Agility dog with lumbar pain and luxating patellas

[Guest guest]

Hi all,

Hope your holidays were wonderful.

This is a follow up to a dog I posted before. 7 year old Bearded

Collie with a chronic, mild right rear lameness. Finally saw the dog

and found bilateral luxating patellas, painful on manipulation of

right patella only with atrophy of vastus medialis and tightness of

semimembranosus and gracillis. 20% reduction of weight bearing in

right hind compared to left hind on force plate.

However, he also has significant pain throughout his caudal lumbar

spine, and also sensitive near T-L and C-T junctions. He is coming

back for CT imaging of the LS junction (MRI not an option for these

clients-plus a new study in JAVMA from Utrecht showed CT=MR in LS

measurements but neither correlated well to surgical findings).

The neurologists think his back pain is real and that he should be

retired if the owner is concerned about his lameness and pain. My

question is why can't it be referred from chronic luxating patellas?

Yes, the dog is quite responsive to spinal palpation, but I've seen

other dogs and horses that will bite your hand/kick your head off with

referred back pain.

What have your experiences been? Have you seen acute decompensation

in competing agility dogs with super subtle LS disease? My

conservative plan is to strengthen both quads if CT is clear and bring

back to work slowly. If lameness persists or performance changes then

retire or do recreational agility.

Thanks and have a Happy New Year,

Marti Drum DVM, PhD

[Guest guest]

Hi Marti,

What grade patellar luxation does this pooch have?

Does he have neuro deficits or is it just pain?

I guess for me, I would link the two... perhaps refer for the patellas, treat the back pain with Ice, e-stim, massage, etc.

Good luck, would love to hear the outcome as I have several that are very similar!

Pam

-----Original Message-----From: VetRehab [mailto:VetRehab ]On Behalf Of mgshearinSent: Thursday, December 28, 2006 11:56 AMTo: VetRehab Subject: Agility dog with lumbar pain and luxating patellas

Hi all, Hope your holidays were wonderful. This is a follow up to a dog I posted before. 7 year old BeardedCollie with a chronic, mild right rear lameness. Finally saw the dogand found bilateral luxating patellas, painful on manipulation ofright patella only with atrophy of vastus medialis and tightness ofsemimembranosus and gracillis. 20% reduction of weight bearing inright hind compared to left hind on force plate.However, he also has significant pain throughout his caudal lumbarspine, and also sensitive near T-L and C-T junctions. He is comingback for CT imaging of the LS junction (MRI not an option for theseclients-plus a new study in JAVMA from Utrecht showed CT=MR in LSmeasurements but neither correlated well to surgical findings). The neurologists think his back pain is real and that he should beretired if the owner is concerned about his lameness and pain. Myquestion is why can't it be referred from chronic luxating patellas? Yes, the dog is quite responsive to spinal palpation, but I've seenother dogs and horses that will bite your hand/kick your head off withreferred back pain. What have your experiences been? Have you seen acute decompensationin competing agility dogs with super subtle LS disease? Myconservative plan is to strengthen both quads if CT is clear and bringback to work slowly. If lameness persists or performance changes thenretire or do recreational agility. Thanks and have a Happy New Year,Marti Drum DVM, PhD

[Guest guest]

Grade 1 luxating patellas, no neuro

deficits, hopefully referred back pain. My thoughts are the same

to attribute all problems to luxating patellas. If CT is clear, we'll

start rehab. The sticky point would be if he gets worse with rehab

then is it early LS disease or a surgical patella?

Marti Drum, DVM, PhD

Small Animal Physical Rehabilitation

Department of Small Animal Clinical Sciences

C247 Veterinary Teaching Hospital

Knoxville, TN 37996

" The most exciting phrase to hear in science,

the one that heralds the most discoveries,

is not 'Eureka!' (I found it!),

but 'That's funny...' "

-Isaac Asimov

[Guest guest]

Hi Marti, The question would be is he worse neurologically or worse in the pain department as therapy progresses! I am with you on this one, Hope the CT is good, let me know, I still just use MRI on my backs, so it will be interesting to see which you like better!

Pam

-----Original Message-----From: VetRehab [mailto:VetRehab ]On Behalf Of Martha G Drum/SACS/VET/UTIASent: Thursday, January 04, 2007 11:24 AMTo: VetRehab Subject: RE: Agility dog with lumbar pain and luxating patellas

Grade 1 luxating patellas, no neuro deficits, hopefully referred back pain. My thoughts are the same to attribute all problems to luxating patellas. If CT is clear, we'll start rehab. The sticky point would be if he gets worse with rehab then is it early LS disease or a surgical patella? Marti Drum, DVM, PhDSmall Animal Physical RehabilitationDepartment of Small Animal Clinical SciencesC247 Veterinary Teaching HospitalKnoxville, TN 37996"The most exciting phrase to hear in science,the one that heralds the most discoveries,is not 'Eureka!' (I found it!),but 'That's funny...'" -Isaac Asimov

[Guest guest]

Just saw this guy again today. No visible lameness, forceplate

normal, not painful on patellar palpation, stil residual pin over

lumbar spine. CT, EMG and NCV were all normal. Although MRI gives

peace of mind about some additional soft tissue structures, I feel

confident with CT in this case.

Sent home on rehab program. However, my question is how long does it

typically take to get these agility dogs back to competition?

Right now avoiding agility obstacles, but focusing on stretching the

back and quads/hamstrings after moist heat, and strengthening

exercises (cavalettis and sit to stand on an incline to start, add

dancing and begging exercises later). No access to UWTM for this

client. I was thinking if he's sound, slowly begin re-introducing

jumping and weave poles in 6 weeks with return to competition in 2-3

months.

Thanks, Marti

>

> Hi Marti, The question would be is he worse neurologically or worse

in the

> pain department as therapy progresses! I am with you on this one,

Hope the

> CT is good, let me know, I still just use MRI on my backs, so it will be

> interesting to see which you like better!

> Pam

>

> RE: Agility dog with lumbar pain and luxating

patellas

>

>

>

> Grade 1 luxating patellas, no neuro deficits, hopefully referred back

> pain. My thoughts are the same to attribute all problems to luxating

> patellas. If CT is clear, we'll start rehab. The sticky point

would be if

> he gets worse with rehab then is it early LS disease or a surgical

patella?

>

> Marti Drum, DVM, PhD

> Small Animal Physical Rehabilitation

> Department of Small Animal Clinical Sciences

> C247 Veterinary Teaching Hospital

> Knoxville, TN 37996

>

>

> " The most exciting phrase to hear in science,

> the one that heralds the most discoveries,

> is not 'Eureka!' (I found it!),

> but 'That's funny...' "

> -Isaac Asimov

>

[Guest guest]

How about some ankle weights? I use them often on my agilty cases and

they seem to really help get the most out of a home exercise program.

If you need " which kind " " how much weight " ext. let me know.

J Porter VT, LMT, CCRP

> >

> > Hi Marti, The question would be is he worse neurologically or

worse

> in the

> > pain department as therapy progresses! I am with you on this one,

> Hope the

> > CT is good, let me know, I still just use MRI on my backs, so it

will be

> > interesting to see which you like better!

> > Pam

> >

> > RE: Agility dog with lumbar pain and

luxating

> patellas

> >

> >

> >

> > Grade 1 luxating patellas, no neuro deficits, hopefully

referred back

> > pain. My thoughts are the same to attribute all problems to

luxating

> > patellas. If CT is clear, we'll start rehab. The sticky point

> would be if

> > he gets worse with rehab then is it early LS disease or a surgical

> patella?

> >

> > Marti Drum, DVM, PhD

> > Small Animal Physical Rehabilitation

> > Department of Small Animal Clinical Sciences

> > C247 Veterinary Teaching Hospital

> > Knoxville, TN 37996

> >

> >

> > " The most exciting phrase to hear in science,

> > the one that heralds the most discoveries,

> > is not 'Eureka!' (I found it!),

> > but 'That's funny...' "

> > -Isaac Asimov

> >

>