Front Matter

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Canine Sports Medicine and Rehabilitation, Second Edition. Edited by Chris Zink and Janet B. Van Dyke.
© 2018 John Wiley & Sons, Inc. Published 2018 by John Wiley & Sons, Inc.


294


Disorders of the Canine


Thoracic Limb: Diagnosis


and Treatment


Sherman O. Canapp, Jr, DVM, MS, DACVS, DACVSMR, CCRT,


David Dycus, DVM, MS, DACVS, CCRP, and Kristin Kirkby Shaw,


DVM, MS, PhD, DACVS, DACVSMR, CCRT


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Summary
While thoracic limb lameness in the dog is very common, it can be extremely chal-
lenging and frustrating at times to determine the exact cause. An injury as simple as a
digit sprain can throw off the entire musculoskeletal system, leading to secondary
compensatory issues further up the limb and also affecting the rest of the body. When
there are pathological changes in the shoulder and elbow at the same time, it can be
very confusing as to which is the primary cause of pain and lameness.
In canine sports medicine practice it is no longer acceptable to state that the patient
has a “shoulder condition” as its cause of lameness. We need to know not only the
exact structure in the shoulder that  is injured, but the specific area of that structure
involved (i.e., muscle; muscle–tendon interface; tendon; or tendon insertion) as the
treatments for each may vary. Advancements in diagnostic musculoskeletal ultrasound
allow these challenging soft tissue injuries to be assessed down to the fiber pattern,
and allow assessment of the patient’s response to treatment over time. Another exciting
development in canine sports medicine as it relates to thoracic limb conditions is the
growing evidence for the use of biological therapies.
This chapter focuses primarily on the most common shoulder conditions in sport-
ing, working, and companion dogs (supraspinatus tendinopathy, medial shoulder
syndrome, biceps tendinopathy, and osteochondrosis dissecans).
Elbow dysplasia is a common cause of thoracic limb lameness in dogs. Early diagnosis
and treatment is critical to slowing the progression of osteoarthritis. Unlike joint replace-
ment for the hip, there has yet to be an established successful total elbow replacement
technology for the dog, and the other advanced aggressive surgical techniques have
shown less than favorable results long term. Therefore, a multimodal approach including
arthroscopic treatments, rehabilitation therapy, medical management, weight manage-
ment, joint supplements, and intra‐articular injections including biological therapies
(platelet‐rich plasma and stem cell therapy) should be considered.
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