Many dog owners at one time or another have witnessed their pet favoring a paw or a leg after playing outdoors or even following a long nap. Our hearts immediately go out to our four-legged friends as they limp their way to their food dish or their dog bed, and we wonder what happened.
While limping is an all-too-common condition for dogs and cats, the causes are widespread, says Dr. Jerica Lugo, VMD, of Doylestown Veterinary Hospital. Reasons for lameness can range from basic and fleeting soreness to more complicated, and even severe conditions.
Her colleague, Dr. David MacDonald, DVM, CVA, CVSMT, agrees.
“If an animal is limping, there’s a reason why,” he says. “And the answer is not always the same.”
Clearly, some structural interference has impacted how the dog can bear weight and how they’re able to move, Dr. MacDonald notes.
“But does the limping start when they first get up in the morning, and then after they walk around for a little bit they feel better? That’s a very common sign we associate with arthritis. If a dog is limping more after a physically taxing activity – like a long walk or hike – and comes back feeling sore, that’s a bit of a different thing. That can be more than just aches and pains with arthritis and bones and joints. And if they’re limping, limping, limping all day long, and nothing changes? There may be something physically wrong with the leg.”
INJURY
“One of the most common causes of limping or lameness is damage to the paws or nails,” Dr. Lugo says. Whether a broken nail or a lacerated paw irritated by the dry air and salty pavements of winter, paw pad injuries are a significant contributor to a limping dog. Luckily, these reasons are often readily identified, and easily treated. With time and perhaps some OTC treatment, paws will ultimately heal.
Of course, fractures may also be a culprit, Dr. Lugo adds – though one that she and her fellow veterinarians fortunately see less frequently. X-rays are key in determining if bones have been damaged in any way so that proper treatment can be administered.
JOINT ISSUES
Moving up the leg from the paws, more intricate issues may develop. Arthritis or injury to the ligaments, connective tissue, or tendons surrounding the joints can also impact dogs of all ages.
CCL Tears
“With the back legs, one of the big things we look at is the cruciate ligaments,” Dr. Lugo says. “Most people have heard of ACL injuries – which are commonly seen in athletes. In canine patients, we call ACL tears CCL tears, or cranial cruciate ligament tears.”
These injuries, she notes, are not exclusive to athletic dogs. It’s often middle-aged dogs who suffer from CCL tears.
“What happens is that ligament weakens as our pets age. And it could be something as simple as your dog is out playing in the yard, and they come back in and they’re not putting any weight on their foot.”
Bicep Tendonitis
Front legs are more commonly impacted by a condition called bicep tendonitis, says Dr. Lugo.
“The biceps tendon is in the shoulder area. Overwork injuries – meaning our dogs are using front legs a lot, they’re running a lot, maybe they are athletic – can sometimes strain or stress that biceps tendon, and you might see lameness for that reason.”
Malformation and Dysplasia
“Other common reasons for limping include conditions dogs are born with that worsen as they get older,” Dr. Lugo says.
Malformation of the joints, also called dysplasia, refers to situations in which the bones don’t fit together correctly.
With hip dysplasia, a dog’s leg bone doesn’t fit in the socket properly. “So, the bone grinds against the socket or pops a bit out.”
Most of us are familiar with the term “hip dysplasia,” Dr. Lugo says – but what many may not realize is that the condition can also affect the elbows and is frequently seen in younger, more active dogs.
KNEECAP CONCERNS
As a puppy, Dr. Lugo’s own dog required surgery for a luxating patella – a condition commonly seen in small breed dogs, but occasionally impacting larger breeds and cats, as well. Here, the kneecap does not sit comfortably in the groove of the leg bone.
Small breeds frequently have shallow grooves in their leg bones, or the connective tendon may be a bit loose, causing their kneecaps to shift inward when they take a step.
“I’ll often have pet owners tell me that their dog will be running, then stop, hold up their leg, give a couple kicks backward, and then keep running as if nothing happened,” Dr. Lugo says. “We see this a lot with the kneecap popping. Sometimes it pops inward when a dog is running. They pick their foot up because it hurts. Then, when they kick their foot out a little bit, it pushes the kneecap back into place.”
Surgery is highly effective in correcting this condition, though not always required, or recommended.
“Thankfully, my puppy had surgery and has been running on that knee for 11 years since without a problem in the world,” Dr. Lugo says.
CANCER
According to Dr. Lugo, there are, of course, more insidious reasons for lameness, including bone cancer.
“Cancer is definitely something we see in patients, and why we will often tell people, ‘If your pet is lame – especially if they’re not putting weight on the leg = don’t wait to get them examined.’ The faster we can diagnose what’s wrong, the sooner we can get the pet help.”
DIAGNOSING THE LIMP
Diagnosing lameness in a dog or cat can occasionally be accomplished with a simple physical exam.
“If we can feel the crunching and grinding in the joint, that tells us there’s likely inflammation and arthritis,” says Dr. Lugo, adding that with CCL tears, trained veterinarians can typically feel the instability in the joint.
Diagnostic imaging like X-rays is also invaluable in ruling out bone cancer, while also helping to pinpoint hip and elbow dysplasia, arthritis, and – as mentioned – fractures.
“If we can’t pinpoint exactly what’s going on, we can refer a patient to an orthopedic specialist who can determine what’s wrong and how best to treat it. Sometimes, that’s surgical. But sometimes it’s not. Physical therapy can also be used to help provide relief.”
POTENTIAL TREATMENTS
Treatment for the most severe cause of limping – cancer – depends largely on timing.
“If we find it soon enough, and if the patient would be tolerant, we can sometimes amputate and give that dog some quality of life,” Dr. Lugo says.
There are also various cancer vaccines specific to canine osteosarcoma in development and undergoing clinical trials, Dr. Lugo says.
As far as arthritis and other forms of pain like cruciate tears and hip dysplasia are concerned, there are several avenues available to pet owners and their dogs and cats to provide relief.
“I often hear pet owners say, ‘Oh, my pet’s getting old, so they’re slowing down.’ But most of the time, arthritis doesn’t have to be, ‘My dog’s just old and that’s how they’re going to walk forever.’ We can do things to help with arthritis-related discomfort.”
Doylestown Veterinary Hospital, in particular, offers an integrative practice leveraging both holistic medicine and more western solutions, says Dr. Lugo. Its specialists regularly combine treatments such as acupuncture and chiropractic care, along with pain medications.
“Sometimes one therapy alone is all that a pet needs. And then, sometimes one therapy works for a while and then stops, and maybe we have to add or switch to something else.”
For her part, Dr. Lugo specializes in Stem Cell Injections and Platelet Rich Plasma (PRP) methodologies, two forms of generation that have proven wildly successful in relieving arthritis caused by hip and elbow dysplasia and previous surgeries for cruciate tears.
“I’ve done stem cell treatments for all of those conditions and have seen a huge improvement in those dogs,” Dr. Lugo says.
HOLISTIC APPROACHES
“The name of the game for all of this is that there is some pain element our pets are experiencing,” Dr. MacDonald says. “You may be able to feel it and touch it and see why it’s uncomfortable. Or maybe it’s more of a sensation that the animal feels, but as a doctor, you can’t point to the area where they’re sore. You just have to make them feel better by taking away the pain.”
Acupuncture allows veterinarians to do just that, says Dr. MacDonald, a certified veterinary acupuncturist.
“Even if I don’t know specifically that it’s the knee or the hip, or some kind of ligament or joint, acupuncture always helps by decreasing pain in their body… It reduces pain and inflammation while helping to treat an area that has been compromised or injured by utilizing the body’s ability to initiate a healing process and direct blood supply to the affected area.”
Dr. MacDonald, who also specializes in chiropractic care, says that acupuncture provides relief by treating the entire animal, not just the localized area of pain.
“If a dog is limping on one leg, you don’t put all of the needles in that leg,” he continues. Instead, command points throughout the body provide a route for a second layer of treatment that delivers a universal healing effect.
“There is a general change in their whole physiology that decreases inflammation. We have points that are specifically designed to relieve discomfort in a dog’s bones, ligaments, or tendons. In some cases, acupuncture can even help to change a pet’s emotional or mental state of awareness.”
Similarly, the chiropractic work that Dr. MacDonald routinely provides also addresses how inflammation may interfere with nerve functions.
“This is often accentuated in an animal where all four legs must be used in synchrony so that everything works like a well-oiled machine. If something is throwing that four-legged balancing act off – whether lower back pain or a pinched nerve – then that may be where the limping is coming from.”
In cases like these, inflammation can often be eased by simply adjusting the animal’s spine. Chiropractic care and acupuncture work are often paired together for optimal relief, Dr. MacDonald says.
“Just because we’re coming at things from two different perspectives doesn’t mean that one is duplicating the other or negating what the other does. In fact, they work very well together. It’s a synergistic response.”
WHAT SHOULD I DO IF MY DOG IS LIMPING?
Both Dr. MacDonald and Dr. Lugo agree that there is no single “magic bullet” in treating limping or lameness in our pets.
“It’s always a combination of many things,” Dr. MacDonald says. “Acupuncture and chiropractic care are always available to us. We’ll always work through different options. We’ll talk about supplements, herbs, laser treatments, and other ways of helping. Most of the time, these are patients that need not just one or two – but several things happening all at the same time to get their body on board with getting to a better place. That’s part of the artistry of working with patients. Over time, you learn to walk that rhythm of what treatments are needed now and in the future. The best outcomes happen because we have a good relationship with the patient and the pet owner.”
And – perhaps the most important thing to remember – if you believe something is wrong with your pet, contact Doylestown Veterinary Hospital today.
“The sooner we get things diagnosed, the better chance we have at trying to treat those conditions however we can,” Dr. Lugo says.
