1 year 9 month,
by Matthew Scott BSc (Hons) MNAVP
Presented to the vet with a week long history of hopping on right pelvic limb every other stride and reluctance to jump into car. Upon examination, reduced hip extension (right>left) was present and a kyphotic lumbar spinal posture. X-ray revealed narrowed L6-L7 disc space/spondylosis, hips within normal limits. He was started on gabapentin due to some previous gastrointestinal issues with NSAIDs. At this time was on 2x 10 minute walks a day but active around the house.
Mildly offloading right pelvic limb but willing to have the left lifted. Mild carpal valgus and straight pelvic limb conformation. No obvious lameness when moving, reduced active range of motion of the hips, and reluctant to move at a slow walk (owner walked on anti-pull harness). Hopping occurs when transitioning from trot to canter.
When asked to sit he sat with tarsus externally rotated (right>left). Myofascial trigger points present bilaterally in medial gluteal and longissimus around thoracolumbar spine with fasciculation upon palpation. Pain response to palpation of iliopsoas bilaterally (right>left). Increased muscle tone through shoulders, thoracolumbar junction, and biceps brachii. Reduced passive hip extension (right>left) with empty end feels, reduced lateral mobility of the thoracolumbar spine to the left. Reduced left biceps stretch.
Initial treatments consisted of PEMF over the back and iliopsoas, as well as massage and stretching of the iliopsoas. Home plan included change of harness to a “Y” shape, slow walking training, reward better sitting posture, and massage and stretching of the pelvic limbs. Over following weeks and months, frequency of the hopping decreased, with occasional flare ups. Home plan had started to include active hip stretches (thoracic limbs on a step), tail pull stretches, 3 leg standing, and massage and passive stretching of the left biceps brachii muscle. As passive hip extension improved, walking over cavaletti rails, baited stretches, and 2 leg diagonal standing were added to the home exercise plan, with less focus on passive stretching and massage. Able to move onto maintenance plan, with sessions every 8 weeks, and give the owner a maintenance home management and exercise plan to maintain strength, flexibility, and comfort through the hips and lumbar spine. This also included advice to reduce the risk of the condition deteriorating as the dog ages.