Case 20: Reduced elbow movement
publication date: Aug 8, 2008
TUFTY, ESS, Male (entire) 01/05/00
Liphook, Hants.
20/10/07; Previous history; Owner reported normally walks Tufty for approx 1 ½ hours twice daily, recently, after approx 35-40 minutes, he holds up his left fore leg. Yesterday he started to ‘drop’ when weight bearing on left leg. Prescribed Rimadyl (carprofen) NSAID, ½ twice daily.
Examination; Right fore = full (very good) musculature over scapula/bicep/tricep areas.
Full range of movement in carpus/elbow/shoulder
Left fore = reduced (quite severely) muscle cover over scapula/bicep/tricep.
Very reduced range of movement in elbow & barely able to get to 30 degrees on flexion (right = 60 degrees), and only 150 degree on extension, (right = 170 degrees)
| DATE |
SESSION
NUMBER |
SPEED
(k/h) |
DURATION
(MINUTES) |
NOTES |
| 20/10/07 |
1 |
3.0
3.4
5.8 |
4
2
2 |
Obvious muscle wastage Left fore when viewed from above
pronounced toeing out & pointing elbow out
severely toeing out, pointing out of elbow, and dropping/lame
Quite a large knot in tricep muscle of left fore.
Advise owner to stick to 45 minutes twice daily on lead, and report any lameness, continue rimadyl.
|
| 22/10/07 |
2 |
3.2
3.4
3.2 |
3
5
3 |
Owner reports on above regime, no lameness noted
Toeing out, but not pointing elbow out, muscle started to bulk up, and not dropping on left fore. Tricep muscle knot reduced. |
| 25/10/07 |
3 |
3.2
3.4
3.6
3.8 |
2
2
3.5
2.5 |
Elbow is not turning out and appears to be toeing out less. Tufty is not dropping his shoulder when walking. Advise owner to continue with 45 minutes lead exercise twice daily. Reduce rimadyl to ¼ am, ½ pm. |
| 29/10/07 |
4 |
3.2
3.4
3.6
3.8 |
2.5
4
3.5
2 |
Owner reported that reduced rimadyl and no apparent problems.
Wagging tail +++ today & barking with excitement, he seems like a different dog!
Examination = much more movement in elbow, now 50 degrees on flexion, and 160 degrees on extension. Doing really well.
|
| 29/10/07 |
5 |
3.2
3.4
3.6
3.8 |
1.5
6
2
1.5 |
Owner now walking Tufty for 1 hour twice daily with 15 minutes off lead each time, no problems noted.
Barking & wagging tail throughout session! Still slightly toeing out, but not pointing elbow out. Muscle mass over shoulder/bicep/tricep has increased.
|
| 12/11/07 |
6 |
3.0
3.2
5.4
3.0 |
2
4
2
2 |
Now on ¼ rimadyl twice daily & 1 hour exercise twice daily, no problems.
5% incline
Running – no problems |
| 22/11/07 |
7 |
3.0
3.2
3.4
3.6
3.4 |
1.5
2
2
4.5
1 |
5% incline
Happy, tail wagging +++ very slight toeing out of left fore. |
| 28/11/07 |
8 |
3.0
3.2
3.4
3.6
3.2 |
1
2
5
2
1 |
10% incline |
| 6/12/07 |
9 |
3.6
3.4
3.2 |
5
3
2 |
10 % incline |
Signed off of treadmill sessions, Tufty has equal range of movement in both elbows, only a very slight (unnoticeable) amount of toeing out when running and no evidence of any pain response when elbow fully extended and flexed, and has fully regained the musculature lost over the shoulder region.
His owner is now exercising him normally with no problems, and I have advised to stop the rimadyl (keeping some in reserve) and report back in 1 week.
14/12/07; Owner reports that Tufty is back to his old regime and has not shown any signs of lameness.
