Erica Dunphy, DVM, CVMMP, CVA, CCRP
Columbia Veterinary Emergency Trauma and Specialist (CVETS) | Columbia, SC
Case Overview
I evaluated an older German Shepherd–type dog with a known history of bilateral hip dysplasia that had progressed to notable functional limitation. The patient was presented for supportive care options, including rehabilitation therapies, with the owner seeking ways to improve comfort and mobility.
Because this patient was already scheduled for repeat rehabilitation visits, I elected to document both subjective clinical observations and objective gait data before and after an intra-articular intervention performed during the same visit. For privacy, the patient’s name and owner-identifying details have been anonymized.
Signalment
An 11-year, 8-month-old, 60-lb, spayed female German Shepherd with a history of bilateral hip dysplasia.
Presenting Signs & Functional Limitations
At the initial evaluation, the dog demonstrated movement patterns and postural changes consistent with chronic hip disease. She was slow to rise and reluctant to fully engage the pelvic limbs. While standing, mild but persistent weight shifting between the hind limbs was observed, with increased offloading onto the forelimbs.
During gait assessment, she exhibited limited hip extension bilaterally and a shortened stance phase in the hind limbs. Compensatory forelimb loading was evident, and overall movement appeared guarded and inconsistent. These findings aligned with the owner’s report of reduced activity at home and difficulty performing previously routine behaviors.
Baseline Objective Assessment
Prior to sedation or any procedural intervention, baseline gait analysis was performed using a pressure-sensing gait analysis system (Strideway). The dog was walked across the runway multiple times, with two valid trials recorded to reduce variability related to speed or behavior. Measurements were collected for each limb, mean values were calculated, and standard deviations were used to assess stride-to-stride variability.
At baseline, objective findings reflected the clinical presentation and included:
- Decreased peak vertical force in both hind limbs
- Reduced vertical impulse in the pelvic limbs
- Compensatory overloading of the forelimbs
- Shortened stance time in the hind limbs
- Increased stride-to-stride variability, indicating inconsistent weightbearing
These findings were consistent with reduced willingness to load the pelvic limbs during ambulation.
Procedure & Therapy (as performed in this case)
Given the dog’s presentation and the owner’s interest in proceeding, I elected to perform a bilateral hip joint intervention under sedation. The patient received dexmedetomidine (4 µg/kg IV) and butorphanol (0.27 mg/kg IV). Prior to the joint procedure, shockwave therapy was administered.
For the joint implantation, ultrasound guidance was used to support accurate intra-articular placement. Given the chronic nature of the condition and the goal of minimizing repeat procedures, confirming correct placement was a priority. At my discretion, 1.0 cc of AlphaFlo® was implanted intra-articularly into each hip.
Following the procedure, atipamezole (Antisedan®) was administered intramuscularly. The patient recovered without complication and was discharged to the owner later the same day.
Follow-Up & Observations
Objective gait analysis was repeated at two follow-up timepoints using the same equipment and methodology:
- Day 0: Baseline assessment immediately prior to sedation
- Day 20: First recheck (timing influenced by the holiday schedule)
- Day 29: Second recheck
Day 20 Recheck
At the first follow-up, changes were evident both clinically and in the gait data. Compared with baseline, objective measurements demonstrated:
- Increased hind limb peak vertical force
- Increased vertical impulse in the pelvic limbs
- Improved hind limb stance time
- More balanced distribution of load between forelimbs and hind limbs
- Reduced stride-to-stride variability
When reviewed, hind limb peak vertical force had increased by approximately 41% by day 20, and vertical impulse increased by approximately 53% over the same period.
Subjectively, the dog demonstrated a flatter topline during stance and movement, less apparent guarding, and improved comfort during ambulation in the clinic.
Day 29 Recheck
At the second follow-up, owner feedback was strongly positive. They reported improved comfort at home, increased energy, and a return to behaviors such as playing with toys that had not been observed previously.
Objectively, while some gait parameters were not numerically superior to the day 20 measurements, the overall dataset continued to demonstrate meaningful improvement compared with baseline. Based on case review, one hind limb showed an approximate increase of 20 PSI in pressure loading and the other approximately 15 PSI relative to baseline, reflecting increased willingness to bear weight through the pelvic limbs.
Ongoing Monitoring
Because this patient was also participating in underwater treadmill therapy for strengthening, the plan was to continue longitudinal monitoring during scheduled rehabilitation visits. This approach allows for continued objective assessment over time without requiring additional standalone appointments.
Discussion
This case highlights the value of combining clinical observation with objective gait analysis when evaluating changes in mobility over time. At baseline, the patient demonstrated clear hind limb unloading with compensatory forelimb overuse. By day 20, objective measures showed improvements in force distribution, stance time, and stride consistency, accompanied by visible clinical changes.
Several limitations should be acknowledged. This report reflects a single case, and the patient also received shockwave therapy, so observed changes cannot be attributed to a single modality in isolation. Follow-up timing was influenced by scheduling constraints, and earlier reassessment may have provided additional insight into short-term changes. Additionally, gait analysis data are influenced by patient behavior and velocity, despite efforts to reduce variability through repeated trials and averaged measurements.
It is also notable that objective gait metrics and owner-reported function did not change in perfect parallel at every timepoint, reinforcing the importance of interpreting gait data within the broader clinical context.
Given the patient’s age and chronic condition, continued monitoring will help clarify the durability of observed changes over a longer timeframe.
Disclaimer
This case summary reflects the veterinarian’s clinical experience and observations. AlphaLogix did not author or verify these statements. This content is not medical advice.
About the Author
Erica Dunphy, DVM, CVMMP, CVA, CCRP, is a veterinarian at Columbia Veterinary Emergency Trauma and Specialist (CVETS) in Columbia, South Carolina. Her clinical work focuses on integrative and rehabilitation-based care, with advanced training as a Certified Canine Rehabilitation Practitioner (CCRP), Veterinary Medical Manipulation Practitioner (CVMMP), and Certified Veterinary Acupuncturist (CVA).