Many patients, whether coming in for a musculoskeletal examination or a wellness visit, may experience subtle lameness that can be difficult to pinpoint through visual observation alone. Pets often do not show symptoms, and owners can be hesitant to move forward with work-ups for hidden unquantifiable conditions. It is in these situations that a stance analyzer can come in handy.
Why should I use a stance analyzer?
A stance analyzer, when used appropriately, can become an important part of early orthopaedic disease detection. Stance analysis can be performed on any dog able to stand. It enables the veterinarian to take a snapshot of the general orthopaedic health of a patient. With this tool, the practitioner can easily detect lameness in patients earlier, leading to quicker intervention.
As a compact and sensitive tool for lameness detection, the stance analyzer does not require the additional space or cost of more expensive diagnostic tools
Stance analysis involves measuring the weight distribution of a patient at a stance, and using one instead of a traditional weighing scale allows practitioners to obtain bodyweight simultaneously (Figure 1). As a compact and sensitive tool for lameness detection, the stance analyzer does not require the additional space or cost of more expensive diagnostic tools.
Stance analyzer case studies
The veterinary teams in the following cases observed proper stance analysis data collection techniques. A minimum of 15 weight distribution samples were obtained for each patient. Upper and lower extremes were discarded, and the average of the remaining samples was stored and used to help evaluate the patient’s ongoing progress.
Additional objective data assessed during these studies included each patient’s physical examination, goniometry of joints and measurement of thigh circumference.
After stance analysis, each patient underwent further diagnostic testing, including radiography and musculoskeletal ultrasound, to help definitively diagnose the cause of lameness.
| When reading these case studies, please bear in mind that the normal weight distribution in a dog is defined as 30 percent in each forelimb and 20 percent in each hindlimb, or “30/30/20/20 (LF/RF/LH/RH)”. |
Case 1
A seven-year-old neutered male Border Collie presented after three months of unsuccessful medical management with NSAIDs for a shoulder injury sustained during an agility trial. The owner’s goal was for the patient to run agility again.
The patient’s physical evaluation most prominently showed reduced extension of the right shoulder compared with the left and some changes in coxofemoral extension. It was unknown which limb the dog had originally injured. The right biceps tendon was thickened, with palpable right shoulder effusion.
Stance analysis revealed a weight distribution of 40/24/20/16, and indicated additional diagnostics to determine whether additional abnormalities were present
Stance analysis revealed a weight distribution of 40/24/20/16, and indicated additional diagnostics to determine whether additional abnormalities were present. Musculoskeletal ultrasound revealed supraspinatus insertional tendinopathy, bicipital tenosynovitis and an inflamed joint capsule in the right shoulder. Radiographs obtained of the hips and stifles revealed bilateral coxofemoral degenerative joint disease, which had not been diagnosed previously.
Regenerative medicine using platelet-rich plasma together with the use of hobbles was initiated alongside an intense rehabilitation programme as arthroscopy or surgical repair of medial shoulder syndrome were not options for this patient. Objective measurements obtained every two weeks during rehabilitation revealed continued progression towards normal as well as continued improvement in strength, flexibility and control. At discharge from rehabilitation, the patient measured 34/28/20/18 on the stance analyzer.
Case 2
A 16-week-old spayed female Corgi presented for a new puppy evaluation. Her owners had no concerns about gait or joints prior to presentation.
On physical examination, the patient’s hip joints had a decreased range of motion, with hip extension at 142 degrees left hind and 152 degrees right hind. Stance analysis revealed a weight distribution of 37/38/10/15, and radiographs revealed bilateral coxofemoral joint subluxation.
The patient was started on chondroprotectants and rehabilitation. The patient’s final stance analysis was 25/37/13/25, with hip extension improved to 163 degrees bilaterally. Now, at four years old, the patient can compete in agility and obedience.
Conclusion
By including stance analysis as part of an annual examination and lameness evaluations, underlying orthopaedic disease can be investigated and treated earlier, reducing morbidity among veterinary patients.
