Shoulder Injuries in Dogs: Is Cookie Suffering From Medial Shoulder Syndrome (MSS) or Instability (MSI)?

There isn’t much talk about front leg lameness in dogs or shoulder injuries.

Unless you have an agility dog, you might have never heard of these issues; neither have I until recently.

Most people are familiar with hind leg problems in dogs such as cruciate ligament tears, hip dysplasia, luxating patella, and so on. The only front leg condition that is generally familiar is elbow dysplasia.

In the past, we had too much experience with hind leg lameness. When my dog started limping, I was relieved when it was “just a front leg.” As it turns out, “just a front leg lameness” can be a much bigger problem.

Awareness of shoulder injuries, their diagnosis, and treatment seem to have lagged. The diagnosis your dog might often get is a “soft tissue” injury. That, in all fairness, is technically true but far from as simple as it sounds.

Shoulder Injuries in Dogs: Is Cookie Suffering From Medial Shoulder Syndrome (MSS) or Instability (MSI)?

Dog shoulder injuries

The canine shoulder facilitates all sorts of movement and it contains all many stabilizing soft tissues any of which can get hurt. Shoulder joint ligament and tendon conditions are the most common cause of front leg lameness in dogs.

I am not going to list the common types, their names are horrible and you can look them up. The most common, however, is medial shoulder instability (MSI) and medial shoulder syndrome (MSS). As the terms indicate, they are similar but in MSI the joint is unstable and in MSS it is not. Both cause pain and lameness.

Medial shoulder instability is similar to the rotator cuff injuries in humans. That doesn’t sound like fun at all.

Cookie’s story

The first time Cookie hurt her shoulder was during winter time about two years ago. We were sure it was from the way her legs would break through the deep snow with layers of ice throughout.

It took a while but we were able to successfully treated with rest, physical therapy, massage, laser treatment, and dry needling.

Full story: Shoulder Injury in a Dog: It Never Rains …
Observation Skills for Dog Owners: Cookie’s Sore Shoulder

Eventually, Cookie recovered and the shoulder didn’t bother her for two years. That changed toward the end of last winter.

It was the same scenario—ungodly mess outside consisting of deep snow with ice layers. Of course, we made safe trails, but that’s not where the wild huntress Cookie wanted to be. I was trying to balance between keeping her safe and giving her reasonable freedom to do what she wanted.

Sometimes, though, she’d just lose it and get zoomies which are difficult to control

First signs

Long before the actual acute event that led to terrible lameness on her front left leg, I was seeing concerning things. It was subtle and every practitioner we saw had a different theory about what’s behind it.

I too leaned toward a sore back rather than a shoulder injury. But that’s what it turned out to be.

More about that here: Example Report for Dog PT: Cookie’s New Lameness

The treatment

We attacked the problem with initial rest and slow return to activity combined with vigorous physical therapy, laser therapy, and acupuncture.

The recovery was taking much longer this time. However, slowly but surely we were getting Cookie where we wanted her to be. She was able to return to her normal activity, mouse and frog hunting, and doing well. She wasn’t hundred percent but getting closer.

Subtle signs

After the initial good improvement, I started seeing some new things. Some days she would walk with a bob. Did she overdo it that day? She was still going down the ramp slower than prior the ordeal.

But since overall things seemed to be moving in the right direction, and the process had been slow, we figured it was part of getting there. It seemed like residual issues from the original injury when Cookie pushed things too far.

Latest setback

That all changed last night.

She was very happy and very excited all day, enjoying a visitor, hunting frogs. Maybe too excited? She did a lot of bouncing. She stumbled or tripped couple times after that and walked, rather than ran to the frog pond. That was it, though.

After we came home, however, I could see something was wrong just from her face. She also didn’t come out on the deck with us every time we went, which is what she normally would do. I was already concerned.

She remained put in her bed until after her dinner. When she got up, I thought I heard a whimper. She stood there, front legs far apart, and then she limped horribly—on the front right leg this time.

What the heck happened now?

Shoulder Injuries in Dogs: Is Cookie Suffering From Medial Shoulder Syndrome (MSS) or Instability (MSI)?
This rough graph illustrates the weirdness of the latest setback

The quest for answers

The strong suspicion now is that there is more to it than an acute injury. Something chronic going on, made worse when she does just the wrong thing. I thought I was “seeing things” but it appears I was actually seeing things.

Does she suffer from medial shoulder instability or medial shoulder syndrome after all? And if so, what is the next step? What we’ve been doing doesn’t seem enough. Will a shoulder support brace help? Will Cookie need surgery?

That are the things we need to figure out. What the diagnosis really is—even though it means more invasive diagnostics now, and what we’re going to do to fix it.

Related articles:
Example Report for Dog PT: Cookie’s New Lameness
Observation Skills for Dog Owners: Cookie’s Sore Shoulder
Shoulder Injury in a Dog: It Never Rains … though Rain Did Have a Lot to Do with It

Further reading:
Why Is My Dog Limping On The Front Leg
Canine Shoulder Instability – Tips to Diagnosis and Methods of Treatment

  1. I hope Cookie doesn’t need surgery. I had two surgeries on my right shoulder 10 years ago. I was doing great until about 2 weeks ago and I am now in pain and have lost some range of motion. I see the doctor this week. Hopefully, some ice and heat and some PT will help.

    • I hope so too for sure. I’d prefer dealing with it with regenerative therapy. But it really kills me that we still just have theories and not a solid diagnosis. The original diagnosis seemed to add up. But this new even puts everything on its head.

  2. nancytsocial

    Poor baby! I’m so sorry she is going through this. Glad you have a good vet who will surely sort it out. Keep us posted!

  3. This was a really informative read. Like most, I was incredibly familiar with rear leg injuries, especially hip dysplasia (I’ve had German Shepherds all my life) but had no knowledge of the signs, symptoms and risks associated with shoulder injuries. Thank you for taking the time to educate us on this!

  4. So sorry to read about Cookie – must be so hard for her. You are on a good path to helping identify what is wrong and she’s in great hands. I’ll keep Cookie in my thoughts and hope against surgery. Those frogs need to be chased!

    • Thank you. I’d rather avoid surgery too. Meanwhile, some practitioners raised a suspicion of a neck involvement–so I like that even less.

  5. I learn so much from your posts and am dealing with Layla and a neck injury and she seems to be slowly getting better but I think we have a long way to go still

  6. Marjorie Dawson

    You are being very level headed in reporting on the ups and downs of Cookies healing journey. You have taught me to believe in my own observations, consult a qualified practitioner and not give up but keep monitoring and trying to find out what might be wrong with my cats (yes your example still applies!)

    My best wishes for Cookie’s recovery. She is the luckiest dog in having you as her family.

    • Level-headed is about the last thing I’d say about myself. And I often wish I just didn’t see most of the things I do. But it seems to be my purpose in life. Taking care of these babies.

      I am glad I taught you to trust your observations–so important. You see what you see for a reason.

      Thank you for the good wishes.

  7. I am so sorry to hear that Cookie is in pain again. It is difficult to watch our pups suffer when we can’t figure out what exactly is wrong.

    We went through this with our golden but it was his hind leg and as you mentioned it is more common. I think it is also easier to diagnose.

    I wish you and Cookie the best. I hope she will be frog chasing again real soon.

    • I’m just about beside myself at this point. But gotta keep working on it while trying to figure out what is really going on.

    • I’m so sorry to hear Cookie is in pain and struggling to enjoy her frog hunts and fun times. There’s nothing worse than not being able to help our furbaby when they are sick or hurt. I hope you get answers and a plan soon.

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