536 Canine Sports Medicine and Rehabilitation
Client given instruction on PROM exercises, and
manual and cryo/thermal therapies. Client advised to
seek professional canine rehabilitation therapy includ-
ing laser and acupuncture if symptoms worsened
while traveling or upon arriving home.Second presentation: One year later, patient pre-
sented for re-evaluation of left shoulder and right
pelvic limb. Patient had been successfully working
larger flocks and bigger areas, and had competed in
several small, novice-level herding competitions.
Eight months previously, he had displayed a mild,
undiagnosed lameness of right pelvic limb that had
improved gradually over the next few months. No
problems had been reported until 3 weeks prior to
the second presentation. Patient disappeared fromClient’s view while moving sheep behind a barn,
reappearing with a significant lameness of right pel-
vic limb.Physical examination: Patient shows slight (1/5) gait
abnormality of right pelvic limb at trot with shortened
posterior stance phase and jerky, spastic lift into swing
phase. Patient crabs slightly to right with a loss of normal
reach to midline (right pelvic limb places directly under
hip and left pelvic limb moves toward midline). Patient
appears to have wider stance on thoracic limbs and to
use front end to pull himself forward. Left shoulder has
no loss of ROM in extension, but slight initial resistance
to flexion before moving into full flexion. No obvious
abnormalities in neutral postural position, visual gait
movement, or muscle development. No sensitivities or(A) (B)Figure 21.12 (A) Thermal image of the cranial chest demonstrating an asymmetrical pattern between the right
and left shoulders with a focus of heat in the area of the left supraspinatus tendon (arrow). (B) Left lateral view
showing the same pinpoint area of heat in the area of the distal supraspinatus (pink arrow). This heat signature
radiates caudally and dorsally along the proximal supraspinatus and proximal deltoideus. There is another strong
heat signature just caudal to the scapula (pink arrowhead) which is consistent with increased blood supply to the
teres major.Figure 21.13 Ultrasonographic exam of the supraspinatus muscle demonstrating mild hyperechogenicity in the
distal supraspinatus muscle (arrows) possibly displaying bruising or muscle trauma, with a repeatable muscle
hypoechoic core lesion distally (dashed circle).