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Hi Laurie

Hope you are well. On the back of our last correspondence about core I took the plunge and did a workshop on the absence of core in dogs. It was well received and got people thinking.

Anyway a question for you.

Mild slipping patella in a working collie who is VERY cow hocked. This dog will compete well and then all of a sudden will flick her back leg as if she has been bitten and hops for 2 strides and then sound again.

Patella does not move under testing with vet but assume it is an alignment issue and the patella is riding over the femoral ridge occasionally.

Have done lots of squats and stand to down and soft tissue release. Dog does under water treadmill. Dog has made no improvement and will be retired if it doesn't improve.

Is there anything else you would do.

thank you. I am really stuck with this..

sue

Hi Sue!

I want you to tell me more about your ‘core in dogs’ workshop… could it be conducted online???? Hmmm??

Now to your question.

I’d actually move away from thinking about the patella. Other than test for laxity with the stifle in varying degrees of flexion. I have seen this ONCE, where the patella was stable in extension, but I could luxate it in some degree of flexion. All other signs for this dog pointed to MPL (tenderness at / around the patella)… it just took me looking to find it.
My thoughts on what / where to look:

Nerve pain from the femoral nerve trapped in / along the iliopsoas, and/or an L4-L6 issue.
Issue with the Long Digital Extensor tendon popping out of it’s groove on the lateral side of the proximal tibia.
Damage to the short collateral ligaments at the tarsus. Wobble the calcaneus from side to side, noting end-feel and range, & compare to the other side.
Maybe some fascial restriction (TFL, iliopsoas, hamstrings…). Ah, never mind, I see you’ve been doing lots of soft tissue release.
SIJ… just because. But I assume you looked there. Doesn’t fit with the hopping / flicking.
One of the peronei tendons getting caught / stuck / luxating at the level of the lateral malleoli. (I have seen one dog with this! We could reproduce it by flexing the tarsus while putting the stifle in varying degrees of flexion as well. And essentially, could get the tarsus to ‘lock’ and be unable to flex it further despite the stifle being in full flexion).

Sounds like a difficult case… I wish I could be of more help, but maybe one of these ideas / suggestions above will prove fruitful (and treatable).

Best of luck!

Laurie

I would add SDF luxation at the calcaneus to Laurie's list, and agree with everything else she said.

David Lane DVM
ACVSMR