Would appreciate some advice on the dog below.
3 yo Doberman bitch, extremely well bred and competes in showing at a national level. Owner has noticed for some time that she skips into trot with her right HL. I treated her about a year ago and she improved. The owner saw it returned, I treated her with minimal change and now she has a wider BOS as she enters trot.
Ax: Cx nad. FLs all ok. Tx good. Lx some tenderness on right facet joints. I feel there is some muscle mass difference between the hindlimbs but you be the judge. Hips, stifles, hocks nad. Some tightness right quads.
Rx: dry needling to quads on right hind, Photizo Lx andSIJ, Dv mobs Lx both spinous processes and facet joints right side.
HEP: FLs on step weight shift caudally, standing square lifting left HL (which is heavier to lift).
She also always steps forward with lift FL when the owner positions her into square for showing.
Brief video below but it's so consistent with the skipping and at trot tracking up is 100%. Thank you!!!
A.B.
Video link:
https://youtu.be/Ht5cyZmtbpU
Skipping and odd stance
Re: Skipping and odd stance
Hi A,
So, the dog it ‘hiding something’ from you. This isn’t just a motor control and timing issue… there’s something with the right hind leg.
Therefore, all I have for you at this point is a list of things to check further… things that would cause movement issues / stance issues, but mild or no lameness.
SIJ: I know you said you worked it. Is the piriformis tender? Or the sacrotuberous ligament. Some combo-SIJ-issues can mask themselves (i.e. a combo cranial slip with a dorsal rotation, or a caudal slip with a ventral rotation, or a sacral torsion.) If you have any pain at the SIJ, Piriformis, or Sacrotuberous ligament… then there is something there that needs correcting, even if it’s hard to see. Be nit picky. The cranial or caudal thing I see missed a lot.
Iliopsoas strain: Did you palpate the entire length?
Patellar instability: Especially in a large breed dog, if the patella has any irritation / inflammation around it. Try compressing the patella with flexion and extension. (Saw a police dog with this once!) Alternately, something more unstable like a laterally luxating patella.
Short collateral ligament of the tarsus: check for swelling behind each malleolus and compare the ‘excursion of the wobble’ of the calcaneus from side to side as it compares to the unaffected leg.
Toes… just because she’s black and tan and therefore at a greater risk of digital neoplasia.
Hamstring flexibility and Sciatic nerve excursion: Hamstring stretch and sciatic nerve tension test. A difference from side to side? If yes, can you increase mobility / excursion by pulling the tail at the same time? (i.e. indicating a pinched nerve, likely at the lumbosacral junction.)
Lumbosacral junction: Pop her L/S into flexion and push quite firmly on L7 from each side. Any pain? Any evidence or reporting of licking rear feet / toes?
Muscle strains: Nit pick each muscle / muscle group.
Hips: Any pain when you extend the hip and block the pelvis from ventrally rotating. (I saw a young Newf once with a hip capsule sprain.) Also internally rotate the hip to check for capsular pain as well. (which throws CHD into your differentials - although a bit of a long shot!)
Anal Glands… outside of our scope as physios, but I’d walk that way too if I had anal glands that needed to be expressed!
My GUT says it’s in the SIJ, Hip, or Iliopsoas Region based on how she looks & moves.
Good luck searching, sorry I couldn’t be more definitive.
Laurie
So, the dog it ‘hiding something’ from you. This isn’t just a motor control and timing issue… there’s something with the right hind leg.
Therefore, all I have for you at this point is a list of things to check further… things that would cause movement issues / stance issues, but mild or no lameness.
SIJ: I know you said you worked it. Is the piriformis tender? Or the sacrotuberous ligament. Some combo-SIJ-issues can mask themselves (i.e. a combo cranial slip with a dorsal rotation, or a caudal slip with a ventral rotation, or a sacral torsion.) If you have any pain at the SIJ, Piriformis, or Sacrotuberous ligament… then there is something there that needs correcting, even if it’s hard to see. Be nit picky. The cranial or caudal thing I see missed a lot.
Iliopsoas strain: Did you palpate the entire length?
Patellar instability: Especially in a large breed dog, if the patella has any irritation / inflammation around it. Try compressing the patella with flexion and extension. (Saw a police dog with this once!) Alternately, something more unstable like a laterally luxating patella.
Short collateral ligament of the tarsus: check for swelling behind each malleolus and compare the ‘excursion of the wobble’ of the calcaneus from side to side as it compares to the unaffected leg.
Toes… just because she’s black and tan and therefore at a greater risk of digital neoplasia.
Hamstring flexibility and Sciatic nerve excursion: Hamstring stretch and sciatic nerve tension test. A difference from side to side? If yes, can you increase mobility / excursion by pulling the tail at the same time? (i.e. indicating a pinched nerve, likely at the lumbosacral junction.)
Lumbosacral junction: Pop her L/S into flexion and push quite firmly on L7 from each side. Any pain? Any evidence or reporting of licking rear feet / toes?
Muscle strains: Nit pick each muscle / muscle group.
Hips: Any pain when you extend the hip and block the pelvis from ventrally rotating. (I saw a young Newf once with a hip capsule sprain.) Also internally rotate the hip to check for capsular pain as well. (which throws CHD into your differentials - although a bit of a long shot!)
Anal Glands… outside of our scope as physios, but I’d walk that way too if I had anal glands that needed to be expressed!
My GUT says it’s in the SIJ, Hip, or Iliopsoas Region based on how she looks & moves.
Good luck searching, sorry I couldn’t be more definitive.
Laurie
LAURIE EDGE-HUGHES
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sblovedvm@gmail.com
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Re: Skipping and odd stance
That is a great list for those nonspecific HL lameness, thanks!
I agree with looking at her patella stability, especially in extension for mild luxation. Also, I'd palpate the long digital extensor tendon for "popping" out of its "groove" at the proximal lateral tibia.
sbl
I agree with looking at her patella stability, especially in extension for mild luxation. Also, I'd palpate the long digital extensor tendon for "popping" out of its "groove" at the proximal lateral tibia.
sbl
Re: Skipping and odd stance
Ah right! GREAT! As I was typing the list I thought, oh, I have to remember to include the LDET, but then forgot!
Thanks for adding that to the list!
Laurie
Thanks for adding that to the list!
Laurie
LAURIE EDGE-HUGHES