Knee injuries in dogs – an interesting case study!
The Physio-Vet team has seen a few cases recently that mimic the signs of cruciate disease, but are actually caused by a different kind of knee injury.
Handsome Bailey is a 13-year-old male Labrador who visited us with a two-week history of lameness on his right hindlimb. This improved with rest, but worsened again when he fell down the stairs and there was no significant improvement with anti-inflammatory pain medication. On clinical presentation, Bailey was 3/10 lame and only taking 11% of his body weight through this limb as measured on our stance analyser. (Normal weight bearing for a back leg for a dog standing, would be 20%). His hip had good range of motion and did not seem painful during the examination. Significant pain response was noted when attempting forward drawer, which is a test that vets perform to look for signs of cruciate disease. However, no forward drawer was present, but the joint did seem slightly lax.
Diagnosing the fractured fabella
- CT scan showed that Bailey had a fractured lateral fabella, a small bone that sits near the knee joint and a tear in the gastrocnemius muscle, which is one of the main muscles in the calf. Watch David’s explainer video below.
- These cases present like cruciate injuries with pain on knee manipulation. However, the pain is from pressure on the fabella and movement of the torn gastrocnemius muscle.
- If X-ray findings are inconclusive, then referral for CT scan will enable differentiation between the conditions. Both conditions will benefit from referral for physiotherapy and other adjunctive therapies that we offer at Physio-Vet.
Treatment and follow-up
Bailey’s treatment plan included laser, pulsed electromagnetic therapy, underwater treadmill sessions and a home exercise programme. These treatments helped to increase the rate of healing of the torn gastrocnemius muscle.
He was initially prescribed non-steroidal anti-inflammatory medications and 10 minute lead exercise. The walking time was slowly increased up to 30 minutes by week 8. Bailey was then allowed 5 minutes off lead at the end of each walk. He is now managing 45 minute walks with off lead for the last 15 minutes. There is no pain on palpation of the lateral fabella and no lameness has been reported. Total recovery time 10 weeks. Without laser and a controlled exercise program recovery would have been much longer.