Signs of lameness can be subtle and hard to see. The sooner you discover a problem, the easier it is to deal with. Watch for any changes in gait or posture.
Hubby used to think that I see ghosts. Over time he came to realize that ghosts are real.
Often I am not sure if my mind is playing tricks on me. Do I see a problem or am I making things up? Was Cookie’s left shoulder dropping ever so slightly when she walks or is that just the uneven terrain?
It all started at the end of winter.
It was winter when I noticed Cookie favoring her front left leg at times.
Hubby didn’t see it. He insisted that she’s fine.
Cookie’s physical therapist did see it when analyzing Cookie’s gait on the underwater treadmill and was finding sore spots. We assumed that Cookie likely injured a muscle when she busted through the deep crusty snow. It was quite nasty outside—quite deep, with three layers of ice throughout from all the thaws we had.
Cookie was getting physical therapy, laser therapy, and hydrotherapy and things improved.
Then I noticed her dropping the shoulder again.
The question was, why? Was it from what we thought an injury she sustained in the winter? Or was the shoulder getting sore for compensating for a problem elsewhere, namely on the hind end? We must not forget that Cookie did have issues with her cruciate ligaments.
Compensation is often the cause of lameness or soreness in weird places.
Cookie’s hind legs looked good, though, both to me, to her PT, and her vet. The muscles were strong, well-defined and even. There was no indication anybody could tell of a problem with Cookie’s knees or hips.
Jasmine used to get strange front leg lameness. It was attributed to arthritis in her elbow, but in hindsight, problems with her neck were the most likely cause.
Cookie is, however, seeing a chiropractor regularly and while she always needs some adjustments, nothing seems to stick out enough to be suspect.
The issue has gone on long enough for me to want answers.
I had her PT write up a report, and I made an appointment with Cookie’s local vet.
Here is what the report said:
Cookie Rade has been coming to see me following a series of hind end injuries from an iliopsoas injury, to a left stifle injury for which she received a PLP injection followed by rehabilitation. We have continued with her therapy on a monthly basis to maintain muscle strength and flexibility and to monitor the left stifle for the re-occurrence of the CCL injury.
In October I noticed that her gait has changed slightly but with the front left. She was slightly slower with the swing phase and not lifting as high as the other leg. She didn’t appear to show much in the way of pain or lameness when walking or running and no offloading or non-weight bearing. I massaged and stretched through the neck and shoulder in case we were seeing compensatory injuries.
It went away after this for several months but returned in February again with subtle signs in the UWTM and perhaps some subtle signs with certain movements at home. I massaged and stretched through neck and shoulders and revisited in 2 weeks to repeat massage as there was some tightness with shoulder movement. She was much improved following this and was showing no signs at home or in the UWTM following the second massage. We continued to visit monthly for maintenance and noticed the subtle gait change in June 2018. I massaged and stretched again at this visit and at this point Jana and I discussed some diagnostics as it was recurring more often.
In the last visit, I noted the same delay in the swing phase and reluctance to lift the leg as high as the other. On massage, there was some muscle tension through the triceps, infraspinatus and along the trapezius. I did also find that the muscles along the neck into the shoulder were tense but she tolerated a deep massage and stretch.
I look forward to your findings in the shoulder and thought perhaps if there was myofascial pain some acupuncture will help.
Cookie continues to do well with her therapy for the back legs and shows no signs of gait abnormalities or pain. Regular therapy using several modalities has helped her maintain her active lifestyle with minimal difficulties.
I wanted a comprehensive exam to maybe figure out what was going on.
If it was muscle(s) not wanting to heal because of too much abuse, then we would want to do some dry needling. Otherwise maybe some acupuncture and whatever ideas come out of the vet visit.
The veterinarian was curious about Cookie’s knees knowing we used platelet-rich plasma (PRP) therapy for her partial cruciate tears. I reported I didn’t observe any issues and examination didn’t reveal any. There seemed to be a consensus that the hind end is not to blame for the shoulder.
The veterinarian found the same sore areas Cookie’s PT found; they agreed as to what areas were affected.
One thing the vet noted was that she felt Cookie’s shoulder blades were bunched up closer together than they should be. She asked about Cookie’s stance and the potential of repetitive stress type of issue. Interesting notion. It was a theory worth considering. Cookie does have some awkward sitting habits and hunting froggies day in and day out could qualify as repetitive.
We decided to proceed based on that theory.
Cookie did receive both acupuncture and dry needling—poor thing looked like a pincushion. Fortunately, all the needles don’t seem to bother her.
The night after the visit I didn’t see any improvement. However, the next day Cookie’s gait seemed to look better. As well as the following physio appointment confirmed improvement for one reason or another.
In the meantime, I’ve learned some new massage techniques to do for Cookie between appointments.
Cookie likes the rubbies a lot.
Amazingly, the dry needling seemed to be what the doctor prescribed. A couple of days later Cookie’s gait looked normal and at her next PT appointment, her physiotherapist confirmed she couldn’t find any sensitive spots or areas anymore.
Dry needling seems to be the only technique effective for myofascial trigger points. I wish I knew about it in the past when Jasmine was suffering from this regularly. Though her therapist wouldn’t have been able to use this treatment and we would have to have found another professional to administer it.
I am glad I knew about it and that our veterinarian knows how to do that because it worked like a charm.
If things didn’t resolve, and nobody had any further ideas, we would have ended up going down South for consultation with Jasmine’s vet. His x-ray diagnostic hands are always what we resort to when everything else fails. But we found the problem and fixed it. Which is great because myofascial trigger points can be crazy painful.
With Jasmine, I learned to watch for problems. I didn’t even have to see her limping, I could hear it. I could tell whether she was limping on the front or rear leg and how much. This habit of paranoid observation spilled over to JD and Cookie as well.
Even more so with Cookie, because she started her life with us lame on her hind leg on the second day. It looked so much like a busted knee, my heart stopped. Fortunately, it was all from a piece of porcupine quill hidden in her foot.
Shortly after, an encounter with an electric horse fence ended up with a limp again.
We also found on from x-rays that she had an old pelvic injury, which might be contributing to her getting hurt easier. It was an old injury, never treated though I can’t imagine how it could have gone unnoticed.
The fact is that her back end is a bit off, even though it doesn’t slow her down much.
We started chiropractic adjustments for her after the initial period of limping because of the porcupine quill. Since then we get her adjusted regularly.
However, the other day I noticed something I wasn’t sure what to make of. She jumped off the couch, rushing to the door to greet our friend and I thought I saw her bunny hop a couple of times on the way. All looked normal after that. But the observation got filed in my mind and I was watching more carefully.
There was no visible limping.
But for the next couple of day, every now and then, things didn’t look right. You know, that kind of thing when you can’t quite put your finger on it but still you know.
I could have shrugged it off since she wasn’t lame, wasn’t slowing down and wasn’t complaining. But I had my suspicion that something got tweaked.
I made a chiropractic appointment for her for Monday, just to be on the safe side.
Sure as shooting, she had a serious tweak in her sacroiliac joint lower back were quite off. She actually yelped when the chiropractor touched one of the spots. That never happened before and clearly, it was more painful than usual.
The chiropractor adjusted it, then went over it again at the end of the visit to make sure it’s happy. It was.
How much pain was that causing Cookie we’ll never know.
But I’m pretty sure it would have been quite painful. With her enthusiasm for physical activity, she wouldn’t let it slow her down but was compensating for it.
I feel it still needs to be revisited sometime soon. But I’m glad I did believe my instinct that something was off.
Is the pelvis behind all that?
Perhaps. Sounds like a reasonable assumption. With that and Cookie’s activity level, I can see she’ll be seeing her chiropractor for her entire life. It is something we’re going to have to stay on top of.