Hindlimb Lameness Research Articles

Monitoring of Non-Lame Horses and Horses with Unilateral Hindlimb Lameness at Rest with the Aid of Accelerometers

The aim of this study was to determine whether horses exhibiting unilateral hindlimb lameness unload (rest) the lame limb more than the contralateral limb. The resting/unloading of the hindlimbs and the time spent lying down were measured using accelerometers. Ten non-lame horses and 20 lame horses were recruited for participation and monitored for 11 h overnight with accelerometers (MSR145, sampling rate: 1 Hz, and measuring range: ±15 g) attached to the lateral metatarsal and metacarpal regions of each limb. Metatarsal and metacarpal orientation were used to determine whether the limb was unloaded (rested) or loaded, respectively, or whether the horses were lying down. The relation of resting time between non-lame and lame limbs (non-lame/lame: 0.85 ± 1.2) of the lame horses differed significantly (p = 0.035) from that of the non-lame horses (right/left: 1.08 ± 0.47). Non-lame horses rested their hindlimbs evenly (left: 15 ± 10%; right: 17 ± 16%). Horses with unilateral hindlimb lameness unloaded the lame limb longer (lame limb: 61.8 ± 25.3%, non-lame limb: 38.2 ± 25.3%) than their contralateral limb. The lame horses (13 ± 11%) lay down longer (p = 0.012) than the non-lame horses (3 ± 6%). The degree of lameness determined by the participating veterinarians (Vet Score) (r = −0.691, p < 0.01) and the asymmetry evaluated by the lameness locator (ALL) (r = −0.426, p = 0.019) correlated with the resting ratio (rest time ratio). Both factors were also correlated with the time spent lying down (Vet Score (r = 0.364, p = 0.048) and the ALL (r = 0.398, p = 0.03)). The ALL and VET Score were significantly correlated (r = 0.557, p = 0.01). The results of this study provide a good baseline for future research into how individual resting patterns may help to detect pain.

Disseminated Neospora caninum Encephalomyelitis and Myositis in a 3-Month-Old Cane Corso Puppy

We present a case of fatal disseminated neosporosis in a 3-month-old Cane Corso puppy. The puppy presented to the Purdue Veterinary Hospital emergency service with a 1-week history of progressive left hindlimb lameness. On presentation, the puppy was nonambulatory paraparetic. Signs progressed over two days to nonambulatory tetraparesis, and decreased to absent limb reflexes, cranial nerve deficits, and dull mentation. Blood work showed eosinophilia, elevated ALT, and extremely elevated creatine kinase at 36,000 IU/L (reference interval 22–491 IU/L). Two days after diagnostics were performed, the puppy experienced acute cardiac arrest, and the body was submitted for necropsy. At necropsy, skeletal muscle in all four limbs was diffusely pale tan. Tan streaks were disseminated through the diaphragm, abdominal wall, and myocardium. Histologically, Skeletal myocytes and cardiomyocytes were frequently degenerative, with abundant lymphohistiocytic inflammation and fibrosis. White matter within the brain and spinal cord was inflamed and contained frequent dilated myelin sheaths and spheroids. A few protozoal cysts were within the brain and skeletal myocytes. Antemortem antibody titers were positive for IgG against Neospora caninum (dilution titer of 1:4096, baseline 1:32), confirming protozoal cysts as Neospora caninum. Disseminated neosporosis is an uncommon but important clinical differential for ascending paresis in young dogs.

Computed tomography of the equine caudal spine and pelvis. Pathological findings in 56 clinical cases (2018-2023).

Computed tomography (CT) of the axial skeleton is increasing across many equine hospitals. CT of the pelvis and caudal spine in a large group of clinical cases has not been reported previously. To describe the pathological lesions identified in the caudal spine/pelvis in horses and ponies undergoing CT spine of this region. A retrospective case series. Horses with CT imaging of the caudal spine/pelvis were included. Horses aged under 6 months and those with CT examinations performed post-mortem were excluded. Fifty-six horses met the inclusion criteria. Ages ranged from 8 months to 20 years and bodyweights from 85 to 680 kg (mean 488 kg). Horses presented predominantly for lameness (30/56) and poor performance (18/56). Osseous pathology was identified in 41/56 horses; including osteoarthritis of the sacroiliac joint(s) (n: 28), pathology of the intervertebral disc joint(s) (n: 12), pelvic fractures (n: 9), osteoarthritis of the coxofemoral joint(s) (n: 8), ventral spondylosis (n: 6), acetabular rim fracture (n: 2), dislocation of coxofemoral joint(s) (n: 2), and dorsal dermal sinus of the sacrum (n: 1). The relationship between CT imaging findings and clinical signs in horses remains unclear. Further work is required to describe the relationship between congenital, developmental, and acquired changes in the caudal spine and pelvis, and clinical signs. CT of the caudal spine and pelvis can be utilised in horses and ponies for diagnosing a range of clinical disorders that may be causing 'lumbosacroiliac pain', poor performance, hindlimb lameness, and stiffness. The pathologies we observed were diverse and many patients had multiple lesions.

Ultrasound is an accurate imaging modality for diagnosing hip luxation in dogs presenting with hind limb lameness.

To determine the accuracy of ultrasound for diagnosing hip luxation in dogs presenting for hind limb lameness. 24 client-owned dogs presenting with pelvic limb lameness and concern for hip luxation were enrolled in this prospective diagnostic accuracy study from April 1, 2021, to July 1, 2022. An experienced ultrasonographer and a novice ultrasonographer, both masked to the diagnoses, performed hip ultrasonography using a point-of-care ultrasound machine. The experienced evaluator also performed a more comprehensive ultrasonography with a high-end ultrasound machine to characterize concurrent pelvis and hip disease. Pelvic radiographs served as the criterion standard for the diagnosis of hip luxation. Ultrasonographic diagnosis of hip luxation demonstrated high accuracy, ranging from 84.2% to 100% for detecting the presence of luxation and 80.6% to 98.1% for diagnosing the direction of luxation for the novice and experienced evaluators, respectively, with substantial interevaluator agreement (κ = 0.722). Compared to radiographs, ultrasound accurately diagnosed the presence of osteoarthrosis with almost perfect agreement (κ = 0.913) and the presence of fractures of the femoral head/neck and the nonaxial portions of the pelvis with substantial intermodality agreement (κ = 0.775). In 36% of patients, ultrasound identified injury to soft tissue structures that contribute to hip stability, including the gluteal muscles, gemelli, and joint capsule. Ultrasound can be utilized to accurately diagnose the presence of hip luxation and document concurrent hip and pelvic disease. Applications include the use of ultrasonography as part of a routine point-of-care protocol to catalogue injuries in patients with acute trauma and in mobile practice or remote settings where radiography is not readily available.

Characterization of spatiotemporal and kinetic gait variables in dogs with hindlimb ataxia and bilateral hindlimb lameness

BackgroundDiscriminating the underlying cause of gait abnormalities can be challenging in a clinical setting, especially in the presence of bilateral disease. Pressure-sensitive walkways (PSWs) have been utilized to characterize the gait of dogs with various neurologic or orthopaedic conditions. The potential use of the PSW includes the discrimination of conditions that can be similar in clinical presentation, such as bilateral hindlimb lameness and hindlimb ataxia. The primary aim of this study was to describe the spatial, temporal, and kinetic gait parameters of dogs with hindlimb ataxia or bilateral hindlimb lameness and compare them to those of normal dogs. Forty-six dogs were prospectively recruited. The normal group included 20 dogs with normal neurologic and orthopaedic exams. The orthopaedic group included 15 dogs with bilateral hindlimb orthopaedic diseases with weight-bearing hindlimb lameness and normal neurologic exams. The neurologic group included 11 dogs with ambulatory paraparesis and normal orthopaedic exams. Each dog was walked across the PSW, and at least 3 valid trials were collected. The stride time, stance time, swing time, stride length, gait velocity, peak vertical force (PVF), vertical impulse (VI), and limb symmetry were recorded. The mean values of all parameters from the valid trials were calculated and used for data analysis. The outcomes were compared among all groups.ResultsCompared with the normal group, the orthopaedic group had a significantly greater percent body weight distribution (%BWD) and vertical impulse distribution (VID) in the forelimbs. When comparing the spatiotemporal parameters, the neurologic group showed an increase in forelimb stance time compared to that of the normal group. Compared with that in the normal group, the stride velocity in the forelimbs in the orthopaedic group was greater. There were no significant differences in the kinetic parameters between the neurologic group and the normal group, nor in stride time or stride length among the groups.ConclusionThe gait parameters obtained by PSW demonstrated that the orthopaedic and neurologic groups may have different compensatory mechanisms for their gait deficiencies. These parameters can potentially be used to construct a predictive model to evaluate PSW as a diagnostic tool in future studies.

Pain related syndrome of inappropriate antidiuretic hormone secretion in a kitten

A 2-month-old domestic shorthair kitten was presented for evaluation of weakness, gait abnormalities, and signs of pain after trauma. On admission, the patient was found laterally recumbent with obvious gait abnormalities: difficulty rising from sitting and marked unilateral left hind limb lameness. On orthopedic examination, severe pain, crepitations, and swelling of the left hind limb were detected. Results of the first diagnostic work-up were all consistent with hyponatremia, hypochloremia and a Salter-Harris type I fracture.The kitten initially received isotonic fluids, analgesia, and antiemetic treatment. Twelve hours after admission, the analgesic plan was considered insufficient, and the general patient's condition worsened, showing severe mental depression. Blood and urine samples were collected for a more in-depth diagnostic evaluation; the patient showed worsening hyponatremia (113 mmol/L; [RR: 146,2-156,2]), severe plasma hypoosmolality (218.2 mOsm/kg; [RR: 287-307 mOsm/kg]), high natriuresis (Na: 74.9 mmol/L; [RR: <40 mmol/L]), and urinary hyperosmolality (630 mOsm/kg; [RR: <150 mOsm/kg]). Based on these new clinical findings syndrome of inappropriate antidiuretic hormone (SIADH) secretion was diagnosed.Emergency treatment with hypertonic saline was then instituted, a constant rate infusion of 3% hypertonic saline infusion to increase plasma sodium was initiated and a loop diuretic, furosemide (1 mg/kg/IV), was administered at 12-hour intervals to induce diuresis. Discharge occurred 4 days after admission as the patient was clinically stable and the hyponatremia progressively resolved. To the author's knowledge this is the first report of a kitten developing pain related SIADH associated to orthopedic trauma.

Kinematic changes in dairy cows with induced hindlimb lameness: transferring methodology from the field of equine biomechanics

Lameness is a common issue on dairy farms, with serious implications for economy and animal welfare. Affected animals may be overlooked until their condition becomes severe. Thus, improved lameness detection methods are needed. In this study, we describe kinematic changes in dairy cows with induced, mild to moderate hindlimb lameness in detail using a “whole-body approach”. Thereby, we aimed to identify explicable features to discriminate between lame and non-lame animals for use in future automated surveillance systems. For this purpose, we induced a mild to moderate and fully reversible hindlimb lameness in 16 dairy cows. We obtained 41 straight-line walk measurements (containing > 3 000 stride cycles) using 11 inertial measurement units attached to predefined locations on the cows’ upper body and limbs. One baseline and ≥ 1 induction measurement(s) were obtained from each cow. Thirty-one spatial and temporal parameters related to limb movement and inter-limb coordination, upper body vertical displacement symmetry and range of motion (ROMz), as well as pelvic pitch and roll, were calculated on a stride-by-stride basis. For upper body locations, vertical within-stride movement asymmetry was investigated both by calculating within-stride differences between local extrema, and by a signal decomposition approach. For each parameter, the baseline condition was compared with induction condition in linear mixed−effect models, while accounting for stride duration. Significant difference between baseline and induction condition was seen for 23 out of 31 kinematic parameters. Lameness induction was associated with decreased maximum protraction (−5.8%) and retraction (−3.7%) angles of the distal portion of the induced/non-induced limb respectively. Diagonal and lateral dissociation of foot placement (ratio of stride duration) involving the non-induced limb decreased by 8.8 and 4.4%, while diagonal dissociation involving the induced limb increased by 7.7%. Increased within-stride vertical displacement asymmetry of the poll, neck, withers, thoracolumbar junction (back) and tubera sacrale (TS) were seen. This was most notable for the back and poll, where a 40 and 24% increase of the first harmonic amplitude (asymmetric component) and 27 and 14% decrease of the second harmonic amplitude (symmetric component) of vertical displacement were seen. ROMz increased in all these landmarks except for TS. Changes in pelvic roll main components, but not in the range of motion of either pitch or roll angle per stride, were seen. Thus, we identified several kinematic features which may be used in future surveillance systems. Further studies are needed to determine their usefulness in realistic conditions, and to implement methods on farms.

Vertical pelvic movement asymmetry and lameness location in ipsilateral combined forelimb and hindlimb lameness cases.

Compensatory vertical head and pelvis movement asymmetry may occur in trotting horses with a primary cause of lameness in one end of the body due to the weight shifting between limbs, leading to apparent combined forelimb and hindlimb lameness (CFHL). Little is known about CFHL patterns observed with body-mounted inertial sensors (BMIS) and regardless of their underlying mechanisms, compensatory and secondary lameness may complicate the definitive identification of the primary causes of lameness. Determine associations between vertical pelvic movement asymmetry and location of primary lameness in ipsilateral CFHL cases where hindlimb lameness is solely impact or push-off type. Retrospective cohort. From a body-mounted inertial sensor (BMIS) evaluated equine lameness database, we identified cases with a consistent, low-variability ipsilateral impact (IpI) or ipsilateral pushoff (IpP) hindlimb lameness in a straight-line trot and that had definitive diagnoses. Cases were categorised by lameness location to the limb(s), diagnosis, and ratio of the amplitude of forelimb to hindlimb lameness (Forea/Hinda). Differences in the numbers of IpI and IpP cases in these categories were analysed with chi-square tests, effect sizes, and odds ratios. Among the 2375 total lameness cases screened, 49 IpI and 36 IpP cases met the criteria for consistency, low variability, and definitive diagnosis. IpI cases were more likely than IpP cases to have forelimb-only lameness causes when Forea/Hinda >1 (OR = 43, 95% CI = 2.3-798). IpP cases were more likely than IpI cases to have hindlimb-only causes at both Forea/Hinda >1.0 (OR = 20, 95% CI = 2.2-200) and <1.0 (OR = 14, 95% CI = 2.9-66.7). Compared with IpI, IpP cases were more frequently diagnosed with tendon, suspensory ligament, or high-motion joint disorders in hindlimbs (OR = 3.6, 95% CI = 1.1-12.3) and less with unknown causes (OR = 13.2, 95% CI = 3.2-75.2). In IpI cases, positive forelimb regional anaesthesia often reduced hindlimb lameness, whereas in IpP cases, positive hindlimb regional anaesthesia typically lessened forelimb lameness. Most cases were Quarter Horses. The likelihood of location and cause of lameness may be different for other breeds. The type of pelvic movement asymmetry observed in IpI and IpP cases is linked to the location and underlying cause of the primary lameness.

A Preliminary Protocol of Radiographic Image Processing for Quantifying the Severity of Equine Osteoarthritis in the Field: A Model of Bone Spavin

Osteoarthritis (OA) of the tarsal joint, also known as bone spavin, is a progressive joint disease that increases in severity with age. It is a significant cause of hind limb lameness, leading to a deterioration in the quality of life of horses, particularly in old age. In this study, the tarsal joints of 20 older horses aged 15 to 35 years were radiographically imaged and processed using the computed digital absorptiometry (CDA) method for bone mineral density (BMD) assessment. The radiological signs of bone spavin were scored on a scale ranging from normal (0) to severe OA (3), and the examined joints were grouped according to the severity of OA. The percentage of color pixels (%color pixels), representing successive steps on the scale of X-ray absorption by a density standard, differed between the steps in a BMD characteristic manner for each group. Furthermore, two examined ranges of relative density allowed for the distinction of joints affected by severe OA from other joints, while another two ranges allowed for the differentiation of joints affected by moderate and severe OA from normal joints. The proposed color annotation-assisted decomposition of radiological images based on the CDA protocol shows promise for advancing research on the quantification of radiological signs of OA. This approach could be valuable for monitoring the progression of the disease in older horses.

Total patellectomy in a dog: Long term outcome

Patellectomy alters stifle biomechanics and has been demonstrated to result in degenerative joint lesions and to increase the force required for its extension. A 3-year-old male dog was admitted with right hindlimb lameness due to a penetrating wound in the stifle. After exploratory arthrotomy, diagnosis of straight patellar ligament avulsion and patellar fracture was established. In three months, the dog underwent three surgeries to repair the straight patellar ligament, drainage of the stifle, and total patellectomy. Antimicrobial and anti-inflammatory drugs were administered. Restriction of activity and physiotherapy were also advised. Patellectomy was performed because the patella was no longer adhered to its adjacent soft tissues and appeared to be necrotic. Follow-up information for seven years showed mild lameness in the affected limb and a body attempt to substitute the patella.

Ultrasonography of the normal donkey tarsus (equus asinus)

Tarsal joint illness is a frequent source of hind limb lameness due to the complex anatomy of the region and the presence of numerous bony and soft tissue structures. Proper lameness diagnosis aims to discover the structure provoking lameness. Ultrasonography documents valuable information of soft tissues and characterizes soft tissue injuries that have heretofore been difficult to obtain either noninvasively or via radiography. The objectives of the current study were to develop and describe a standardized ultrasonographic protocol for investigation of the tarsal region in donkeys. The donkey tarsal anatomy was investigated in 5 cadavers and the tarsi of 11 healthy lameness free adult donkeys were echographically investigated. The dorsal, plantar, lateral and medial aspects of the tarsal region were substantially evaluated at four anatomical landmarks in both the longitudinal and horizontal planes using a multi-frequency 5–12 MHz linear transducer. Sonoanatomy of the extensor and flexor tarsal tendons, collateral and plantar ligaments, and synovial pouches was delineated and described. Systematic echography of the tarsal region allowed accurate localization and thorough exploration of various soft tissues of clinical interest in the donkey tarsus. Sonograms provided in this study should serve as a reference database for tarsal ultrasonography in clinical circumstances.

Classification performance of sEMG and kinematic parameters for distinguishing between non-lame and induced lameness conditions in horses.

Despite its proven research applications, it remains unknown whether surface electromyography (sEMG) can be used clinically to discriminate non-lame from lame conditions in horses. This study compared the classification performance of sEMG absolute value (sEMGabs) and asymmetry (sEMGasym) parameters, alongside validated kinematic upper-body asymmetry parameters, for distinguishing non-lame from induced fore- (iFL) and hindlimb (iHL) lameness. Bilateral sEMG and 3D-kinematic data were collected from clinically non-lame horses (n = 8) during in-hand trot. iFL and iHL (2-3/5 AAEP) were induced on separate days using a modified horseshoe, with baseline data initially collected each day. sEMG signals were DC-offset removed, high-pass filtered (40 Hz), and full-wave rectified. Normalized, average rectified value (ARV) was calculated for each muscle and stride (sEMGabs), with the difference between right and left-side ARV representing sEMGasym. Asymmetry parameters (MinDiff, MaxDiff, Hip Hike) were calculated from poll, withers, and pelvis vertical displacement. Receiver-operating-characteristic (ROC) and area under the curve (AUC) analysis determined the accuracy of each parameter for distinguishing baseline from iFL or iHL. Both sEMG parameters performed better for detecting iHL (0.97 ≥ AUC ≥ 0.48) compared to iFL (0.77 ≥ AUC ≥ 0.49). sEMGabs performed better (0.97 ≥ AUC ≥ 0.49) than sEMGasym (0.76 ≥ AUC ≥ 0.48) for detecting both iFL and iHL. Like previous studies, MinDiff Poll and Pelvis asymmetry parameters (MinDiff, MaxDiff, Hip Hike) demonstrated excellent discrimination for iFL and iHL, respectively (AUC > 0.95). Findings support future development of multivariate lameness-detection approaches that combine kinematics and sEMG. This may provide a more comprehensive approach to diagnosis, treatment, and monitoring of equine lameness, by measuring the underlying functional cause(s) at a neuromuscular level.

The Equiband Pro System improves gait symmetry in horses at the trot.

Abstract It has been shown that there is a relationship between spinal stability and gait symmetry in horses (1-3). Use of the Equiband Pro System, an elastic band system used for in-hand or ridden work with horses, has previously been shown to improve spinal stability and abdominal muscle engagement (4-6). More recently, it was demonstrated that a 4 week handwalking protocol with the System improves hindlimb symmetry in horses with a mild hind limb lameness (7). The purpose of this study was to determine whether the Equiband Pro System affects gait symmetry immediately in horses trotting on the lunge, using a repeated measures crossover study design. Six horses with varying degrees of gait asymmetries trotted on a lunge in both directions, with and without the abdominal and hindquarter bands of the Equiband Pro System. After evaluation of movement symmetry data, generated by an inertial measurement unit (the Equestic SaddleClip), landing forces were found to be significantly more symmetrical between the left and right diagonal limbs in horses while using the Equiband Pro System (p = 0.05). These results suggest that the Equiband Pro System can immediately alter motor patterns, leading to improved gait symmetry. More work is needed to understand the precise mechanism of this effect.

Traumatic lateral patellar luxation in a dog

AbstractA 2‐year‐old, female, entire, German shepherd dog presented for investigation of non‐weight‐bearing right hindlimb lameness following a suspected road traffic accident 1 day prior. Orthopaedic examination confirmed right lateral patellar luxation. Stifle radiographs revealed normal patella positioning with stifle joint effusion and periarticular soft tissue swelling. A surgical approach to the stifle was performed via a craniomedial parapatellar incision. A 10 cm proximodistal tear was present in the medial retinacular muscular fascia, vastus medialis, medial parapatellar fibrocartilage and joint capsule. The soft tissues were meticulously reconstructed using absorbable monofilament sutures. Surgical repair of the traumatised medial soft tissues allowed for complete resolution of the traumatic lateral patellar luxation. Moderate right hindlimb lameness persisted immediately postoperatively and improved to only a mild lameness before discharge (4 days postoperatively). The dog returned to normal exercise, with no lameness or postoperative complications reported at short‐ or long‐term follow‐up (42 and 424 days, respectively).

Advances in the Clinical Diagnostics to Equine Back Pain: A Review of Imaging and Functional Modalities.

Back pain is common in ridden horses. Back diseases in horses include Impinging Dorsal Spinous Processes, Ventral Spondylosis, Osteoarthritis of Articular Process, Intervertebral Discs Disease, Vertebral Fractures, Conformational Abnormalities, Desmopathy of the Supraspinous Ligament, Desmopathy of the Intraspinous Ligament, and Longissimus Muscle Strain. Back pain may also develop as a result of lameness (particularly hindlimb lameness). A poorly fitting saddle and an unbalanced rider are also considered important factors influencing the development of back pain in horses. The conventional diagnosis of equine back pain includes a clinical examination and diagnostic imaging examination using ultrasound, radiography, and thermography. Advanced diagnostic modalities of equine back pain involve the objectification of standard procedures through the use of algometers, a lameness locator, biometric mats, and the geometric morphometrics method. In addition to modern diagnostic methods, such as computed tomography and scintigraphy, advances in the diagnosis of equine back pain include the use of electromyography and functional electrical stimulation. The aim of this review article is to familiarize clinicians with the usefulness and capabilities of conventional diagnostic protocols and advanced diagnostic modalities. Although orthopedic examination and traditional diagnostic methods will remain the foundation of the diagnosis of back diseases, modern methods meet the growing expectations towards high-performance horses and allow for deeper diagnostics and objective monitoring of rehabilitation and training progress.

Sacral fracture stabilisation using dorsal transiliac locking plates: 12 cases (2017-2023).

To describe the clinical presentations, outcomes and complications associated with the use of dorsal transiliac locking plates to stabilise sacral fractures in dogs and cats. A single-centre retrospective analysis of all patients that presented with sacral fractures between February 2017 and February 2023 that were managed surgically using paired dorsal transiliac locking plates. Twelve animals met the criteria for inclusion in a retrospective clinical case series. An owner questionnaire was employed to assess long-term outcomes. Eleven dogs and one cat with a mean age of 3.1 years (range 0.6 to 8.8) were included. Eleven patients presented following a motor vehicle accident and most were either non-ambulatory (n=8) or displayed severe unilateral hindlimb lameness (n=4). Nine sacral fractures were considered Anderson type II and three Anderson type V. The plate fixation was augmented with additional surgical stabilisation in 11 cases. Eleven patients were ambulatory at discharge and all cases healed uneventfully without major surgical or postoperative complications. Long-term follow-up (>60 days) was available in 10 animals at a mean of 694 days (range 65 to 1805) and owner-assessed outcomes via questionnaire were reported as good to excellent in all cases. The application of transiliac locking plates provided sufficient stability to facilitate sacral fracture healing with minimal clinical complications. This method represents a robust and safe option to stabilise sacral fractures in dogs and cats, offering an alternative to iliosacral lag screw fixation.

Conservative management of a fracture of the greater trochanter of the femur in an adult horse

SummaryAn 8‐year‐old Warmblood cross mare was presented for further investigation of an acute‐onset lameness of the right hindlimb. Three weeks prior to presentation, the horse was found markedly lame at walk following a fall during exercise. The horse was initially managed with field rest, but the lameness persisted. A marked right hindlimb lameness at trot graded 5/10 was confirmed. Atrophy of the right gluteal musculature was evident, and palpation over the region of the right coxofemoral joint provoked a pain reaction. Nuclear scintigraphy revealed a diffuse area of increased radiopharmaceutical uptake in the right femoral head, neck and greater trochanter. Radiographs identified a complete, slightly displaced fracture of the base of the greater trochanter of the right femur. Ultrasound examination of the proximal femur demonstrated an irregularity of the caudolateral bone surface of the greater trochanter, extending along its attachment to the femur; this was consistent with the radiological findings. On re‐examination, after 9 months of stable rest, the horse was found to be sound when trotted in a straight line on the hard surface. Follow‐up two and a half years after the initial incident reported the horse to be nonlame and at its previous level of work.

Outcome of eight working dogs with fibrotic myopathy following extracorporeal shockwave and rehabilitation therapy: a case series.

Fibrotic myopathy of the gracilis, semitendinosus, and semimembranosus is described primarily in working German Shepherd dogs. The purpose of this case series is to describe the rehabilitation modalities and treatments utilized in working dogs with fibrotic myopathy and the time frame they were able to continue working. Medical records of patients with hindlimb lameness that were presented to the Schwarzman Animal Medical Center in New York City from 2012 to 2023 were retrospectively searched. Signalment, history, clinical evaluation, gait analysis, goniometry of stifles, and follow-up evaluation were compared among patients. Ten male working dogs met inclusion criteria. Extracorporeal Shockwave Therapy (ECSWT) was administered under sedation or general anesthesia. Rehabilitation therapy (RT), including massage, hamstring stretch, photobiomodulation, pulsed electromagnetic field therapy, warm compress, therapeutic ultrasound, underwater treadmill, and therapeutic exercises, were performed once every one to 3 weeks with varying protocols according to patient assessments. Follow-up phone calls and emails were conducted to determine long-term outcome. On average, dogs were able to work full-time for 32.1 months (range 6-82; SD 23.6) from the time of diagnosis. No activity limitation was reported by the owners/handlers. This report is the first to describe non-invasive medical treatments that may extend the working ability of dogs diagnosed with fibrotic myopathy. Further prospective randomized controlled studies are needed to demonstrate the efficacy of ECSWT and RT for treating fibrotic myopathy. The results of this retrospective study suggest that the combination of ECSWT and RT may allow working dogs with fibrotic myopathy to continue their working capacity for an extended period of time.

Rib fracture as a cause of hindlimb lameness in a horse

SummaryA 2‐year‐old racing Thoroughbred gelding in training was presented with moderate (6/10) right hindlimb lameness unresponsive to regional anaesthesia of the right hindlimb. Gamma scintigraphic examination revealed severe, focal, increased radio‐pharmaceutical uptake over the dorsal aspect of the right 18th rib, which had an abnormal contour. Ultrasonographic examination of this area confirmed the presence of a complete, displaced fracture of the proximal aspect of the right 18th rib. Local infiltration with anaesthetic solution around the right 18th right rib (10 mL cranial and 10 mL caudal to the fracture site) abolished the right hindlimb lameness. A diagnosis of rib fracture causing moderate ipsilateral hindlimb lameness was made. The horse returned to walking exercise after 12 weeks of rest and was reported to be sound on the same limb 12 months after presentation. Caudal rib fractures should be considered as a possible cause of hindlimb lameness. Local diagnostic anaesthesia around the fracture site can aid localisation of the origin of lameness.

Multiparametric Comparison of Two TTA-Based Surgical Techniques in Dogs with Cranial Cruciate Ligament Tears.

Tearing of the cranial cruciate ligament causes hindlimb lameness in dogs. Different surgical procedures have been proposed to treat this condition. In this study, two different TTA-based techniques and implants were compared. A total of 30 dogs were separated into two groups according to the technique and implant used (Porous TTA® or Model Xgen®). The aim of the study was to assess whether one of these techniques has better functional recovery of the joint, better bone consolidation after the osteotomy procedure and fewer osteoarthritic changes. We compared both groups up to 3 months after surgery. No significant differences were found in any of the assessed parameters. Thus, both procedures were found to be equally effective and safe.