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Musculoskeletal System
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Musculoskeletal
Although dogs and cats walk on four legs, their anatomy is very similar to people. The musculoskeletal system allows your pet to move around in their environment. Abnormalities of this system are often associated with injury.
- Cranial cruciate ligament rupture and fractures represent the majority of musculoskeletal problems.
- Congenital defects commonly affect bone and/or cartilage development, such as elbow and hip dysplasias and patella luxation.
- Infectious diseases of the skeletal system include tick borne diseases such as: Borreliosis (Lyme’s disease), other Rickettsial infections, and systemic fungal infections (e.g.: Blastomycosis).
- Osteoarthritis develops in unstable joints over time.
- Metabolic and nutritional disorders, such as kidney failure, can weaken bones.
- Cancers commonly affecting the bone include: osteosarcoma, chondrosarcoma, fibrosarcoma, and metastatic disease (spread of cancer).
Musculoskeletal abnormalities are more common in dogs than cats. Surgical intervention may be needed in some cases of musculoskeletal disease. Recovery from musculoskeletal disease or injury often requires a combination of pain management, exercise restriction, rehabilitatitive care, weight management, and nutritional supplements.
Elbow
Elbow
Dogs bear 60% of their body weight in their front limbs, thus elbow health is essential. For normal elbow function, all of the bones (humerus, radius, and ulna) of the joint must align. Abnormal elbow joint development, termed dysplasia, is a common cause of lameness in young, large breed dogs. The incongruent joint disrupts the normal gliding that occurs with joint movement. Over time, this disruption causes arthritis to settle in to the joint. Dogs with elbow pain may exhibit signs as subtle as hesitation to use stairs or they may have more obvious signs such as not bearing weight on the limb. A healthy body weight is the best insurance to minimize joint inflammation in your pet’s later years. Anti-inflammatory medications, nutritional supplements, physical therapy, and/or surgery may be recommended by your veterinarian to keep your dog’s elbow joints strong and mobile.
Ununited Anconeal Process
Ununited anconeal process (UAP) describes an abnormal formation of the elbow joint. UAP tends to be a heritable disease of large and giant breed male dogs. Lameness due to UAP is typically seen by 6-12 months of age. Affected dogs limp on the affected limb(s) after activity; lameness may be intermittent. Physical examination reveals a limited range of motion and/or pain in the elbow joint. Definitive diagnosis requires x-rays of the elbow joints. If the dog appears lame on only one limb, the opposite limb should also be x-rayed as UAP may occur on both sides in a third of the cases. Affected dogs, diagnosed early before arthritis settles into the joint, may benefit from surgical removal of the malformed anconeal process to relieve acute pain. Surgery is unlikely to be of benefit in dogs that present after arthritis has settled into the joint. Regardless of whether surgery is done or not, dogs with UAP will eventually develop arthritis in the joint. To slow down the progression of arthritis, your pet should be maintained at an ideal body weight to limit pressure on the elbows. Nutritional supplements and anti-inflammatories can be beneficial in minimizing the inflammation in the joints. Your veterinarian may also recommend physical therapy to keep the elbow joint flexible and the supporting muscles strong.
Femur
Femur
The femur bone spans the distance between the hip and stifle (knee) joints. Large muscle groups attach to the femur to allow flexion and extension of the rear limb. The top of the femur forms the ball in the ball and socket hip joint, while the bottom of the femur articulates with the tibia in the knee joint. Problems associated with the femur occur from developmental abnormalities (e.g.: hip dysplasia), fractures, dislocation of the femur from the hip joint, bone infections (e.g.: Blastomycosis), and tumors (e.g.: osteosarcoma). Pets with mild femur pain may favor the affected leg, be slow to rise, and become exercise intolerant. Significant femur pain (e.g.: traumatic or pathologic fracture) appears as swelling and non-weight bearing lameness on the affected limb.
Fracture
Fractures in dogs and cats often result from trauma such as being hit by a car. Bones may also fracture due to disease (e.g.: infection, cancer). The most common bones to fracture from trauma are the pelvis and the long bones of the limbs: humerus, femur. Pets with fractures favor the limb and may not bear weight on it. Fractures are suspected when there is loss of weight bearing, swelling, bruising, and pain. Diagnosis of a fracture requires a physical examination and x-rays of the affected area. Due to limb shape and patient size/tolerance, most fractures in dogs and cats are repaired surgically, not with cast placement. Surgical repair of fractures involves the use of screws, pins, and/or plates to return the bone to it normal position, allow healing, and return to function. Complications of surgical repair are uncommon and often relate to a patient that is too active during the healing process. Post operative care requires rest to allow the bone to heal properly; excessive activity delays healing. Your veterinarian will schedule follow-up visits to take x-rays and monitor the progress of the healing process. Once the fracture has healed, your pet’s activity level can be gradually increased back to normal.
Hips
Hips
The pelvis is composed of 4 bones (ilium, ischium, pubis, and sacrum) that form a box to connect the spine to both of the hind limbs at the hip joints. The pelvic box surrounds and protects portions of the intestinal, urinary, and reproductive tracts. Common ailments of the pelvis include malformed joints (termed, dysplasia) and fractures from trauma. Dysplastic hips cause arthritis over time if not corrected. Due to the box-like nature of the pelvis, fractures tend to be multiple and concomitant injury to the internal organs may occur. Dogs with hip pain rise more slowly or limp; their endurance may wane. A healthy body weight is the best insurance to minimize joint inflammation in your pet’s later years. Anti-inflammatory medications, nutritional supplements, physical therapy, and/or surgery may be recommended by your veterinarian to keep your dog’s hip joints strong and mobile so s/he can keep chasing balls at the park.
Hip dysplasia (HD)
Hip dysplasia (HD) is a heritable growth abnormality of both hip joints that causes instability, abnormal joint function, and arthritis. HD occurs most frequently in large and giant breed dogs. Dogs with hip dysplasia may not show any signs of a problem, while others can be markedly lame: difficulty rising, limping, bunny hopping, and reluctance to jump or do stairs. Suspicion of hip dysplasia is based on breed, age, and symptoms. To confirm the diagnosis, radiographs must be taken to evaluate the hip joints for laxity. The appearance of the hips on radiographs does not always correlate with the clinical signs. That is, dogs with severe pain may have mild changes on radiographs and dogs with no pain may have marked changes on radiographs. Over time, dogs with hip dysplasia develop varying degrees of arthritis due to the instability in the joint. Treatment for hip dysplasia will depend on the age of your dog, the degree of arthritis that is present, body weight, and joint architecture. The goal of therapy is to restore the joint to normal function and eliminate pain. Some cases involve surgery, such as a triple pelvic osteotomy (TPO) and total hip replacement. Other cases may be best managed with medical interventions such as: weight loss, non-steroidal anti-inflammatory drugs (NSAID’s), nutritional supplements (e.g.: glucosamine and omega-3 fatty acids), and physical therapy (strengthening exercises). Dogs diagnosed with hip dysplasia should not be bred as this is a well-documented heritable condition.
Osteoarthritis (OA)
Osteoarthritis (OA) develops in joints as a result of an underlying condition such as trauma, injury, developmental abnormalities, such as hip and elbow dysplasia; infection (e.g.: Lyme’s disease); and obesity. Older patients with osteoarthritis may seem to be slowing down: slow to rise, low energy level, accidents in the house, stiff after exercise, and they may limp on affected limbs. Diagnosis of OA is based on history, physical examination findings, and x-rays. Some patients with more complicated OA may require more extensive testing to rule out other arthritic conditions (e.g.: Lyme disease, rheumatoid arthritis). One of the most important treatments for osteoarthritis is maintaining a healthy body weight. Excess body weight exacerbates the joint inflammation. Medical therapy of osteoarthritis requires a combination of therapies to address pain and decrease inflammation. Anti-inflammatory medications relieve acute painful episodes. Long term nutritional supplements, such as glucosamine products and omega-3 fatty acids, have been proven to decrease the amount of anti-inflammatory drugs needed to keep a patient with OA comfortable. Developing a physical therapy and weight loss program for patients with OA is essential to keep the joints mobile and supporting muscles strong.
Knee
Knee
Your dog loves to run and play…healthy joints help ensure that these fun activities can continue throughout your pet’s life. The stifle joint, also known as the knee, is a common site of injury in dogs. Stifle injuries, such as cranial cruciate ligament tears, often occur after play activity. Abnormal joint development, such as medial patella luxation, causes joint instability and leads to joint inflammation. Dogs with stifle pain may hold up the affected leg or partially bear weight on it. A healthy body weight is the best insurance to minimize joint inflammation in your pet’s later years. Anti-inflammatory medications, nutritional supplements, physical therapy, and/or surgery may be recommended to keep the stifle joints strong and mobile so your dog can keep chasing squirrels into the golden years.
Cranial Cruciate Rupture
Inside the knee, ligaments stabilize the joint during movement. Sudden twisting motions of the knee create excess stress on these ligaments, resulting in tears. In people, this is a common football injury (Anterior Cruciate Ligament, ACL, tear). Overweight patients and certain breeds (e.g.: Labrador Retrievers) are at increased risk of cruciate ligament injury. Pets with cruciate ligament injury have a sudden onset of lameness of the affected back leg. Initially, they may hold the leg up and not bear weight on it. Over time, they will begin to bear partial weight on the limb. Diagnosis of cruciate ligament injury is made based on history and physical examination. Detection of a “drawer sign” and confirmatory knee x-rays make the final diagnosis. For most dogs, the treatment of choice is surgical repair of the joint. Your veterinarian will discuss the multiple surgical options available to repair your pet’s injured knee and restore function. Recovery from the surgery requires a combination of physical therapy, nutritional supplements to minimize inflammation (e.g.: glucosamine, omega-3 fatty acids), and a weight loss program.
Medial Patella Luxation
Medial patella luxation is a congenital (born with) defect affecting the knee joint of, most commonly, small breed dogs. The knee cap (patella) normally glides within a groove in the femur (large bone above the knee). When this groove is not deep enough, the patella slides in and out of the groove and causes instability of the knee. Medial refers to the direction the knee cap slides out of the groove, i.e.: toward the middle; Patella is the knee cap; and Luxation is the medical term describing a bone coming out of the joint space. The joint instability caused by the luxation leads to other soft tissue injuries in the knee (e.g.: cruciate ligament and meniscal tears). MPL is diagnosed on physical examination. Your veterinarian will take x-rays of your dog’s knee to evaluate the joint more closely. Treatment for MPL varies depending on the degree of affliction. Mildly affected dogs can be treated conservatively with weight management and nutritional supplements to promote joint health. More severely affected patients greatly benefit from surgery to correct the anatomical defect. Surgical correction deepens the groove in the femur, where the patella rests, to prevent luxation and restore joint stability.
Shoulder
Shoulder
Dogs bear 60% of their body weight in their front limbs; thus, shoulder health is essential. For normal function, all of the bones (humerus and scapula) of the shoulder joint must align properly. The shoulder connects the front limbs to the trunk and provides support for the front half of the body. Disruption of the normal gliding of the shoulder joint results in pain. Developmental abnormalities, such as osteochondritis dissecans, cause inflammation due to abnormal joint formation. Without intervention, arthritis progresses in the joint. Shoulder pain may not be obvious in stoic dogs; other dogs may limp on the affected leg. A healthy body weight is the best insurance to minimize joint inflammation in your dog’s shoulders. Anti-inflammatory medications, nutritional supplements, physical therapy and/or surgery may be recommended by your veterinarian to keep your dog’s shoulder joints strong and mobile.
Osteochondritis Dissecans (OCD)
Osteochondritis dissecans (OCD) is a developmental abnormality caused by abnormal cartilage and bone development in affected joints. Commons sites of this heritable condition include the shoulder, elbow, knee, and hock (ankle). The cause of this condition is not precisely understood, however, genetics and nutrition appear to play key roles. Accelerated growth rates in large and giant breeds predispose dogs to the development of this disease. Dogs with OCD commonly present with problems around 4 to 8 months of age; some dogs may not show symptoms until they reach middle age. Diagnosis of OCD requires a physical examination and conclusive radiographs of the affected joint(s). Because OCD tends to be a bilateral (occurring on both sides) disease, both right and left affected joints should be x-rayed. Treatment ranges from conservative therapy (e.g.: rest, weight management, anti-inflammatories) to surgical intervention in more severely affected patients or for patients that do not respond to conservative therapy.
Skull
Skull
The skull, containing numerous fused bones, gives shape to your dog’s head, facilitates jaw movement, and envelops the fragile brain to offer protection from trauma. Skull injuries commonly occur from head trauma resulting in fractures, brain injury, and bleeding.
Periodontal Disease
The foul odor you smell coming from your dog’s mouth is caused by an infection around the teeth. The most common cause of the infection in your dog’s mouth is periodontal disease, which affects over 75% of dogs over 2 years of age. The inflammation begins when bacteria set up house in the gums surrounding your pet’s teeth. Without tooth brushing, these bacteria flourish and, in combination with food particles, cause calculus deposition on the teeth. The vicious cycle begins: bacteria grow, creating inflammation, calculus deposits on the teeth, more bacteria grow, while the inflammation and calculus deposition continues. Left untreated, this inflammation progresses to periodontal disease. Periodontal disease describes an irreversible loss of the support tissues of the teeth. Destruction of the support tissues surrounding the teeth causes pain, deeper infections, and tooth loss. Unresolved infections caused by periodontal disease can spread beyond the oral cavity to include distant organs, such as the kidneys, liver, and heart. The goal of periodontal therapy is to restore oral health by cleaning the teeth before irreversible damage occurs. Dogs need their teeth cleaned regularly just as people do. Home dental care and regular teeth cleanings help maintain oral health to ensure a healthy, pain-free pet.
Vertebrae
Vertebrae
As the skull protects the brain, the bony spine protects the spinal cord. The spinal cord passes through multiple vertebrae to provide a neurologic highway that connects the brain to the rest of the body. Muscles intimately attach to the spine and allow movement and activity. Disorders of the spinal column may involve the bony structures of the spinal column (e.g.: arthritis), the muscles that attach to it (e.g.: trauma), or the nerves that pass through (e.g.: intervertebral disc disease or a “slipped disc”). Symptoms of spinal injury include: pain along the spine, weakness, inability to walk or stand, and restlessness. Spinal injury requires immediate veterinary attention.
Intervertebral Disc Disease
The spinal cord is protected by bony vertebrae. To allow shock absorption and flexion of the spine, the vertebrae are separated by soft cushions (intervertebral discs). These cushions are similar to jelly donuts: they have a firm exterior and a soft middle. Due to age or genetics, the outer portion degenerates and the soft center is pushed out (ruptured) without warning when the spine moves. When the disc ruptures, the center is expelled with high velocity and force, bruising the spinal cord that lies above it. The spinal cord swells from the impact and becomes compressed by the surrounding bone. Pressure on the spinal cord impairs nerve conduction along the spinal column. Symptoms of intervertebral disc disease range from acute pain to paralysis. The area of the body affected depends on the location of the disc rupture. Diagnosis of IVDD requires physical examination to localize the lesion followed by imaging studies with a myelogram (radiographs with contrast material) or MRI. Treatment depends on the severity of the signs. Mild cases benefit from strict rest and pain management. Patients with acute paralysis require emergency surgery to restore normal nerve conduction and prevent permanent nerve damage.
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