Hock Pain in Dogs

The hock is essentially the equivalent of the ankle in a human. The joint is below the knee and creates that sharp angle in the rear leg. Injuries of the hock and hock pain in dogs are fairly noticeable as dogs will exhibit signs of pain and discomfortness almost immediately.

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 Hock Pain

Achilles Tendon Injury

An Achilles’ tendon injury is typically caused by blunt force trauma that can include lacerations or severe stretching or pulling. These are categorized as traumatic injuries while atraumatic injuries include chronic or degenerative conditions that can be caused by repetitive movements (which is largely seen in Doberman Pinschers and Labrador Retrievers). Also known as the calcaneal tendon, the Achilles’ tendon is a set of tendons from different muscles in the hind limb so when injury occurs, many dogs will be lame on that limb with a variable amount of swelling around the injury. Dogs can have either a partial or a complete rupture.  With a partial rupture, the gastrocnemius tendon is ripped in a partial rupture,while the superficial digital flexor tendon remains intact. A partial rupture will result in symptoms of a lowered hock (ankle), lameness in the afflicted limb, and curled toes. Dogs with a full rupture of the Achilles tendon (when all five tendons are ruptured) will have a completely lowered hock, walking flat-footed rather than on his “tippy toes” as they should, and will display indications of lameness. Vets can diagnose an achilles’ tendon rupture by looking at the clinical signs as well as doing a complete physical examination as well as an ultrasound or X-ray scan. 

Treatment:

  • Treatment based on severity.
  • Externally treated with supportive casts or splints.
  • Surgery to attach the healthy ends of the tendon back together.
Cranial Cruciate Ligament Tear

A Cranial Cruciate Ligament Tear is an extremely painful yet very common injury among dogs. One of the most important stabilizers within the canine knee (stifle) joint, the middle joint of the back leg, is the cranial cruciate ligament. The CrCL is also known as the anterior cruciate ligament in humans (ACL). The meniscus is a cartilage-like organ that lies between the femur (thigh bone) and the tibia (shin bone). It performs a variety of functions in the joint, including shock resistance, location sensing, and load-bearing, and it may be affected if the CrCL ruptures. CrCLD is most often caused by a variety of causes, including ligament degeneration, obesity, poor physical health, genetics, conformation (skeletal structure and configuration), and breed. Ligament damage in CrCLD happens as a result of progressive degeneration over months or even years, rather than as a result of severe, sudden damage to an otherwise stable ligament which is very rare.

Treatment:

  • Rest and anti-inflammatory medications for dogs under 30 lbs, which is followed by exercise and weight loss if needed.
  • Surgery to provide stability for the joint.
  • Physical rehabilitation included icing the dog’s joint and performing gentle range exercises.
  • Stem cell therapy.
Hock Dislocation/Instability

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

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:

Immune-mediated Polyarthritis

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

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. 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.
Lyme Disease

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:

Osteoarthritis

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. 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. 
Osteochondritis Dissecans

Osteochondritis Dissecans (OCD) is a painful abnormality that disrupts the healthy development of bone from cartilage. When OCD happens, a flap of cartilage develops within joints which then causes lameness and joint pain. The most commonly affected joints include the elbow, shoulder, and knee. Dogs with OCD in the shoulder also tend to be male. Factors such as diet, genetics, hormonal imbalance, trauma, growth rate, and joint architecture, can increase the likelihood of developing OCD. Due to its nature, OCD tends to affect larger breeds like Golden Retrievers, Mastiffs, Old English Sheepdogs, Labrador Retrievers, Chow Chows, German Shepherds, Newfoundlands, Bernese Mountain Dogs, Rottweilers, and Standard Poodles. With genetics playing a big role, many vets recommend affected dogs be withheld from breeding. Dogs will start showing signs around 4-7 months of age with many displaying lameness after heavy exercise or long periods of rest. Clinical signs of OCD include limping and lameness in affected legs, vocalization of pain when the affected joint is touched. The affected joint will also be swollen and warm to the touch. Depending on the severity and pain level, dogs may avoid putting any pressure on the affected leg. OCD can affect both legs so determining if one leg is experiencing greater impact can be difficult. Diagnosing this condition primarily includes X-rays, CT scans, or MRIs. 

Treatment:

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

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 have 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

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.
Rheumatoid Arthritis

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

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

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

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.
Talus Bone Dislocation

The talus bone is one of the many bones that are held in place by strong ligaments in dogs’ paws and when one of these ligaments tear, it can result in a dislocation of the talus bone. Unfortunately, one of the most common causes of this dislocation is from a human stepping on the paw along with being hit by a car, getting the paw caught in a chain-linked fence or even getting the paw caught in a hole in the ground when running. Depending on the severity, the skin over the wound may become an open wound which could result in infection. 

Treatment:

  • Surgical intervention is often performed, which entails moving the bone back into position and locking it with a screw to a neighboring bone inside the paw. 
Torn Hock Ligament

A torn hock ligament in dogs can often occur when a dog’s paw gets stuck in a hole when running or between fence posts. A torn hock ligament can also occur from a violent, traumatic injury such as being hit by a car or being stepped on which can then damage and rupture the ligament. Small ligament tears that don’t appear to be serious at first might lead to ligament degeneration over time. Due to greater tension on the hock joint, obese dogs are more likely to suffer from dog carpal injuries. Signs of a torn hock ligament are often a swollen hock. Limping and the inability to put weight on a paw are also symptoms of a torn hock ligament. When your dog walks, the hock may shift in an unusual way, indicating that the joint is unstable. An x-ray is usually taken to confirm the diagnosis by the vet.

Treatment: