Laurie's Blogs.

Hi Laurie,

I have a dog with a Medial Shoulder Instability (MSI) (possibly about a 5 month duration, suspect trauma).  She is a 5 ½ year old collie cross.  My measurements are off because I cannot get a full extension on her elbow so I am not including them.  I do know that there is considerable difference between the left and right glenohumeral joint abduction and she is painful, and there is increased lat to med glide at the G-H joint.  My problem is that I tried to put on a support wrap and it didn’t work out with her elbow degenerative joint disease (MSI and elbow DJD are on the same side).  I tried wrapping it different ways but was unable to come up with a way to make it comfortable for her.  I have a consult with a surgeon in mid March (he is going away on a holiday and we can’t get in sooner) and I have contacted an orthotic company.  I have a quote on a rigid splint that has the option of incorporating an elbow if necessary.  My question is whether you have had this issue before and if you were able to do anything non-surgical to help.  I appreciate your help. 

RM

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Hi R!!

Okay - now as for your dog.  Right off, I've never had a MSI dog go for surgery.  So... there is hope!

Now as for elbow OA... there isn't a brace out there that improves OA.  Period... so making something rigid would not be in my thought processing.

As for a brace - look at the Dogleggs ones or the ones by Orthopets...  and see what you think given what you've seen with this dog.

I'd persist with the tensor bandage... try starting with the mid point of the bandage behind the front legs, wrap around each leg with a criss cross under the chest as the ends move backwards and then tie on the top.  OR... try starting with the midpoint of the bandage in front of the chest, bring around the legs, criss cross under the chest (behind the front legs) and then tie on top of the shoulders.  Don't make the bandage too tight - keep it loose - so that it is essentially just proprioceptive... not restrictive. (ps Training Video 5 shows the first bandaging technique.)  I think that anything rigid or restrictive will be problematic.  The dog has likely developed movement strategies because of the elbow - and now the the shoulder has been compromised... any restriction of the shoulder is likely difficult for the elbow to accommodate.... which is why I figure you should persist with trying to figure out something with the tensor bandage.

I'd also use any and all modalities on the shoulder.  3-leg stands with perturbations to the affected / standing leg, grade 2 - 3 shoulder mobilizations (wiggle side to side... and show the owner how to do the same).  And this is a good one for NSAIDS & nutraceuticals if they are not already on board.  Hit the shoulder with anything you've got!  Acupuncture... maybe even a joint injection if it comes down to that!

Maybe an elbow brace from Back On Track (ceramic fibres - keeps heat in - I poo-pooed them for a while... but I've had owners swear by them... so could be worth a try for the OA elbow... then a shoulder wrap might actually help!

Does this help in any way?  

-Laurie

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Hi Laurie,

Yes that helps a lot.  I will have them come back and we will persist.  I just need some coaxing as I am wary of being accused of being negligent by not recommending surgery.  It is good to know that you have been able to treat yours conservatively, consistently.  Thanks again!

RM