Laurie's Blogs.

Here's a case I saw this past Fall at The Canine Fitness Centre.  This is an interesting and unique presentation of a rib dysfunction.

Case 1

Ten-year-old neutered male Labrador Retriever presented to a physical therapist at a canine rehabilitation facility with a veterinary referral that described the problem as “a chronic issue revolving around repeated stretching when at dog parks or when exercising, sometimes accompanied with a yelp.  Pain is found repeatedly at the thoracolumbar area on physical examination, and the dog is reluctant to extend the shoulders and elbows, but no further diagnostics have been administered.”  The owners reported similarly, stating that the dog has stretched excessively since a puppy, and will even stop playing in order to stretch (downward-dog position).  Over the past year, the owners had noted that the dog was frequently licking his left front paw.  It had recently been prescribed a different NSAID after the first one was not well tolerated.  No relevant past medical history that could account for the stretching or paw-licking was known or recounted.

On examination, the dog was not lame, but did stretch several times during the appointment.  The most painful areas on palpation were ribs 1 – 3 on the left and rib 2 on the right.   The ribs throughout the left side of the caudal thorax (T7 – 13) were also painful on direct palpation.  Treatment administered comprised of mobilizations to the ribs in the form of rotational glides and distraction techniques (three repetitions of each, then retesting for pain on palpation, and a repeat of the mobilizations to any ribs that were still painful until there was no longer pain with direct palpation).  Dorsal glides to the thoracic spinal facet joints (via the rib cage) were also utilized and laser therapy was administered to the costovertebral and costotransverse joints as well.  The owners were advised to perform ‘chest lifts’ as a home exercise.

The follow-up appointment occurred three weeks later, at which time the owners reported that the dog was much better and much reduced in his stretching.  They had only witnessed him stretch once since his last appointment, and he was no longer licking his left front paw.  On examination, there was only minimal pain on palpation of T3 spinous process and ribs 3 bilaterally.  Mobilizations (as described above) and laser therapy were provided at that time and the dog was discharged from active treatment.  Owners were contacted 1-month following discharge and they reported to see no signs of recurrence of the stretching or licking habits.

Better add rib dysfunction to your list of differentials in some of your musculoskeletal cases!

Cheers,

Laurie