Page 67 - Canine Lameness

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For example, dogs with significant elbow pathology (such as coronoid disease or incomplete ossi-
fication of the humeral condyle) may show no pain response during joint range of motion. This
may be explained by the fact that weight‐bearing causes a much different force than range of
motion (perhaps displacing a coronoid fragment or causing micromotion in the condyle). Therefore,
joint compressions (i.e. manual compression of the joint performed by pushing the distal bone
forming the joint against the stabilized proximal bone) may be an examination method that can
mimic these forces and be utilized in cases when lameness is difficult to localize with routine
palpation techniques.
In horses, flexion tests are used frequently to further isolate the source of a lameness by holding
a joint in flexion for 30–60 seconds and evaluating any worsening of lameness during motion
immediately after its release (Baxter and Stashak 2011). Many normal horses demonstrate a posi-
tive response to flexion tests, which makes interpretation challenging. However, flexion tests have
not been validated as a reliable indicator of musculoskeletal pathology in dogs. Nevertheless, when
performing this test on dogs, a difference between the affected and unaffected side can be helpful
in further narrowing the differential list (i.e. if a difference in response between contralateral limbs
is identified, this suggests that the source of lameness is localizing to the joint and associated soft
tissue structures stretched). In general, dogs will display two possible positive responses to flexion
testing: Some dogs show varying degrees of discomfort when the sustained joint flexion is per-
formed (i.e. in some dogs, it may not be feasible to hold the joint in flexion for 30 seconds), whereas
others show a substantial difference in lameness degree after flexion is released. Again, since this
test has not been validated in dogs, it must be performed in exactly the same manner for both limbs
and even if a difference between sides is identified, the results need to be interpreted with
caution.

References

Baxter, G.M. and Stashak, T.S. (2011). Examination for lameness. In: Adams and Stashak’s Lameness in
Horses (ed. G.M. Baxter), 109–206. Hoboken: Wiley‐Blackwell.
Canapp, S.O., Canapp, D.A., Carr, B.J. et al. (2016). Supraspinatus tendinopathy in 327 dogs: a
retrospective study. Veterinary Evidence 1 (3) https://doi.org/10.18849/ve.v1i3.32.
Milgram, J., Slonim, E., Kass, P.H., and Shahar, R. (2004). A radiographic study of joint angles in
standing dogs. Veterinary and Comparative Orthopaedics and Traumatology 17 (2): 82–90.
Sargan, D.R. (2004). Idid: inherited diseases in dogs: web‐based information for canine inherited
disease genetics. Mammalian Genome 15 (6): 503–506.
Unsworth, A., Dowson, D., and Wright, V. (1971). “Cracking joints”. A bioengineering study of
cavitation in the metacarpophalangeal joint. Annals of the Rheumatic Diseases 30 (4): 348–358.
von Pfeil, D.J.F., Lee, J., Thompson, S., and Hinchcliff, K., 2015. Musher and Veterinary Handbook, 3.
Raleigh, NC: International Sled Dog Veterinary Medical Association/Lulu Press.