Approaches & Outcomes for Nonspecific Lameness in Dogs

In the Literature

Ramos MT, Hartzell AM, Otto CM. Retrospective evaluation and review of approaches for nonspecific lameness in dogs presented to an emergency service (2013-2014): 134 cases. J Vet Emerg Crit Care (San Antonio). 2024;34(1):81-88. doi:10.1111/vec.13344

The Research …

Evaluation of lameness can be challenging. In some cases, lameness may be due to an obvious cause (eg, penetrating injury, fracture, joint luxation), and treatment recommendations are relatively straightforward.^1,2 In other cases, the cause of lameness may not be apparent despite thorough examination and radiography, and external concerns (eg, lack of available resources, pet owner financial limitations) may limit accurate diagnosis and treatment.

This retrospective study evaluated management of dogs with nonspecific lameness (n = 134) presented to an emergency clinic over a 12-month period. Patients with lameness due to fracture, cranial cruciate ligament tear, elbow dysplasia, or intervertebral disk disease were excluded. Diagnostics included orthopedic consultation (12.7%), neurologic consultation (3%), and radiography (21.8%). Treatment recommendations included general exercise restriction (45.5%), cage rest (35.8%), and pain medication (88.8%). Of the dogs prescribed pain medication, 58% received an NSAID, 34.5% received an NSAID and an opioid, 5% received gabapentin, and 1.7% received a corticosteroid.

Owners of patients still alive at the time of data collection (n = 128) were given an outcome survey; 32 owners responded. Lameness was reported resolved in 68.8% of cases. Improvement in lameness was not associated with patient sex, administration of an NSAID or opioid, cage rest or activity restriction, or physical rehabilitation. Dogs with an injury localized to >1 joint were significantly less likely to have resolution of lameness. Owners were more likely to report resolution of lameness when pain medication was administered, regardless of medication type.

… The Takeaways

Key pearls to put into practice:

• Evaluation of nonspecific lameness can be challenging for both novice and experienced clinicians. Systematic evaluation of each limb with a thorough and complete orthopedic and neurologic examination is important to help elucidate the source of pain. Familiarity with common soft tissue injuries and regional anatomy may increase confidence during evaluation of lameness.

• In cases without a definitive diagnosis, and in which critical causes (eg, fracture) have been ruled out, treatment with pain medication and activity restriction may be reasonable and resolve nonspecific lameness due to soft tissue injury. Of the 32 owners who responded to outcome surveys in this study, 68.8% reported resolution of lameness, with 59.4% reporting resolution within one month.

• A follow-up plan—which may include evaluation by an orthopedic specialist, physical rehabilitation specialist, or neurologist—should be recommended if lameness does not resolve in a reasonable amount of time (several days to ≥1 month depending on the severity and type of lameness).