Managing Disorders of the Canine Hind Limb - Pelvis and Hip

Original Editor - Jess Bell Top Contributors - Jess Bell, Kim Jackson, Tarina van der Stockt and Stacy Schiurring

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Introduction

Hind limb lameness is more commonly seen than forelimb lameness in canine patients. This lameness is often due to dysfunction at the stifle (e.g. cranial cruciate disease) or the hip (e.g. hip dysplasia). This page explores some of the most common canine pelvic and hip conditions encountered in animal physiotherapy practice. While some conditions are more common than others, a thorough assessment is always essential to ensure a correct diagnosis is made.

Pelvic Fracture

At least 25 percent of all fractures seen in small animal patients are pelvic fractures. Almost all pelvic fractures are caused by major trauma (e.g. being hit by a car). Because the pelvis has a continuous ring configuration, fractures do not occur in isolation - there will always be more than one fracture.

Pelvic fractures are often associated with other injuries due to the forces involved. These include:

• Thoracic trauma (in 50 percent of patients)
• Urinary tract trauma (in 39 percent of patients)
• Peripheral nerve damage (in 11 percent of patients)

Treatment

Because the major muscle groups around the pelvis provide significant stability to most fractures, pelvic fractures are usually managed conservatively. 75 percent of animals with pelvic fractures will recover without surgery. This is particularly true of small animal patients.

Surgery is most commonly considered in patients with:

• Sacral fractures
• Sacroiliac luxations
• Iliac body fractures
• Acetabular fractures

Surgery tends not to be indicated in patients with:

• Minimally displaced fractures
• Fractures outside the cranial two thirds of the acetabulum
• Well managed pain
• Fractures that are more than 7 to 10 days old

General management includes:

• Pain management
• Restricted movement (cage rest) for 4 weeks
• Gradual controlled increase in movement for the following 4 weeks

The key goals of physiotherapy management for pelvic fracture are to manage pain and ensure that the patient’s general strength and mobility are maintained during its period of confinement. It is particularly important to make sure that the uninjured limbs remain strong.

Specific treatments might include:

• Hot pack or massage to promote circulation in the affected limb
• Avoiding end range positions for the first three weeks post-injury. From week 4, the therapist can start to encourage full passive and active range of motion based on patient comfort
• Electrical muscle stimulation