╨╧рб▒с>■  (*■   '                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴ ┐jbjbjкjк ╚╚       ]FFFFF RFy ъzzzzzzzz6 8 8 8 8 8 8 ,c ЇW hd zzzzzd ЖzzzЖЖЖz6zz6 .z6 Ж░Ж6 6 n ┘NЦ╢FF░╓6 Facts (R=relevant; I=irrelevant) 9-month-old Ц R --young dog-growing quickly-active-prob. Not chronic since this is a puppy-points more toward congenital or trauma or growth abnormality FS - I Rottweiler Ц R--large breed dogs (Rottweilers) have genetic predispositions for many congenital joint or bone abnormalities Lame in both hind legs Ц R--bilateral lameness, so not likely to be an injury (unless HBC or compensatory lameness in one leg); back problem? Neuro? Hip? Pelvis? Awkward gait developed a few weeks ago Ц R Цprogressive, so not chronic; not healing, so probably not inflammatory Primarily in rear legs; right leg seems to be worse than left Ц R--localization to R leg? Dog uncomfortable when sits down Ц R--suggests hips or back pain Worse am and after running - R--activity increases pain-possible wearing or rubbing of joint? Dislocation of joint? Owners carry dog up and down stairs past 1-2 wks since dog reluctant to climb stairs Ц R--range of motion compromised; reluctance to bear weight on hind limbs suggests pain Rimadyl 10 mg/kg given when painful; owners didnТt note obvious response to drug-RЧnot primary inflammatory response since did not respond to NSAID No history of trauma Ц RЧmakes possibility of trauma less likely (lower on R/O list) Vaccinations current Ц RЧprobably not viral origin On Frontline tablets Ц RЧprobably not tick-borne disease process Lives inside; leash walks Ц R--moderate activity level, so probably not an injury (sprain, strain, bruise, self-inflicted, etc.) Eats Iams Lg Breed free-choice Ц R--dietary factors involved in lameness? Accelerated growth a problem in large breed dogs; excessive weight is a problem on developing bones; excess calcium problematic in large breed dogs. Physical Exam Musculoskeletal: Disprop amt wt carried on forelegs Ц RЧreluctance to be weight-bearing on hind limbs (abnormal gait) mild lameness, grade 1 of 4 in right hind leg - R--barely perceptible, but indicates R hind limb problem mild clicking in elbow jt (no pain, no reduced range of motion, or crepitance) Ц R? Could be separate problem, or is excess wt on front legs causing elbow jt problem? no muscle pain or atrophy Ц RЧnot neuro problem-probably not severe trauma since muscles not affected no neuro deficit Ц RЧsuggests joint or ligament problem stable, non-painful hock and stifle jointsЧRЧisolates to hip; not ligament or meniscal rupture no cranial drawer-RЧnot ligament or meniscal rupture no joint effusion ЦRЧno inflammation, probably no trauma to stifle or hock Hips: palpation produces pain reaction, more on R than L, more on extension than flexion Ц RЧlocalizes pain to R hip; pain on extension suggests possibility of subluxation range of motion reduced to about 100 degrees Ц R--decreased range of motion by about 10 degrees (normal approx 110 degrees for hip joint) ortalani sign positive on L hip; unable to eval on R due to pain Ц RЧindicates hip joint laxity; positive sign or hip dysplasia; L hip not as painful as R, so L probably not as degenerated as R "#╝╛╞BCхцYZ╡╢ў°no▒▓  ; < } ~   ¤√√√√√√√√√√√√√√√√√√√√√√√√√√√√"#╝╛╞BCхцYZ╡╢ў°no▒▓  ; < } ~   ▀ р ю я   h i ╙ ╘ } ~ ф х   ~  ┤ ╡   ▒▓=>■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■< ▀ р ю я   h i ╙ ╘ } ~ ф х   ~  ┤ ╡   ▒▓=>¤¤√¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤░╨/ ░р=!░"░#Ра$Ра%░ [4@ё 4NormalCJOJPJQJmH 0@0 Heading 1$@&5Б0@0 Heading 2$@&>*<A@Є б<Default Paragraph Font      !  !   e     ╞╨шє╤╓ЬЯ$   я■  ыэ!oqаешэl t г л д п  > F i m ┤ ╜  5F┴┬╤╫▌фpqXm;Iim╘╪~Ахч $  Б ╡ ╖  ▓ ╖ > F     Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of Facts-Case Math Emporium8Macintosh HD:Desktop Folder:Student's Folder:Facts-Case1 Math Emporium?Macintosh HD:Desktop Folder:Student's Folder:Word Work File A 3 Math Emporium8Macintosh HD:Desktop Folder:Student's Folder:Facts-Case1 Math EmporiumBMacintosh HD:Desktop Folder:Student's Folder:Word Work File A 2286 Math EmporiumBMacintosh HD:Desktop Folder:Student's Folder:Word Work File A 2286 Math Emporium8Macintosh HD:Desktop Folder:Student's Folder:Facts-Case1 Math Emporium8Macintosh HD:Desktop Folder:Student's Folder:Facts-Case1 Math Emporium<Macintosh HD:Desktop Folder:Student's Folder:Facts-Case1.txt Math EmporiumZIP-100:Facts-Case 1 @А▀▀$█▀╛5 ╨@GРTimes New Roman5РАSymbol3Р Arial3РTimes"qИ╨h,╠QЖ,╠QЖ┐Ў !е└┤┤А20d; ╨  Facts Math Emporium Math Emporium■  рЕЯЄ∙OhлС+'│┘0dИРам─╨р °  , 8DLT\'FactsfactMath EmporiumoathNormalpMath Emporiumo2thMicrosoft Word 8.0d@@P4эЗ└@P4эЗ└┐Ў ■  ╒═╒Ь.УЧ+,∙о0° hpИРШа и░╕└ ╚ ┌'Virginia Techc; м Facts Title ■   ■   ■    !"#$%&■   ¤   )■   ■   ■                                                                                                                                                                                                                                                                                                                                                   Root Entry         └FА╩W&юЖ└+А1Table            WordDocument        SummaryInformation(    DocumentSummaryInformation8            CompObj    XObjectPool            А╩W&юЖ└А╩W&юЖ└            ■                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           ■      └FMicrosoft Word Document■   NB6WWord.Document.8