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Infraspinatus Tendon Disorders 547

PEARLS & CONSIDERATIONS • Dogs presenting for veterinary care due to • Warm food to enhance smell when offering
food (nasal congestion) (p. 1199).
acute respiratory signs should be handled as • Wash hands frequently and change clothes
VetBooks.ir • Use proper isolation precautions (p. 987). • Dogs with unexplained cough and/or nasal Client Education Diseases and Disorders
Comments
if they have a contagious disease.
prior to handling non-exposed animals.
• Unless hospitalization required (e.g., oxygen
discharge should be kept isolated.
therapy, IV fluids and medications), treat as
outpatients. • Restrict access to high-density dog • If treating at home, teach owner how to take
populations.
○ Teach owners how to monitor hydration, temperature and monitor membrane color
temperature, respiratory rate/effort Technician Tips and breathing effort/respiratory rate.
○ Provide parameters for necessary return • Wear gloves and wear protective gowns/ • Keep separated from other pets, and vaccinate
to hospital clothing when handing dogs with CIRDC/ other dogs in the household.
• Progression to pneumonia may take 5-10 CIV. Wash hands, and remove gown before • Do not take to public areas (e.g., dog parks,
days. handling other dogs. groomer) for a month after illness.
• Coughing can continue for 10-30 days. • Strict isolation procedures: minimum 20-foot
(6-meter) separation from other animals; SUGGESTED READINGS
Prevention when cleaning, use virucidal disinfectants Crawford C, et al: Canine influenza. In Miller L, et
• Conditional use of vaccines; CIV bivalent/ with a minimum of 10 minutes contact time; al, editors: Infectious disease management in animal
univalent vaccines are inactivated vaccines dry surfaces well. shelters, Ames, IA, 2009, Wiley-Blackwell, 173-180.
given as initial series of two doses (2 weeks • Clear shower curtains hung in front of run/ AUTHOR: Wendy Wolfson, DVM
apart) with annual boosters. cage may reduce aerosol spread if separate EDITOR: Joseph Taboada, DVM, DACVIM
○ Vaccine may not prevent infection but isolation housing is unavailable.
can reduce disease severity and viral • Clean nasal and ocular discharge with a warm
shedding. moist disposable cloth.

Video
Infraspinatus Tendon Disorders Client Education Available
Sheet

BASIC INFORMATION PHYSICAL EXAM FINDINGS ultrasonography may reveal disruption of the
• In the acute stage, there may be muscle normal architecture of the infraspinatus muscle.
Definition swelling and pain on palpation caudal to
Disorders of the infraspinatus and teres minor the scapular spine. Differential Diagnosis
muscles in the shoulder area of dogs, including • Chronic infraspinatus contracture has several • Bicipital tenosynovitis
myopathy and fibrotic contracture distinguishing clinical signs. • Shoulder osteoarthritis
○ Characteristic stance with adduction of the • Shoulder instability/luxation
Synonyms shoulder and elbow and external rotation • Elbow dysplasia
• Infraspinatus contracture of the distal limb. • Osteosarcoma of the proximal humerus
• Fibrotic contracture of the infraspinatus ○ Atrophy of the infraspinatus muscle, with • Nerve sheath tumor (especially before onset
muscle supination of the distal limb (most evident of neurologic dysfunction)
• Infraspinatus myopathy when the dog is held up so the limb is
not bearing weight) Initial Database
Epidemiology ○ During the swing phase, the distal limb • Orthopedic (p. 1143) and neurologic (p.
SPECIES, AGE, SEX circumducts in a lateral arc, producing a 1136) evaluations
Most commonly seen in medium-sized adult characteristic paddling gait (see Video). • Radiography of the shoulder; lateral, cra-
dogs ○ Restriction to elbow flexion may disappear niocaudal, and cranioproximal-craniodistal
if the limb is held in normal alignment and views: findings usually normal
GENETICS, BREED PREDISPOSITION externally rotated during manipulation. • CBC, serum biochemistry panel, urinalysis
Infraspinatus contracture is classically seen in ○ Pain is usually not a feature of the chronic in older dogs
hunting or working dogs. stage.
Advanced or Confirmatory Testing
RISK FACTORS Etiology and Pathophysiology • Localization of pain involves applying
Overuse, trauma, or aging may play a role. • Infraspinatus contracture may be a result of digital pressure to the insertion of the
trauma causing rupture of the muscle, which supraspinatus tendon (craniomedial greater
Clinical Presentation is then replaced with fibrotic tissue, leading tubercle of humerus), the bicipital tendon
DISEASE FORMS/SUBTYPES to contracture over time. (intertubercular groove), and infraspinatus
• Acute, subtle to severe lameness • Compartment syndrome (muscle necrosis tendon of insertion (lateral and distal to
• Mechanical lameness resulting from fibrotic secondary to high pressure within a space greater tubercle).
contracture constrained by a fascia) is suspected in at • Ultrasonography of the infraspinatus
least some cases. muscle often reveals structural changes:
HISTORY, CHIEF COMPLAINT hypoechogenicity during the acute phase
Infraspinatus myopathy is associated with an DIAGNOSIS and hyperechogenicity with development
acute lameness that resolves initially to be of fibrosis.
replaced by a chronic gait abnormality (external Diagnostic Overview • The presence of mineralization alone is not
rotation of the manus in the swing phase) of Infraspinatus contracture in the chronic stage is diagnostic because it can be an incidental
gradual onset 4-8 weeks later. diagnosed on physical exam. In the acute phase, finding.
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