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Front Leg Pain in Dogs

When it comes to front leg pain in dogs, it’s important to note that the leg is made up of separate parts including the carpal and elbow which can have their own debilitating conditions. Dogs with a front leg disorder may have more trouble walking and standing compared to those with just a carpal or elbow disorder as the entire leg is affected.

Common Symptoms:

  • Lameness
  • Limping
  • Difficulty walking, standing or jumping
  • Reluctance to be touched in that area
  • Unable to walk or run normally
  • Loss of muscle mass around affected leg
  • Walking at a slower pace
  • Not placing paw on the floor
  • Joint swelling
  • Licking, chewing, or biting the affected area

Causes of Front Leg Pain

A tiny fragment of cartilage enters the circulatory system of the spinal cord and restricts blood flow to the spine, causing a fibrocartilaginous embolization (FCE). Incoordination and weakness/paralysis symptoms appear quickly and may worsen over the next six to twelve hours. The indications are stable to improving after the first 12 hours. It’s usually associated with middle-aged large and giant dogs and is often caused by mild trauma or vigorous exercise. It often affects the middle part of the spinal cord, affecting only the hind limbs, but it can occur in the neck affecting all four limbs. Signs of FCE in dogs include acute pain for a short period of time, and nervous system deficits in one side of the body (but can occasionally affect both sides). To diagnose FCE, a vet will look at the clinical signs, consider the dog’s medical history, as well as a neurologic exam, and spinal cord imaging.

Treatment:

  • No treatment available.

Hock dislocation or instability can be caused by the tearing of ligaments that hold the hock’s bones in place, a fracture at the bottom of the tibia bone, or fracture of the fibula. The hock joint is similar to the ankle joint in humans with bones and ligaments having specific roles for mobility and function. Hock instability or dislocation is usually a result of physical trauma. Clinical signs of hock injury are pain, swelling, heat at the site, as well as a sudden onset of lameness. Diagnosing a hock injury includes a physical examination where the vet tests the flexion and extension of the hock joint and twisting it from side to side to test the stability of surrounding ligaments. Radiographs can also be taken to evaluate a bone fracture. 

Treatment: 

  • Surgery to address the fracture or torn ligament. 

Hypertrophic osteodystrophy is an auto-inflammatory disease that affects the bones in dogs between 3-5 months of age. HOD typically affects fast-growing puppies that belong to large or giant breeds. These breeds can include the Weimaraner, Great Dane, Mastiff, Boxer, Bull Mastiff, Doberman Pinscher, Rottweiler, and the Saint Bernard breed. HOD decreases blood flow to the part of the bone that’s directly adjacent to the joint. This disrupts proper bone growth and leads to weaker bones in puppies. HOD can also permanently damage growth plates and affect more than one leg. Clinical signs vary depending on how severe with some puppies only experiencing a slight limp with pain. Puppies experiencing a more severe form of HOD can have a fever, discharge from the eyes or nose, increased respiratory sounds, bloody diarrhea, bumps on the skin (may have pus), an inflamed vulva/vagina, and lameness. These symptoms present themselves as episodes lasting several weeks with possible remission. HOD can be very painful and pose a risk for quality of life so monitoring is critical. Diagnosing is made through a physical examination to spot swollen soft tissue over leg bones, radiographs, and blood tests. 

Treatment:

Polyarthritis is the inflammation and swelling of joints making them painful and swollen that may cause dogs difficulty walking. Immune-mediated Polyarthritis refers to arthritis that’s a direct result of abnormal immune response by the body directed at the joints. This can come from either an auto-immune disorder or infection. Signs include overall joint pain, fever, loss of appetite, swelling of multiple joints, lameness. To diagnose this, a thorough physical examination and a variety of laboratory examinations, including blood and urine tests and urine culture, are common tests used to identify a possible origin of an internal infection.

Treatment:

  • Generally treated with immunosuppressive medications until the lowest dose is found that still manages the disease.

Juxta-articular fractures are fractures that occur near a joint surface and they may be intra- or extra-articular. Salter III and IV fractures, as well as humeral and femoral supracondylar fractures, are examples of intra-articular fractures. The bulk of juxta-articular fractures occur in dogs with immature skeletons. This type of fracture can cause immediate changes in joint anatomy, impacting joint cohesion, causing discomfort, and disrupting joint motion. Because of the short length of one of the bone segments, the possible small size of the bone, the relative softness of bone, and the involvement of articular surfaces close to the fracture site or involved in the fracture, these fractures are difficult to treat. Signs that a dog is suffering from a juxta-articular fracture include limb lameness and swelling around the affected area. Treatment goals include restoring joint flexibility and congruity, minimizing degenerative articular modifications, and maintaining joint efficiency.

Treatment:

  • Internal plating of the fracture via surgery.
  • External coaptation which is the use of bandages, casts and splints to stabilize the fracture.
  • Transarticular external stabilization is a procedure that involves positioning an external skeletal attachment mechanism above and below a joint and connecting it with rigid bars to minimize joint mobility.

Lumbosacral stenosis (also referred to as sacral stenosis) is a disease that directly affects the structures of the spinal cord in the lumbar and sacral regions of the spine. Lumbosacral stenosis is caused by the narrowing of the spinal canal which then imposes compression on the spinal nerve roots (the nerves that directly exit the spine). This compression can be caused by intervertebral disc herniation, congenital malformation, arthritis, or a spinal tumor. More commonly, this condition is caused by arthritis or an intervertebral disc herniation. Signs of lumbosacral stenosis include pain in the hind end, unable to rise or wag their tail, difficulty rising after sitting or lying down, gnawing on paws or tail, or urinary/fecal incontinence. These signs indicate inflammation of nerves and muscles to the aggravated spinal cord and the affected area. As the disease progresses, the disc located between the last lumbar vertebrae and sacrum may erupt, causing uncoordinated movement or paralysis of the rear legs. X-rays can indicate arthritic changes but diagnosing the condition consists of a myelogram (injection of contrast to highlight any pressure put on the spinal cord) or MRI and CT scans.

Treatment:

Lyme disease is not directly a joint-related disease but causes pain. Lyme disease is the most common disease transmitted from ticks although it only shows symptoms in 5-10% of infected dogs. The most notable signs of Lyme disease are recurrent lameness from inflammation of the joints, general discomfortness and a fever. Lameness from lyme disease usually only lasts about 3-4 days but often recurs in the same legs or other legs days or even weeks later. Only your veterinarian can diagnose lyme disease through blood tests, urinalysis, fecal examination, complete blood cell count, x-rays, and possibly fluid drawn from the joints.

Treatment:

Myotonia Congenita is a rare disease that affects the muscles by causing muscle fibers to contract continuously which causes dogs to experience abnormal muscle stiffness and difficulty getting up. The disease is painful and is a result of chloride channel malformations in dogs. Clinical signs to look out for include an enlarged tongue which makes it difficult to swallow, craniofacial structure anomalies, furrowing on several muscles when they are struck, muscle stiffness, and a gait that resembles a bunny hop. Symptoms usually present themselves when dogs are a few weeks old. Diagnosis is done through genetic testing, clinical signs, EMG, and muscle biopsies.

Treatment:

  • No treatment available.
  • Physical therapy may help alleviate pain and uncomfortableness. 
  • Procainamide may help alleviate symptoms.

Osteoarthritis, also known as Degenerative Joint Disease (DJD), affects both dogs and humans alike and is the most common form of arthritis affecting nearly a quarter of a million dogs worldwide at any given time. It is a progressive, chronic joint condition marked by the weakening of joint cartilage, thickening of the joint capsule, and the forming of new bone around the joint (osteophytosis), both of which contribute to pain and limb dysfunction. The majority of OA in dogs is caused by developmental orthopedic diseases including cranial cruciate ligament disease, hip dysplasia, elbow dysplasia, OCD, and patella (knee cap) dislocation. In a small percentage of dogs, OA develops for no apparent reason and is linked to genetics and age. Bodyweight, obesity, exercise, and diet are all factors that contribute to osteoarthritis. Symptoms of osteoarthritis itis in dogs are fairly noticeable and include stiffness, limping, difficulty standing, not wanting to run or jump, weakness, muscle atrophy irritability, weight gain, vocalizing when touched, and incontinence. Unfortunately, the damage caused by OA is irreversible but treatment plans help reduce pain and improve quality of life. 

Treatments: 

  • Weight loss for overweight dogs can help take pressure off affected joints.
  • Regular moderate exercise helps keep joints healthy.
  • Physical medicine including acupuncture, chiropractic, laser therapy, regenerative medicine, medicinal massage, and physical rehabilitation.

Osteochondrosis is a disorder that affects the development of cartilage and bones in both medium and large-sized dogs that grow quickly. The premature joint cartilage fractures and splits from the underlying bone in this state in which cysts will develop under the cartilage if fluid occupies the room. Cartilage fragments may come loose from the end of a bone and float about in the joint cavity which causes inflammation in the infected joint and may progress to arthritis and cartilage breakdown, restricting joint motion. Signs that a dog may be suffering osteochondrosis include lameness, fluid buildup within the joint, and joint stiffness. To determine the extent of the damage, a veterinarian might take an x-ray but endoscope surgery can also be done to further identify the damage. Another option is a CT scan.

Treatment:

  • Surgical removal of cartilage flaps or the free-floating fragments of cartilage.
  • Use nonsteroidal anti-inflammatory drugs and joint fluid modifiers.

Osteogenesis Imperfecta is also known as brittle bone disease. Osteogenesis Imperfecta is essentially the inability of the body to produce the collagen protein which provides elasticity to the bones. Because of this, affected dogs’ bones lack the ability to withstand impact and pressure causing them to easily break and fracture. Signs of Osteogenesis Imperfecta are reduced bone density, severe joint pain as well as bone and teeth fractures as affected dogs don’t have the Type 1 collagen needed. Other symptoms include difficulty walking, loose joints, stunted growth, weak tendons and muscles, and malformation of bones. They also present joint pain. There’s, unfortunately, no treatment for this condition but vets may prescribe pain medication to help. The occurrence of multiple bone breaks as well as x-rays can give a definitive diagnosis of osteogenesis imperfecta. Blood tests may also be run to see if the levels of vitamin D, phosphorus, calcium, and parathormone are abnormal. 

Treatment:

  • There is no true treatment that heals this disease.
  • Corrective orthopedic surgery may be done for mild cases.

Osteosarcoma is a bone tumor that is malignant and resembles human pediatric osteosarcoma. Limbs are the most often affected but it can still affect other bones like the jaw, hips, pelvis, ribcage, and skull. It's even possible for it to arise in non-bony tissue like mammary glands and muscles. It’s more often found in large and giant breed dogs such as Great Danes, Rottweilers, and Irish wolfhounds. This disease can be quite painful in the joints and lameness is often presented in affected dogs. Pain medication may be given to help with joints and lameness but may only work for about one to two weeks. Swelling of the bone at the tumor site can be observed at this point and is sometimes sore, swollen, and hot to the touch. Amputation is often the recommended treatment to prevent cancer from spreading but seeing an oncologist is recommended since it can still spread. 

Treatment:

  • Amputation of the affected limb to maintain control of the spread of cancer.
  • Chemotherapy.
  • Radiation therapy.
  • Pain Medication for temporary relief.

The peripheral nerves are located outside the brain and spinal cord and peripheral nerve sheath tumors are comprised of Schwann cells that are found in the cover (myelin) that surrounds and insulates the nerve. The tumors grow on the nerve but don’t spread to other parts of the body. The tumors are firm nodules that attach to the peripheral and central nerve tissue. Signs a dog may have a peripheral nerve sheath tumor include atrophy (muscle weakness), ataxia (lack of muscle control), trouble walking, limb weakness, swelling, overall pain or Horner’s Syndrome. But overall, the actual signs are dependent on the nerve affected. As the tumor grows, the affected area becomes progressively worse as the dog might start with weakness in a leg but may eventually be unable to use that leg. These tumors can even affect the face and head (as to why Horner’s Syndrome is a symptom). If it affects the head and face, they may have trouble chewing due to the facial muscles being affected or trouble blinking. If a vet suspects this, x-rays and lab tests are conducted but even if the tests are normal, it still may be suspected if the symptoms continue to worsen despite medication intervention. They often do a neurological examination as well to determine weakness. A final diagnosis will be made through biopsy of the tumor.

Treatment:

  • Surgical removal of the tumor which often involves amputation of the affected leg.
  • Radiation therapy.
  • Palliative therapy.

Rheumatoid arthritis in dogs is very similar to that in humans and the diagnosis criteria is very similar, just adapted for dogs. It’s an immune-related arthritis targeting the cartilage in the joints. Multiple joints are often affected at once and dog pain presents lameness from the pain. Symptoms may include recurrent UTIs, lameness, joint swelling, fever limb atrophy, joint pain, tonsillitis, and inability to walk. The causes of Rheumatoid arthritis aren’t exact but since it’s immune-related, some possible causes could be a genetic predisposition, digestive disease, or cancer. Because Rheumatoid arthritis is not common for dogs and the symptoms can vary greatly, it can be difficult to diagnose. The most common symptoms, such as lameness, is a common symptom in many other disorders and they can come and go. Radiographs are usually the most effective way to determine a diagnosis to see the swelling and trouble in the joints. The vet may also opt to do a biopsy of the tissue to test for inflammation.

Treatment:

  • Generally treated with immunosuppressive medications until the lowest dose is found that still manages the disease.

Septic arthritis is a painful disorder caused by the introduction of bacteria or another infectious agent into one or more joints, resulting in debilitating inflammation. Male, large, and giant breed dogs are the most frequently affected, and although septic arthritis may affect dogs of any age, it is most commonly seen in dogs aged 3 to 11 years. Pressure, swelling, and discomfort in one or more joints are all symptoms of septic arthritis. Reduced range of motion in the affected joint(s), as well as fever, lethargy, and a loss of appetite often accompany those prior symptoms. To diagnose, a vet will look at the dog’s complete medical history as well as any injuries that could have caused wounds leading to septic arthritis. They will do a blood test, a physical examination, urinalysis, and a biochemistry profile. Imaging is also used to diagnose septic arthritis in dogs and the vet will test for bacterial infection by taking fluid from a joint which is the most important test during this process

Treatment:

  • IV and oral antibiotics.
  • Lavage (flush) the joint to minimize joint damage.
  • Surgical opening of the joint, removal of abnormal tissue, and copious lavage.
  • Flushing catheter for post-operative flushing.

Synovial Sarcoma, also known as Joint Cancer, causes painful swelling of the affected limb eventually making it difficult to walk. Joint cancer is a connective tissue and joint condition that is seldom observed. It is often hard to diagnose since cancer symptoms can vary but you can often feel a bump where the tumor is located. Since this type of cancer is aggressive and spreads rapidly, timely care is critical for your dog's health. Joint cancer is another type of cancer found in large and giant breeds but the reason for this is unknown. Signs to look for include lameness, limping, swelling, joint pain, fever, ulcerated sore of affected area, loss of appetite/losing weight and possibly difficult breathing if the cancer spreads to the lungs. Amputation is often the recommended treatment to prevent the cancer from spreading but seeing an oncologist is recommended since it can still spread.

Treatment:

  • Amputation of the affected limb to maintain control of the spread of the cancer.
  • Chemotherapy.
  • Radiation therapy.

Systemic lupus erythematosus (SLE) is an immune-mediated disease in which a dog’s immune system begins to attack its own tissue. Essentially, the dog’s body produces antibodies to antigens that are found in its body systems and tissues. Some breeds have a greater predisposition to SLE such as medium to large dogs that are over five years of age. This includes the Shetland sheepdog, Old English sheepdog, Beagle, German shepherd, Irish setter, Nova Scotia duck tolling retriever, Poodle, Collie, and Afghan hound. Signs of SLE can peak and slow over a period of time, with signs increasing as the disease progresses. These include lameness that moves from limb to limb, lethargy, fever, enlarged spleen, enlarged lymph nodes, ulcers at mucocutaneous joints (lips), muscle pain (or atrophy), skin abnormalities (such as thinning or loss of hair, ulcers, redness). Factors such as genetic, physiologic, and environmental elements can increase SLE development. 

Treatment: 

  • Dependent on which body system is affected:
    • Kidneys: modified prescription diet.
    • Joints: limited and restricted activity.