Case 27: Right elbow arthrotomy FCP

publication date: Sep 12, 2008

‘HOLLY’ Female (n), Golden Retriever, 31/07/04.

History;  Overweight, 32.2kg, aim for 27kg.

15/03/08; Owner reported Lame Right fore, and trouble jumping into car.

Start on Royal Canin Satiety Support food.

18/03/08;  GA x-ray. ? possible FCP right, possibly both elbows, reduced flexion in both carpi, mild Hip Dysplasia Left side, early Cauda Equina Disease start on Rimadyl (carprofen) 50mg BID. NB Demodex mange also diagnosed, supplies Advocate.

26/03/08;  Treadmill / assessment;

  Left fore = Carpus = reduced rom ++

                   Elbow = good rom

                   Shoulder = good rom

 Right fore = Carpus = good rom

                    Elbow = reduced rom ++

                    Shoulder = good rom but reduced muscles triceps area

 Left hind = Hip = good rom, but resents me moving, Stifle = good rom

 Right hind = Hip = good rom, Stifle = good rom

Treadmill = 2.7 k/h  7 minutes

                   3.1 k/h  3 minutes

Toeing out bilaterally.

Poor movement in hind end, appears ‘tucked under’.

31/03/08;  Treadmill;  2.8 k/h  2 minutes

                                   3.0 k/h  2 minutes

                                   3.2 k/h  10 minutes

No apparent lameness.

04/04/08;  Owner reported occasional lameness Left fore, pain focus lateral carpus, also pain focus anterior Right elbow, but commented ‘she is a different dog, much happier’.

  Treadmill ; 2. 8 k/h  2 minutes

                    3.0 k/h   3 minutes

                    3.2 k/h   3 minutes

                    3.4 k/h   3 minutes – lame right fore

07/04/08;  Consultation with Veterinary Surgeon, surgery decided.

11/04/08;  GA Arthrotomy Right elbow, FCP removed, Arthrotomy Left Carpus, bone fragment removed sent for histopathology. Robert Jones dressing applied to left fore.

Hospitalised overnight. Home on Rimadyl (carprofen) 50mg 1 BID.

13/04/08;  Histopath report = No sign of neoplasia/infection or significant inflammation – probable reactive tissue as a result of trauma.

15/04/08;  Dressing removed from left fore, drain seroma right elbow, walking well already. Inject 1^st Cartrphen.

15004/08;  pm, Managing to get to Left fore foot and chewing (not the wound, but the foot), supplied larger buster collar.

16/04/08;  K-Laser treatment, Left carpus, Right elbow, and over lick lesion on left foot, apply dressing to left fore foot, as now using edge of buster collar to rub.

21/04/08;  Inject 2^nd Cartrophen.

24/04/08;  Treadmill; Dressing removed

                                  2.0 k/h   2 minutes

                                  2.2 k/h   2 minutes

                                  2.4 k/h   2 minutes

                                  2.6 k/h   4 minutes

                                  3.0 k/h   1 minute

Walking really well, Left = no lameness, Right = very little lameness, slight toeing out. Redress foot.

26/04/08;  Dressing removed, lesion looking good ? Demodex lesion as dog is frantic to get to foot, prescribe Piriton and restart the Advocate (treatment lapsed)

                  Treadmill;  2.0 k/h  1 minute

                                    2.2 k/h  2 minutes

                                    2.6 k/h  3 minutes

                                    3.0 k/h  4 minutes

                                    3.2 k/h  2 minutes

Walking really well, Left fore = normal, no lameness / pain focus, Right = Walking well, fully weight bearing, only slightly toeing out. Left fore redressed.

28/04/08;  Dressing removed

                 Treadmill ; 2.2 k/h  1 minute

                                   2.4 k/h  1 minute

                                   2.6 k/h  2 minutes

                                   2.8 k/h  3 minutes

                                   3.2 k/h  9 minutes!!

NO lameness either leg! Very, very keen, tail wagging +++, need to build up muscle over right tricep area, but doing really well! Hind end movement improved, less ‘tucked’. Redress left fore.

Full rom in right elbow, equal / better than left!

Inject 3^rd Cartrofen.

01/05/08;  Dressing removed

                  Treadmill;  2.2 k/h   1 minute

                                    2.4 k/h   1 minute

                                    2.6 k/h   2 minutes

                                    2.8 k/h   2 minutes

                                    3.0 k/h   4 minutes

                                    3.2 k/h   4 minutes

No lameness, owner reported doing well.

Leave dressing off left fore foot.

03/05/08;  Chewed at foot +++ new baby crying all night and Holly got V stressed, oedema down leg.

                  Treadmill;  2.2 k/h   1 minute

                                    2.4 k/h   1 minute

                                    2.6 k/h   2 minutes

                                    2.8 k/h   3 minutes

                                    3.0 k/h   4 minutes

                                    3.2 k/h   4 minutes

Doing really well, no apparent lameness.

08/05/08;  Treadmill;  2.2k/h   1 minute

                                   2.6 k/h   2 minutes

                                   2.8 k/h   4 minutes

                                   3.2 k/h   5 minutes

Very happy, walking very well, No lameness, seroma resorbed.

Signed off treadmills as walking/trotting normally, and is doing so well. Owner to lead walk 15 minutes, off lead 10 minutes, the lead walk 15 minutes, twice daily.

Check in 2 weeks.