Page 158 - Veterinary Laser Therapy in Small Animal Practice

144 Veterinary Laser Therapy in Small Animal Practice

Case no. 19

A., canine, 7 years old, German Shepherd, MC, 38 kg
• Complaint: pain and hindlimb lameness.
• History: he was diagnosed with gracilis muscle contracture in the left hindlimb 5 months ago. A month ago
the right hindlimb seemed to start developing similar changes. He does not want to walk or play.
• Physical examination:
• Abnormal gait with shortened stride and elastic, rapid medial rotation of the paw, external rotation of the

calcaneus, and internal rotation of the stifle, typical of gracilis muscle myopathy (Fig. C19.1a, b).

• Left hindlimb: severe gracilis fibrosis. The semitendinosus and semimembranosus muscles were very

contracted and there was an abnormal fibrosis in the common calcaneal tendon. The extension of both

the hock and stifle were very limited.

• Right hindlimb: mild fibrosis of gracilis; contracture of the semitendinosus muscle was not as severe as in

the contralateral limb, and neither was the limitation in ROM of the stifle and hock.
• Diagnosis: fibrotic gracilis myopathy, progressing to

bilateral involvement.
• Treatment:
• Laser therapy:
2
• An area of 600 cm was covered in each
limb, from the calcaneus to the ischium.
• With a dose of 8 J/cm , a total of 4800 J per
2
limb was used in each session.
• A. received LT three times a week during the
first 2 weeks, then twice a week for 3 more

weeks, then once a week for 6 more
weeks.
• Others: treadmill exercises, therapeutic massage
and stretching techniques, dry needle.
• Outcome: after the second session, A. was eager to
play again. Also after the second session, the right
side contracture started to improve, with eventual

resolution. ROM of the left stifle improved after four
treatments. The left semitendinosus contracture
progressively improved and the calcaneal tendon Figure C19.1 (a, b) Typical gait of gracilis muscle myopathy.

fibrosis disappeared. The left gracilis fibrosis did not
disappear.
2
P (W) Tx time J/cm 2 Total J/Tx Spot (cm ) W/cm 2 Tx/week No. Tx
a
1600 s (26.7 min, 9600 (4800
6 13.3 min each 8 each limb) 5 1 3-2-1 20
limb)

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