Hello all
I am hoping for a little direction with a case I have been seeing.
Ninja is a 2 year old Siberian Husky that was diagnosed with a cranial cruciate tear in October 2017. He had a TPLO in early November 2017. He was doing well and his rehab was going great until just after Christmas when it was very icy and he slipped on the ice. He got an iliopsoas strain on the same side and then also developed a medial meniscal tear. He had a meniscectomy with the same surgeon in February 2018. His iliopsoas is still a bit tight but he still seems to have extreme weakness despite our exercise program and his walking program. He limps on the limb after about 15 minutes of walking on a flat surface. I cannot localize the source of pain and am getting frustrated that I cannot get this dog back to function. He keeps the surgical leg his right hind abducted and internally rotates it with each step. I would love to upload a video but for some reason the video I have will not upload here.
2 yr old Siberian Husky still lame after TPLO in November 2017
Re: 2 yr old Siberian Husky still lame after TPLO in November 2017
Hi Lori,
To upload a video, you'll have to upload it to YouTube and then provide the link. I"ve not figured out a different way!
As for the dog. Questions:
Is there now full range at the stifle, any sign of pain or swelling there, can he do a proper sit?
Any pain when you palpate the plate? Any pain in the postero-medial joint line sulcus?
Try meniscal tests... just in case.
Test MCL & LCL.
The gait you describe could be what vets are calling a "pivot shift" (which is an entirely bastardized term from what we use it to mean in humans...but that's a different discussion.)
If you think the stifle is happy... then
Check SIJ, Check for hip pain (deep gluteal & pectineus), and lumbosacral pain.
If those are good, then perhaps you just need to try getting the dog to 'buy into' using the leg again. Sometimes where there have been 'multiple insults' to one particular leg, I have seen dogs almost 'give up' on that leg. So, try the bandaging technique (I show it in a video - in the white box on the far right hand side type in bandaging to search for it): essentially you banadage and make the external rotation look worse - walk with bandage on for 10 mins, then off for 10 mins. Try adding bags, socks, booties, tape, etc to the unaffected leg. Go with more aggressive targetted strengthening (step ups, Squat blocks, hill walking, tug of war...).
If it's a 'pivot shift'... then it could require further stabilization. However, we've mostly had success with strengthening. Alternately a brace could be in order.
That's off the top of my head anyways!
Try to get the video up here and maybe more ideas / thoughts will come!
Laurie
To upload a video, you'll have to upload it to YouTube and then provide the link. I"ve not figured out a different way!
As for the dog. Questions:
Is there now full range at the stifle, any sign of pain or swelling there, can he do a proper sit?
Any pain when you palpate the plate? Any pain in the postero-medial joint line sulcus?
Try meniscal tests... just in case.
Test MCL & LCL.
The gait you describe could be what vets are calling a "pivot shift" (which is an entirely bastardized term from what we use it to mean in humans...but that's a different discussion.)
If you think the stifle is happy... then
Check SIJ, Check for hip pain (deep gluteal & pectineus), and lumbosacral pain.
If those are good, then perhaps you just need to try getting the dog to 'buy into' using the leg again. Sometimes where there have been 'multiple insults' to one particular leg, I have seen dogs almost 'give up' on that leg. So, try the bandaging technique (I show it in a video - in the white box on the far right hand side type in bandaging to search for it): essentially you banadage and make the external rotation look worse - walk with bandage on for 10 mins, then off for 10 mins. Try adding bags, socks, booties, tape, etc to the unaffected leg. Go with more aggressive targetted strengthening (step ups, Squat blocks, hill walking, tug of war...).
If it's a 'pivot shift'... then it could require further stabilization. However, we've mostly had success with strengthening. Alternately a brace could be in order.
That's off the top of my head anyways!
Try to get the video up here and maybe more ideas / thoughts will come!
Laurie
LAURIE EDGE-HUGHES