Clicking post TPLO HWR, Bone spur after FHO

[Guest guest]

Hello Group! I would appreciate any input on two recent referrals.

1) I have not seen this dog yet, but this is the information I have so

far. A 7 year old, 69 lb, NM mixed breed that had bilateral TPLOs in

2005, with meniscus releases. The dog became lame on the right rear a

few months ago, and was initially diagnosed with an iliopsoas strain.

The strain was then healed per the DVM, and since the dog still had

lameness, the DVM thought it could be a possible infection at the

stifle. The owner wanted the hardware removed from both TPLOs. Owner

states that there is audible clicking during active and PROM of the

right stifle, and that her dog has increased lameness and pain. The

DVM suspects meniscus instability. This DVM did the hardware

removmal, but not the initial surgery. The vet who performed the

TPLOs did meniscus releases.

Other than the meniscus being involved, could there be something else

intra-articularly causing the clicking? Have many of you seen this

following HWR? I will know more after I see the dog, and I will be

sure to assess the spine, pelvis, hips, etc as well.

2) Second question is regarding a 1 yr old, 9.5 lb intact male

Manchester Terrier who underwent an FHO 5 weeks ago due to Legg Calves

Perthes Disease. The DVM did not mention a bone spur that was left

after the surgery, but the owner told me that there is one, and that

the vet wants to try extensive rehab. I know in the CRI course we

learned that if there is painful passive hip extension, there could be

a bone spur, and to refer back to the DVM. The dog had discomfort

with all hip movements, but did not yelp until 3 legged standing was

done after walking over poles, cookies to the hip, manual treatment,

etc.

So, my question is, can the bone spur cause pain without extension,

but with increased weight through the " joint " ? Do all bone spurs

following FHOs need to be removed? I will be calling the vet tomorrow,

but would appreciate your thoughts and experience regarding these cases.

Wishing all of you a wonderful Holiday!

Kathie Touhey, PT

[Guest guest]

Hi Kathie

I occasionally get a patella click when the quads are very weak.

To rule this out I fix the patella between my fingers so it stays in the groove

as I flex and extend the knee. The click is no longer present if this is the

cause.

Tomlinson BVSc MS PhD DACVS

Rehabilitation Practitioner (CCRP Pending)

Twin Cities Animal Rehabilitation Clinic

12010 Riverwood Dr, Burnsville MN 55337

www.tcrehab.com

From:

VetRehab [mailto:VetRehab ] On Behalf Of touheykathleen

Sent: Sunday, December 16, 2007 7:21 PM

To: VetRehab

Subject: Clicking post TPLO HWR, Bone spur after FHO

Hello Group! I would appreciate any input on

two recent referrals.

1) I have not seen this dog yet, but this is the information I have so

far. A 7 year old, 69 lb, NM mixed breed that had bilateral TPLOs in

2005, with meniscus releases. The dog became lame on the right rear a

few months ago, and was initially diagnosed with an iliopsoas strain.

The strain was then healed per the DVM, and since the dog still had

lameness, the DVM thought it could be a possible infection at the

stifle. The owner wanted the hardware removed from both TPLOs. Owner

states that there is audible clicking during active and PROM of the

right stifle, and that her dog has increased lameness and pain. The

DVM suspects meniscus instability. This DVM did the hardware

removmal, but not the initial surgery. The vet who performed the

TPLOs did meniscus releases.

Other than the meniscus being involved, could there be something else

intra-articularly causing the clicking? Have many of you seen this

following HWR? I will know more after I see the dog, and I will be

sure to assess the spine, pelvis, hips, etc as well.

2) Second question is regarding a 1 yr old, 9.5 lb intact male

Manchester Terrier who underwent an FHO 5 weeks ago due to Legg Calves

Perthes Disease. The DVM did not mention a bone spur that was left

after the surgery, but the owner told me that there is one, and that

the vet wants to try extensive rehab. I know in the CRI course we

learned that if there is painful passive hip extension, there could be

a bone spur, and to refer back to the DVM. The dog had discomfort

with all hip movements, but did not yelp until 3 legged standing was

done after walking over poles, cookies to the hip, manual treatment,

etc.

So, my question is, can the bone spur cause pain without extension,

but with increased weight through the " joint " ? Do all bone spurs

following FHOs need to be removed? I will be calling the vet tomorrow,

but would appreciate your thoughts and experience regarding these cases.

Wishing all of you a wonderful Holiday!

Kathie Touhey, PT