Case Study: Jacob

4 Year Old Labrador
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What clinical signs were first noticed? At 8 months old limping and difficulty exercising was noticed, behaving like a dog much older and appeared ‘depressed’.

Any behavioural changes noted during this time? Lethargic and not willing to exercise, withdrawal from activity and reluctant to engage with companion dog.

What was the length of time before veterinary intervention was sought: After a period of noticing behavioural changes, the owner took him for an initial veterinary consult concluded that primary NSAID trial was needed to assess response prior to diagnostics.

What diagnostic tests were used?: Primary NSAID trial and then radiographs. When severe incongruity was noted on radiograph, Jacob was referred for CT scans. Findings from the CT scans then informed the Veterinarians decision to operate.

What was the veterinary diagnosis given: Initially FCP (Fragmented Coronoid Process) & then incidentally Bilateral Elbow Osteoarthritis. A unilateral Proximal Abducting Ulnar Osteotomy was performed which is limb alignment corrective surgery designed to unload the medial aspect of the joint.

Were there any coexisting conditions which meant treatment had to be altered or changed to suit the individual animal? No, aside from being a young dog there was no co-existing conditions that changed the treatment protocol- NSAID use was of course considered important due to the young age- long term use was not first choice due to potential damage.

Which pharmaceutical/ NSAIDs were prescribed?: Onsior and Pardale following surgery.

Were any dietary alterations or supplements used?: Weight management was started from early diagnosis and Jacob has since kept to a optimum body condition score. Omega 3s were added to Jacob’s diet to aid joint mobility.

Was the dog’s daily exercise altered following diagnosis?: For an 8 month old dog he was already struggling with what would be considered a normal amount of exercise so he was only doing what was deemed comfortable for him on a day to day basis. The exercise he did do was optimised by changing his restraint to slow him down and use his hind end as opposed to overloading his forelimbs making his exercise more functional and constructive.

Any complimentary therapies used? E.g. hydrotherapy, physiotherapy, acupuncture etc? When surgical intervention gave little clinical improvement in comfort and little reduction in analgesia requirements after a significant period of no improvement the veterinary surgeon signed and approved a physiotherapist to begin working with him. During the time elapsed between surgery and presentation for physiotherapy, there was a distinct loss of ROM at the elbows with profound muscle atrophy bilaterally.

Any lifestyle or home adaptions made following diagnosis? Jacob was stopped from jumping in and out of the family car and then a ramp introduced to enable him to get in and out safely. This was the same with preventing jumping on and off furniture, this was followed up by putting in traction mats to prevent slipping around the key areas of the house being used by Jacob.

Have the clinical symptoms improved, worsened or stayed the same? Jacob’s comfort, functional ability and mobility has surpassed all expectations and continues to live a very comfortable life with the bony changes to his elbows being managed conservatively with minor use of analgesia when required. He has also regained lost muscle mass and range of motion.