Background

Farrah, a 1.5 y FS Labrador, presented with a 6-month history of left hind limb lameness and more recent history of right hind limb lameness. She had possibly sustained an injury to her left tarsus when she was a puppy.

Functional Limitations: Jumping up (bed and car), going downstairs, getting up from lying down

Current medications: Rimadyl 150 mg, once a day

Current diet:

• Orijen Fit and Trim- 1 cup, twice a day (804 calories)
• 1-2 marrow bones daily (750-1500 calories)
• Occasional other treats
  • Total daily calories: at least 1550

Physical exam

• BCS: 8/9
• Bodyweight: 91 lbs
• % overweight: 30%
• Ideal BW: 64 lbs
• Posture: Caudal pelvic tilt with weight shifted to front limbs and off of LH limb
• Gait: Bilateral hind limb lameness, characterized as short strides with decreased swing phase and reduced stifle flexion.
• Palpation: Bilateral stifle effusion with positive cranial drawer (no cranial tibial thrust or meniscal click). Decreased left tarsal ROM with periarticular fibrosis. Spine and thoracic limbs normal.

Diagnosis

• Obese
• Bilateral CCL disease (suspect partial tear/ Grade 2 sprain)
• Left tarsal OA- OCD vs. prior trauma

CARE QUAD Customized Plan

Nutrition Plan

• Ideal BW: 63 lb  (28 kg)
• Current daily calories: 1550
• Daily caloric requirement based on Ideal Body Weight (IBW):
  • RER=852  (the number of calories needed each day once IBW reached)
  • 80% of RER = 681 (daily calories to reach IBW)
• Alternative method: 20% fewer calories than currently eating
  • 1550- (1550 x 20%) = 1240

There is a BIG discrepancy here! The biggest problem with Farrah’s current diet is the daily marrow bones. If we take those out and feed 20% of just her food, we get:

• 804- (804 x 20%) = 643

Now, these numbers are close! Let’s take the average and say 660 cal/ day.

Treats + Food Calorie Allotment

Treat allowance = 10% of daily calories= 60 calories
Food calories: 600

Caloric Content of Food

Current Food – Orijen Fit and Trim (dry):

• 402 cal/ cup (42% protein)
  • She would get 600/402= 1.5 cups/ day or 0.75 cups twice a day plus 60 calories in treats (view chart of low-calorie treats at bottom of the article)

Weight loss diets are less calorie dense (typically with lower protein and fat content and more calories coming from fiber and other carbohydrates). This allows for a greater amount of food to be fed; this may be a good option for dogs during the weight loss phase if they always seem to be “starving.”

Weight Loss Diet Options

• Purina Pro Plan OM (dry):
  • 266 cal/ cup (26% protein)—600/266= 2.25 cups/ day
• Royal Canin Weight Control Large dogs (dry)
  • 267 cal/ cup (26% protein)—600/267= 2.25 cups/ day
• Science Diet Metabolic + Mobility (dry)
  • 291 cal/cup (28% protein)—600/291= 2 cups/ day

Weight Loss Plan:

The goal is 1lb weight loss/ week.

This should take 30-40 weeks to meet the target (Ideal Body Weight).

Ideally, the client should do weekly weigh-ins using the same scale. At a minimum, the client should do a once a month weigh-in.

Due to bilateral CCL disease, long leash walks are not possible or recommended prior to surgery.

Recommend 5-10 minute leash walks, 3x day for the first month. Additionally, underwater treadmill (UWTM) exercise is recommended 2-3x/ week.

Low-Calorie Treats

Author: Dr. Kristin Kirkby Shaw

Link: https://caninearthritis.org/case-study/case-study-hind-limb-lameness

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