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Lamenesses: Diagnosis, Treatments and Prognosis

Can lameness evaluations in the dog and cat be simplified?

When a dog enters your practice with a non-traumatic lameness, figuring out the cause of the lameness can at times be daunting. Having a plan of how to approach a lame patient before you even enter the exam will help to get to the problem more quickly and reliably. In this workshop we will discuss how to diagnose the various non-traumatic lamenesses; what their treatment options are and the pet’s likely prognosis based on the treatment plan.

Situational Awareness

The truth is that there are a limited number of conditions that will cause a dog to become lame. Working on the principle that “common things are common” helps keep the list of rule-outs manageable and memorable. There will always be the odd case, the unusual lameness that is difficult to diagnose and whose treatment plan maybe elusive and prognosis unknown. However, those cases are the exception, not the rule.

$149

Get ready to Manage a Lame Patient:

All the information you need. Fully narrated surgical videos. In depth guide and more.
Pre-Lameness Evaluation Considerations:
  • • It is really important to get a good history so that you can get a feel for how this lameness is behaving and affecting the patient.

    • Watch the dog move, confirm the lameness and make sure that the other limbs are moving well (or not).

    • Have blood work done if planning on using NSAIDs especially for longterm and in the patient geriatric.

What the client needs to know:
  • • The pet’s prognosis is based on an accurate and often timely diagnosis.

    • The outcome is also dependent on selecting the best treatment option for the pet.  A less than ideal treatment plan may be the only option available to a client for a     variety of reasons but it is important to understand that the pet’s outcome will likely correspond with the selected treatment plan.

    •  Timely implementation of a treatment plan can make a difference to the longterm prognosis (so get your clients to act!)

    •  Many joint related issues will lead to osteoarthritis (OA) but OA can be a very manageable problem.

Key points for a successful cystotomy

Use stay sutures instead of tissue forceps to handle the bladder. This will minimize tissue trauma.
Once you have created your ventral midline cystotomy incision, enlarge it to facilitate removal of the stones
Before closing, evert the bladder and look for tiny stones within the mucosa and flush.
I like the 2 layer closure in the dog because it is fast, has few knots and the inversion helps to prevent adherence of the bladder to the midline abdominal incision. Cats tend to have a thick small bladder which is harder to invert so I close in 1 layer with a simple interrupted pattern.
Use a short lasting, preferably monofilament suture material for closing. Avoid PDS or other long lasting sutures as they can act as a nidus for stone formation as seen in the radiograph

Get ready to diagnose and manage a lame patient:

When dealing with a lameness in a dog that is of non-traumatic origin, keep these rule-outs in mind:

Young patient (<.5 yrs):

Adult Patient:

Geriatric patients:

Q & A

How long is the recovery from a cystotomy?

Most pets will recover quite quickly from this surgery, however, it is an abdominal surgery. The abdominal incision should be allowed to heal properly. This usually takes about 2 weeks.

What happens after a cystotomy?

The pet may have blood in its urine for a few days after surgery and he/she may feel the need to urinate frequently in the first 24-48 hours after surgery, even though the bladder is empty. Many will show no signs of having any urinary issues after the surgery. The appropriate diet will be recommended once the type of stone has been determined.

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