Objective—To determine the accuracy of asymmetry indices of ground reaction forces (GRF) for diagnosis of hind limb lameness in dogs.
Animals—36 healthy dogs and 13 dogs with naturally acquired cranial cruciate ligament rupture or hip dysplasia.
Procedures—Lameness for affected dogs ranged from not detectable to minor and constant. While dogs trotted on an instrumented treadmill, GRF variables were recorded and analyzed with asymmetry indices. Each index was tested for its ability to discriminate between healthy and affected dogs. Combinations of several indices were also assessed.
Results—Vertical force variables had better accuracy than craniocaudal force variables. Peak vertical force was the most accurate variable. Partial asymmetry during trotting was detected in healthy dogs. A multivariate approach that used peak vertical force and maximal rising slope yielded the optimum combination to distinguish between healthy and affected dogs. In addition, sensitivity of 92% or specificity of 95% may be achieved with 2 cutoff values while simultaneously maintaining specificity or sensitivity, respectively, at > 85%.
Conclusions and Clinical Relevance—Asymmetry indices of GRFs were accurate for detection of hind limb lameness in dogs. This is particularly relevant for study designs in which only a single gait evaluation is possible.
Case Description—A 2-year-old Griffon Vendéen was examined because of a 1-month history of right hind limb lameness after a traumatic injury.
Clinical Findings—Neurologic examination revealed monoplegia and anesthesia of the right hind limb distal to the stifle (femorotibial) joint except for the area supplied by the cutaneous saphenous nerve. Results of electromyographic testing were consistent with a severe lesion of the tibial and peroneal nerves at the level of the stifle joint.
Treatment and Outcome—Exploratory surgery revealed an 80-mm-long gap in both the peroneal and tibial branches of the right sciatic nerve. A section of the left cutaneous saphenous nerve was interposed to graft the nerve defects. The dog received joint mechanotherapy and electrophysiologic therapy during the reinnervation process. Ten months after surgery, the dog had recovered almost completely. Neurologic examination revealed diminished flexion of the tarsal and digital joints. Repeat electromyographic testing revealed no abnormal spontaneous electrical activity in the right hind limb musculature, and small compound muscle action potentials were recorded in the right interosseous and cranial tibial muscles.
Clinical Relevance—Without surgical treatment, neurotmesis injury results in poor recovery of motor and sensory functions and may result in amputation. If a nerve defect exists, nerve grafting should be considered, even if the procedure is delayed until well after the injury. The sensory portion of the cutaneous saphenous nerve is a potential source of peripheral nerve for grafting in dogs. Reinnervation is a long-term process and physiologic support and owner involvement are necessary, but nearly complete functional recovery is possible.