Clean Run - January 2016 - 16

COURTESY OF RICH KNECT
PHOTOGRAPHY

Returning to Agility Competition
After Treatment for

Medial Shoulder
Syndrome
By Sherman O. Canapp, Jr., DVM, MS, CCRT, DACVS-SA, DACVSMR
Photos courtesy of VOSM except where noted

Case Study
Lacey is a 10-year-old female spayed
German Shorthaired Pointer from Staten Island, New York who presented to
Veterinary Orthopedic & Sports Medicine Group (VOSM) in April of 2009 for
right thoracic limb lameness. At initial
presentation, Lacey had a shortened
stride in her right forelimb at a walk and
a trot. On physical examination, there
was a significantly decreased range
of motion in the right shoulder during extension. The abduction angle of
the right shoulder was increased when
compared to the left. Significant pain,
spasm, and discomfort were noted on
abduction of the right shoulder. Discomfort was noted on direct palpation
of both biceps tendons and when the
shoulders were flexed while the elbows
were extended, also indicating biceps
tendon pain. Initial GAIT4Dog® objective gait analysis revealed a decreased
pressure on the right thoracic limb as
compared to the left thoracic limb.
Based on the clinical signs and the
physical exam findings, shoulder arthroscopy was recommended and
performed in April of 2009. Arthroscopic exploration of the right shoulder
revealed significant pathology to all
compartments, and a medial shoulder
instability. Thermal capsulorrhaphy,
or radiofrequency (RF) treatment, was
performed to all areas of inflammation
and disruption. Significant tissue shrinkage and tightening were observed.
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Following treatment, Lacey was placed in a DogLeggs Shoulder Stabilization System
(commonly referred to as "hobbles") for three months and entered into a dedicated
rehabilitation therapy program. GAIT4Dog objective gait analysis revealed an even
pressure on the right forelimb as compared to the left six months post treatment.
Lacey made an excellent recovery and returned to agility eight months after her
treatment. In February of 2012 Lacey earned her AKC MACH, in February of 2013 she
achieved her MACH 2, and subsequently her MACH 3 in August of 2013. The German
Shorthaired Pointer Club of America, an AKC Parent Club, named Lacey the Agility Dog
of the Year in both 2013 and 2014. Lacey went on to earn her MACH 4 in February of
2014 and her MACH 5 in August of 2014. Lacey qualified as the #5 dog of her breed for
the AKC Agility Invitational in 2013, #1 for 2014, and #3 for 2015. Lacey was rated the #1
German Shorthaired Pointer at the AKC Invitational in 2014. Lacey earned her MACH
6 in February of 2015, and her owner anticipates that she will earn her MACH 7 by the
end of 2015. Lacey is currently over 6 years out and competing at her pre-injury level.

Medial Shoulder Syndrome in Agility Dogs
One of the most common causes of forelimb gait related issues and lameness in performance dogs that present to VOSM is medial shoulder syndrome (MSS). This condition may be considered somewhat similar to rotator cuff injuries in people including
ligament disruption, tendinopathy, and labral and capsular tears or disruption. Unlike
medial shoulder instability (MSI), these shoulders are not unstable but instead show evidence of sprain and strain injury leading to discomfort and dysfunction. Anatomically,
the shoulder joint is the least stable joint in the dog, relying on soft tissue structures for
stability and function. Subscapularis tendinopathy is the most common component of
medial shoulder syndrome, however, other components of the shoulder joint are also
commonly affected, including the craniomedial joint capsule, medial glenohumeral ligament (MGL), supraspinatus tendon, and less commonly the biceps tendon. Depending on the severity and chronicity of the instability, the cartilage may also be affected.
Signs of MSS may be as slight as performance-related problems such as missing
cues or refusing tight turns, or be as severe as a weight-bearing lameness. The exact
cause of MSS is unknown, but is thought to be related to chronic repetitive activity,
or overuse, rather than trauma. Sporting athletes that participate in activities such as
agility undergo extreme stresses on their muscles, ligaments, and tendons. Repetitive activities in agility dogs, such as jump-turn combinations and weave poles, place
the shoulder near its end range of abduction, stressing the soft tissues of the medial
shoulder complex. Additionally, events such as slipping on wet surfaces, mishaps on
the dogwalk, teeter, or A-frame may also contribute to the trauma inflicted on the
Clean Run | January 16

Table of Contents for the Digital Edition of Clean Run - January 2016