Lameness in the Hindlimb
This article discusses lameness in the hind legs of dogs. A previous article published here discusses forelimb lameness in dogs. Hindlimb lameness is actually a much more common problem, and accounts for about three quarters of lameness cases in my veterinary hospital.
Much of what I discussed at the beginning of Part 1 regarding wounds, skin infections and nail problems applies to the hindlimb also. The same system of visually inspecting and palpating the structures of the legs should be followed. Muscle strains in the hindlimb are very common, and are most commonly located at the back of the thigh or the calf muscles. If muscle pain is found, the system of resting the leg and icing the injury described in this article should be followed.
The causes of bone pain are the same for the hindlimb as the forelimb. The most common sites for bone tumours in the back leg of the dog are the end of the femur (thigh bone), and the top of the tibia (shin bone); i.e. either side of the knee joint. Dogs with bone pain must be presented to your veterinarian as they will need to be x-rayed.
The most common reason for a dog to limp on a back leg is the presence of joint pain. When examining your dog be sure to flex and extend the ankle (or hock), knee (stifle), and hip joints. You may be able to palpate fluid swelling on the hock and stifle joints if they are injured.
Stiffness after rest usually indicates joint pain, and you may notice your dog 'loosening up' with activity. Lameness which worsens with exercise usually indicates soft tissue pain (muscle or tendon).
Pain in the hock and stifle joints may be first indicated by your dog changing his position when sitting—see image above. The foot is often held out to the side, or the leg may be extended forwards.
Osteochondrosis as a Cause of Joint Pain:
Osteochondrosis is a failure of joint cartilage development, and is seen in young dogs from 4 to 12 months of age who develop a limp that gradually worsens over weeks to months. It typically affects the hock and stifle, leaving an area of bone unprotected by cartilage which rubs painfully when the dog moves its leg. It is most commonly seen in large and giant breed dogs on poor quality food or being fed diets with inappropriate amounts of calcium and vitamin D. Early diagnosis is vital to prevent the development of osteoarthritis.
Problems in the Hock Joint
With the exception of osteochondrosis, most problems affecting the hock joint are the result of a significant trauma such as a road traffic accident, and so the problem will usually be very obvious. Fractures and dislocations of the joint are common, and almost always require surgical repair.
Stifle (knee) Injuries
The most common cause of lameness in active dogs is cranial (or anterior) cruciate ligament rupture (CCL/ACL rupture). The cruciate ligament is responsible for allowing the knee joint to 'hinge' without being unstable. It prevents the shin bone sliding forward when weight is put on the leg. The CCL is usually torn by a combination of braking and turning forces, so it is often seen in dogs that love to chase and fetch.
Without an intact CCL, the stifle joint becomes unstable, bone knocks on bone causing pain, and very often the cartilage 'island' within the joint, called the meniscus, is pinched and torn between the thigh and shin bones. Dogs with CCL rupture usually become suddenly very lame, not bearing weight, and with meniscal injuries there may be an audible 'click' or 'clunk' when the joint is flexed.
While there has been some controversy in the past about the best treatment for CCL rupture, there is now no doubt that dogs with the injury do much better following surgery than those managed without surgical repair. There are many techniques for CCL repair, your vet will advise you on his/her preferred method. Postoperative rehabilitation is at least as important as the surgery and must not be neglected by your veterinarian.
Another very significant problem within the stifle joint is patellar luxation, or a 'slipping kneecap'. It is a problem most commonly seen in small breed dogs such as Terriers and Cavaliers, and presents as a 'skipping' action. Most dogs will walk normally for much of the time, but occasionally (depending on the severity of the problem) pick up one or other hindlimb and skip along on three legs. Many dog owners mistakenly believe that this is normal for their dog, but as with most joint problems, arthritis is likely to develop in dogs with this problem. Again, there are several surgical techniques which may be used to correct the problem. In overweight dogs with mild patellar luxation, weight loss is very often enough to manage the problem.
Causes of Hip Pain in Dogs
The first of two common problems affecting the hip joint is Legg-Calve-Perthes Disease. It is seen in young Terrier dogs, and usually presents in pups between 5 and 8 months of age. Extension of the hip (stretching the leg backwards) is usually very painful. The condition is caused by a failure of the blood vessels 'feeding' the growing head of the thigh bone. The head of the femur forms part of the hip joint, and as it starts to decay without a blood supply, it becomes painful for the dog to move the joint, as each movement causes tiny microfractures of the bone. Surgery is necessary to remove the affected bit of bone; a femoral head and neck ostectomy effectively removes the hip joint, but these small dogs do very well after the procedure and very rarely show any long-term lameness.
Hip dysplasia is the most common disorder of the hip joint, and is usually seen in large breed pedigree dogs such as the Labrador and German Shepherd. The condition is a failure of the hip joint to develop properly, allowing the head of the femur to slip in and out of the joint, causing pain and damage to the joint surface. Signs are often seen in young dogs from 5 to 14 months of age, but often subside when the dog has grown to his/her adult size. However, even in dogs which appear sound after this period, osteoarthritis will develop later in life.
There are several factors involved in the development of hip dysplasia. The first is genetics, as parents with hip dysplasia are much more likely to produce puppies with the condition. For this reason, hip scoring schemes have been brought in by the Kennel Clubs to avoid breeding from affected parents. this has been partially effective in reducing the number of case.
Good nutrition is important; again, calcium and vitamin D amounts must be correct, and it is important that large breed dogs do not grow too quickly, thereby putting too much stress on immature joints. Despite what some eccentrics will argue, a commercial large breed puppy food is the best diet for your large breed puppy. Controlling the type and amount of exercise your puppy gets can also help prevent the condition. Regular moderate exercise rather than infrequent bursts of intense exercise are best.
Treatments for Lameness in Dogs
Although some of these causes of lameness in dogs may benefit from surgical treatment, many dogs with joint injuries may go on to develop osteoarthritis, stiffness, and/or long term lameness. These pets may benefit from medical treatments such as:
- glucosamine & chondroitin supplements, which are very safe and usually the first option I would pursue
- anti-inflammatory medications, but only for dogs without any signs of kidney problems
- opioids such as tramadol
Alternative treatments such as acupuncture may also have a place in treating pets with arthritis, but most veterinarians would see them as being complementary to the type of traditional treatments listed above rather than replacing them.
Brian SOTEROS on July 13, 2019:
Our dog had THO left side 2 days ago. He has not put any weight at all on the limb when walking. The leg "dangles" as he walks on other 3 legs. He had his right hip replaced 2 years ago and his recovery showed no dangling at all. It looks as though the leg is "dead"- hence the dangling reference. could it have been a surgery error- nerve damage? We have carpet runners throughout our house ( as we had when he had his right hip replaced) so he hasn't "tripped" or splayed, etc.
johndivine on September 30, 2018:
Hi I've been reading on your site and there is excellent content available. My question is my 40 pound (lifetime adult weight) 13 year old moyen poodle started having his rear left leg going at no particular time. I have always fed him a high quality no grain dog food with some homemade from to time. A soon as the vet heard she started him on Dasuquin but know this helps with any pain. I have not seen any change and I was wondering if the back leg braces at Amazon might give him more stability. I am out of town and won't see my vet until November. Baby is very spunky and I do not want him to hurt himself. Thanks Red
suzie morigeau on June 01, 2018:
my boston frenchie is limping on left hind leg for one week. She is in no pain. when I move her leg you can hear a pop in it and also feel it pop!
Carol on January 24, 2018:
Hi, my rescue dog is 2 years old and very active, loves running around with his 'sister'. During the last while, at the end of the day, his back legs (especially one) ate quite lame to the point where he struggles to get up. Any thoughts?
Lucyna on June 28, 2016:
My dog a cocker spaniel has had a toe removed after about a fortnight we noticed she was falling over while trying to walk what has caused this
Alsn on May 02, 2016:
the first place to ask about what's wrong with your dog is at the vet!! only they will be able to give you a clear diagnosis of the problem. for us a limp meant a torn ACL. We used the Ortocanis dog knee brace to help manage the pain and keep the knee stable while it healed itself. There are lots of other technical supports out there on the market that can help with different conditions your dog may have.. but first you need to be sure of what's wrong before you can look to treat it. The more time goes by.. the more likely is that the injury or whatever is wrong will get worse.
Daniel on December 25, 2014:
Dog Parks are also a great place to go. Grandview Park in SeaTac/Kent is a great dogpark in the South Sound area. They also have a buietlln board for such advertisements. If you don't mind going up to Seattle Magnuson Park is one of the best dog parks in the country. I'm sure there are South Sound people that go there. Otherwise, I would suggest pet stores such as Mud Bay, humane society shelters (sometimes people just go there to pet the dogs, some buy and when they do your advertisement will be the first one they see), and also vets in the area.
Ana on December 23, 2014:
Awww I wish I still lived in TX and that I still had a dog I'd so be there.It sucks living in CO for one resoan I rarely get to see my Rangers play I grew up watching them (dad was military, I lived in a suburb of FW for 4 years from when I was 4-8. I missed it so terribly and tv baseball is just not the same!
5 Causes For Lameness In Dogs
Almost all dog owners have had a dog start limping at one time or another. Although alarming at first, it’s not always cause for panic. There are probably thousands of reasons your dog may suddenly come up lame. Some are certainly more problematic than others, but generally speaking you will often need only a single veterinary visit to find the diagnosis. Lameness can and does happen in dogs of every age, breed, size and degree of health, so don’t be surprised if your athletic youngest comes up with a limp. Since there are so many causes, we can’t cover them all, but we can certainly discuss a few of the most common.
#1 – Injury
Injuries are probably the most common causes of lameness in dogs and they range from very minor to quite severe. Injuries are most notable because of their sudden onset, especially during or after physical activity like running or jumping. Bruises and strains to muscles and tendons from overexertion or minor impact are common in younger dogs with less self-preservation skills (we all know the dog that will jump off a cliff for a frisbee). More serious injuries include torn ACLs (called CCL or cranial cruciate ligament in dogs), fractures and dislocations also occur. Regardless of the cause, veterinary attention should be consider if your dog does come up lame after physical activity. Our dogs are stoic creatures, so what might look like a mild limp to you could be a sign of a serious injury in your dog.
Image source: Heather Morrison | Flickr
#2 – Osteoarthritis
Just like humans, dogs begin to experience musculoskeletal weakness as they age. Regardless of your dog’s overall health, osteoarthritis may begin to set in. This is very common and will likely present in limping or stiffness in the bones and joints, most noticeable when our dogs begin to have difficulty moving around. Osteoarthritis is generally treated by managing the condition and most owners and veterinarians are able to come up with a workable plan for aging dogs.
#3 – Dysplasia
Hip and elbow dysplasia are relatively common ailments in dogs regardless of breed or mixed breed. Although some are genetic prone to the condition, it has been seen in dogs of nearly every shape, size and background. The disease is characterized by the malformation of the elbow or hip joint, making them sit awkwardly in the socket. It can be mild, showing no symptoms, or very severe, requiring surgery to offer comfortable mobility. Dogs are often diagnosed early in life if they are symptomatic because they show lameness that seems not to improve after crate rest and other treatments. Without surgical intervention, these diseases are lifelong. However, many dogs are able to live comfortable, normal lives on alternative treatments.
Image source: OakleyOriginals | Flickr
#4 – Panosteitis
Panosteitis is a condition similar to growing pains in humans. Large breed dogs such as German Shepherds and Great Danes are most susceptible to this disease. The cause is not known and treatment varies, but all of the dogs eventually grow out of the ailment. Panosteitis can present as minor limping or total lameness in any number of legs. Sometimes the lameness will move from leg to leg over a period of weeks, always presenting as acute pain without injury. Panosteitis is a strange condition that still isn’t fully understood.
#5 – Paw Problems
Injury to the feet will also cause a dog to come up lame. Many times when we think there is an issue with the leg, it’s simply an issue with the paw. Torn pads, broken toenails, fractured toes and even stickers or bee stings can cause a dog to show acute lameness. If your dog does start limping, it’s always a good idea to check the feet for injury before immediately assuming it’s one of the legs. Although rare, panosteitis has also been reported in paws of affected dogs.
Symptoms of Weak Back Legs in Dogs
Depending on your dog and their particular medical condition, the weakness in their back legs may appear suddenly or come around gradually over a long period of time.
Keep an eye out for the following symptoms:
- Weakness, instability, and loss of mobility – also known as “ataxia.”
- Loss of coordination or balance staggering or wobbling as they walk.
- Lameness or having a difficult time walking.
- Using an abnormal or slow gait.
- Having a difficult time standing up or showing a reluctance to move, jump, or be active.
- Pain, swelling, or licking joints.
- Complete or partial paralysis.
- Incontinence or, conversely, an inability to urinate.
- Weight gain or loss of muscle mass.
- Lethargy or collapse.
Not all of these symptoms may appear at once. For example, your dog might not seem to be in any pain, even though they are suddenly unable to run.
Their tail may still wag as they lie on the floor, unable to stand. This is because there are multiple causes for weak back legs in dogs.
As you could imagine any injury to muscles or bone can result in dog leg lameness. This includes aging related bone issues that result from a decline in calcium absorption, slipped discs or vertebrae and fractures that affect the pelvis or spine. Symptoms usually appear suddenly.
- Diagnostic Tests: Imaging tests such as X-Rays
A recent case presented with intermittent lameness in the hind leg. For seven to 10 days before treatment, the dog had been limping off and on but with no apparent pain. A veterinary diagnosis confirmed a soft tissue injury in the hind limb.
The cause of this dog’s injury was unknown. However, when taking the dog’s history a number of owner observations indicated the limping may be a symptom of a longer term condition. The owners had observed the following:
- Change in dog’s behaviour – not scratching at the door when owners come home.
- Reluctance to jump onto the furniture. This change was noted about five or six months before any limping.
- Dog’s tail not wagging – the dog holds their tail in a neutral position. (See https://www.fullstride.com.au/blog/why-is-my-dog-not-wagging-his-tail) for more information.
My observations from a gait assessment supported their owner’s observations about a longer term condition. Specifically, I noted:
- Muscle atrophy in the dog’s hind quarters. The thigh muscles (femoral biceps) and gluteals were atrophied with poor muscle tone.
- The dog also sat with the right hind limb tucked and the left leg held laterally. The owners indicated that the dog had always sat that way.
- Over very low obstacles the dog was skipping over them with his hind legs, not weight bearing evenly.
A physical examination found muscular tension in the neck, right and left shoulders and chest. The left hind limb had a muscle knot in the gracilis. A muscle spasm was present in the pectineus which was very sensitive to touch. In the right hind limb, the leg that the dog showed the most lameness, there was a muscle knot in the semitendinous and sensitivity at the stifle.