Enhancing Your Proficiency in Canine Lameness Assessment
As veterinary professionals, accurately evaluating and diagnosing the cause of lameness in our canine patients is one of the most critical skills we can develop. By enhancing our proficiency in conducting thorough lameness examinations, we position ourselves to provide the best possible care for our furry companions.
The lameness evaluation begins even before the physical examination, as we gather a detailed history from the owner regarding the onset, duration, progression, and characteristics of their dog’s impaired mobility. Critical details include any recent traumas, changes in exercise routine, terrain the dog is walked on, and the owner’s perspective on pain or discomfort. Specific questions about vocalizations, reluctance to move, changes in behavior, or alterations in gait can provide key insights. Observation of the dog’s natural gaits and postures in the waiting area gives us a valuable unbiased perspective before they adapt their movement in response to the clinical setting.
Once in the exam room, comparing bilateral limbs, watching their movement on different surfaces like concrete versus carpet, and assessing various speeds of gait from walking to trotting to running can help reveal subtle irregularities. For example, a condition may only cause lameness at a trot but not a walk. Moving from a hard surface to a softer one may make the lameness more pronounced if there is increased discomfort on the harder terrain. Subtle manifestations like muscle atrophy or limb guarding can also offer clues pointing to the affected area.
Equally important is a systematic head-to-tail musculoskeletal and neurological evaluation. Palpating for joint swelling, pain, or deformities provides localization cues to potentially affected areas. We apply gradually increasing pressure during palpation to identify subtle discomfort. Specific orthopedic maneuvers can indicate cruciate ligament, shoulder, elbow, hip, stifle or spinal involvement. For example, the cranial drawer test assesses cranial cruciate ligament rupture. Performed with the dog in lateral recumbency and the stifle flexed at 90 degrees, the veterinarian applies mild cranial force on the proximal tibia while stabilizing the distal femur. Excessive tibial movement indicates a cruciate tear.
The tibial compression test evaluates cranial and caudal cruciate ligament integrity. With the stifle flexed at 135-140 degrees, the veterinarian applies caudal force on the calf while compressing the femur and tibia. Abnormal tibial thrust suggests cruciate injury.
Meanwhile, neurological tests like proprioception, spinal reflexes, and postural reaction assessments help determine if nerve dysfunction or spinal issues are contributing factors.
Additional diagnostic imaging modalities including radiography, ultrasonography, CT, and MRI provide visualization of the anatomical structures involved and are key in obtaining an accurate diagnosis. Each modality has pros and cons – radiographs effectively show bone detail, ultrasonography excels at soft tissue assessment, CT provides clear cross-sectional views, and MRI offers unparalleled nervous and musculoskeletal system evaluation.
Throughout the process, being cognizant of our own observational biases is important. Collaborating with another veterinarian to confirm findings from the lameness exam can improve accuracy and consistency. Open communication with pet owners regarding what we are assessing, demonstrating lameness, and explaining findings is also key to provide the highest quality care.
With a comprehensive, meticulous approach using all the tools available to today’s veterinarian, we can shed light on the cause of canine lameness. This allows us to map an effective treatment strategy and restore our furry patients to health, mobility, and quality of life.