Groups 3 & 4

Key Issues:Module 7 Week 2

In relation to Bouncer (Video 1) and Flash (Video 3)

Anna George, Devin Dobbins, Sally Tan, Megan Perley, Ciara McKay, Garylee Stevenson, Yau Bo Yee

Question 1

What is lameness and what signs can you use to identify the affected limb?

Question 1• What is lameness?

– When the animal is unable to walk without difficulty; having an abnormal gait or posture

• What signs can you use to identify the affected limb?– (applies to both forelimb)

• Lame limb:– Non-weight bearing– More inclined to protract– Shorter strides

• Head position/nodding– Head drop on sound limb– Up on lame limb

• Unable to turn smoothly

Question 2

What techniques could you use in each case to try and localize the source of the

lameness?

General Techniques:• Clinical History• Physical Examination– Observation– Palpation– Manipulation

• Diagnostic Imaging

Species Specifics Techniques:• Equine:

– Gait Assessment• Straight-Line • Lunge (circle)

– Diagnostic Nerve Blocks• Perineural Blocks• Intrasynovial Blocks

– Diagnostic Scintigraphy (physiological imaging)

• Canine:– Manipulation Tests

• Cranial Drawer Test• Tibial Thrust

Question 2

Question 3

What criteria could you use to grade the severity of the lameness in each case?

Grading Equine Lameness (AAEP Scale)0. Lameness not perceptible under any circumstances1. Lameness is difficult to observe and is not consistently apparent, regardless of circumstances2. Lameness is difficult to observe at a walk or when trotting in a straight line but consistently apparent under certain circumstances3. Lameness is consistently observable at a trot under all circumstances4. Lameness is obvious at a walk5. Lameness produces minimal weightbearing in motion and/or at rest or a complete inability to move

Other scales include the Modified Scoring System, and scales on a 0-10 basis.

Grading Canine Lameness0. Stands and walks normally 1. Stands with abnormal posture and walks without lameness2. Mild lameness when walking3. Moderate lameness when walking 4. Severe lameness when walking5. Non-weightbearing

Objective assessment such as force plate or pressure mat analysis can be used in order to more accurately grade lameness.

Question 3

In both cases, numerical grading can be extremely subjective. Animals should be graded on the same scale by all professionals involved.

Question 4

What directional terminology would you use to accurately describe the location of

the abnormality?

Bouncer: Dysplasia of elbow joint on right fore limb. • Elbow joint found on caudal aspect

of proximal limb, distal to the shoulder joint.

Flash: SDFT lesion on left fore limb.

• SDFT located on caudal aspect of limb • It begins at the palmer aspect of the carpus and

crosses the palmer aspect of the proximal interphalangeal joint, inserting on the middle phalanx.

Question 4

Question 5

What diagnostic techniques could you use in each case to try and determine the

cause of the lameness? 

Bouncer (Canine):• Manual palpation of the limb• Radiology/Ultrasound• Arthrocentesis• CT / MRI• Blood sampling for biochemistries

Flash (Equine):• All of the above tests mentioned• Equine Nerve Block

Question 5

Question 6

 What would you need to know about how bones heal

in order to successfully manage a fracture? 

Type of Bone:• Lamellar Bone

• Compact bone (bone outer surface)

• Spongy bone (bone interior) • Woven Bone

• Temporary bone during healing • Random orientation of collagen

fibers• Often replaced by lamellar bone

Location of fracture relative to structure:• Diaphysis• Metaphysis (often growth plates

involved)• Epiphysis

Question 6

Question 6

Fracture Healing Times:

Healing Complications:• Inadequate blood supply• Leading to cartilage formation• Necrosis can occur

• Instability• Lots of movement and tension

will encourage development of a fibrous tissue callus

• Fibrous tissues won’t stabilize fractures

Question 6