Thomas Newland, DVM
Adobe Animal Hospital | Scottsdale, AZ
Case Overview
I evaluated a 3-year-old, female Labrador Retriever weighing 76 lbs. that presented for chronic forelimb lameness associated with activity. The dog had a history of intermittent improvement with rest and medical management, followed by consistent relapse when normal exercise was resumed. Although the owner primarily perceived lameness as left-sided, advanced imaging demonstrated bilateral shoulder involvement, with the left side more affected than the right.
For privacy, the patient’s name and owner-identifying details have been anonymized.
Presenting Signs & Functional Limitations
The owner reported that the dog would improve with rest and anti-inflammatory medication but would reliably become lame again once routine walks were resumed. At the time of presentation, the dog was receiving the following medications and supplements:
- Rimadyl® 100 mg daily
- Dasuquin® once daily
- Apoquel® 16 mg every other day
- Probiotic daily
- Psyllium husk daily
On clinical examination, lameness appeared most apparent in the left forelimb. Review of baseline gait video demonstrated a head rise during left forelimb weight-bearing, consistent with left forelimb lameness. No obvious right-sided compensation was observed at that time, despite subsequent imaging confirming bilateral involvement.
Baseline Objective Assessment
This case was evaluated with both advanced imaging and radiographs prior to intervention.
- CT imaging localized pathology to the supraspinatus insertion region and acromion area bilaterally.
- Radiographs demonstrated calcification along the anterior aspect of the humerus, consistent with supraspinatus involvement.
- Changes at the left acromion were more pronounced, with a lesser degree of involvement noted on the right.
Based on the imaging findings and clinical presentation, a diagnosis of bilateral supraspinatus tenosynovitis with calcification was made, with the left shoulder more severely affected.
The owner initially presented seeking stem cell therapy. After discussion of available options, we elected to proceed with a combined approach.
Procedure & Treatment (as performed in this case)
Treatment was performed on 08/25/2025.
In this case, Ardent labs stem cell kit was used to process same-day stem cells. The stem cells and platelet-rich plasma (PRP) were combined with AlphaFlo® for administration at the veterinarian’s discretion.
The total preparation consisted of:
- 2.0 mL AlphaFlo® mixed with 1.6 mL of cells/PRP
Administration was performed as follows:
- 0.5 mL into each shoulder joint (bilateral)
- 0.5 mL into each supraspinatus insertion (bilateral)
- 0.5 mL into each acromion area (bilateral)
- 0.6 mL administered intraperitoneally into the Falciform Fat
Post-procedure, the dog remained on Rimadyl® for approximately five days, after which it was discontinued.
Follow-Up & Observations
One-Month Recheck (09/25/2025)
At the one-month follow-up, gait assessment showed the dog to be normal on gait evaluation. The owner reported that the dog had not been “this good since April,” noting sustained functional improvement during normal daily activity.
Three-Month Recheck (11/25/2025)
At the three-month follow-up, the dog continued to show no observable lameness and was doing well clinically. Functional improvement noted at the one-month recheck was maintained.
Based on this response, the plan discussed included:
- Repeating AlphaFlo® in three months
- Repeating shoulder radiographs at that time to reassess the status of the calcifications
Discussion
This case represents bilateral supraspinatus tenosynovitis with imaging-confirmed calcification and asymmetric clinical expression. While owner observation and baseline gait assessment suggested primarily left-sided lameness, both CT imaging and radiographs demonstrated bilateral disease, highlighting the importance of diagnostic imaging in cases with unilateral clinical signs.
This dog demonstrated a consistent pattern of improvement with rest and NSAID therapy followed by relapse with activity, which is commonly observed in chronic supraspinatus pathology. Following the combined intervention performed on 08/25/2025, normalization of gait was observed at one month, with maintained functional improvement at three months.
Several limitations should be acknowledged:
- This is a single case report, and multiple biologic components (stem cells, PRP, and AlphaFlo®) were used concurrently.
- Outcomes were assessed clinically and through gait observation; longer-term durability and imaging-based changes remain to be evaluated.
- Follow-up imaging to reassess calcification has been planned but is not yet available.
Within these limitations, the functional changes observed at one and three months were notable in the context of chronic supraspinatus disease with calcification.
Disclaimer
This case summary reflects the veterinarian’s clinical experience and observations. AlphaLogix did not author or verify these statements. This content is not intended as medical advice.
About the Author
Thomas Newland, DVM is a veterinarian at Adobe Animal Hospital in Scottsdale, Arizona. He is a Purdue-trained DVM with a clinical focus on complex orthopedic and medical cases, including the integration of advanced imaging and biologic therapies in clinical practice.