Helping pets to lead happy and healthy lives


Case notes

Magnus was presented with a three-year history of hip osteoarthritis, which had recently become less responsive to NSAIDs. He had lost interest in walks, was not sleeping well and pacing about at night, had started resenting being groomed over his hindquarters, was not interested in play and was recently also showing (Clip 1) a right forelimb lameness .

His presenting problems may be summarised:

• Nociceptive pain and peripheral sensitisation following osteoarthritis in his hips.

• Central sensitisation, amplifying & distorting sensory stimuli, contributing to allodynia over his hindquarters.

• The groups of muscles involved in walking and posture can be thought of as working together in ‘trains’. Altered  gait and posture cause muscle pain (myofascial pain), which is often distant from the original problem. The recent deterioration in his hindquarter pain had altered his gait and posture, with more weight being taken on his forelimbs, causing myofascial pain in the muscles of his shoulders, especially the right.

• Myofascial pain not only further alters his gait but, in a ‘vicious cycle’, also further contributes to central sensitisation and thus further amplifying pain signals.

• A multimodal treatment plan was tailored for Magnus and, after 6 days, his right forelimb lameness had improved. He once again enjoyed exercise and being groomed, had initiated play with his owners and now looked forward to walks. (Clip 2)

• He still has hip arthritis, but multimodal treatment has dealt with the muscle pain, reducing its contribution to central sensitisation.

• Having established effective multimodal management of his pain, Magnus was started on a programme of physical rehabilitation to help restore normal muscle function.

• 3 years later (December 2014) he celebrated his 15th birthday and continues to enjoy a good quality of life.

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  Magnus before treatment

Magnus 6 days later