Page 8 - Clinical Connections - Spring 2024
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RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK
         Orthopaedics
        LATEST IN GAIT ASSESSMENT WITH THE
        ORTHOPAEDIC SERVICE


        Richard Meeson, Professor of Orthopaedics and Head of the Orthopaedic Service

              ecently, thanks to the kind generosity   and for monitoring response to treatment.
              of the Animal Care Trust (ACT), the   Over the last 10 years, the Queen
       R RVC’s registered charity, a grant   Mother Hospital for  Animals has used a
        was awarded to upgrade the now out of   flat  pressure-mat,  which  measures  the
        date pressure mat, to allow the team to   pressure from each paw as a dog walks
        expand their lameness diagnosis and   across it.  Technology and the computer’s
        clinical monitoring through a state-of-the-art   software have improved greatly since then
        instrumented dog treadmill.         and a further development was to combine
          The treadmill is similar to that used by   this with a treadmill. For the first time, it is
        humans in gyms, however this one blends   possible to have a dog walking consistently
        a state-of- the-art matrix of tiny pressure   without ‘running out of runway’ and to
        sensors.  A computer then matches the   evaluate them at faster speeds.
        pressure sensor activation to the correct   For dogs that are not very mobile, it will
        foot, from the synchronised cameras filming   even give a standing evaluation of how
        as the dog walks.                   much of their body weight they are placing   Figure 2: Jerry getting ready to walk on the
          Technology constantly develops and   on each limb when standing.       instrumented  treadmill,  with  the  Orthopaedic
        this new instrumented treadmill is able to                               Service’s Registered Veterinary Nurses
        provide instant  data on the  characteristics   Jerry’s RVC treadmill story  injection to ‘block’ his elbow and, on
        of how the dog is using its legs. Previously,   Jerry  is  a  10-year-old  Staffordshire  bull   repeated treadmill evaluation, his lameness
        data retrieval had been  complicated and   terrier, who was initially referred to the   was significantly improved. This allowed the
        time consuming, preventing it from being a   Neurology and Neurosurgery Service   team to focus treatment on his elbow joint,
        routine ‘bedside’ clinical aid. Additionally, it   with a three-week history of progressive   and he has made great progress since.
        produces graphical ‘heat-map’ pictures with   left forelimb lameness. He had a complex   Difficult  to  identify  lameness,  or  subtle
        a simple overview summary which can be   history, including a previous thoracolumbar   performance changes, can now be
        provided to clients (Figure 1).     disc extrusions and myelopathy.     objectively evaluated. Likewise chronic pain
                                             Examination determined that his lameness   conditions, typically seen by the Anaesthesia
        Objective evaluation                was not neurological and he was assessed   and Analgesia Service bespoke Pain Clinic,
        Evaluating ‘how well’ a dog is walking by   by the Orthopaedics Service. It was clear   will have static measurements taken to
        observing them walking has been proved   that  he  was  lame  on  his  left  forelimb,  but   monitor responses to their treatments.
        to be very unreliable, unless they  are   he was extremely stoic, preventing more   With  this  new  pressure  mat,  the
        completely  normal  or  severely  affected.   accurate localisation, and diagnostic CT   Orthopaedic  Service  will  continue  to
        Many dogs seen for lameness are between   found arthritis in his elbow and carpus.   contribute and expand their clinical research
        the two and therefore a more reliable and   Jerry  was  evaluated  on  the  treadmill,   to provide evidenced-based objective
        non-biased way to measure how well they’re   which confirmed his left forelimb lameness.   understanding  of  dogs  with  orthopaedic
        walking is extremely important for research   Afterwards he had a local anaesthetic   conditions and the impact of treatments.
                                                                                 The Orthopaedic Service at RVC Small
                                                                                Animal Referrals is one of the largest
                                                                                teams in Europe, currently with eight
                                                                                surgeons (six European Diploma holders/
                                                                                RCVS Recognised Specialists),  including
                                                                                Head of Service Richard Meeson, Deputy
                                                                                Head of Service, Rebekah Knight, Senior
                                                                                Orthopaedic  Surgeon  Matthew  Pead,  and
                                                                                faculty surgeons Anna Frykfors, Rhiannon
                                                                                Strickland, Carlos Sanchez, Matthew
                                                                                Simpson  and Charlotte Banks. They work
                                                                                with three Specialist Orthopaedic Service
                                                                                RVNs – Kate Fitton, Emily Few, Nancy
                                                                                Mclaughlin.  Additionally, there are six
                                                                                surgical residents.



         Figure 1: The left side shows the usage of Jerry's legs before local anaesthetic was used to numb     For small animal referrals, please call:
         his left elbow. The right hand side shows that after the local anaesthetic injection he doubled the %   01707 666399
         of weight on that leg, indicating that the elbow joint was the cause of his limp. Red arrows show his     Email:
         left front paw weight distribution, before and after                         qmhreception@rvc.ac.uk

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