Forelimb osteoarthritis Unweighted forelimb when standing
‘ Head bob ’ walk 7 Head nods up when the lame forelimb hits the ground to unload the painful joint . It may be easier to see the head nodding down when the healthy limb hits the ground .
The ‘ duck feet ’ pose 5 With elbow dysplasia or osteoarthritis , dogs may stand or sit with their elbows adducted ( purple arrows ), carpi abducted and their front paws turned outward ( white arrows ).
Behavioural changes are often seen early on in patients in pain
Because postural and gait changes can be subtle in early osteoarthritis , the first changes that an owner notices may be behavioural . Pain has a negative effect on emotions and makes dogs less able to deal with the world around them . They often show more reluctance in performing their daily activities , such as hesitating before jumping into the car .
Pain-related changes generally involve the loss of normal , and gain of abnormal , behaviours like :
• Being less interactive or willing to play
• Avoidance of potentially painful situations
• Comfort-seeking from their owner
• Being less tolerant of their owner , children or other animals
• Resource-guarding
• Compulsive licking or chewing
The ‘ duck feet ’ pose often indicates elbow pathology
Pain has been reported to account for 20 – 82 % of referral behaviour consults 8 . It is always worth carrying out a full clinical and orthopaedic examination of a dog that is presented for behaviour problems .
Identifying dogs at risk of OA
Risk Factor 1 : Predisposing joint abnormalities or disease The following joint abnormalities increase the risk for secondary osteoarthritis in the affected joint :
• Hip or elbow dysplasia
• Osteochondritis dissecans ( OCD )
• Cranial cruciate ligament disease
• Patellar luxation
• Other abnormal joint conformation ( e . g . trauma-related , angular limb deformities )
Risk Factor 2 : Genetics / breed In general , large and giant breeds are at higher risk for most predisposing joint disease , except for medial patellar luxation with a higher risk for small breed dogs 1 , 9 . Crossbreeds of breeds at risk may also be affected 10 , 11 .
The table on the next page lists examples of breeds at high risk of common predisposing joint disease .
Risk Factor 3 : Body weight A high caloric intake during growth increases the risk of developmental orthopaedic disease in puppies with a genetic predisposition 17 , 18 . Overweight dogs are at higher risk of osteoarthritis development and progression to advanced osteoarthritis 17 .
Risk Factor 4 : Inappropriate exercise Exercising a dog can help prevent osteoarthritis development as it supports muscle and bone strength and joint function . However , exercise that is inappropriate for the age , breed or condition of the dog may increase the risk of osteoarthritis 18 – 20 .
Risk Factor 5 : Neutering status Neutering before closure of the growth plates , ( which occurs at around 6 , 12 and 18 months for small , large and giant breeds , respectively ) may increase the risk for joint diseases in some large and giant breeds 21 , 22 .
Risk Factor 6 : Musculoskeletal injury An injury can cause abnormal stress through the joint even after the injury appears to be healed , increasing the risk for osteoarthritis 23 .
20 Veterinary Nursing Journal