Rationale of Facts (revised 1/24/01)

1. Nine month old: this is significant because there are several specific musculoskeltal 
disorders that occur in young and growing dogs. This knowledge can help in 
narrowing down possible differential diagnoses.

2. Rottweiler: this is significant because it is a large breed dog. Large breed dogs are 
known to have several breed related developmental abnormalities. The clinician must 
keep these in mind while trying to diagnose the problem.

3. No history of trauma: this can lead the veterinarian to focus on congenital defects or 
other disease mechanisms rather than trauma related injuries. However, the 
veterinarian must be cognizant that trauma could potentially occur without the 
ownerÕs knowledge.

4. Uncomfortable while trying to sit: this helps the veterinarian to focus on and confirm 
potential hindlimb lameness.

5. Worse early in the morning: this is a very important point due to the fact that some 
hindlimb problems are exacerbated by extended periods of lying down. This could 
hint that the dog might be suffering from hip dysplasia or arthritis of some sort.

6. Worse after exercise: this is also important by suggesting that the pain is 
inflammation related. Excessive movement  or stress on the joint will increase the 
inflammation resulting in worsening pain.

7. Reluctant to climb stairs: see above

8. No obvious response to Rimadyl (NSAID): this suggests that the animal is not 
suffering from simple soft tissue injury or arthritis. Treatment with Rimadyl is 
probably not sufficient to treat pain caused by severe bone/joint malformations or 
degenerative joint diseases.

9. Increased weight distribution to front legs: this also points to hindlimb lameness.

10. Grade 1 lameness in right hind limb: this shows the problem is truly associated with 
the right hind limb.

11. Long bone palpation normal: this helps to rule-out fracture, neoplasia, or other non-
joint related problems.

12.  No muscle pain or atrophy: this further points to a joint related problem.

13. No neurological deficits: this helps to rule out any problems caused by nervous 
system defects or spinal cord injury.

14. No cranial drawer sign: this helps to rule out torn or strained cranial cruciate 
ligaments in the knee.

15. No joint effusion: this helps indicate that there is not severe inflammation at this 
point.

16. Hip joint palpation: palpation helped to localize the area of pain to the right hip. This 
further allows the veterinarian to hone in and create differentials regarding pain in the 
right hip.

17. Decreased hip range of motion: further indicates pain in the right hip.

18. Ortalani sign positive on left and couldnÕt evaluate the right due to pain: this test 
showed laxity in the left hip which indicates that the joint isnÕt held together tightly. 
The right hip could also be lax but cannot be evaluated at the moment.

19. Hock and stifle not painful and stable: indicates no problems in those joints.

20. Awkward gait noticed a few weeks ago: indicates the beginning of the problem and 
suggests that it could be a progressively worsening condition.