortable than the other
    - - fragmentation of ulnar coronoid process +/- medial humeral condylar lesion +/- anointed anneal process (medium/large dogs)
      - hx and clinical signs
        
        pain and lameness in one or both forelimbs
        
        pain evident on both extreme elbow flexion and whilst supinating the paw and forced extension
        
        stiffness, reluctance to play or tendency to lie down
        
        front paws often externally rotated when dog is sitting or standing
        
        (relieve pressure from medial side of elbow)
        
        poor forelimb muscle mass may be evident in chronic cases
        
        palpable effusion (puffy, fluid-filled component on caudolateral elbow)
    - - small breed dogs, labradors, occasionally large breeds e.g. great dane
      - not usually painful on PE
      - initially problem is intermittent and when lunated in locomotion the affected limb is carried in flexion for a few steps --> skipping lameness
    - - Legg-calve-perthes
      - terriers
      - hx and clinical signs
        
        markedly painful
        
        severely lame or non wt bearing
        
        affected dog severely lame or non wt bearing
        
        hip manipulation v uncomfortable esp on extension
        
        chronic lameness results in visible and palpable loss of muscle mass in affected limb
        
        disease usually unilateral, but ca be bilateral (generally one limb more severely affected than the other)
  - - - GSDs
      - medium-large dogs
      - hx and clinical sign
        
        long bone pain due to inflammatory changes in medullary cavity
        
        ulna, radius humerus, femur or tibia
        
        often lameness episodic and can affect different bones at different times
        
        cyclic or shifting lameness
        
        marked pain when firm digital pressure is applied to affected bones
        
        affected dogs may be inappetent and mildly pyrexic
      - more common in males than females
    - - metaphysical osteopathy
      - all dogs, esp collies, great danes, weimaraners
      - often occurs following vaccination
      - clinical signs and hx
        
        lameness, often all four limbs
        
        pyrexic, dull, depressed
        
        markedly painful and swollen distal long bone metaphases (radius/ulna and tibia/fibula
        
        gentle pressure on metaphysics elicits a pain response that can be differentiated from joint pain by careful localisation
      - affected dogs become severely ill, anticipate morbidity
  - - - physical fractures are common in puppies and generally caused by minor trauma
        
        jumping down from furniture
        
        being dropped from o arms
      - affected dogs generally non wt bearing on affected limbs and marked pain of injured regions often w soft tissue swelling
      - +/- marked displacement
      - trauma to growth plate can result in premature closure and cessation of growth at physis
        
        shortening of bone
      - can occur even if radiograph normal
    - - medium-large breed dogs following minor trauma
      - chrondrodystrophoid breeds without trauma