Assessing Gait in Dogs
Gait observation is used to clarify which limb(s) the patient is lame on and how severely.
Move to an area where gait observation (standing, walking and trotting) can best be performed. In every practice the availability of locations may limit the options, but indoors a long wide corridor with a non-slip surface is best; outdoors a smooth flat private tarmac road works very well. Most flooring materials used in vet practices are smooth, meaning our patients makes our patients are reluctant to ‘walk normally’ – this doesn’t help us!
Well lit, straight and flat walkways that don’t have ‘distractions’ provide an environment where you will be able to better focus on what your patients does, not where they might try to go to!
If you don’t have either of these then improvise. Carparks, pavements and lanes can all work. Pull on your jacket and get outside….
Get the assistance of an owner or colleague to walk the patient away from and towards you in as straight a line as possible. Forewarn your assistant to help you see the patient: ‘relaxed lead’, letting dog walk to side, all important to optimise assessment of mobility and gait, head nod and other changes which can be important in your assessment.
Observe the dog walking at different paces:
- Walking: slow, normal and quick walking. Observing the gait at different speeds allow detection of subtle lameness that may only be visible at certain speeds. It may be necessary to watch the dog for some time until the dog becomes comfortable with its environment and settles into a relaxed moving pace at which lameness can be appreciated. The dog should also be watched turning in tight circles to the left and right. This can be useful to help identify neurological problems.
- Trotting: this may require an extra assistant to trot the dog as not all owners are able to jog alongside their dog (for health or other reasons) – also a sufficiently long space is necessary.
- Running: it is usually impossible to directly observe a dog running at full speed in the clinical setting because letting the dog off lead is usually impractical, and finding sufficient time and space to allow the dog to build up speed is not usually possible.
If observing the dog running fast is an essential part of the examination (for example a lameness only visible at high speed), the owners can be asked to make a video of the dog running and to bring the video to the consultation or to send in beforehand.
Key Point: It is easiest to assess thoracic limb lameness as the dog walks towards you, and to assess pelvic limb lameness as the dog walks away.
Gait observation can be challenging and difficult. With practice and advice however it is often possible for owner and veterinary surgeon alike to correctly identify the affected limb with pelvic limb lameness. Forelimb lameness however if often much more challenging.
Key Point: Gait assessment is a true ‘art’ and takes practice. Using the same area of the practice to watch patients and performing repeated, standardised assessment helps optimise the value of your lameness assessments.
Abnormal gait characteristics, which are supportive of a thoracic limb lameness, include:
- a head bob when the patient’s weight is transferred to the lame leg,
- a head drop when weight is transferred to the sound leg,
- a shorter stride length,
- an abnormal placement of the foot relative to the body (e.g., placing the sound leg directly under the body and the lame leg more eccentrically (ie, away from midline).
Bilaterally affected dogs may shift weight onto the pelvic limbs without an obvious head bob or drop.
Pelvic limb lameness are usually easiest to identify when watching a dog walk from behind them and from the side.
Abnormal gait characteristics, which support a hindlimb lameness, include:
- a hip lift (ie, hips move upward) when weight is transferred to the lame leg,
- a hip drop (ie, hips move downward) when weight is transferred to the sound leg,
- shorter stride length
- an abnormal placement of the foot relative to the body (eg, placing the sound leg directly under the body and the lame leg more eccentrically [ie, away from midline])
Bilateral lameness will often cloud clear identification of a specific limb being favoured, but gait abnormalities including a hip sway, bilateral short-strided gait, or visible attempt to shift weight onto the thoracic limbs may be apparent.
For some dogs, lameness is difficult to identify if only intermittent, or only apparent under certain circumstances. For such patients gait assessment that involves the dog walking or trotting in a circle or a figure of 8 pattern, ascending and descending stairs, and navigating over obstacles might be useful.
For some lameness, walking or trot might not be adequate for the lameness to be apparent and so attempting gallop may be required. Doing this at the clinic can be tricky and requires a clear plan and care!
One solution that is very helpful is video recordings, which the owner has collected pre-consult. These help mitigate the masking of milder lameness caused by the ‘endorphin rush’ pre-consult.
Owners sending you videos for review prior to the consult can be worked into your mobility assessment and be ‘attached to file’ to document progress.
For some patients with challenging behaviour it can be very difficult to assess any lameness watching them in clinic. The use of video consults during the COVID pandemic taught many of us the value of well filmed videos from owners, sent into the clinic. Often sending ‘examples’ of what you would like the owners to film can improve the value of their home movies. One example used by the author for this purpose can be viewed here.
Assessing Gait in Cats
Unlike dogs, where generally they are obliging, it is difficult to persuade cats to consistently walk as desired and also difficult to differentiate pain from fear or anxiety-related behaviour.
At the same time, do try. Your practice might have ‘cat consult rooms’, or quieter cat clinic times, when there is better opportunity to observe them without barking dogs and busy waiting rooms.
The aim, as with dogs, is to observe their posture, stance, and ambulation. Coax them to walk, unless they used to being on a lead.
Your clinic may have ‘cat steps’, or other elements that are designed to enable assessment of movement – not only to aid them getting onto your worktop. Observing their movement up the stairs can help you start to form an opinion as to the location of the problem. For example, cats with hip or back pain may be less willing to jump up on a chair or may attempt to jump and miss, or cats may stand on their pelvic limbs but keep their hips flexed and fully extend their hocks.