Pet Parent Larry called me yesterday with a concern.
“Dr Johnny, Ellington has been limping for the past four days on his right hind leg. Can you come over?”
Limping dogs are rarely fun appointments; usually because it portends painful news for all involved.
When I arrived at the home, Ellington, a five month, un-neutered Shar Pei, greeted me with his usual hello: growls, barks and a reluctance to come near “thermometer man.”
After taking a history: a period of questions/answers, I started the physical examination. The temperature was normal, a good sign. (This often rules out an inflammatory concern, usually an infection.) The heart rate, pulse, and respiration were also within normal limits.
The “a ha” moment, however, was when I started to palpate the limbs. There were no swellings, further validation that we weren’t dealing with an infection. Sometimes, if a pet slips on wet pavement or ice, the pet will injury a joint, or “pull a muscle.” Usually that type of injury is painful and warm to the touch. Warmth means inflammatory cells are rushing to the area to clean up the damage. Too much damage means thousands of these cells. Too many cells means an infection and an infection of magnitude leads to an increase in temperature. For this reason, every pet parent should have a digital thermometer at home. Normal rectal temperature for a dog: 99.5 to 102.5 F.
However, after palpating all four limbs, I noticed the right hindlimb had a problem. I lifted the limb, cupped the knee, a.k.a. the stifle, and extended it. The knee cap (patella) slipped out of the trochlear groove, medially. This causes the “ouch,” the limp, and the reason for the call.
Unlike a simple sprain/strain, where resting the limb, limiting activity, and a ‘doggy’ Tylenol sometimes provides good-as-new results. Patellar luxation has four grades of dislocation with increasing severity. Often seen as a congenital, inherited condition in young dogs like Ellington. This, at a minimum, will require a consultation with a bone/joint specialist.
A college friend recently called to chide me on the outrageous prices her veterinarian charged when her “pup” presented with similar signs. “He wanted to perform x-rays, run bloodwork, etc. What a rip-off!” I didn’t have the heart to tell her there are dozens of causes for lameness. Since our pets can’t speak, we don’t know if it’s a foot or paw issue, tendon/ligament/bone concern, or a metabolic issue affecting the muscles. The only way to rule-out these causes is to perform a good physical examination, and offer validating tests for the pet parent to consider.
Is it cheap? No.
A consult with a board-certified orthopedist could run a few hundred dollars. During this visit, ask for options other than surgery. These options may not provide the permanent ‘fix’ like surgery, however, it will help stabilize the joint, and relieve pain as you ponder sneaking coins from your son’s college fund.
Ellington’s owner is motivated to learn if any other 5 month old pups have presented with this problem from her breeder. Spending close to a grand for this Chinese dog, known more for their skin problems than knee issues, she wants answers.
I suggested she look into pet insurance. Hey, that might be my next blog post!