Page 726 - Cote clinical veterinary advisor dogs and cats 4th

338.e2 Fibrotic Myopathy of Caudal Thigh Muscles

Video
Fibrotic Myopathy of Caudal Thigh Muscles Available Client Education
Sheet
VetBooks.ir

end of limb advancement. Best recognized
BASIC INFORMATION
at a trot. • Cross-fiber massage and therapeutic ultra-
sound have reportedly resulted in some
Definition ○ A firm, fibrotic band can be palpated improvement.
A disorder characterized by fibrosis of the running longitudinally in the caudal thigh • Injection of adipose-derived stem cells in
semitendinosus or gracilis muscle; sometimes musculature (see second Video). cases of ultrasonographically detected early
bilateral ○ Decreased range of motion in hip, stifle, muscle strains may be helpful. There is one
and hock, +/− pain report of successful return to function after
Synonyms stem cell therapy in 11 dogs with more
Fibrotic myopathy of dogs, gracilis or semi- Etiology and Pathophysiology advanced disease.
tendinosus myopathy/contracture The cause is unknown, but onset appears to be
associated with prior muscle trauma in many Chronic Treatment
Epidemiology dogs. Histopathology of excised tight muscle Most patients are nonpainful in the chronic
SPECIES, AGE, SEX bands shows fibrosis rather than evidence of phase and can live as otherwise normal, active
Adult dogs, male > female denervation atrophy. pets despite having a gait abnormality.
GENETICS, BREED PREDISPOSITION DIAGNOSIS Behavior/Exercise
Predominantly German shepherds but also • Normal activity can be allowed.
reported in Dobermans and rottweilers Diagnostic Overview • Working dogs do not usually return to full
Diagnosis should be suspected from the performance levels.
RISK FACTORS distinctive gait; palpation of the fibrotic band
Hindlimb conformation that puts additional and decreased range of motion confirm the PROGNOSIS & OUTCOME
strain on the caudal thigh muscles is a reported diagnosis. Palpation of the contralateral limb
risk factor. Because affected animals are often may highlight the difference between the • Poor for resolution of gait deficit
working dogs, jumping and other high- affected and unaffected limbs, but bear in mind • Good for quality of life in pet dogs
performance activities may be involved with that the condition is often bilateral.
the initiating injury. PEARLS & CONSIDERATIONS
Differential Diagnosis
Clinical Presentation Differential diagnosis includes all causes of Comments
DISEASE FORMS/SUBTYPES hindlimb lameness, but the characteristic gait The key to diagnosing the lameness is recogniz-
• Dogs may be seen early due to lameness abnormality is virtually pathognomonic for ing the gait and palpating the fibrous bands in
from high-grade muscle strains. fibrotic myopathy. the affected muscle(s).
• After fibrotic contracture has occurred,
presentation is due to the gait deficit Initial Database Technician Tips
characteristic of this condition. Orthopedic exam (p. 1143) The fibrotic band runs diagonally along the
inner aspect of the thigh from the ischium to
HISTORY, CHIEF COMPLAINT Advanced or Confirmatory Testing the medial aspect of the stifle and is not usually
• There may have been an acute onset of lame- Ultrasonography highlights fibrous cords in overtly painful.
ness weeks to months before development the semitendinosus or gracilis; in early cases,
of the characteristic gait deficit. hypoechogenic areas in the muscle may also SUGGESTED READINGS
• Many dogs have an insidious onset with no be evident; not required for diagnosis of the Gibson MA, et al: Semitendinosus myopathy and
history of acute lameness. contracture form of the disease treatment with adipose-derived stem cells in
working German shepherds. Can Vet J 58:241-
PHYSICAL EXAM FINDINGS TREATMENT 246, 2017.
• Early presentation: usually weight-bearing Steiss JE: Muscle disorders and rehabilitation in canine
hindlimb lameness; swelling often palpable Treatment Overview athletes. Vet Clin North Am Small Anim Pract
within the body of the caudal thigh muscles By the time the characteristic gait changes 32:267-285, 2002.
• Fibrotic contracture presentation have developed, treatment has been largely
○ Hindlimb lameness that appears to be unrewarding at returning dogs to normality. RELATED CLIENT EDUCATION
mechanical rather than associated with Surgical resection of the fibrotic band followed SHEET
pain by physical rehabilitation and stretching
○ Characteristic gait: distal hindlimb provides temporary return to a normal gait, How to Perform Range-of-Motion Exercises
adducted, metatarsals and stifle inwardly but fibrosis tends to return despite multiple AUTHOR: Andrew E. Sams, DVM, MS, DACVS
rotated in an elastic fashion during the different treatment protocols. EDITOR: Kathleen Linn, DVM, MS, DACVS
middle to late swing phase of the stride,
just before sudden placement of the paw Acute General Treatment
on the ground (see first Video). The most • Nonsteroidal antiinflammatory drugs and
easily noticed feature is often an abrupt analgesics can be used if the patient is
external rotation of the calcaneus at the uncomfortable (p. 218).

www.ExpertConsult.com