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Limping

You think your dog is limping but you’re not sure. There’s something off about the gait...something’s different! Lameness is one of the most common reasons people present their dogs to the vet. Sometimes it is so subtle that is difficult to tell which leg is involved.

The front legs take two thirds of the weight when the dog is in motion.

Often even before an overt lameness manifest, behaviour changes signal that something is wrong. Dogs with discomfort will be reluctant to go up or down stairs or jump in or out of the car. They might stop sleeping on the couch as it hurts to get on and off.  So, short of them having an obvious injury where they are holding up a paw and looking pathetic, how can we tell?

The front legs take two thirds of the weight when the dog is in motion. Even so, front-end lameness can be very subtle.  Usually there will be a head bob associated with it. The head will come up when the sore leg takes weight. This can be confusing sometimes but they are guarding the sore leg ~ pulling up on it.

Have your dog walk towards you on an even, non-slip surface such as the sidewalk. If you can’t see anything, have someone jog the dog towards you. Be careful they are not pulling up on the leash as this could mask the head bob. If you still don’t see anything, watch from behind as the dog moves away from you. Sometimes the head bob can be seen from behind.

Now that you are watching from behind, observe the hind legs. Some lameness will cause a hip hitch. The hip on the affected side will pop up as they move. Also watch where the paws land. Neurologic issues will cause the paws to cross over or splay out as the dog doesn’t know where they are in space. Another sign of neurologic lameness is wear of the top surface of the middle two toenails on the affected foot.

Have your dog sit. If they won’t sit squarely they may have a sore stifle or knee on the side the foot is sticking out on.

When you get to the vet don’t be offended if they do all this over again to confirm your diagnosis. They probably will. Then they will examine the limb or limbs from the tip of the nails to the shoulder or hip looking for the specific site on the limb. It can be as simple as a torn nail or puncture of the pad or as serious as a bone tumour.

All the joints will be felt for heat, pain or swelling. Then they will be taken through their flexion and extension looking for a pain response, decreased range of motion and feeling for crepitus or grinding. The degree of flexion and extension can be measured against known normals. If none of the joints seem to be involved, the long bones will be palpated deeply. The muscle mass will be palpated and compared to the other limb. Muscles that are not getting used as much are smaller.

If the limbs don’t seem to be the source, the spine and tail will be examined in the same way. Some lameness comes from there. Have you ever suffered from sciatica? Your butt and leg feel like someone is stabbing them with a hot iron.

If an area of concern is identified or the vet still isn’t sure exactly where the problem is stemming from, diagnostic tests may be ordered. Radiographs are the most likely. This usually requires an anaesthetic to get a good set as sometimes it is painful to position the patient. If your dog moves, the rad is ruined and that means a do over, which means more radiation for your dog and hospital staff.  If we still can’t find the source, a referral may be offered. Most referral centres have the ability to do CT and/or MRI.