Cranial cruciate ligament tears are one of the most common causes of hind leg lameness in dogs. How often does it become a default diagnosis?
Experience bias is a dangerous thing. If what CCL injuries are what you see most often, it is what your brain goes to when you see a dog lame on their hind leg. Yet, it is not always a knee injury.
Here are some other potential causes of hind leg lameness:
- broken or injured toenails
- injured foot pads
- foreign objects
- other soft tissue injuries
- hip dysplasia
- luxating patella
- and more
Can you tell them apart by the way the limp looks? I can tell you with certainty that you cannot. Can a veterinarian?
Lucy is an 8-year-old Goldendoodle. She is typical for her breed—smart, friendly, loving, and social. She’s not overly rambunctious but does like to have fun.
While her parents were on holiday, Lucy spent time at a boarding place she was familiar with. Everything was going well until her parents got an email that Lucy hurt herself while running off leash.
When Lucy’s parents picked her up a few days later, they learned that she injured herself worse than they thought. Lucy was not bearing any weight on the injured leg at all. They took her to a veterinarian right away.
The veterinarian diagnosed Lucy with a partial cruciate tear and suggested immediate surgery. Her parents were taken aback by such a radical approach and decided to try to give it some time with conservative treatment.
Along with rest and restricted activity, Lucy started weekly hydrotherapy. Her parents also consulted with a naturopathic vet. She agreed with Lucy’s diagnosis but also didn’t feel that surgery was necessary.
The measures seemed to be working—Lucy was improving.
Things were going well until they weren’t. Lucy’s parents heard a crunching noise, and Lucy returned to hopping on three legs again. The sound appeared to come from Lucy’s leg. That scared her parents and they went to see their holistic vet the next morning.
She felt that Lucy had now fully blown her CCL and that surgery ought to come back into consideration. She referred Lucy to an orthopedic specialist.
For three months, that was precisely what Lucy’s parents were trying to avoid. And now, with all that time wasted, they were back to where they started.
Consultation with an orthopedic specialist
Lucy got her appointment and the day when her parents expected to hear surgery was the only option arrived.
While the specialist was examining Lucy, he seemed to be more focused on Lucy’s back than her knee. During manipulation, Lucy whimpered. But it wasn’t when the veterinarian was doing things with her knee.
The specialist recommended taking x-rays to see if they bring more clarity. There were no changes to Lucy’s knee joint that would show on the images. There was no arthritis and no fluid pockets. The knee looked perfectly happy on the x-rays.
Iliopsoas injuries in dogs often go undiagnosed. That was Lucy’s diagnosis. She did not need surgery, only more rest and no more swimming until she heals.
Three weeks later, Lucy made a wonderful recovery and was using the injured leg normally.
In all fairness, symptoms of iliopsoas injury can be quite ambiguous and hard to decipher. Not many veterinarians can diagnose it. Lucy was lucky that her orthopedic specialist did a thorough job when diagnosing her.
Injury Misdiagnosis – Lucy