There are a few conditions that are relatively simple, benign and resolve quickly but often present as a dog who refuses to bear weight on the leg.
|This dog was brought in for limping.|
Her foot hurt so badly she refused to walk on it.
Can you see the bruise on her pad?
For any dog who is either lame, or worst yet, carrying a limb, the best place to start is with a calm, relaxed, slow methodical hands and eyes on 'every-tiny-inch of the leg' approach. I see a whole lot of lame dogs, and I thought it might be helpful if I explained how I approach these cases.
Here is how I approach the dog who presents for "lameness."
When I am trying to determine the cause of a limp or lameness I always start with watching the dog ambulate. The best place to do this is in a closed, quiet, open room with as little furniture or hiding places as possible. In the exam room I will stand at the far corner and ask the owner to place the dog on the floor and calmly walk over to me as they coax the dog to follow. The dog will in most cases follow their mom or dad if they and this which allows me a few moments to watch them walk.
Analyze the walk
How much weight will they put on the leg? I scale lameness out of 1 to 5. 0 being normal, 5 indicating they will not put the foot on the floor.
|This is my pup Jekyll. Grade 5.|
I corrected his cruciate rupture a week ago, on the other side.
Time for this one to be done is now ASAP.
There are many subtle clues to a walking dog. They give me some hints about the bones, joints, muscles, and the nerves. When it comes to getting what you pay for an experienced eye from your vet can help your dog in innumerable ways. When a client calls me at 10 pm wondering whether their dog needs to go to the ER or whether they can wait until we are open I always tell them to send me a video. I can usually tell them with 30 seconds of a good walking clip.
The Physical Exam
I then try to take an educated guess where I think the problem is. If I think it is in the toe I look at the opposite leg from the shoulder down. Then I examine the lame leg from the shoulder down. Your hands do much of the work in veterinary medicine. We palpate for muscle size, lymph node size and number, bone pain and irregularities, joint swelling and range of motion, muscle size and sensitivity, etc. I try to palpate every muscle belly, every nook and cranny, and every anatomical structure in the leg. I also have to remember that some lameness results from an injury to the spinal cord.
When I think I have found the source of pain, (remember we are lame usually because we are painful) I then focus on what the root cause is.
Here's a tip from experience; For almost every single lameness exam, after I have watched the dog walking, I warn the parent that I am probably going to have to muzzle their dog. I know that people hate muzzles, for some reason they think they are cruel punishment devices?, or that it is a reflection of their parenting skills (sometimes there is a hint of truth to this), but I am looking for clues for the source of the discomfort/pain and I am asking the dog to respond. We all respond to pain differently, and when I am restraining them prohibiting their ability to flee that only leaves them with one other option. And so, I expect that in almost all cases the dog will respond with their best defense, a snip, a bit, a growl, and a harsh warning to back my inquisitive annoying self off. I don't blame them. I would bite the hand that hurts me too!
Remember when it comes to assessing the leg for lameness you have a cheat sheet. Use the other leg/foot to help identify differences. Subtle clues like;
- How much weight is being placed on the foot (a flatter foot has more weight on it).
- How long the toe nails are. Indicates how the foot is used.
- How the toes touch the ground. Is the dog reluctant or unable to place the foot correctly.
- What is the muscle mass from one leg to the other. A loss of muscle mass indicates dis-use, and more atrophy indicates either severity or chronicity.
- Is there saliva staining. A black/rust colored foot is a clue the dog is trying to tell you something.
|This is Peanut.|
Her mom noticed that she was intermittently carrying her back left leg.
Can you spot her boo-boo?
|Peanut has a blister between her middle two toes.|
For those of us who suffer walking around in a new pair of high heels we know how painful this is!
|Ellie Mae's feet are brown, the toenails are dark brown at the base.|
She has been sitting around all week licking her paws.
|Lorelei's nail is almost broken off at the base of the nail.|
Every time she tries to stand on the foot the raw skin and jagged nail hurts her sensitive toe.
My point is that limping dogs arrive for a multitude of reasons.
A good exam, a thorough history, a watchful eye, adept hands, and maybe even an x-ray or two, and most of our limping dogs can be treated quickly, easily, and alleviated of their discomfort.
Most limping dogs are not an emergency.
But the identification of the root cause, and a plan to assist the dog parents in understanding the consequences of waiting, and helping them to curb it in the future all help to find a quick end to a common presenting complaint.
The Treatment Plan
This should always be tailored to the patient and should address the following items;
- How do we alleviate the pain?
- How much time should it take for the lameness to resolve?
- When should the problem be re-checked?
- What are signs of the problem not resolving?
- How can we prevent it from happening again? Understanding how this occurred and how you can prevent it will hopefully keep your dog pain free and out of the vets office. (Almost ALL of the toe nail problems occur because people are not keeping them trimmed).
If you have a question, concerns, or just want to share your pet knowledge with our pet enthusiasts please visit Pawbly.com. We are a free pet community with a big heart.
Krista Magnifico, DVM owns a small animal hospital in northern Maryland, where she practices everyday. She wants to make quality veterinary care available to everyone, everywhere at any time; trying to save the world 1 wet nose @ a time. Her blog is a diary of he day-to-day life & the animals and people she meets.
Dr. Krista is also the founder of pawbly.com, free pet advice and assistance.
To contact her, you may leave a comment on her blog, email her or catch her on Twitter or Facebook.
Articles by Dr. Magnifico:
Don't Make This Mistake: Ruby's Death To Heat Stroke
Parvo: Cora's Story
Jake's Laryngeal Paralysis
The Tip Of The Iceberg: The Unexpected Dental Dilemma
The Ear Ache That Wasn't Going Away: Tottsie's Story
Cody's Eyelid Tumor
Ruger's Mysterious Illness
The Day The Heart Stood Still: Timber's Story
Different Definition Of Comfort Food: Levi's Story
Histiocytoma: Rio's Mysterious Bump
Von Willebrand's Disease: Greta's Story
Alice's Heart Murmur
Jekyll Loses His Tail Mo-Jo
Pale Gums Are An Emergency: Bailey's Story
To Amputate Or Not To Amputate: Heidi's Story
Lessons From A Real-Life Veterinarian
Charlie's Life Saving Lipoma Surgery
Symptoms To Watch For In Your Dog: What Is That Limp?
Common Misdiagnoses (Part 2)
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What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?
Email me, I'll be happy to hear from you!