Common Canine Conditions
Cranial Cruciate Ligament (CCL) Tear: one of the most common injuries in dogs, especially in large or giant breeds, deconditioned, older or obese dogs. The CCL is an important ligament of the stifle (knee joint) that provides stability. A rupture can be caused by trauma (sudden twisting movement) or due to age and gradual degeneration of the joint; and will result in arthritis, pain, instability and lameness. Diagnosed with manual “cranial drawer” test. Intracapsular, extracapsular or TPLO (Tibial Plateau Leveling Osteotomy) surgical repairs are the treatments of choice and should not be delayed. Immediate post-surgery rehab will result in improved functional outcomes.
Hip Dysplasia (HD): a malformation of the hip (ball and socket) joint; frequently resulting in luxation (dislocation) of the hip, pain, muscle atrophy, degenerative osteoarthritis, instability and lameness. Hip Dysplasia is most common in large and giant breeds, with a genetic component. Depending on the severity, surgery and/or rehab are treatment options, with considerations for weight control, exercise, anti-inflammatory drugs and chondroprotective agents. Avoid jumping and extension of the hip!
Intervertebral Disc Disease (IVDD): a degeneration and bulging or herniation of the discs located between the spinal vertebrae; resulting in varying degrees of spinal cord or nerve compression and ischemia. Symptoms may include pain, weakness, difficulty moving or walking, loss of sensation, loss of proprioception, loss of balance, loss of bowel/bladder control or paralysis. IVDD of the cervical spine (neck) can affect all four limbs; in the thoraco-lumbar spine (lower back), it affects the rear limbs. Steroids should be given immediately to reduce spinal inflammation. Surgery may be necessary (ideally within 24-48 hours); and in less severe cases, rehab and medications may help alleviate symptoms.
Degenerative Myelopathy (DM): is a progressive disease similar to Multiple Sclerosis (MS) in humans; thought to possibly be due to immunodeficiency and/or genetics. Loss of proprioception (knuckling under of paws) is usually the first sign, with progressive rear limb weakness and muscle atrophy, stumbling and difficulty walking. It is not painful. Nerves are not able to properly conduct impulses to the muscles, so the muscles become weaker. Surgery is not an option; and rehab treatment focuses on strengthening, range of motion, positioning, nutrition, owner support and education, and carts and slings if needed.
Fibrocartilagenous Emboli (FCE): occurs when fibrocartilage from discs migrate in the blood vessels and cut off blood supply to the spinal cord. Onset is sudden and usually non-progressive after 24 hours, and the condition is non-painful. Symptoms include loss of proprioception, weakness, paralysis and loss of bladder and bowel control. Diagnosis is made by ruling out other neurological conditions such as IVDD or neoplasia (tumor). Approximately 50% of cases can improve; and if there will be improvement, it is usually noted within 7-10 days; although recovery can take weeks to months. There is no surgical remedy, but steroids may be used to decrease inflammation. Rehab is aimed at restoring normal function more quickly.
DiskoSpondylitis: is the infection and inflammation of spinal discs and vertebrae, usually by staph aureus, which results in neurological signs such as severe pain, progressive weakness and staggering gait. There is calcification or “bridging” of the ventral longitudinal ligament that provides stability to the spine. Surgery is rarely an option. Treatment may include antibiotics, pain management, maintaining range of motion, strength and mobility.
Osteoarthritis (OA): or degenerative joint disease is a progressive degradation of articular cartilage with resultant decreased lubrication and stability, bone-on-bone joint damage, pain and inflammation. It can be caused by trauma, old age, and conditions such as CCL ruptures, dysplasia or other joint injuries. Weight control is very important. Treatment is focused on maintaining joint range of motion and muscular strength, mild to moderate level exercises, joint preservation, pain reduction, proper medications, environmental accommodations, anti-inflammatory drugs and chondroprotective agents.
Muscle and Tendon Injuries: are strains and sprains to the soft tissues when fibers are stretched or overworked beyond their capacity; resulting in pain, inflammation, difficulty moving, lameness and scar tissue development. Treatment is aimed at reducing these symptoms as quickly as possible while allowing normal healing of the soft tissues. Bursitis (inflammation of the sac-like fluid-filled bursa) is also treated by reducing pain and inflammation, maintaining range of motion and restoring normal function and gait.
Neuropathies: include a variety of nerve conditions due to trauma, infection or disease. Symptoms range from weakness and loss of sensation to paralysis. Some conditions may be temporary and some may be permanent; but there is always some underlying nerve damage. It is very important to maintain normal range of motion and as much strength as possible, decrease any associated pain, prevent contractures, facilitate proprioception and normal weightbearing and provide appropriate nutrition and supplements. Splinting may be helpful in some cases.
Post-Surgical Conditions: include repairs of fractures, ligament ruptures, spinal surgery, femoral head osteotomy (FHO), hip replacement (HR), patellar luxation stabilization, amputations, Osteochondritis Dissecans (OCD), hip dysplasia (HD), Triple Pelvic Osteotomy (TPO) and CCL repairs (intra or extracapsular, TPLO). Early post-surgical rehab will result in a reduction in pain and inflammation, maintenance of range of motion, preservation or restoration of muscular strength, prevention of scar thickening or adherence to underlying tissues, more rapid return to function, normalization of weightbearing, proprioception, balance and gait pattern, improved outcomes, prevention of complications and slowed progression of degenerative changes.