Text Box: Text Box: The following guidance is most likely familiar reading for most veterinary surgeons, however it may be useful to have it convenient for reference when considering referral of orthopaedic cases. These notes are guidance on the likely common cases and obviously the less common causes have to be considered. Foreleg lameness in young large breed dogs (labs, Retievers, Rottweillers, GSD, giant breeds) The most common site will be at the elbow with conditions such as fragmented coronoid process (FCP) and osteochrondrosis of the medial humeral condyle, elbow dysplasia and ununited anconeal process (UAP). The most useful radiograph is a flexed lateral view in which the anconeus is visible. AP view is also useful. FCP and osteochrondrosis are very difficult to diagnosis on radiograph in the early stages and some cases have no visible radiographic changes. Hence in a young large dog with elbow pain which is persisting for more than a few weeks after rest consider arthrotomy or better is arthroscopy for a diagnosis +/- treatment. This is best done early ie 6-8 months old. A diagnosis of UAP can only be made after 20 weeks old as the anconeus does not normally fuse until this time. After 25 weeks the diagnosis is definite, common in GSD, often bilateral. Shoulder pain can often be mistaken for elbow pain, because when the shoulder is extended the elbow extends also and it can be very difficult to distinguish between shoulder and elbow pain particularly in large active young dog. Hence if nothing is seen radiographically at the shoulder consider the elbow. Shoulder OCD is seen in large and giant dogs and can be treated arthroscopically. Hindleg lameness in young large breed dogs (labs, Retrievers, Rottweillers, GSD, giant breeds) The most common cause will be hip dysplasia with cases presenting from 6-9 months usually. Standard VD view usually gives a diagnosis and a laxity in the hip (ortolania sign) may be felt. Without surgery many cases will resolve at around 12 months old due to fibrosis and stabilisation of the subluxation however DJD and significant remodelling of the femoral neck and acetabulum will occur leading to DJD related pain later which cannot be reversed. If instead, cases are selected early and have surgery such as TPO to rotate the acetabulum and increase femoral head coverage whilst the dog is still growing (ie 6-9 months old ideally) DJD development can be significantly reduced or avoided. If surgery is performed at over 1 year old the outcome is not as good. Once DJD is present the surgery is not recommended. Consider medial patellar luxation in some breeds with straight hind legs eg Japanese Akitas or in association with hip dyspasia. Osteochrondrosis of the femoral condyle and hock are less common causes is this group. Hindleg lameness in young small breed dogs (JRT, Yorkshire terriers, toy breeds) The most common cause is patellar luxation. Usually it is medial luxation and either the patella can be luxated medially easily (grade 1-3) or else it is permantly fixed (grade 4). The dog often skips with the leg held up every few steps or may frequently extend in out backwards to help relocate the patella. Patellar luxation is often found incidently at first vaccination although we tend only to operate on those who are clinically lame and all grade 4 cases. Most cases require tibial transposition. Failure to carry out a transposition and correct the quadriceps-patellar-tibial aligment is the most common cause of failure or recurrance. Perthes disease of the hip causes avascular necrosis and acute pain. The only treatment option is femoral head and neck excision. This is best performed with an oscilating saw and not a gigi wire as the neck must also be removed. Leaving a spur on the neck will result in continued pain and require repeat surgery to remove. Referral, Greenmount, Veterinary, vet, disc, disease, prolpase, Orthopaedic, orthopedic, clinic, fractures, joint, surgery, arthroscopy, endoscopy, spinal, northern, ireland, OCD, FCP, TPO, hip, dysplasia, dislocation, medial, patellar, luxation, broken, leg, wobbler, caudal cervical spondylopathy, lumbar, paralysis,ACL, anterior cruciate ligament rupture, dislocated, dislocation, plating, pinning, external fixator, triple pelvic osteotomy, portadown, co armagh northern ireland, www.vetortho.co.uk, www.vetclinic.co.uk, fracture repairText Box: Advice to referring Veterinary Surgeon on case selection Referral, Greenmount, Veterinary, vet, disc, disease, prolpase, Orthopaedic, orthopedic, clinic, fractures, joint, surgery, arthroscopy, endoscopy, spinal, northern, ireland, OCD, FCP, TPO, hip, dysplasia, dislocation, medial, patellar, luxation, broken, leg, wobbler, caudal cervical spondylopathy, lumbar, paralysis,ACL, anterior cruciate ligament rupture, dislocated, dislocation, plating, pinning, external fixator, triple pelvic osteotomy, portadown, co armagh northern ireland, www.vetortho.co.uk, www.vetclinic.co.uk, fracture repair

© GVC

Digital vision

24 hours following Bilateral elbow arthroscopy
Referral, Greenmount, Veterinary, vet, disc, disease, prolpase, Orthopaedic, orthopedic, clinic, fractures, joint, surgery, arthroscopy, endoscopy, spinal, northern, ireland, OCD, FCP, TPO, hip, dysplasia, dislocation, medial, patellar, luxation, broken, leg, wobbler, caudal cervical spondylopathy, lumbar, paralysis,ACL, anterior cruciate ligament rupture, dislocated, dislocation, plating, pinning, external fixator, triple pelvic osteotomy, portadown, co armagh northern ireland, www.vetortho.co.uk, www.vetclinic.co.uk, fracture repair

© GVC

Digital vision

This orthopaedic website domain www.vetortho.co.uk is owned by Ewing Walker of Greenmount Veterinary Clinic, and is produced to provide information for referring veterinary surgeons and their clients.

General veterinary information can be found on our practice website www.vetclinic.co.uk; www.equineclinic.co.uk; www.vetclinic.ie; www.vetortho.ie
This webpage was protected by HtmlProtector

Greenmount Veterinary Clinic 72 Gilford Road

Portadown Co Armagh Northern Ireland www.vetortho.co.uk www.vetclinic.co.uk