Zola presented on 11/4/08 with a 3-month history of intermittent front leg lameness. This lameness was first noted at Doggie Daycare and often became worse after strenuous exercise. No improvement was seen with glucosamine/chondroitin and/or buffered aspirin.
Presenting Problems
Intermittent left front leg lameness. Symptoms ranged from mild limp to 3 legged lame.
Condition / Diagnosis / Findings
Grade 4/5 lame on left front limb. Suspect biceps tendonitis with possible medial shoulder joint instability. Elicited pain upon palpation/stretch of left biceps tendon, tenderness upon extension/abduction of left shoulder joint, noted muscle atrophy of left supra and infraspinatus, pectoral muscle spasm.
Therapy Goals
Resume normal activity without restrictions. Most importantly to return to doggie day care.
Course of Therapy
Strict leash restriction, 2 weeks of Deramaxx, 8 wks of Dogglegg Hobble Stabilization Support for front limbs. In clinic therapy consisted of LASER, ultrasound, Hakomed whirlpool, underwater treadmill, massage, stretching, and therapeutic exercises (4 months totaling 22 in clinic therapy sessions). Home therapy included thermotherapy, stretching, massage, and therapeutic exercises.
Progress Evaluation
By January, there was no lameness apparent. Some mild muscle atrophy of the left supra and infraspinatus musculature was still present. Zola exhibited a slight hesitation upon full extension of her left shoulder. She had slightly worn toenails (P3/P4) on dorsal aspect of left front limb. By April, Zola had no tenderness in her left shoulder upon manipulation and was well on her way to a full recovery.
Progress to Date
As of 4/13/09, Zola is back to normal activities including Doggie Daycare. Her owner reports no signs of lameness and/or pain. She continues with exercises to strengthen her shoulder and core musculature.
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Name: Zola