Osteopathic Case study
(Note: In this study we will be using osteopathic nomenclature which will be
covered in the courses)
Mico, a four-year-old retired search-and-rescue dog (Doberman), was first seen
in my office on September 2001 with the following symptoms:
aLeft front paw discomfort
aHistory of one month duration of right hind lameness (partial weight bearing)
aC/o. dog was not able to jump in the back of the owner’s car
aAsymmetrical sit (right leg abducted/externally rotated)
With the gait analysis, the dog revealed an asynchronous gait between the fore
and the hind limbs. X-rays of the right stifle and the L7-S1 region of the
spine revealed no areas of abnormalities.
In February 2000, the orthopedic veterinarian diagnosed mild discomfort with
palpation of the cervical region and limited range of motion in both the left
shoulder and right hip area. X-rays of the cervical region revealed a cervical
instability at C3-4, C5-6, and C6-7. Recommended treatment was conservative --
rest and medication. Mico
’s symptoms improved only minimally.
Osteopathic Evaluation:
aCervical spine: No loss of motion and no pain at end feel.
aLeft shoulder: 50-60% range of motion (ROM) for extension and internal rotation.
Pain at end range and hard end feel. ROM for elbow and wrist was normal.
aRib cage: 1st and 2nd rib dysfunction on the left (exhalation restriction).
Costo-vertebral joint dysfunction level T1 on left side and tight deep
scalenous muscles, same side.
aLumbar spine: L7-S1 facet joint dysfunction (flexed, rotated left, side bend
left).
aSacrum: Left on left forward sacral torsion, “out of pattern” with L7.
aIlium: Right ventral rotation in sacro-iliac joint, 50 % limited flexion.
aRight hip: 40-50% flexion and guarding at end range. Extension was normal.
Treatment: functional indirect techniques/muscle energy techniques/biovalent systems.
Area of Greatest Restriction (AGR): L7-S1, sacrum and ilium rotation. After
restoring 70-80% of the previous area, I continued to work on the upper region.
Second AGR were the rib cage and the costo-vertebral joint dysfunctions.
After the first visit, Mico was able to sit normally with correct posture.
Furthermore, he was able to jump in the car from a
“stand still” position. I treated. Mico a total of three visits (in one month’s time) and discharged him, symptom free, with full range of motion in the
shoulder and hip region, and a normal gait.
