Clean Run - January 2016 - 17

COURTESY OF RICH KNECHT PHOTOGRAPHY

Lacey competing in agility. (Courtesy of Sandy and Sid Gonchar)

shoulder while participating in agility. Overuse can lead to degeneration of the shoulder support structures thus decreasing their tensile strength predisposing them to
fraying, disruption, and eventually complete breakdown.

Diagnostics and Treatment
Treating the condition early is important to prevent further shoulder instability and osteoarthritic progression. The shoulder abduction test allows for a pre-operative diagnosis of
MSS, and is performed by placing the elbow and shoulder in full extension with concurrent abduction of the forelimb. In addition, diagnostic musculoskeletal ultrasound can
further support the diagnosis of MSS. Shoulder arthroscopy is a minimally invasive procedure that allows for complete evaluation of all major intra-articular structures within
the shoulder joint using magnification, active range of motion in real time to watch the
tissues engage, and arthroscopic instrumentation, and is considered the gold standard
in MSS diagnosis. If MSS is identified, it can be treated arthroscopically at the same time.
Based on the results of the orthopedic examination, abduction angle tests, and arthroscopic scoring, patients are placed into one of three treatment categories: mild,
moderate, or severe. Dogs with mild pathology are placed in a DogLeggs Shoulder
Stabilization System ("hobbles") for two to three months and entered into a dedicated rehabilitation therapy program. Dogs with moderate pathology, like Lacey, are
treated arthroscopically with thermal capsulorrhaphy, or radio frequency (RF) treatment, placed in "hobbles" for two to three months, and entered into a dedicated rehabilitation therapy program. Dogs with severe pathology are treated with RF treatment, reconstruction and stem cell therapy depending upon the severity, as well as
"hobbles" and a dedicated rehabilitation therapy program.
The current technique for RF treatment in dogs has been developed based on current application in humans in which a single pass striping technique is utilized versus a multi-pass paintbrush technique due to detrimental effects that can occur with
aggressive application. Tissues treated with RF become weaker than pre-treatment
before they become stronger and, therefore, must be protected. There is a delicate
balance between too much immobilization and insuﬃcient immobilization, as the
former can result in joint stiffness and muscle contracture, and the latter can result
in stretching and recurring laxity of the treated tissues. Recovery generally ranges

from three to four months, and return to
training at four to six months. Secondlook arthroscopy has been performed in
numerous cases as requested by owners prior to entering back into agility to
confirm healing. Second look arthroscopy has revealed areas of neovascularization (new blood supply to the site
of injury), a tighter joint capsule, healed
tendon, and no residual or negative effects to surrounding tissues or cartilage.

Return to Agility Competition
Return to competition and sport is a
well-accepted measure of successful
surgical outcome in human and equine
literature. Dog agility involves speed,
sharp turns, and jumps, and provides
an excellent comparison to human and
equine athletes. VOSM is in the process
of conducting a retrospective study on
the return to agility following RF treatment for MSS using the VOSM Return
to Agility Grading Scale. The goal is to
determine if agility dogs were able to
return to competition, and if they were
able to do so at the same performance
level as they had prior to injury.
Of the greater than 500 cases of MSS
treated at VOSM since 2007 from around
the United States, 90 of those cases
were agility dogs. A survey was sent to
all owners via e-mail or was completed

VOSM Return to Agility Grading Scale
Grade

Post-Surgical Procedure

Grade 1

Owner chose not to return dog to agility for reasons unrelated to surgery

Grade 2

Dog was physically unable to return to agility

Grade 3

Dog returned to agility but performed worse than pre-operative level

Grade 4

Dog returned to agility and performed at pre-operative level

Grade 5

Dog returned to agility and performed better than pre-operative level

January 16 | Clean Run

17
Table of Contents for the Digital Edition of Clean Run - January 2016
