Biceps Tendon Injury

[Elfin]

One of my dogs has injured a biceps tendon, causing some minor instability in the shoulder (ie. intermittent grade I - II lameness).

I was wondering if anyone else had any similar experiences and how it was treated.

TIA

[Asalei]

Hrm... I'm not sure if it's the bicep tendon, but my girl has a pulled tendon in her shoulder. I was told it's the only tendon in the dogs body that goes over two joints.

She's been given a homeopathic injection of traumeel into the tendon, then two weeks later, the vet was very happy with her progress and she's not on a traumeel tablet morning and night. I'm going back again tomorrow afternoon to see what he thinks.

I was told 6 weeks recovery. I haven't really crated her, but tried to keep her quiet. I haven't shown her for 4 weeks, will be 5 this weekend and I'm hoping this is enough to heal it. When we went back two weeks ago, he was very impressed with how much the swelling had reduced.

[hollykatew]

Hi everyone at Dogz Online.

I have a story that is directly related to the previous posts here about bicep tendon injuries.

I have a 19 month old German Shepherd pure bred, she's black and tan and her name is Vyvyan, Vyv for short.

At 6 months of age Vyv started limping, I took her to the vet after a week when it began, and she was prescribed anti inflammatories and rest for a week to 2 weeks. 2 weeks later, nothing had improved, and I had xrays done of her front legs. Unfortunately, the vet I was seeing at that time failed to xrays her shoulders as well, despite me asking them to do so and saying that I suspected there may be a problem with her shoulders. However, I only found this out after she was xrayed. In order to xray her shoulders, I'd have to put Vyv through another load of anistetic and hospitalisation fees. Therefore, I accepted we had no xrays to eliminate any problems in her shoulders.

The vet prescribed Vyv with cartorphen, since on physical examination, she felt no inflammation in her legs, and because GSD's are notorious for bone disorders, she thought the limping may be caused by something to do with that. The xrays showed no sure sign of elbow displaysia, cracked bones, etc, but the vet said her bones did look slightly abnormal, but that may be due to her still growing. Anyway, I had no idea of biceps tendonitis, or any muscle injury/condition. On top of this, I was worried of the idea of Vyv already having some bone-related disorder. I took the expensive food to make sure Vyv was getting A+ nuttrients and I made regular trips to the vet for cartophen injections. Cartorphen is a similar drug to glucosemine for humans, which repairs cartliage in osteo-arthritis sufferers.

Over then next 4 months, I noticed a slight improvement, but the limping was still there. It would get worse after exercise, and I'd regularly schedule a day or two of rest after each day of limited exercise. The vets knew this, as with each visit for cartrophen, I'd keep them updated of her progress, or lack of.

Looking back, I should've gone to a different vet within a few weeks of their prescribed treatment not working. They were not suggesting any other reasons for the limping, yet still recommended the same useless treatment.

Unfortunately, (and this is totally my fault for not socialising her at that critical age of 2-4months), Vyv has a fear of humans and acts aggressively towards people who approach her, including the vet. I would always have Vyvy restrained with a leash and my arms and she wore a secure muzzle, but the vets wouldn't physically examine her after those first few times around the time of her xrays.

Also being in the country, there wasn't another vet for another hundred kilometres, and I figured they'd know pretty much the same things as each other. It was at 11 months, when Vyv had one of her doggie friends over (Kirby, a golden retriever, who she's incredibly fond of), that Vyv suddenly yelped and came crying to me when she landed on the cement after jumping around excitedly with Kirby. This time, her left leg (it had been her right leg from the beginning) was limping and she could not put it on the ground at all. She hobbled around and squirmed into me and cried. I immediately brought her inside. Kirby and Vyv's first doggie sleep over was over before it really got rocking. They were separated the entire time, and Vyv was heartbroken she couldn't go out and play with her mate. Kirby also had to sleep outside to avoid stirring up Vyv again with her new limp.

I decided this wasn't good enough (about time!) and booked us into the Vet specialist in Norwood. Luckily I had painkillers left over from the time Vyv first injured herself, and I'd been giving her those until our appointment 2 weeks later. I had a new lot of GOOD xrays done and some new, incredibly knowledgable advice from the specialist to go with it.

The specialist immediately said it sounded more like a muscular injury, the most common being a bicep tendon injury. The xrays showed Vyv's bones to be slightly abnormal, but nothing indicating elbow displaysia, and more down to her still growing.

The spec said she felt vyv flinch when her bicep's tendon was manouvered. The spec was fantastic and very patient and thorough and determined to get a good examination out of the very stiff and scared Vyv.

She said I had three options: first treatment being strict cage style resting for 6-8 weeks, where she was not allowed to be exercised at all, unless going to the toilet outside, which had to be done on a leash. The next stage was steroids, which could also be combined with the rest for maximum effect. The next stage, if there still was no improvement, would be surgery, where the biceps tendon would be surgically removed, she would be slowly re-introduced to exercise again over the course of 2-3 months, and the other muscles in her shoulder would learn to take over the task of the bicep tendon.

Once I heard the idea of surgery, the idea of resting my hyperactive and amazingly intelligent GSD didn't seem so bad or hard to do! Vyvyan and I stuck to the strict rest for 7 weeks, we used the crate and also the lobby area of our house. Vyv never managed to escape from my grasp to chase cats or have a FRAP (Frenetic Random Activity Period - a normal thing where puppies go nuts for 5 minutes then flop on the floor). Vyvyan was rested about as well as anyone could rest a GSD.

In the 8th week, we had built up her exercise to just walking around the yard gently. Next was going for a walk around the block. Vyv seemed great and when we got back, I took a shower. When I came out of the shower I was horrified because Vyv was flat out on the tiles in the kitchen and she didn't want to get up. She tried to walk with me to the laundry, but limped so badly that her leg wouldn't touch the ground. She layed back down and looked miserable.

I rang the vet and we had a long good discussion about the options and potential for those options to succeed. We both agree that combing steroids wouldn't do much good considering the strict rest had failed despite us doing our best and sticking to it for so long.

Surgery, we decided, was our only option in order to improve Vyv much more. I asked the vet if it was ok if I slowly rebuilt Vyv's exercise until we were ready to do the surgery, just so Vyv could regain some of her normal life, to the point where she would be able to be outside by herself again, without being tied up, caged or attached to me in some way. The vet said yes, that would be fine.

For the next few months, Vyv slowly got back to the old stage she was at where she would limp after a day of exercise-but at least we could have that day of exercise. It's not much fun for a pup to be restricted so much.

Now, we are at the point of decided whether or not to do the surgery.

It is expensive, I must admit, however it is certainly not part of the decision at all. I have plenty of money to cover it 2 times over and if I knew it would work, then I'd do it immediately. The trouble is, for me, I don't want to put Vyv through it, if it won't work.

Will it work?

Does anyone know if removing the biceps tendon really works? If a dog can recover from such a surgery?

Mentally, the surgical option seems great: the best vet I've met so far and such a knowledgable, reliable and honest person as well; I can understand how tendons can lose their elasticisity to a point where they become useless, and dogs don't need their biceps tendon in the same way we do (shoulder movements are different-we use it to lift, they use it to pull themselves forward, which can be taken over by the other muscles); and on top of this, apparently there hasn't been a single case with this surgery that hasn't worked - every case has had positive outcomes.

But, I'm not all brains - I have a heart too. In my heart I worry about my dog. She would have both her shoulders' tendons removed and recovering will be difficult. For example, how will she rest/sleep with a wound on both sides of her body? Plus, what if it doesn't work? I am, once again, basing my dog's health and future and our relationship's future on the advice of, essentially, a stranger! The vet seems great. But do I really want to put my dog's life in the hands of someone who SEEMS great?

Well, Vyv seemed absolutely fine when the spec did the xrays and the spec is extremely good with Vyvyan, despite Vyv's temperment. But still, and perhaps it is just because I've been burnt once before, I am still reluctant to give my dog to some one else to cut open, remove parts from and trust that she'll be fine, EVEN BETTER, afterwards.

I hope my story can help others with this bicep tendon injury - one thing to remember is that once a tendon is injured, it will never be the same as what it was initially. Not like bones that can heal and repair and be as strong as they were before. A tendon can only be stretched so many times. Usually twisting and turning or abrupt stopping in the dog is what injures the tendon.

On top of this, and most importantly, (sorry), I hope someone will contribute to my story, and perhaps give me their story of how their dog has gone after this surgery, which removes the biceps tendon.

Hopefully, I can come to a decision about the surgery within the next few weeks, so if I decide I will put Vyv through it, then it will be during my uni holidays so I can nurse Vyv if she needs it when she's sore.

Thankyou, and any responses, will be soooooooooo appreciated. If you know of anyone who may have experienced a similar thing with their dog, or a friend of a friend, etc, I'd absolutely appreciate a response. It doesn't have to be as long as this one!

Thanks, Holly

[ness]

I might as well throw my young BCs story into the mix (I suspect she has been seen by the same specialist as yours Holly, I came across your post elsewhere when I was google searching today). We went the specialist Monday week ago and Kenz was booked in for x-rays and ultrasound scans last Wednesday.

Kenz is a 3 year old BC who in December of 2010 was badly lame on her right shoulder. Normal vet diagnosed shoulder muscle injury and prescribed rimadyl and crate rest. I took her off to the chiro vet who I normally use a few days later and he treated some trigger points in her tricep and we were on restricted activity. Kenz improved and was only really intermittently lame at the end of a day but blink and you would miss it.

Couple of rounds of acupuncture and she was about 90% better. Vet friend suggested I contact the physio and see what her take was on it. Kenz had a few rounds of treatment by the physio and I thought she was starting to come good.

A few days after Easter she went backwards to the point we had a couple of days where she was limping more often then not, at which point after discussion with her physio and my vet friend we opted to go to the specialist centre for a consult.

Her results are a little inconclusive - there is suspected ligament damage in the shoulder but the ultrasound ruled out major biceps lesions. Her pain responses were also a little inconsistent but she has a fairly high pain threshold. Did you get an ultrasound as well or just xrays?? She also isn't lame all the time but rather just waking up occasionally lame and warming out of it.

At the moment we are on 3 weeks crate rest and then we are going to reassess and see what happens when I increase her exercise again. She is also having a course of cartrophen injections. In her case the recommendation at first instance is probably the steroid injection because of the degree of her lameness but its a bit of a wait and see game at the moment.

I have been doing some reading re surgery however and it does appear that the rest of the muscles do adequately compensate and in almost all situations the dog is then fully recovered and able to do all normal activities.

This is especially important to me as my youngster is a competitive obedience and agility dog.