fourleg.com

Ok not my patient for once!

My colleague had a dog in for “ check hind end”. Very observant owner that found the dog (little shih tzu mix 14 yo FS) was stiff on her hind legs.

My colleague found massive hamstrings and teeny quads with bilateral tarsal hyperextension and hyperflexion. I always think stifle or hip with tarsal hyperextension but she didn’t find anything. rDVM reported luxating patellas but my colleague was unable to displace with normal pressure and they were in place in standing. No back pain, iliopsoas comfortable, hip ROM normal. Left was slightly larger than the right on muscle mass (1cm difference on thigh circumference).

Any thoughts or ideas what could cause this?

Thanks as always for your thoughts on things!!

KP

Hey K,

So I am going around and around in my head trying to think outside the box -
Soft Tissue Tumour? Bilateral is unlikely.
Tumour at the L5 region causing atrophy to quads? Then you’d see more neuro signs LMNL & UMNL (as it would have to be impacting both sides and then subsequently the main body of the cord.
SIJ - nah, doesn’t present that way.
CHD causing tarsal hyperextension - you’d find the hips.

So, I go back to Patellas.
I am reminded of a case I saw, little chihuahua. Big hamstrings, externally rotated leg, and it took me forever to get her calm enough that she ‘showed me’ the luxation. Grade 2. But I think she has learned to compensate with her gait pattern / leg positioning so as to avoid the luxation events. I reported this back to the regular vet, who referred her to the surgeon… who could not find / get a luxation and sent her away “you’re dog is fine.” Fast forward to a year later when the dog was far more affected and THEN the surgeon was able to luxate the patellas and surgery was done…but the little dog was VERY sore by then.

All in all, I’d say go back to the patellas. Go slow. Try many times, while getting the dog to relax. Try in different positions. I once had a Cane Corso that would medially luxate in mid range flexion (shallow groove? patella alta? Both…?)

AND/OR… treat as if she is a Grade 2 (2-) MPL, and work on Quads strengthening - inner range at first (mini sit to stands). See the MPL Conservative Mgmt Protocol.

I’ve spun it around and around and that’s what I came back to based on your description.

I’ll post it on the forum anyways, and maybe someone else will pipe up… but that’s my thinking!

Best of luck!

Cheers,

Laurie