fourleg.com

Hi all,
Looking for discussion/input for a 1 year, 9mos old standard poodle/standard schnauzer mix, F/s.
History of intermittent mild left pelvic limb lameness over the last year (grade 1-2/5)
Active dog, hikes, runs, plays frisbee. Owner began restricting frisbee play 2 weeks ago after a recurrence of the lameness and the otherwise nice dog growled at her while resting, guarding the left hind end.
A DVM chiropractor saw the dog during one of the episodes last August and said the sacrum was out of alignment, performed cold laser, and recommended a core strengthening program.
The owner noticed improvement lasting about 1 week after.
When the most recent episode recurred 2 weeks ago, hip, knee, and lumbar spine X-rays were obtained and submitted to radiologist who reported as normal. DVM couldn't find obvious pain, performed acupuncture, and sent to rehab.
The only abnormalities I could palpate were mild spasms of left lumbar paraspinals and very mild discomfort when palpating left iliopsoas at insertion. Thinking it's a acute on chronic strain but suspicious it's not the primary problem.
Orthopedic and neuro exams normal, Lyme 4dx negative.
We started treating for iliopsoas strain since the owner wanted a conservative approach (with the understanding we may need to refer for diagnostic ultrasound/further workup), but wondered what others thought.
Thanks!
Lynn Nalepa, LVT, CCRP

Hi Lynn!

Sounds like an interesting case. (These are the kinds of cases I love to see / treat, personally!)

So, let's go through a list of differentials:

1. SIJ dysfunction (if working on the sacrum helped before, it's a good bet. I'd also check for the motor control & timing problems (check video training 16). The SIJ won't 'stay' as it should if the timing is problematic. Check for symmetry of the pelvis, and for pain at the piriformis muscles, over the dorsal SIJ ligaments, and the sacrotuberous ligaments.)

2. Lumbosacral nerve irritation. I think this could happen without radiographic evidence. We know that such things are true in humans. So feel for a reduced (or increased) tone of the expaxials down at the L5/6/7-S1 levels. Push on the spinous processes from the side (transversely) and assess for pain. A pinched nerve could cause pain or sensations enough to make dog growl.

I would agree that the iliopsoas is not likely primary... certainly not if you can actually get to the insertion. A true strain would be yelping before you were able to landmark to that point!!

3. Long shot, but check for trigger points up the sartorius, Quads, & TFL. I usually find these to be secondary due to compensation for a primary issue... but I did once have ONE dog in which MFTrP's was the primary issue.

And of course, you can never really rule out a neoplasia. But to hunt for that first, is just throwing money down the drain in most cases in my opinion. Check these other things, treat accordingly, and use that as your diagnostic test!!

Best of luck!

Laurie