In my last post, I talked about difficulties diagnosing dermatological and hormonal diseases in dogs. Now, let’s take a look at conditions affecting the bones and other parts of the musculoskeletal system.
If a dog has a painful musculoskeletal condition, he will usually favor his affected leg.
However, if multiple legs are affected, limping may not be so obvious. The dog may simply appear stiff or reluctant to move.
During a physical examination, a vet will try to pinpoint where in the body the problem lies.
For example, a dog may react painfully to rotation of a hip but not to flexion and extension of his knee), However, some dogs are so stoic that they wont “tell” us where it hurts. In other cases, a dog may react like almost everything we do is painful. Are these guys just wimpy or do they really hurt all over? Figuring out how to proceed in these cases can be a bit of a challenge.
X-rays are the next step, but they don’t always provide a clear cut answer either.
In some cases, despite knowing exactly where the problem is, the X-rays look normal and provide no help in identifying the cause of the limp.
X-rays are good for looking at bones but not as useful if the problem involves ligaments, tendons, muscles, or other soft tissues.
On the other hand, if the x-rays show multiple abnormalities (e.g., arthritis in multiple joints), determining the primary source of a dog’s pain can be difficult. It’s not always what looks the worst on an X-ray!
The effect on treatment options and prognosis
Diagnosing the exact cause of a dog’s limp may not be all that important if medical treatment (anti-inflammatories, pain relief, nutritional supplements, etc.) are the treatment of choice since these will help no matter where the problem is.
But, if a veterinarian is recommending surgery make sure your dog’s diagnosis is solid.
No one will be happy if a dog undergoes a TPLO for a cruciate ligament rupture if his knee is not the real source of his pain.
An accurate diagnosis is also necessary when it comes to knowing what the future holds for your dog.
When a large breed dog has hind end pain, owners and sometimes even vets may assume that hip dysplasia and the resulting osteoarthritis are to blame. However, another common condition called lumbosacral stenosis shouldn’t be overlooked.
This disease looks a lot like hip dysplasia. However, lumbosacral stenosis can also cause neurologic dysfunction of the back legs and incontinence. These are symptoms that don’t fit with hip dysplasia.
And worst of all is also osteosarcoma. This deadly form of bone cancer is sometimes confused with less serious conditions like osteoarthritis in its early stages.
What this all boils down to is, if you are not comfortable with your dog’s diagnosis, talk to your vet.
If he or she cannot explain the situation to your satisfaction and is unwilling to look in another direction, get a second opinion. Or even a third one.
When diagnosis gets complicated, it never hurts to have more than one imperfect human brain involved in your dog’s care.
Dog Lameness – Causes and Treatment of Limping in Dogs