Case 5: Tendonitus
TOBY, Labrador, Male (entire), 01/03/02
Haslemere, Surrey, GU27 1RQ
Weight= 36.4 kg
Neck = 55cm
Chest = 76cm
Waist = 74cm
Ant. Elbow - ant. Elbow Shoulder = 65cm
Tricep, Left = 27.5cm, Right = 28.5cm
Thigh = 44cm
Known Conditions ; Left fore; Elbow= probable early DJD; Shoulder = Tendonitis and calcification of insertion of biceps tendon at insertion to humeral head.Right fore; Previous history of tendonitis and probable early DJD.
Aim; This dog is, in general, in good condition although it would be beneficial for him to drop his weight to 35.0kg.
The tendonitis and calcification in the bicep tendon of the left fore leg is the main concern as there is already deviation of the elbow when standing and at rest. There is also muscle wastage on the bicep and tricep of that leg. Firstly, an intra-synovial injection of a cortico-steroid (depo-medrone) has been given surgically to reduce swelling in the tendon, and a short post-operative course (3 days) of Rimadyl (carprophen),a non-steroidal anti-inflammatory has been prescribed. Once post -operative healing has been allowed, approx. 7-10 days, a course of session will resume to build up the triceps and biceps to stabilise and strengthen the elbow and shoulder joints.
The first session (pre-operative) was carried out as a trial to assess level of lameness; 5 minutes at 3.2k/h
The program will aim to have Toby walking at 4.0 - 4.2k/h over 10 -15 minutes within 4 weeks.
23 Session assessment
| START | END | |
| WEIGHT | 36.4 kg | 35.4 kg |
| NECK | 55cm | 55cm |
| CHEST | 76cm | 80cm |
| WAIST | 74cm | 64.5cm |
| ANT. ELBOW - ANT. ELBOW, SHOULDER | 65cm | 63.5cm |
| TRICEP, LEFT TRICEP, RIGHT |
27.5cm 28.5cm |
29cm 29cm |
| THIGH | 44cm | 46cm |
The first session, pre-operative, was carried out to assess Toby’s fitness level, and to also see how much he was compromised by the calcification of the tendon. Toby showed marked lameness on the left fore limb and this was markedly increased after only a short 5 minute session.
The second session only 6 days post -operatively, having injected a cortico-steriod (depo-medrone) into the bicep tendon, showed already a marked improvement in movement and a reduction in lameness, even after 10 minutes on the treadmill.
Toby has continued to increase his speed and times on each occasion, and is starting to show a reduction in the lateral deviation of his left fore leg, and also an increase in the weight bearing ability.
| DATE | SESSION NUMBER |
SPEED (k/h) |
DURATION (MINUTES) |
NOTES |
| 18/07/05 | 1 | 3.2 | 5 | |
| 25/07/05 | 2 | 3.8 3.6 |
6.5 3.5 |
|
| 27/07/05 | 3 | 4.0 3.8 |
6 4 |
|
| 01/08/05 | 4 | 4.0 3.8 3.6 |
5 4 3 |
|
| 03/08/05 | 5 | 4.0 3.8 3.6 |
5 5 3 |
|
| 05/08/05 | 6 | 4.0 3.8 3.6 |
6 4 2 |
|
| 08/08/05 | 7 | 4.0 3.8 |
7 5 |
|
| 11/08/05 | 8 | 4.0 3.8 3.6 |
5 5 2 |
|
| 13/08/05 | 9 | 4.0 3.8 |
8.5 3.5 |
Onto Cosequin DS, 2 am, 1 pm. Now no knot in tricep muscle, but owner noticed Toby holds food up when sitting, slight lateral rotation of foot, but right fore does this also. |
| 15/08/05 | 10 | 4.0 3.8 3.6 |
8 2 2 |
|
| 31/08/05 | 11 | N/A | N/A | Attempt treadmill, but severely lame, been in kennels for 2 weeks, knot in triceps recurred, but also pain over elbow. 02/09/05, x-rays taken of shoulder and elbow, referred to Noel Fitzpatrick., who advised arthrotomy of elbow for FCP (fragmented coronoid process) 22/09/05 ; G.A. , medial arthrotomy of left elbow, FCP removal and joint scavenge, post-op rimadyl (carprophen) 50mg BID, 5 days. 29/09/05 ; Post-op check, rimadyl 50mg MID, 7 days |
| 05/10/05 | 12 | 2.4 2.6 |
6 3 |
No adduction or abduction of elbow when walking, still lateral foot deviation , but does this on right also! NO lameness, and very much happier and livelier dog! |
| 10/10/05 | 13 | 2.6 2.4 |
5 5 |
No lameness |
| 12/10/05 | 14 | 2.8 2.6 |
5 5 |
No lameness |
| 14/10/05 | 15 | 3.0 2.8 |
5 5 |
No lameness |
| 20/10/05 | 16 | 3.0 2.8 |
6 4 |
No lameness |
| 22/10/05 | 17 | 3.2 3.0 2.8 |
4 4 2 |
Brilliant, no lameness, some slight deficit of muscle mass around radius/ulna on right fore |
| 24/10/05 | 18 | 3.0 2.8 |
6 4 |
|
| 26/10/05 | 19 | 3.2 3.0 |
3 2 |
Doing very well, occasional lameness. |
| 28/10/05 | 20 | 3.2 3.0 |
2 2 |
|
| 31/10/05 | 21 | 3.4 3.2 |
3 2 |
Amazing , NO lameness! |
| 02/11/05 | 22 | 3.4 3.2 |
4 3 |
|
| 04/11/05 | 23 | 3.6 3.4 |
6 6 |
No lameness, and muscle mass has now evened up over the radius/ulna area.Regime advised to owner, and Toby to be checked up in 1 month, or before if there are any problems, but overall, Toby has made an amazing recovery from both conditions and the orthopaedic surgery performed. |