Achilles Tendon Injury is an injury to any of the tendons that attach to the calcaneus bone. The tendons that make up the achilles mechanism include the gastrocnemius tendon, common tendon of the biceps femoris, and the superficial digital flexor tendon. Clinical signs depend upon the degree of the injury. There can be variable degrees of hindlimb lameness, flat-footed stance, dropped hock, or excessive toe flexion. Diagnosis is based on examination, hock x-rays, ultrasound, or MRI. Treatment includes surgical repair of the injury, and controlled exercise and physical therapy post-operatively.
Angular Limb Deformities are the abnormal growth of the limb following premature closure of the growth plate as a result of trauma. Clinical signs include limping, discomfort, or limb deviation or shortening. Diagnosis is based on x-rays to assess the degree of deformation. Surgical treatment is indicated to restore joint congruity and/or correct the angular deformity.
Bicipital Tenosynovitis is inflammation of the biceps brachia tendon and its associated sheath which causes forelimb lameness exacerbated with exercise. The condition is diagnosed with shoulder x-rays, ultrasound, or MRI. Treatment includes restricted activity for 6-8 weeks, oral pain medications, intra-articular steroid therapy, or surgery.
Carpal Trauma is the result of a sprain, hyperextension injury, fracture, or shearing injury. Clinical signs include forelimb lameness, carpal swelling, instability, or appearance of the carpal joint more flexed. Diagnosis is made through physical examination, x-rays, bloodwork to rule out other conditions, or CT scan or MRI. Treatment involves restricted activity and pain medication for a sprain and mild hyperextension. Surgery is the treatment of choice for more severe hyperextension, fractures, and shearing injuries.
Collateral Ligament Injuries occur as a result of trauma to the joint. The condition is diagnosed by physical exam, x-rays, or advanced imaging. Treatment depends on the the extent of the injury. Stretched or partial ligament tears may be treated by application of a splint for 2 to 3 weeks. More significant injuries are treated with surgical repair of the ligament and a splint for 3 to 4 weeks. Restricted activity is continued for an additional 3 to 4 more weeks.
Cranial Cruciate Ligament Injury occurs as a result of degeneration and traumatic injury to the cranial (anterior) cruciate ligament. This results in instability of the knee joint and limping. Diagnosis is based on physical examination with a cranial drawer sign and x-rays. Surgery followed by physical therapy are the treatments of choice. Surgical repair by extracapsular methods, tibial tuberosity advancement, or tibial plateau leveling osteotomy are recommended.
Elbow Luxation occurs as a result of trauma. It is diagnosed with physical examination and x-rays. Treatment usually involves closed reduction within the first few days of injury. If the luxation cannot be treated with closed reduction, then surgery is indicated. If there is significant collateral ligament damage or re-luxation occurs easily after closed reduction, then surgery is indicated. A modified Robert-Jones bandage is then placed for 7 days following closed reduction or surgery with restricted activity for up to 2 weeks.
Fractures occur as a result of trauma, disease, or repeated stress to the bone. They are classified based on their appearance on exam and x-rays. Physical exam indicates which bone(s) are involved, as well as, whether the fracture is closed (the bone does not break the skin) or open (the bone breaks through the skin). X-rays define where the fracture(s) is located along the bone, the type of fracture, and the best course of action for repair. Partial/incomplete fractures and some non-displaced fractures can be treated with external coaptation, or a cast. More complicated or displaced fractures have the best chance for successful healing with surgical repair (bone plates, screws, pins, or external fixators). Sometimes a combination of methods are used for treatment.
Fragmented Coronoid Process (FCP) is hereditary and a form of osteochondrosis of the elbow. It occurs when the ossification center of the medial coronoid process fails to fuse causing instability and inflammation. Physical examination reveals swelling and discomfort of the elbow joint. X-rays are performed to rule out other causes for the joint swelling; however, FCP is difficult to diagnose with this method. Often times, advanced imaging (CT scan) is required to diagnose this condition. Surgical removal of the FCP carries a better prognosis prior to the development of degenerative joint disease. Prognosis declines with surgery performed after the development of osteoarthritis. Medical and alternative management is often needed. This includes non-steroidal anti-inflammatory medication, additional pain medication, joint supplements, laser therapy, physical therapy, and acupuncture.
Hip Dysplasia is a hereditary condition that causes the abnormal development or growth of the hip joint(s). This results laxity that causes instability, malformation of the femoral head and acetabulum, and osteoarthritis. Clinical signs include weight bearing or non-weight bearing lameness, bunny hopping gait, or pain on hip extension. Diagnosis is based on the demonstration of an Ortolani sign on orthopedic examination and x-rays. If a puppy is screened by 4 months of age using PennHip x-rays, then a preventive surgery called pubic symphysiodesis can be performed. Prior to one year of age, a triple pelvic osteotomy can be performed. If the condition is diagnosed after that time, then treatment options include medical management or surgery. The two surgical options are femoral head ostectomy or total hip replacement. When the condition is treated medically, this may include non-steroidal anti-inflammatory medication, additional pain medication, joint supplements, laser therapy, physical therapy, and acupuncture.
Hip Luxation can occur secondary to hip dysplasia or trauma. Clinical signs include the history of a traumatic incident, non-weight bearing lameness, and the appearance of limb lengthening or shortening depending on the direction of the luxation. Diagnosis is based on physical exam and x-rays. Treatment for a traumatic luxation of a healthy hip joint can include closed reduction followed by an Ehmer sling for 7-10 days or surgery via pin-and-toggle or synthetic capsule technique. Treatment of a luxated dysplastic hip involves surgery (femoral head ostectomy or total hip replacement).
Legg-Calve-Perthes is a painful hereditary hip condition caused by aseptic necrosis of the femoral head and neck as a result of interrupted blood supply with an unknown underlying cause. The disease affects small breed dogs. Clinical signs include hindlimb lameness and discomfort. The condition is diagnosed through physical examination and x-rays. Surgery (femoral head and neck ostectomy) is the treatment of choice.
Osteoarthritis is the development of bone spurs, or projections, that form along joints as a result of joint instability. Clinical signs include discomfort, limping, stiffness, and crepitation. Diagnosis is based on physical examination and x-rays. The best treatment is prevention. When a known disease is present which gives potential for osteoarthritis, then treatment is aimed at treating that disease (ie. cruciate ligament rupture, weight reduction). Medical management includes rest, heating the affected joint(s), controlled exercise, laser therapy, physical therapy, medication, supplements, or acupuncture. Surgery may involve removing the bone spurs, fusing the joint, or joint replacement surgery.
Osteochondrititis Dessicans (OCD) is a cartilage flap that results from the disturbance in normal cell differentiation in growth plates and joint cartilage. It occurs in the medial humeral trochlear ridge of the elbow joint, the caudolateral humeral head of the shoulder joint, the lateral femoral condyle of the knee joint, or the medial or lateral talus of the ankle joint. Treatment and prognosis is dependent on the location of the lesion. Surgical removal of the cartilage flap in the shoulder and elbow joints provide a good prognosis if performed prior to the start of degenerative joint disease. Surgical removal of the cartilage flap in the knee and ankle joints provide a guarded to fair prognosis; particularly, in very large breeds.
Osteomyelitis is an acute or chronic infection of the bone. The infection is usually associated with open fractures, bone surgery (particularly, involving metallic implants) or systemic illness. The condition is diagnosed with x-rays and culture of the affected bone or implant. Treatment involves antibiotic or antifungal therapy based on culture results or removal of implants, if indicated.
Panosteitis is inflammation of the longs bones of large breed young dogs. Breeds commonly affected are German Shepherds and Basset Hounds. It causes significant lameness of one or more limbs, and can present as a “shifting leg lameness”. Diagnosis is based on x-rays and treatment includes pain medications. The condition is self-limiting and resolves on its own over several months. The underlying cause is unknown.
Patellar Luxation is a hereditary condition that occurs when the alignment of the leg is such that the kneecap is pulled out of the trochlear groove either medially (to the inside of the leg) or laterally (to the outside of the leg). The degree of luxation determines the grade. There are 4 grades of luxation with grade 1 a mild subluxation and grade 4 a severe luxation. The result of the patellar luxation can be cartilage erosion, arthritis, and increased strain on the cruciate ligament predisposing to cruciate ligament tears. Diagnosis is by physical exam and/or x-rays. Treatment may involve medical management with pain medications and joint supplements. Surgical repair to ensure that the kneecap stays in the trochlear groove is ideal. Surgery involves realigning the patellar ligament so that the kneecap is in line with the femoral groove. The recovery time for the procedure is 4-6 weeks of restricted activity. During this time, no running, jumping, playing, or rough housing is allowed. The patient will also go home with a light bandage and post-operative pain medications.
Shoulder Luxation is an uncommon condition in the dog. Breeds most commonly affected are the toy poodle and sheltie. It is diagnosed with physical examination and x-rays. Treatment with surgery can be performed. Prognosis following surgery is dependent on the direction of the luxation and chronicity. Those that are more chronic have a more guarded prognosis.
Ununited Anconeal process (UAP) is hereditary and a form of osteochondrosis of the elbow. It occurs when the ossification center of the anconeus fails to fuse with the olecranon by 5 months of age. The result is instability and inflammation in the elbow joint. Commonly affected breeds include German Shepherds, Basset Hounds, and St. Bernards. The condition is diagnosed by physical examination and x-rays. Surgical treatment is indicated for removal of the anconeal process, followed by placement of a modified Robert-ones bandage for 7 to 10 days.