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Vicky Payne has been scratching her head this month after what appears to be a simple muscle sprain diagnosis turns out to be something much more unusual – but, as ever, her perseverance pays off!
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I’ve been a vet for quite a long time now and have worked in veterinary practices for even longer but there are still things to learn!
This story starts out in familiar territory for a gundog vet. Fred, an English springer, had been working on a shoot and had gone a bit lame. His owner had given him some dog painkillers and expected him to be fine the next day, but he was much worse, not wanting to put the foot down. I examined Fred and found that some of the muscles and biceps tendon in his shoulder were really sore, but there was no sign of a fracture. It seemed likely he had slipped and pulled some muscles so we agreed that rest, painkillers, and some acupuncture and laser therapy should have him working again in no time.
Fred’s owners were diligent with his recovery, bringing him to the clinic for laser therapy, keeping his exercise to controlled lead walking, and doing physiotherapy at home. A few weeks later, Fred was back to his old self and ready to start building up his fitness.
Then something odd happened. Fred wasn’t exactly lame, but he was swinging his leg out in an unusual way when at a trot. A thorough examination showed that the muscles and tendon which had originally been so sore felt fine. It isn’t unusual for dogs to be a bit ‘lazy’ in their gait following an injury and not want to use weakened muscles, so I spoke to a physiotherapist friend, and we devised some new exercises for Fred. Fred did his exercises, but the leg got worse. Fred’s owner said that when Fred was lying on his back on the sofa the bad leg didn’t flop in like the other one, so Fred came to the clinic again for x-rays. The x-rays didn’t show any arthritis or bone chips but even under sedation Fred’s leg would not fully straighten. I searched in my textbooks and on the internet but couldn’t match Fred’s symptoms.
I sent Fred home with a promise to write up a description of his problem so that an animal physiotherapist could work with Fred and try to free up his tight shoulder. I wrote my notes and emailed them, then did one last search of his key symptoms. I was reading an article on shoulder problems that didn’t sound like Fred’s but then kept scrolling down, and read: ‘Infraspinatus Contracture… common in hunting dogs… initially there is acute lameness, pain, and swelling in the shoulder… dogs improve before developing a gait abnormality several weeks later… the limb is circumducted with each stride…’ I had found what was wrong with Fred!
I rang Fred’s owner and explained that following the injury it was likely that the infraspinatus muscle of the shoulder had fibrosed and become shorter, preventing Fred from extending his leg normally. The next question was ‘how do we prove this is what it is and what can we do about it.’ I expected diagnosis to require an MRI scan, but my husband Warwick (also a vet) phoned an orthopaedic surgeon friend who took one look at a video of Fred and said, “yep, that’s infraspinatus contracture”.
Treatment was equally simple, if a little dramatic. All we had to do has cut through the infraspinatus tendon! Warwick is an experienced surgeon, so he volunteered to do the operation. There was an audible ‘snap’ as the tendon was cut and Fred’s leg immediately dropped into a normal position. Fred was understandably sore for several days after his operation but then the change was remarkable, and the swinging leg had gone! Fred is now fully recovered and back enjoying his work in the beating line.
From cuts and eye injuries, to muscle strains and hypothermia, Vicky Payne runs through some common issues in working dogs and how to treat them
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