Left Hindquarter lameness for 1 year –
14 days after epidural infiltration with ACS (Autologous Conditioned Serum) it was cured.

Argos had been showing lameness in the hind left leg for a year. This had been repeatedly examined and treated, but showed no improvement.

 

Medical history

In December 2018 Argos was diagnosed as suffering from a partial cruciate ligament rupture. He underwent TPLO surgery (tibial plateau levelling osteotomy). After the operation, the lameness was better for a short time, but 4 weeks later it was fully present again. After 3 months the plate was removed, but no improvement of the lameness could be achieved. To be on the safe side, a CT study of the back and the knees was made, but this did not reveal any reason for the persistent lameness. The veterinarian attributed Argos’ lameness to osteoarthritis in the knee. Unfortunately, treatment with the usual joint remedies, followed by physiotherapy and a water treadmill for 7 months did not lead to any long-lasting improvement.

In January 2020, Argos was brought to my practice.

The findings of the orthopaedic examination

Argos shows a slope leg lameness rear left 5/6, runs in an outward position and - depending on the cadence and speed of the movement - starts to jump in the hindquarters. In the forehand he shows a pull-move, and while sitting he tilts the pelvis to the left.

The pelvic muscle mass on the left is strongly reduced. There is a difference of 3,5 cm muscle mass on the left side compared to the right hind leg. He also puts practically no weight on the back left. Argos carries the knee in a varus (bow-legged) position, but orthopaedically the knee is inconspicuous. The back, however, is very conspicuous, the pelvic axis is strongly asymmetrical and the lumbar spine deviates to the left (bent).

 

Video
Before treatment/epidural infiltration

Diagnosis

Argos shows a severely altered functional spine with medium to severe radiculoneuritis (inflammation of the spinal nerve roots).

Therapy

Following the diagnostic measures, Argos was treated with orthopaedic kinematic control. The kinematics immediately showed improved stance and swing phases and a significantly improved range of motion. Rehabilitation was then commenced; for this purpose, Argos’ muscles and condition were built up, by jogging uphill.

Due to the fact that Argos’ lameness had persisted for over a year and that there was a clear inflammation of the spinal nerve, an epidural infiltration with ACS was carried out after 4 weeks.

Two weeks after this, Argos was checked again, kinematically measured and orthopaedically examined.

He was lame free and had already built up 1 cm of pelvic muscle mass!

 

Video
After epidural infiltration

What is ACS?

ACS stands for "autologous conditioned serum". To prepare such a serum, 30 ml of blood are taken from the dog and incubated for 8 hours. During this incubation, specially prepared beads in the glass phial interact with the blood to produce interleukin receptor antagonists (IL-1Ra) and growth factors. These substances are important to reduce the inflammation in osteoarthritis and to mimic the regeneration of cartilage cells. This therapeutic option is also very potent in cases of disc damage, protrusions and inflammation of the nerve roots. ACS has been used very successfully in human medicine for around 15 years, and this is also the case in equine medicine. In small animal treatment, this therapy has been largely neglected, and is therefore still very much in its infancy. In my practice however, this option has been part of our routine therapy for several years. In part, this is due to the fact that we are able to follow, quantify and above all objectively assess the course and success of the therapy. This is especially important in the run-up to the therapy in order to be able to estimate in advance whether or not it will be successful.

We will inform you about the exact mechanisms of this therapy in a later newsletter.

Argos can now enjoy a normal life again.

At this point I would like to express my best wishes to the owner and wish her much success for the future. We keep our fingers crossed!