An ‘essential first step’ for our canine patients is to watch them after calling them into our consulting room.

As they get up and move through, and as they settle down in the room, make sure to greet the owners, but also focus your eyes on the patient and ask yourself some questions:

Standing Up

• Do they struggle to stand up, is their owner assisting?
• Do they appear to favour one leg in particular when ‘getting up’ or as they move through?
• Do they appear comfortable to you, or seem to be notably sore/lame in a single leg or more?
• When they stand, do they stand square with even pressure on their limbs, or do you notice them leaning to one side to ‘favour’ a particular limb?

Moving In:

• If they lie down in the consulting room, do they ‘plop’ themselves down in a rapid, uncontrolled manner or do it smoothly? 
• If they change position once in the room, do they seem to be comfortable doing this or do you sense them groaning or being uncomfortable?
• Do they sit ‘straight’ with the hocks below the stifles and hips, or appear to sit with a hindlimb held out to avoid flexion of the hip or stifle?
• When sitting, do their front paws appear face forwards, or do you notice them being angled outwards more than you would expect, is one different from the other?

Further Visual Assessments:

• Are the digits spread evenly across all four feet, or does one seem to be less spread? This may be a sign that one limb is being protected. 
• Do you notice uneven nail growth on one foot in particular? A sign it might be rubbing on the ground and no lifting properly.
• Do the pairs of fore and hindlimbs appear symmetrical or does one seem misaligned or mis angled?
• Do you notice muscle asymmetry, especially on their shoulders, or hindlimbs (glutes and quads) – this is often best viewed from above and standing behind.
• In shorter haired breeds you may be able to start to form an opinion on:
  • What is their Body Condition Score likely to be? (remember that you’ve not ‘touched’ them yet!)
  • What is their likely Muscle Condition Score?

Key Point: The Visual Assessment can be performed alongside gait assessment, but don’t miss the opportunity to view patients on their way into your consult room!

Visual assessment is so powerful in OA diagnosis, yet easily omitted especially in the middle of busy consultations. 

Sticking to a standard meaning of assessment in conditions such as osteoarthritis, where often more than one joint is commonly affected and co-morbidities are common, is really important. Keep your mind open to all that is occurring and try to hold off on focussing on individual joints.