752. SOP for hind lameness for an adult dog

Yesterday, Dec 1, 2011 at 7 pm, a lady in her late 20s came with a 13-year-old Jack Russell. "He is better today," she said to me as I was at the reception counter. I could see the unique make up of a certain airline cabin crew and enquired whether she was from the airline. I said: "Hair in a bun and clipped, as slim as can be, a gait with confidence and a type of facial make up that never fails to attract attention."

"It is called ghost make-up," she was surprised that I could guess correctly her profession. Well, I do to see these slim and pale-looking ladies with blue eye shadows at the Singapore Changi Airport going to work or coming home. I did not realise that they look like "ghosts" until she told me.

In the consultation room, I did the examination with Dr Vanessa. A right hind lameness was the presenting sign. The dog's right paw was barely touching the floor. "This lameness has been going on for many years," she said. Other vets had examined it. I asked Dr Vanessa to do first and then I demonstrated my approach.

The Standard Operating Procedure.
1. History of lameness & general examination including teeth.
2. Observation of gait on the floor
3. Put the dog on the examination table. Muzzle the dog.
4. Palpation of spinal column. No pain/painful? Where?
5. Manipulations - dog standing (extend both hind legs and compare the length*). Put dog on side (left, right, upside down).

This is where I have to demonstrate. Basically, it is palpation, extension, flexion, abduction and adduction. Check patellar luxation.

*Put thumb on hip joint, extend hip, and knee of both limb while the dog stands on front legs. Show the owner the unequal length of the hind limb (if there is subluxation).

6. X-rays (2 views) if necessary. Arthritis, Legg-Perthe Disease, Subluxation, luxation of the right hind compared to the left hind hip.

7. Complete blood test to check for liver or kidney disease is recommended as lameness in 13-year-old Jack Russells may be caused by other reasons.

8. Costs to be made known to the owner.